Job Market for Rhinologists?

[ENTROCKS1234]

Hi, I am a resident looking into fellowships currently. I have heard a lot about the lack of jobs available after Rhinology fellowship in both Academics and private practice. In Academics it seems the market is quite saturated. In private practice, I've heard people don't want to hire Rhinologists even if they are planning on doing general ENT in the fear that they will decrease their own sinus volume.

Has anyone seen this? Anyone seen newly graduated Rhinologists looking for jobs and having success? Have you encountered any practices/hospitals looking for Rhinologists?

In the same vein- do you think this is similar in experience for Head and Neck graduates?

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[asrw77]

I would like to bump this thread, interested in rhino but not sure if best business decision

 

[Wordead]

Yes, generally unless you want to get one of those rare academic rhinologist jobs and do trans-clival whatever surgeries, it's not terribly helpful for getting a job at a hospital or private practice. Generally you don't bring any more value than a well trained generalist. We have a rhinologist in our practice but he is basically a generalist. We aren't giving him all the sinus cases or something.

From my experience, I think head and neck is also a rough job market after fellowship if you can't get an academic position. A lot pf private practitioners don't want to take call for your head and neck complications, so unless you want to just do thyroids parotids and other "Gentlemans head and neck" it can be difficult to practice fellowship-level head and neck.

 

[OtoHNS]

This is not a path for everyone, but...

If I were dead set on being a 100% rhinologist, I would open my own rhinology practice. There's a 100% chance of getting the job!

1. Find a smaller metro area that is underserved with ENT. To avoid living in Tumbleweed Town, I would go with a minimum 100k metro area population. There "should be" about 1 ENT physician per 35k population, so I would look for an area with only 1 ENT per 50k (or higher) population. This plan will not work in a saturated big city market.

2. Open your own practice - exclusively doing sinus, nasal, allergy (maybe snoring and/or cosmetic depending on your interest). You'll need office space, furniture/equipment, medical supplies, and allergy supplies. I would get an in-office CT as quickly as possible. You'll need 2 MAs to start- 1 to man the front desk and phones and another to room patients and help with procedures. You'll also need someone to handle billing- either outsource or hire someone in house. All this can be financed and you can hire practice management company to help you get everything set up.

3. If you picked the right market by following the criteria in #1, you will start seeing patients quickly. As soon as the allergy side of things picks up, hire a dedicated MA for testing and vial prep. Consider hiring a PA or NP to handle allergy, as it is very protocol-driven and routinized. That way you can focus on sinus and nasal procedures. A lot can be done in the office- balloons, Vivaer, turbinates, and so on. The local hospital or ASC would love to have you operate- sinus and nasal cases are very profitable for them. As a fellowship trained rhinologist, you can handle the weird revision frontals and gnarly AFS cases, and you will definitely see this stuff.

4. As things get busier, hire an office business manager but it is vital you oversee things, keep control of banking/payments, and always know what is going on in your business.

Again, it's not the path for everyone, but this would be a likely path to have a very profitable rhinology practice in a couple years.

 

[SkullbaseFoLyfe]

This is a good question that I do not believe has been accurately answered by the previous responses.

My background: Current academic rhinologist, completed fellowship 2023.

I strongly believe that it is not that difficult (if not actually quite easy) to find a job as a rhinologist. The academic market during my fellowship year and during the current fellowship year has been (unusually) strong. There have probably been 15-20 academic jobs in the last two years (and probably another 5-10 that were not advertised or internally filled). This is unusual and likely the result of recovery from the COVID era of few places being able to hire from 2020-2022/23.

I would say that if you are set on academics then it is difficult to prepare for the future as you never know how bad (or good) the job market will be. The quality of the fellowship (reputation, research, big / connected names in the field) certainly helps people become more competitive for the academic openings every year. There are also more and more privademic / pseudoacademic jobs that are popping up over the last few years. These are usually jobs at smaller centers / systems or ancillary sites that residents may or may not rotate at (but that still allow you to practice tertiary level rhinology). The jobs that exist are vastly different from each other. There are research heavy academic positions at big name places that will pay you half or a third of what you can potentially earn at other more clinically focused academic jobs / privademic / private jobs. That is very important to keep in mind when you think about what kind of practice you want. Do you want to do high level research or do you just want to be able to do advanced sinus procedures in an efficient surgery center and go home. Both are rhinology jobs. But the jobs are very different.

In terms of private practice I have actually found the market to be quite favorable. Yes it is true that there are plenty of private practices that do their own sinus cases and arent interested in bringing in someone who wants to exclusively do sinus. But there are a ton of sinus cases that private practice attendings dont want to do. The majority of operative referrals that come to my practice are from private practice ENT groups. So it is reasonable enough to think that a group may realize that they are referring out a large number of sinus cases (either due to complexity or maybe because certain groups incentivize seeing patients in the office over operating) and would consider bringing in a rhinologist who will help them recapture all of those cases. Its not always the case - im sure there are some remote locations where the 1-2 main groups do not want to hire a rhinologist. But for the medium and large metro areas in the US there are definitely private practice options to be found. I have never heard of a rhinologist who was unable to find a job after fellowship. And I doubt the majority of them are moving across the country or to locations they have no interest of being in.

The one caveat that applies to private (and maybe some academic) jobs is that some practices may allow you the ability to build up a rhinology practice, but will want you to see general patients to fill up your time. So I guess if someone is asking how hard is it to find a 100% rhinology job in the location you want right out of fellowship then maybe the answer is "somewhat difficult", but I honestly dont think its that bad. And doing part general until you have a full rhinology practice is a totally viable way to get a full rhinology job within a short time (1 year). Nasal complaints are common after all.