Ask an ENT attending anything

[drdoctor]

Feel free to ask any questions about the life of an ENT.

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[Gilakend]

I guess I found this gold mine first. I'll ask a couple.

What about ENT made you want to pursue it? Did any other specialties pique your interest? Are you happy with your choice?
What's a "typical" work day/week like for you?

 

[joonage]

Ohh~~~ Hope this gets as big as the other ones! Thanks for taking time out to do this!

I've been interested in neuro stuff for a while and am really fascinated with nsurg but the lifestyle could be off-putting. Do many people choose ENT over nsurg due to lifestyle choice?

Also, I know it's a pretty competitive major. What were your stats and what did you do to be a competitive applicant (ie pubs, ECAs, etc)?

 

[Jalby]

What would you want added to this template??


CT sinuses without contrast

HISTORY: The patient is a [ ]

COMPARISON: There are no prior examinations for comparison

TECHNIQUE: Multiple axial with coronal and sagittal reformatted images of the sinuses were obtained without IV contrast.

FINDINGS:
Frontal sinuses:
The frontal sinuses are clear.
There is no mucosal disease identified.
The frontal sinus outflow tracts are patent.

Ethmoid sinuses:
The ethmoid sinuses are clear.
There is no mucosal disease identified.
The cribriform plate is intact.

Sphenoid sinuses:
The sphenoid sinuses are clear.
The [ ] sphenoid sinus is dominant.
This sphenonoethmoid recesses are patent.

Maxillary sinuses:
The maxillary sinuses are clear.
There is no mucosal disease is identified.
The outflow tracts are patent.

Nasopharynx:
[]
There is no nasopharyngeal mass

Other:
The visualized intracranial structures are unremarkable.
The visualized orbits are unremarkable.

IMPRESSION: [ ]

 

[mimelim]

What would you want added to this template??


CT sinuses without contrast

HISTORY: The patient is a [ ]

COMPARISON: There are no prior examinations for comparison

TECHNIQUE: Multiple axial with coronal and sagittal reformatted images of the sinuses were obtained without IV contrast.

FINDINGS:
Frontal sinuses:
The frontal sinuses are clear.
There is no mucosal disease identified.
The frontal sinus outflow tracts are patent.

Ethmoid sinuses:
The ethmoid sinuses are clear.
There is no mucosal disease identified.
The cribriform plate is intact.

Sphenoid sinuses:
The sphenoid sinuses are clear.
The [ ] sphenoid sinus is dominant.
This sphenonoethmoid recesses are patent.

Maxillary sinuses:
The maxillary sinuses are clear.
There is no mucosal disease is identified.
The outflow tracts are patent.

Nasopharynx:
[]
There is no nasopharyngeal mass

Other:
The visualized intracranial structures are unremarkable.
The visualized orbits are unremarkable.

IMPRESSION: [ ]

clinical correlation recommended

 

[holycrap]

How many hours do you work on average per week and what's the hardest thing about your job/specialty. Thanks for this.

 

[theonlytycrane]

do you think your med school prestige mattered for residency?

 

[VoidorNah]

Chiming in for the updates primarily. Also have some questions, where did you do your schooling? Did you get in first try? Rural or urban?

 

[Jalby]

Do you plan on responding to any posts in this thread? This seems familiar.

https://forums.studentdoctor.net/threads/ask-jalby-anything.820369/

 

[The Buff OP]

Do you plan on responding to any posts in this thread? This seems familiar.

https://forums.studentdoctor.net/threads/ask-jalby-anything.820369/

You didn't answer my Hogwarts question either, Jalby.

 

[TimeforChange]

Did you volunteer in highschool?

 

[The Buff OP]

/thread?

 

[caffeinemia]

Feel free to ask any questions about the life of an ENT.

Can you buy me some new loupes with that office balloon sinuplasty money you gots?

Also, have you heard about the new laryngeal transplant?

 

[numbersloth]

Did you know you wanted to be an ENT from the beginning of med school? Why ENT vs. other specialties?
What did you major in undergrad? Any tips for pre-meds?

 

[Coltuna]

Buellerrrrrrr

 

[spikes]

Well that answers the lifestyle question

 

[aalamruad]

To be fair, OP only said to ask questions, s/he didn't actually mention anything about answering those questions

 

[The Buff OP]

To be fair, OP only said to ask questions, s/he didn't actually mention anything about answering those questions

You are right. Welp...looks like I will fail the CARS section.

 

[drdoctor]

I guess I found this gold mine first. I'll ask a couple.

What about ENT made you want to pursue it? Did any other specialties pique your interest? Are you happy with your choice?
What's a "typical" work day/week like for you?

Sorry for the delays! I will answer everyone's questions and will look out for more questions.

