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"you're not even"?



Of all the questions you could ask, I don't even...

images
 
Did you get enough exposure from your clinical electives (or 3rd year even) to make a "for sure" pick on what kinda MD you wanted to be?

My first real exposure to ENT was a clinical correlation lecture one of the head and neck surgeons gave in my M1 anatomy class. There was very little "required" exposure to ENT, almost all my experience was stuff that I personally sought out (i.e. shadowing elective M2, research time, and of course my actual ENT rotation 3rd year).

I'm not sure if anyone can make a "for sure" pick of specialty, but I was damn close. I can at least say that I for sure didn't want to do anything else over ENT.
 
BULLET FRAGMENT??

I can understand cotton, I can understand bugs, I can even understand beads if the patient was a little kid who didn't really know better. I cannot imagine how a bullet fragment was in someone's ear unless they were shot.

Also, please tell me the piece of a balloon was in a child and not an adult.

Yeah, that person got shot, actually many years earlier. The bullet was really lodged in the mastoid but you could see it through the ear canal. You'd be amazed at how many people get shot in the head and don't die. Our skulls are amazing structures. I wouldn't recommend trying it at home though...
 
It's fair to say that ENT is in the top 4 of most difficult residencies to match, probably tied with radiation oncology and behind dermatology and plastics.

From what doctors have told me, ENT was not always this competitive.

Here's the question:

Given that ENT is more competitive to match than it was in the early 80s, do you ever look at some of your fellow ENT attendings (or your attendings while you were in residency) and tell yourself that they wouldn't have gotten ENT residencies had they gone through the match when you did?

Haha, interesting question.

I don't have time to write a full response now, but I'll be back.

The jist of my answer will be "you have to be really smart to get into medschool/match at a competitive residency, but you don't have to be that smart to be a good doctor."

Intrigued?

😉
 
just wondering...is there a lot of chemistry in medical school? If so, does it still follow us during rotations
 
OtoHNS, thanks for starting up this interesting thread.

For those of us on the interview trail this fall, do you think the choice of US med school matters much? In residency, did you find that people from certain institutions performed better or were better prepared than those from other schools? If so, was this likely due to the school or is it more of a case of the motivation and aptitude of the individual student? If the former, can you name some schools that you felt did a good job of preparing students?

Now for something more specific to your field of practice. Years ago I hit myself in the face with my knee and broke my nose. This is just one of my many self-inflicted accidents (hence my choice of username). So I have a crooked nose, and if an ENT were to repair it, how would you go about re-breaking someone's nose to reorient it? Do you cut the bone with a saw, hit it with some kind of hammer or what? I've always wondered about that.

On the locum's topic, who covers your malpractice insurance? Can you moonlight under the policy (this might not be applicable for your speciality though). Does the locum company also take care of tail coverage, or will you have to pay that yourself when you leave the company? Does the locum company cover any standard benefits (health insurance, disability, 401K, CME, etc.) or are you a totally self-employed contractor responsible for all benefits (other than the housing, credentialing, and travel you mentioned)?
 
It's fair to say that ENT is in the top 4 of most difficult residencies to match, probably tied with radiation oncology and behind dermatology and plastics.

From what doctors have told me, ENT was not always this competitive.

Here's the question:

Given that ENT is more competitive to match than it was in the early 80s, do you ever look at some of your fellow ENT attendings (or your attendings while you were in residency) and tell yourself that they wouldn't have gotten ENT residencies had they gone through the match when you did?

OK, so to answer this a little more fully, I don't really think older ENT attendings are any less good because it was easier to match 30 years ago than today.

Academic attendings (in ENT or whatever else) I think tend to be more sharp about rare cases and "difficult" stuff because that is what they see a lot of. Also being in the academic setting forces you to keep abreast of current trends in the field. And people who want to be academic physicians tend to be the type of people who want challenges and to keep learning the latest stuff.

There are plenty of private docs that do the same, but also plenty who decide they don't want to deal with difficult cases anymore and only do ear tubes, tonsils, and other bread and butter cases. BTW, I think this is fine- they are still doing a lot of good and not everybody needs to be a cowboy. IMO, some private docs, however, never really keep learning and tend to practice the standard of care from when they were in residency, even if that was 25 years in the past. Usually this doesn't harm patients, but sometimes there are better options in the current literature.

