Factors to consider for Uro vs. ENT?

[mailloxe]

I’m interested in doing a surgical subspecialty and I’ve particularly enjoyed ENT and urology for somewhat different reasons.

I prefer the surgeries, procedures, and personalities of urology to ENT. I like the mix of robot vs lap vs open vs lasers for stones vs lots of scopes etc. I really like abdominal and pelvic anatomy and I'm not squeamish about genitals but to be honest I just don’t feel particularly passionate or interested in men’s health and bladder problems, and I don't love the idea of my patient population primarily being men over the age of 50. So clinic was meh for me but not necessarily a deal breaker.

For ENT I really love that as a generalist I can see 5 year olds and 80 year olds, men and women all in the same day and I definitely enjoyed ENT clinic more than urology clinic. I think the medical management is more interesting than for urology, and that similar to urology there are lots of in office procedures and scopes. However I really just wasn't crazy about the surgeries I saw — The difficult access for laryngeal procedures seemed frustrating, and I'm worried tubes and tonsils won't satisfy my interest in cutting. The OR wasn't exciting to me which is contrary to all of my other surgical experiences. I am sure I would grow to like the surgeries once I was doing them myself vs. watching as a med student but it feels weird to pick a specialty where I was so often bored in the OR. But again, I recognize that my experience as a medical student is skewed given how little I was able to be hands on and involved in cases. Lastly, while all the ENT docs I met were super nice I really felt most at home among the personalities of urology residents and attendings.


I think overall I can see myself being happy in either specialty but I’m not sure how much patient population/enjoyment of clinic vs colleague personalities/enjoyment of the surgeries matters. I’m not sure which factors to weigh more or how to decide between the two.

It seems like residency is similarly brutal for both, compensation is similar and attending lifestyle is similar.

Does anyone have thoughts on what factors to weigh most heavily or opinions on what I should do?

---

Members don't see this ad.

 

[operaman]

Honestly you can’t go wrong with either. Both great fields with lots of practice models.

I would suggest trying to spend more time with both fields and make sure you get exposure to many attendings. Honestly I think time and gut feeling will be key.

As an ent myself, I can attest that we have a wide variety of personality types. Students often get shunted to the head and neck cancer services since those are the busiest and the cases are cool and students can be more involved. But those staff tend to be a little more intense and gruff and less laid back. Compare that to the Laryngologist or rhinologist who tend to be more laid back and probably closer to the urology vibe.

If you can shadow a general ent and general uro in the community that would also be a great idea. The day to day of a community generalist is very different from academia.

I would also caution you to remember that your attending practice will never, in any field, be as interesting and diverse as your student experience. For now you get to bounce between academic sub specialists doing all the fun cases. Don’t forget that every attending you see doing the big case one day is probably back in clinic or doing paperwork the next. Docs do tend to find their niche, whatever that is, and is highly dependent on what gets sent to you. Uro and ENT both have lots of cool cases and technology, but you’ll rarely have a practice where you’re using all of it frequently. I don’t think I quite understood this point until I was a pgy3 or 4.

I would also say to try and picture what you’ll want at the end of things. Simple bread and butter may sound boring now, but those patients all go home and do well and there’s nobody to round on and you’re home by 4 or 5 every day. Plus even the cool cases become routine eventually. Keep an eye toward the specifics of your lifestyle wants and see if the areas of each field you like would mesh well with that.

 

[i-doctor]

As an impartial person here in a different surgical subspecialty (ophthalmologist here), I think you answered your question in the first paragraph. You said you prefer the surgeries and office procedures of urology to ENT. That’s your pick: urology.
Medical management gets old quickly in any/every field. And treating all age groups will too. Enjoying doing the surgery will be the key to your happiness. I still enjoy doing cataract surgery (primarily) after two decades. That’s the main reason I still love my field. Definitely not the office.
That being said, I operate alongside both ENT docs and Urologists at two different ASC’s. They are all happy docs overall.

 

[Dr G Oogle]

I’m a urogyn and have a very close relative in ent. I think it boils down to what pathology and what patients you want to test. Both fields seem to allow generalists to do a wide breadth of procedures and develop mastery in many of them without doing a fellowship. Both make $$$$. As far as difficulty of procedures, the more you do the less difficult it seems. I still from time to time think I can’t believe some of this stuff comes so easy to me when not that long ago the anatomy and procedure were a big black box.

 

[aldol16]

Do you like boogers more or dicks?

 

[NotTheOne]

“I prefer the surgeries, procedures, and personalities of urology to ENT.”

You have your answer. Don’t complicate it.