So ENT is a very unique field - has the breadth of very simple in-office procedures to massive 12 hour cases with ICU post-op care, etc. It is one of the few fields where you can treat patients of all ages and can have a busy pediatric and adult practice or you can choose to avoid one or the other! It is one of the few fields where there is no medical counterpart. I have patients who I treat solely medically (allergies, ear infections, voice problems, sinus infections) and I have several patients where we end up moving to surgery and then I have a subset of patients who come in with a surgical problem and after surgery, I get to follow-up (cancer surveillance).
It is a field where we truly can interact with a number of other specialists - oncologist, endocrinologist (for my thyroidectomy patients), oral surgeons (TMJ, dental issues), neurologists (headache, migraine, vertigo), thoracic surgery (airway obstruction), and of course we monopolize a part of the body that most pediatricians and internists are not comfortable with at all.

 

[drdoctor]

Ohh~~~ Hope this gets as big as the other ones! Thanks for taking time out to do this!

I've been interested in neuro stuff for a while and am really fascinated with nsurg but the lifestyle could be off-putting. Do many people choose ENT over nsurg due to lifestyle choice?

Also, I know it's a pretty competitive major. What were your stats and what did you do to be a competitive applicant (ie pubs, ECAs, etc)?

The lifestyle of ENT is variable depending on how busy you want to be.
I work 8-4, 4 days a week and most generalist ENTs work 4-5 days per week, standard office hours. Some days can get delayed if I have add-ons and I'm on call or I'm operating and a case gets complicated. Paperwork like any field in medicine can take time. Generally with the addition of paperwork and on-call responsibilities I average about 40-45 hours per week maximum. I have colleagues who like to work longer office hours, 6 days a week, etc. Even ENTs in academics have varying hours depending on how much research/administration they do and which field they focus on. Head and neck surgeons on average will work much longer hours than typical pediatric ENTs - just the nature of the game.

 

[750335]

What makes a good ent intern/resident?

What was residency like for you, what did you hate and what did you love about it?

How well would you say ent is suited for private practice?

How important is research in med school, and away rotations?

Can you discuss a bit about salaries/compensations? Do you feel well compensated?

I know there are women in ENT but still seems to be male-dominated, do you think this helps or hurts women interested in it?

Finally I second the question of the person who asked about if the prestige of the med school you attend matters come residency?

 

[drdoctor]

do you think your med school prestige mattered for residency?

In response to school/stats, etc:

ENT is a field that is usually compared to the likes of urology, plastic surgery since both are similar in that you can do pediatrics and a range of small to large procedures.

I shadowed during my first year of med school in all kinds of fields - ophtho, cards, GI, rad onc, derm, plastic surg, colorectal gen surg, etc.
What I found was that ENT is competitive for a reason - for the all the aforementioned things. The surgeons were always very pleasant for the most part, happy with what they do, seemed to have a good balance of work and home life, were genuinely interested in the pathology. One of the things I like about ENT is that there is a little bit of immunology, rheumatology, ID, neurology in the specialty. Everyday I see cool stuff in the office, stuff that I read about in a textbook, and its fun. Every surgery is also different - the pathology can be different, the anatomy is different. It is never routine to me. Yes just like any field, we get a share of mundane, routine stuff like ear wax, nasal congestion, acid reflux, tonsillitis, but my days are quite varied and I truly see a variety of pathology.

I chose ENT because I wanted something procedural first of all since I like the concept of being technically savvy and having some physical ability distinguishing me from a pure clinician. That ruled out several fields. I also liked quick patient interaction and didn't want to be an internist. I also liked the idea of cutting, not just scoping so cards/GI just weren't interventional enough. Interventional cards has some but its the same thing again and again.
Last week in my OR, I used an ear microscope, a laryngeal microscope, cut open a neck, and using a sinus endoscope. I like that variety. I operated on a 1 year old and a 80 year old.

Within surgical fields, although gen surg and neurosurg have cool stuff, the lifestyle is not what I wanted. An advantage of ENT is that as you become older, can tailor the lifestyle to allow for more clinic time and less operating, can limit bigger procedures and only do small ones, etc. It is very difficult to have a non-surgical gen surg or orthopedics practice. It is not difficult at all in ENT.
I was also more interested in neuro and facial anatomy than the penis so urological problems just didn't interest me as much as ENT stuff.

Where you go to med school can matter - if you go to an ivy league med school, it definitely helps getting into residencies. Of course the better the med school, the higher the rank, the better the scores, the better off you are. That does not mean that you'll be a better ENT. You can definitely get into ENT residency from a below average med school if you do well and you can have co-residents that went to top medical school, AOA, 260+. I went to a below average med school and did well and just like I said, my co-residents went to top 10 med schools, were AOA, and step scores 260+.

 

[deleted421268]

What was the dating scene like for you?

 

[drdoctor]

What makes a good ent intern/resident?

What was residency like for you, what did you hate and what did you love about it?

residency is a beast. It truly is difficult. I was never the complaining type. I put my head down and work. I don't like to confront, create situations, change my residency, etc. I just do the job and shut up. But it was hard, hours can be painful, requirements are high, expectations are high. At the end of the day, I truly am grateful for the process, and equally grateful to be done since it was a b#tch.