Overall, though, in my opinion you really don't need to be a genius to be a good doctor. Much more important is people skills, a good work ethic, a sense of responsibility, and a genuine desire to help your patients. You can always look up how to treat X disease or what to do about Y syndrome.

So, to answer your question, no I don't think older ENTs are less qualified. Probably they didn't have as good of test scores and grades as today's residents, but IMO grades and test scores have little to do with how good of a doctor someone will be.
 
just wondering...is there a lot of chemistry in medical school? If so, does it still follow us during rotations

You take biochemistry in M1 year, but there's not much after that. Maybe some in pharmacology as well.
 
OtoHNS, thanks for starting up this interesting thread.

For those of us on the interview trail this fall, do you think the choice of US med school matters much? In residency, did you find that people from certain institutions performed better or were better prepared than those from other schools? If so, was this likely due to the school or is it more of a case of the motivation and aptitude of the individual student? If the former, can you name some schools that you felt did a good job of preparing students?

Now for something more specific to your field of practice. Years ago I hit myself in the face with my knee and broke my nose. This is just one of my many self-inflicted accidents (hence my choice of username). So I have a crooked nose, and if an ENT were to repair it, how would you go about re-breaking someone's nose to reorient it? Do you cut the bone with a saw, hit it with some kind of hammer or what? I've always wondered about that.

On the locum's topic, who covers your malpractice insurance? Can you moonlight under the policy (this might not be applicable for your speciality though). Does the locum company also take care of tail coverage, or will you have to pay that yourself when you leave the company? Does the locum company cover any standard benefits (health insurance, disability, 401K, CME, etc.) or are you a totally self-employed contractor responsible for all benefits (other than the housing, credentialing, and travel you mentioned)?

OK, first topic: I actually don't think your choice of med school matters at all in the long run. Seriously. The human body and all the ways it can go wrong are the same everywhere. You will learn the same stuff at any school. My advice is to go to the school where you will graduate with the least debt (probably your state school). IMO, that should be your #1 priority in deciding where to go. Salaries are not getting any higher.
Secondary things to consider include:
1. Type and number of teaching hospitals you would be at 3rd year (better to be at places with Veterans hospitals or County hospitals with indigent populations b/c you will get to do more as a student).
2. Location

Things that are not important:
1. 1st 2 years curriculum. Seriously, who gives a crap? Just get through it.
2. Ranking/reputation

***Caveat: this advice applies only to US allopathic schools. Fair or not, DOs and FMGs are at a disadvantage to US MD grads when applying for many residencies.

As far as your broken nose, do a google search for rhinoplasty. That sounds like what you would need.

The locums company pays for my apartment, travel, car, credentialling, and malpractice (including tail coverage). They do not provide any retirement benefits or health insurance. Now that I'm actually getting paid well, I don't have any desire to moonlight.
 
How stressful was medical school compared to your undergrad? What about free time in both as well? Also, it'd be interesting to know how "competitive" your undergrad school was for some context.

Obviously ENT is a very competitive specialty... but for someone "aiming" for a non-competitive specialty (say, peds or psych)... do you think it's possible that med school could be easier to manage than undergrad? 'Cuz hey, the biggest hurdle has been surpassed.

Great thread! 😀
 
1. Were you labeled a STUD in undergrad school? And what was your gpa then?

2. Were you a labeled a STUD in med school?

If so, i'm guessing you're a STUD now. How much does throwing out the line help ha
 
Are you as awesome in real life as you are on SDN?
 
