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1 year Otology fellowship vs ACGME accredited 2year fellowship

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eliteeli

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Hi all,

So I plan on doing Neurotology, however I have minimal to no interest in doing research long term. I would need to gear up for application season next year. What is the long-term career outlook of doing a 1 year non-accredited fellowship vs doing a full 2 year ACGME accredited one? Kinda hesitant to 1. Risk the highly competitive neurotology match and 2. Give up a whole additional year if the main difference is just reputation/academics. Whats the general consensus on the 1 year fellowships? Obviously my otology mentors are telling me to do the 2 years, but I fee like there is some bias there.
 

AOK123

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BUMP. would like to know the answer as well!
 

Wordead

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Having thought about all 3 options (neuro-oto fellowship, unaccredited 1 year fellowship, going into practice and seeing how it goes) and talked to various people Ill at least give my 2 cents, though I have no idea if Im going down the wrong path.

My impression is that the 1 year programs will make you much less competitive for an academic job (who cares, I hate academics anyway). The training tends to be less research focused (though a couple of the 1 year ones I know still do a fair amount of research) and a little more variable. Some of the 1 year programs do zero skull base and some are bangin through acoustics at the same rate as the powerhouse 2 year programs. Some are doing more chronic ear than others. So you really have to do your research and find a program that fits with what you want. The models are also different - a couple of the 1 year programs is a straight apprenticeship model with 1 guy, some at a smaller private practice. The 2 year programs, as far as I can tell, are all several faculty deep. So you do tend to see a few different approaches to things which I think is always valuable.

In the end, the 1 year programs are outside of the match so you could always apply neuro and if you dont match you can look into the 1 year programs. They TEND to be less competitive, though when I was looking a couple of them were already filled 2 or even 3 years down the road.

Job search wise for hospital employed or PP I dont think it matters. A guy with otology expertise is always highly sought after as most ENTs wont touch a stapes/OCR/complex cholesteatoma these days.
 

newyorkrezident

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Hi, which programs are 1 year fellowships? Could you recommend ? It seems to me almost all programs are 2 years ? Thank you much.
 

vertigogo

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Having thought about all 3 options (neuro-oto fellowship, unaccredited 1 year fellowship, going into practice and seeing how it goes) and talked to various people Ill at least give my 2 cents, though I have no idea if Im going down the wrong path.

My impression is that the 1 year programs will make you much less competitive for an academic job (who cares, I hate academics anyway). The training tends to be less research focused (though a couple of the 1 year ones I know still do a fair amount of research) and a little more variable. Some of the 1 year programs do zero skull base and some are bangin through acoustics at the same rate as the powerhouse 2 year programs. Some are doing more chronic ear than others. So you really have to do your research and find a program that fits with what you want. The models are also different - a couple of the 1 year programs is a straight apprenticeship model with 1 guy, some at a smaller private practice. The 2 year programs, as far as I can tell, are all several faculty deep. So you do tend to see a few different approaches to things which I think is always valuable.

In the end, the 1 year programs are outside of the match so you could always apply neuro and if you dont match you can look into the 1 year programs. They TEND to be less competitive, though when I was looking a couple of them were already filled 2 or even 3 years down the road.

Job search wise for hospital employed or PP I dont think it matters. A guy with otology expertise is always highly sought after as most ENTs wont touch a stapes/OCR/complex cholesteatoma these days.
i am a PGY4 interested in neurotology/otology. i plan to apply apply for 2-year accredited fellowships. i’m not the most optimistic in my chances of matching due to the competitive nature and my thus far low research output (although i’m trying to maximize my research out put now)

in your research, which 1-year programs have the most skull base experience? should I not match into a 2-year spot, i would strongly consider applying to one of these but only if there is skull base experience.

my reasons for doing for fellowship are a genuine interest in disease of the ear. also, i do not feel burnt out and am not in a rush to go into practice so why not continue to learn from the best in the field? in an ideal world, i’d love to have a large skull base practice, but I recognize that these opportunities are becoming more and more limited and i would still be happy with a larger proportion of general ENT practice.
 

Wordead

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i am a PGY4 interested in neurotology/otology. i plan to apply apply for 2-year accredited fellowships. i’m not the most optimistic in my chances of matching due to the competitive nature and my thus far low research output (although i’m trying to maximize my research out put now)

in your research, which 1-year programs have the most skull base experience? should I not match into a 2-year spot, i would strongly consider applying to one of these but only if there is skull base experience.

my reasons for doing for fellowship are a genuine interest in disease of the ear. also, i do not feel burnt out and am not in a rush to go into practice so why not continue to learn from the best in the field? in an ideal world, i’d love to have a large skull base practice, but I recognize that these opportunities are becoming more and more limited and i would still be happy with a larger proportion of general ENT practice.


Just read their descriptions - they're pretty up front with the goals of the fellowship. Some directly say this is not intended to train you in skull base work. Some have a multidisciplinary skull base tumor board and obviously you're going to get more exposure at those. Other than that Id reach out to their past fellows; I dont know enough to give specific recommendations.

A large skull base practice is very, very difficult outside of a few select instances. Though I know of one private practice guy that routinely does lateral skull base. But he's really the exception to the rule. You're just not likely to get those referrals and there's no way you'll generate enough patients on your own to book a reasonable number of cases.

As to the why not practice first - some would argue that you'll benefit from refining your technique in fellowship after you've done several surgeries. As in, once you do 10 ossiculoplasties and see X or Y fail you can better refine your technique in fellowship. But that assumes you're confident enough in your skills to go out and practice and aren't harming patients.
 

SkullbaseFoLyfe

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Seems like 1 year fellowships are a great option for people interested in getting more otology experience while not necessarily looking for academic jobs. You will certainly be a desirable hire for private practices or semi-academic programs interested in getting someone who will take care of ear/complex ear cases. Unlike rhinology, otology seems like the field that most generalists dont have too much interest in dabbling in. If you want a big name academic position then I think the 2 year fellows are certainly going to get priority - regardless of how comfortable you get doing complex ear / SB during your 1 year fellowship. Its the unfortunate reality of the situation. Perhaps this might not always be the case (maybe in 'lower tier' academic institutions), but I think you are fooling yourself if you think that the 1 year fellowship will make you just as competitive as the neurotology two year fellowship for most academic otology positions. It all depends on what you want out of your job - are you interested in getting recruited to a high volume academic skull base center, or are you interested in a less academic position that relies on you for their otology referrals.
 
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