I matched in oto last year. Heres my advice:
For M1s and M2s:
I think its important to do well in your preclinical classes, but your grades in the first 2 years are probably not that vital in the grand scheme of things. If youre generally above the mean, you should be in fine shape. Step 1, on the other hand, may be the most important factor in getting oto interviews (along with your 3rd year grades). Obviously shoot for as high a score as possible. The mean for matched applicants has remained fairly steady around 235 in recent years. If you score lower, say <225-230, its not the end of the world, but you will need to bolster your application in other areas.
Anyone who becomes interested in ENT during the M1 year also has a huge golden opportunity to A) get some significant research done and B) make contacts in the department at your school during the summer between 1st and 2nd year. This is the last time you can fully concentrate on a research project until 4th year. For those without oto residency programs at their schools, it is certainly feasible to do some research at another institution that does.
For M3s:
Grades become more important now. You should try to get As/honors in as many rotations as possible, especially medicine and surgery. To get good evaluations, you MUST be a normal, likeable human being. If the residents and attendings you work with like you, they will almost always write you good evals. Its really that simple.
If you havent already met with the chairman/PD of your oto department, I would do this by the spring of your 3rd year. If you are exceptionally motivated, you might even be able to get some work done on a research project during easier rotations (i.e. psych, neuro, family). Now that ENT is regular match, it is not necessary to do an oto sub-I during your 3rd year anymore.
For M4s:
You should do a month of ENT at your own institution as early as possible. Work hard and make friends with everyone- attendings, residents, clinic nurses, secretaries, etc. I would also recommend doing 1 away rotation unless you are dead set on staying at your own program. I did an away rotation and I think it gave me a lot more insight into what I really wanted out of a program. (I rotated at a big-name northeast program and was not very happy there.) I dont think there is much point in doing more than one away.
If you have a marginal Step 1 score, take Step 2 and ace it early in your 4th year.
Last year we were limited to 3 letters of recommendation, I dont know if that is still true or not. One letter must be from the oto chairman at your school. I would suggest that you get all your letters from ENT attendings. The field of otolaryngology is small enough that your letter writers will be personally known by many of the PDs that will be reading them. It is also much more feasible to get a letter from a big-name attending on your away rotation now that oto is regular match. I know you got along great with your medicine/psych/peds/family med attending and they will write you the most glowing letter ever, but a solid but slightly less glowing letter from a big-name oto attending will carry much more weight.
As far as applying, I would aim for about 40 programs if you are an average competitive applicant. If you are a superstar with 260 boards, publications, junior AOA, I would still apply to at least 30 programs. If you are a marginal applicant, 60-70 programs is not unreasonable. The competition is really tough out there.
The best source about where to apply and what programs are good/bad are current residents at your school. Organize a bar night for 4th years and residents to discuss programs and the application process. Most residents are more than happy to do this. I chose the programs I applied to almost entirely from discussions with residents. You can also find out about programs from sites like this one and otomatch, but the info may or may not be reliable.
During interview season, do 2-3 months of research rotations. It will free up your schedule for traveling. It is also fine if you do not have an oto publication yet during interviews. Most people dont. DO NOT schedule hard rotations during interviews.
For interviews (and applying in general), buy the book 101 biggest mistakes made by residency applicants, which gives excellent advice. Go out and buy yourself a new suit and new dress shoes. Guys, shave or at least neatly trim your shaggy facial hair and get a haircut. Superficial crap like this makes a difference.
Programs also want to train academic otolaryngologists, whether they say it explicitly or not. This is especially true for the Michigans/Harvards/U-Washingtons of the world. Do not say that you want to go into private practice. I dont recommend that you lie, but at least come up with several aspects of academic medicine that you find attractive and be able to talk intelligently about them.
Go to as many resident dinners and social events as you can and dont make an ass of yourself. These are the best way to find out if you are a good fit for a program and to get the lowdown. I had a great time interviewing: 99% of applicants are awesome people and you will keep running into the same people over and over again at different interviews.
After that, all thats left is to make your list and try to not have a nervous breakdown the week before the match. I cant imagine having to go to the whole match day ceremony and wait until noon to find out. Last year, the dean called at 7 in the AM and let me know that I had matched and where I was going.
So
in summary, its a long and sometimes nerve-wracking process, but its worth it in the end. I recently did my month of ENT during my intern year and had a great time. It really is the best specialty (no offense to other physicians of the world
). Good luck to all current and future applicants.
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