Do you think i have a shot at top medical schools, such as Baylor, UCSF, Stanford, based on my stats?

cgpa=3.98 sgpa=4.0
2 years of biochem research with 1 poster presentation
30-40 hrs of shadowing a cosmetic surgeon
by the time i apply to med school, ill have 800+ hrs of ER Scribe experience
by the time i apply to med school, ill have 400+ hrs of teaching gen chem2
part of two clubs at school

Also what mcat score do you think i need in order to be accepted into these schools? Any other advice? Thanks.:biglove:
 
Hello premeds-

I'm a new attending ENT physician. My schedule is pretty light at this point in my career so rather than staring at the wall for a large part of the day, I'll be around SDN some to offer advice and answer questions. I've been in your shoes not that long ago (well, kind of long ago...) and I'd like to offer some perspective from the other end of medical training. Any advice I give is just my opinion and may be completely wrong, so don't sue me, ok?

Post questions in this thread. I might just answer them...

How did you get to be so sweet?
 
How much of the stuff that you covered on the MCAT did you actually use in med school, and how much of the stuff that you learned in med school did you actually use in residency respectively?
 
How much of the stuff that you covered on the MCAT did you actually use in med school, and how much of the stuff that you learned in med school did you actually use in residency respectively?

If I may interject:

1. All of it.

2. All of it.

Believe it or not, I don't say these things flippantly. Knowledge is very layered, and if I pulled out some seemingly inconsequential brick from years ago it may affect my current base. Even though I do not use the right hand rule in practice, I do come across situations where my basic knowledge of physics, however diminished by time, does come in handy. Radiation therapy, cardiovascular principles, optics, all of this crap I deal with daily.

I am a pathologist, and much of my job involves correlating what is on the slide with what was seen in the OR/clinic/ER/etc. To pull this off I draw on every bit of clinical medicine I ever had. No matter what specialty you end up in, it will behoove you to have a decent understanding of the fields you interact with, and perhaps the best time you have to foster that understanding is when you're in med school.
 
How stressful was medical school compared to your undergrad? What about free time in both as well? Also, it'd be interesting to know how "competitive" your undergrad school was for some context.

Obviously ENT is a very competitive specialty... but for someone "aiming" for a non-competitive specialty (say, peds or psych)... do you think it's possible that med school could be easier to manage than undergrad? 'Cuz hey, the biggest hurdle has been surpassed.

Great thread! 😀

1st 2 years of medschool are basically like college science classes on steroids. Definitely a step up in terms of amount of material and time studying. 3rd year is a completely different animal in that you are actually at work for many hours. 4th year is a complete joke. So, if you are a person who tends to get really stressed out, it will probably be worse in med school than in college. I did have adequate free time and actually went out a lot the first 2 years. As far as my undergrad, I went instate to a public university that is generally considered to be a "public Ivy." (Hate that term, btw)

For your 2nd question, it would depend on the person. If you are pretty smart and a good testtaker, you could possibly slack off and still pass easily the first 2 years. You have to work and put in the time 3rd year though. Really, though, do you want to spend 4 years and 6 figures to slack off all through med school?
 
1. Were you labeled a STUD in undergrad school? And what was your gpa then?

2. Were you a labeled a STUD in med school?

If so, i'm guessing you're a STUD now. How much does throwing out the line help ha

I suppose. I've always had pretty good grades and scores. I think my undergrad gpa was like 3.8. I also think I'm a pretty good ENT doctor, though, as stated above, I don't think that has so much to do with how smart I am.
 
Do you think i have a shot at top medical schools, such as Baylor, UCSF, Stanford, based on my stats?

cgpa=3.98 sgpa=4.0
2 years of biochem research with 1 poster presentation
30-40 hrs of shadowing a cosmetic surgeon
by the time i apply to med school, ill have 800+ hrs of ER Scribe experience
by the time i apply to med school, ill have 400+ hrs of teaching gen chem2
part of two clubs at school

Also what mcat score do you think i need in order to be accepted into these schools? Any other advice? Thanks.:biglove:

My sensors tell me this may be a fake post. However, I'll answer anyway.

Yes, your numbers are good. You clearly have outstanding research experience and clinical exposure. With this alone, I think you would be accepted to multiple schools assuming you don't come off horribly on interviews.

However, your resume is quite sterile. It tells me nothing about you as a person. This could easily be interpreted as you only engaging in activities that you think will look good to medical school admissions.

