How does completing a pediatric otolaryngology fellowship shape the kinds of problems you see in practice? Are the kinds of surgeries and procedures that one does most commonly much different than treating adults? At this stage in my education I like seeing children...but that could change in 15 years when I'm finally done with training. The only criticism I have heard is "you make less," so I'm looking for a more descriptive picture.
I trained at a peds-heavy program, so I honestly don't feel a pediatric fellowship would have helped me do anything more other than maybe get on staff in a peds hospital ENT dept if I had wanted. I don't do LTR's (or their ilk like cricoid splits) or peds cochlear implants, but by the time I had finished residency I had no problem doing them. I don't do them now because I think you really need a good peds multidisciplinary team to handle them. I don't operate out of a peds hospital so it's not worth the stress for me now.
I know many ENT's who do and many who don't do peds airway foreign bodies. I enjoy doing them. I still do laryngeal papilloma treatment, peds tympanoplasties, peds mastoids (I don't like to do those, though), cong neck masses, bronchs for stridor/recurrent croup/pulm toilet, etc. There are many general ENT's who don't like doing that. A lot really depends on your training.
If you did peds ENT, your practice overall depends on your practice situation. If you join a general ENT practice, you'll still do a lot of routine stuff and may even need to do adult stuff especially if your call is structured to do so. If you join an ENT dept at a children's hospital, expect to be the tertiary referral. You'll still do routine stuff like LeForte described, but you'll also get the weird of the weird. You'll see a TON of syndromic kids with all sorts of weird problems as a result. You'll also have the chance to do great innovative stuff. Mandibular advancements, clefts, unique airway stuff, innovative ear and sinus surgery. There's a ton going on in advancing surgery in these areas and lots that you can be a part of if you want.
And, yes, you will likely make a lot of money as a peds ENT--more than a general ENT in most cases. I had 5 peds ENT attendings in my residency and they all made more than the university docs by quite a bit except, except for the chairman.