At this point, you don't need to prove that you are smart or interested in medicine. Get involved in some non-medical stuff that you are passionate about: that would take your resume from good to truly outstanding. And, BTW, I'm not saying you are not interested in ER scribing and TAing, I'm sure you are. It would benefit you to make your resume a little more rounded.

ps- don't tell admissions people you want to be a cosmetic surgeon, they hate that.
 
If I may interject:

1. All of it.

2. All of it.

Believe it or not, I don't say these things flippantly. Knowledge is very layered, and if I pulled out some seemingly inconsequential brick from years ago it may affect my current base. Even though I do not use the right hand rule in practice, I do come across situations where my basic knowledge of physics, however diminished by time, does come in handy. Radiation therapy, cardiovascular principles, optics, all of this crap I deal with daily.

I am a pathologist, and much of my job involves correlating what is on the slide with what was seen in the OR/clinic/ER/etc. To pull this off I draw on every bit of clinical medicine I ever had. No matter what specialty you end up in, it will behoove you to have a decent understanding of the fields you interact with, and perhaps the best time you have to foster that understanding is when you're in med school.


Haha, I would have answered: 1. none of it and 2. not much of it.

I do think all that basic science and preclinical knowledge is more directly relevant to a pathologist than an ENT. Honestly, though, I probably use it more than I realize, it's just down in my subconscious somewhere and bubbles up when it's needed.
 
I got great answers in my first thread, especially from Parts Unknown (please go ahead and answer this too if you see it), but what do you think Hospital Directors or Employers look for when hiring students? Any weight on undergrad? Medschool? Internship? Residency? Fellowship? Any particular order in weighting?
 
Thank you very much for taking the time to help us out!

I was wondering if you could please explain about locum's as I've never heard this before (not sure if its due to me being Canadian or just a lack of knowledge)

Are you on a contract right now? If so, how long is it for or how long are locum contracts typically?

You mentioned that you will be traveling, will this be medically related or purely pleasure? Are there a wide range of (non-permanent) international work opportunities when you graduate?

Did you do your residency in the same state as your medical degree? Are you now working in this same state? What sorts of support do you have from friends or family where you are living? Do you find that you are closest to the people you went to med school with, or residency, currently working with or people you met before going into medicine? How has you career choice affected your relationships with others?

What do you think made you successful in getting into residency and getting a job?

What, if any, advice do you have for us?
 
I got great answers in my first thread, especially from Parts Unknown (please go ahead and answer this too if you see it), but what do you think Hospital Directors or Employers look for when hiring students? Any weight on undergrad? Medschool? Internship? Residency? Fellowship? Any particular order in weighting?

It is impossible to answer this question succinctly. Every potential employer will have its own priorities, every potential employment opportunity will have its own idiosyncrasies.

For instance, an academic department looking to hire an 80:20 researcher/clinician would probably be highly interested in someone with a good research pedigree, strong publication record, and a proven ability to obtain extramural funding. Clinical prowess may be relegated to "just try not to kill anybody." In contrast, a rural group of family practice physicians looking to hire someone on a partnership track would likely be interested in someone with solid clinical skills who can operate efficiently, good bedside manner, good demeanor, and a proven desire to stay in the area long-term.

And you can find every conceivable variation in between these two disparate scenarios.

In general I would say that when people review your CV they will look at your fellowship first and your residency second. The saying "you're only as good as the last place you trained" has a large kernel of truth.

I would also strongly advise against underestimating the importance of personality. When you reach a certain point everyone will assume you are competent enough to function. At that point the person who is a pretty normal, affable bloke who works hard, is respectful of others, and is willing to go the extra mile will have a distinct, long-term advantage over the person who is more difficult to get along with. There will always be exceptions, of course, but as you go along it's never a bad idea to be nice. It goes a long way.
 
P.S. I am now going to halt my thread hijack, unless someone specifically asks me a question.
 
Do you think playing lots and lots of video games will be useful in hand-monitor-eye coordination when performing laparascopic surgeries?
 
Do you think playing lots and lots of video games will be useful in hand-monitor-eye coordination when performing laparascopic surgeries?
actually, didn't a recent study find this to be actually true?
 
Many studies have found playing video games to be correlated with surgical skill.

here is one: http://www.ncbi.nlm.nih.gov/pubmed/20630431
"RESULTS: Twelve relevant journal articles were discovered. Video game usage has been studied in relationship to laparoscopic, gastrointestinal endoscopic, endovascular, and robotic surgery.
CONCLUSIONS: Video game users acquire endoscopic but not robotic techniques quicker, and training on video games appears to improve performance."

here is another: http://www.ncbi.nlm.nih.gov/pubmed/17309970
"CONCLUSIONS: Video game skill correlates with laparoscopic surgical skills. Training curricula that include video games may help thin the technical interface between surgeons and screen-mediated applications, such as laparoscopic surgery. Video games may be a practical teaching tool to help train surgeons."
 
I doubt that any studies have correlated being an obsessive video gamer with being a top flight surgeon. Most of those guys stay up all night, rarely go to class in college, and have no life outside of their computer. The smartest guy I knew in college wanted to be a doc, but could not get admitted to med school, because he was a gamer addict and had no time to do what is necessary to become a doc. He would have been obliterated by med school. He was rejected twice in the med school application process and gave up. I am sure he is sitting in an apartment somewhere, with his lap top, doing what he does, hoping his mother sends him a check.
 
uh yeah, i have a question, why are you wasting time answering these questions when you could be having kinky sex with various partners due to your doctorliness?
 
I scrubbed into a surgery last week to observe. The surgeon I was with all day told me how he plays first shooter games at home when he's free.

Not sure if there's any connection, this guy was also 50 something. Not a creepy guy at all though, he was pretty fun to follow.
 
I think video games make you smarter. High school = 2.6 GPA. After high school, I started playing video games over the summer. Played hard core for like 1 and half years. Undergrad GPA = 3.87. How??!!?!?!?!?
 
Many studies have found playing video games to be correlated with surgical skill.

here is one: http://www.ncbi.nlm.nih.gov/pubmed/20630431
"RESULTS: Twelve relevant journal articles were discovered. Video game usage has been studied in relationship to laparoscopic, gastrointestinal endoscopic, endovascular, and robotic surgery.
CONCLUSIONS: Video game users acquire endoscopic but not robotic techniques quicker, and training on video games appears to improve performance."

here is another: http://www.ncbi.nlm.nih.gov/pubmed/17309970
"CONCLUSIONS: Video game skill correlates with laparoscopic surgical skills. Training curricula that include video games may help thin the technical interface between surgeons and screen-mediated applications, such as laparoscopic surgery. Video games may be a practical teaching tool to help train surgeons."

Does this once and for all, unequivocally, prove that guys make better surgeons than girls? 😉
 
I would also strongly advise against underestimating the importance of personality. When you reach a certain point everyone will assume you are competent enough to function. At that point the person who is a pretty normal, affable bloke who works hard, is respectful of others, and is willing to go the extra mile will have a distinct, long-term advantage over the person who is more difficult to get along with. There will always be exceptions, of course, but as you go along it's never a bad idea to be nice. It goes a long way.

Agree 100%. Feel free to contribute to this thread, I don't care. 🙂
 
Thank you very much for taking the time to help us out!

I was wondering if you could please explain about locum's as I've never heard this before (not sure if its due to me being Canadian or just a lack of knowledge)

Are you on a contract right now? If so, how long is it for or how long are locum contracts typically?

You mentioned that you will be traveling, will this be medically related or purely pleasure? Are there a wide range of (non-permanent) international work opportunities when you graduate?

Did you do your residency in the same state as your medical degree? Are you now working in this same state? What sorts of support do you have from friends or family where you are living? Do you find that you are closest to the people you went to med school with, or residency, currently working with or people you met before going into medicine? How has you career choice affected your relationships with others?

What do you think made you successful in getting into residency and getting a job?

What, if any, advice do you have for us?

Whoa, lots of questions here. 🙄

As far as locums, I really am the in-demand commodity so I basically dictated the terms of the contract as far as how long and when I wanted to work. Locums contracts can be basically anything non-permanent.

I'm not planning on working internationally, but there are some opportunities out there (in some specialties more than others).

I did med school, residency, and now my work stint all in different states. I do have several relatives and friends within easy driving distance. I've found that it gets harder and harder to stay in touch with old friends from growing up/college/med school etc as I get older. It's still nice to see old friends but you and your friends will be different people after a few years apart and it's never quite the same. Non-medical people I've talked to seem to have the same experience. It's all good though, just make new friends.

In regards to getting a job as an ENT, it's very different than every other application cycle. As you all know, it's hard to get into a good college/med school/competitive residency. However, at the other end, there is a huge demand for basically all types of physicians. There are hundreds if not thousands of ENT jobs all over the country. I have no doubt I could get a job basically anywhere in the US. If by some fluke every practice in a city did not want to hire me, I could just start my own practice. It's a new mindset after always competing with more applicants than positions.
 
I have an oddball question for you, doctor:

Why is it that after all of these years of advances in biomedical science related to ENT, almost nobody in the business of giving vocal lessons seems to have a solid idea of how the vocal system works, how to get the most out of it and how to avoid damaging it?

I suspect you may be able to make a lot of money by being the first guy to write the official "how the vocal system works" book for voice coaches, because none of them seem to know anything past superstition.

Haha, maybe if I made some stuff up. Nobody that I know of really understands how the larynx works exactly. We have a basic knowledge and different models of what's going on but that's it. A lot of laryngology is just voodoo IMO.
 
Do you think playing lots and lots of video games will be useful in hand-monitor-eye coordination when performing laparascopic surgeries?

Yeah, I think there is definitely truth to this, especially as more and more surgeries are done endoscopically or with the robot. I was never a hardcore gamer but I did play my share of Nintendo back in the day.

For ENT, basically all sinus surgery these days is done with a scope. One of my coresidents and I had this nerdy inside joke about how we were going to make a video game series of doing sinus surgery.
 
uh yeah, i have a question, why are you wasting time answering these questions when you could be having kinky sex with various partners due to your doctorliness?

I need a break from the 23.5 hour sex marathon that is the rest of my day.
 
Thanks for reading all of these posts.

After you decided that you were interested in ENT were you able to arrange your clinical years to gain more exposure to ENT? Was it difficult?

You said that you did ENT research, do you think this helped your decision to go into ENT, and how much do you think it helped you get into your residency program?
 
Hello premeds-

I'm a new attending ENT physician. My schedule is pretty light at this point in my career so rather than staring at the wall for a large part of the day, I'll be around SDN some to offer advice and answer questions. I've been in your shoes not that long ago (well, kind of long ago...) and I'd like to offer some perspective from the other end of medical training. Any advice I give is just my opinion and may be completely wrong, so don't sue me, ok?

Post questions in this thread. I might just answer them...
Alot of people are just asking silly and dumb questions. I have two very serious questions.
1.) When are you running for president of the U.S?
2.) Are you god?
You will have all of SDN votes for president.👍
 
Thanks for reading all of these posts.

After you decided that you were interested in ENT were you able to arrange your clinical years to gain more exposure to ENT? Was it difficult?

You said that you did ENT research, do you think this helped your decision to go into ENT, and how much do you think it helped you get into your residency program?

Yeah, it was no problem. The only thing you really have to do is schedule a month rotation on ENT which is typically done at the beginning of the M4 year. Many schools will have subspecialty blocks during the M3 surgery rotation and you can spend some time on the ENT service then as well.

I did research to improve my application. I hate doing research with a passion and I'm glad I never have to do it again. These days, research is almost a requirement for applying for ENT. Basically everyone has ENT research experience, many folks with multiple publications by the time they apply.
 
Alot of people are just asking silly and dumb questions. I have two very serious questions.
1.) When are you running for president of the U.S?
2.) Are you god?
You will have all of SDN votes for president.👍

1. Never. That's like the worst job in the world.
2. Of course, I'm a surgeon.
 
I have a question myself: Do you occasionally misspell otolaryngology?

In all seriousness, great thread OtoHNS. Really informative! 👍
 
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