I did not enjoy research, did not like the resident requirements - the idea that you have to be somewhere at every minute. I loved the comraderie. If you're suffering for a good cause, its way more fun to have friends while doing it. I also loved the environment of having a bunch of residents in the hospital - makes the long days and nights way better seeing friendly faces going through the same stuff. I remember sitting in the trauma room completely destroyed and seeing the ortho resident in the same boat. And both of us just hating on the emergency residents and internal medicine residents who sat at computers and left after their 10 hour shift while we were covering the pager for 36 hours being pulled in 10 directions.
Surgical residency teaches you how to multitask at a whole new level and you truly enter a league above other medical fields. Only surgical residents will understand being in clinic, going to the ED, OR, patient floor for consults, while taking care of your inpatients, doing discharge paperwork, consult notes, prescriptions, answering nurses, etc. It teaches you to become a machine - emergency and internal medicine residents do not have that experience - they have several rotations where its purely outpatient clinical, most if not all rotations are shift work, way more manpower, can easily take sick days, etc.

How well would you say ent is suit for private practice?

ENT is situated extremely well for private practice - solo is tricky but dooable especially for facial plastics. Group ENT private practices are all over the country.
How important is research in med school, and away rotations?

Research is important to get into these things. Realistically, the majority of graduates (pretty much in any field) don't pursue it. Its important to show that you're dedicated to the field. I did a ton of it and learned alot. I do zero now and do not miss it. For me, I'd rather spend every second with my family than spend a friday night reviewing a paper even if a med student or resident wrote it. It is satisfying to publish and get some "fame" from research, but I'd rather watch football and chill w/ my buddies any day. At some point you have to have a personal finish line for your academic rat race. Mine was after residency.

Can you discuss a bit about salaries/compensations? Do you feel well compensated?
I feel well compensated. ENT salaries are good especially for the amount of hours put in (good RVU reimbursement). Most surgical subspecialists and medicine specialists do well. You can search on google for a very very rough estimate of a salary, but expect to make over 350k. The ceiling is much, much higher.

I know there are women in ENT but still seems to be male-dominated, do you think this helps or hurts women interested in it?
It's likely male dominated since it is a surgical field and training is very time consuming. Most women in the field I know did not have kids during residency and waited until afterwards since it is difficult to take time off and definitely not as forgiving compared to non-surgical fields about taking a morning off for a sick kid, etc. ENT residencies are 1-5 per year in all programs in the country. If one person is out, definitely takes a toll on the rest of the residents. In internal medicine, they have a whole back up system so if you take a sick day, there are like 5 people they can pull/call on.

Finally I second the question of the person who asked about if the prestige of the med school you attend matters come residency?

I think it matters to some degree, but honestly how well you do matters the most. I know people from average med schools at top residencies and I know people from top med schools in average residencies. ENT residency programs are all quite good and train well. There are no community ENT residency programs really. Its a small field where everyone knows everyone. If you have a right faculty mentor, you could get in anywhere. Moreover, when you go into private practice, nobody cares where you went to residency. When you're applying for fellowship, nobody cares where you went to med school, and fellowships are relatively not too competitive. If you want a spot you'll get it. Yes certain fellowships are a bit more selective and tend to take people who went to hopkins med school, hopkins residency, etc, but these are few and far between.

 

[drdoctor]

my answers are embedded in your post's questions

 

[drdoctor]

What was the dating scene like for you?

I purposely chose to go to residency in a big city for this reason. There are several so called top us news ent programs in the middle of nowhere. I could care less of how much research money they had or how their chairman published a billion papers. I wanted to be in a place with cool people so that after work I could grab a beer and meet some girls. If you're in a big city, you'll meet plenty of residents within your hospital and from neighboring hospitals since a lot of the time, you hit up known bars/clubs.

 

[drdoctor]

Did you know you wanted to be an ENT from the beginning of med school? Why ENT vs. other specialties?
What did you major in undergrad? Any tips for pre-meds?

For pre-med, your major means nothing. Study what you like and get the MCAT and grades to get into med school. There are rare cases where someone majored in statistics or engineering and they are able to do research way better in residency. I think if anything, I would've studied statistics in college so that I could understand papers and data a bit better, would've made it a lot easier to write papers in residency. Now that I'm out, I learned the hard way, but I also don't need any of that anymore. Now I just talk about politics, weather, sports with patients and people. Don't need a degree for that.

 

[drdoctor]

Chiming in for the updates primarily. Also have some questions, where did you do your schooling? Did you get in first try? Rural or urban?

I got in first try. 3 things matter to get into ENT residency - step 1 score, grades/AOA status, research. If you have 2/3 in high standing and the third passeable, you'll get in. Just need something to hang your hat on. For example - bunch of ENT research posters/papers and 250, good grades but not AOA, you'll get in. 235, junior AOA, research year off with publications, you'll get in. Its when you only have 1/3 that its a struggle. Gotta break that 240 score, gotta be in the top third of your class, and have to have at least a case report or poster nowadays to bag some interviews and all that. Just pure numbers since all these dudes be applyin.

 

[deleted421268]

I purposely chose to go to residency in a big city for this reason. There are several so called top us news ent programs in the middle of nowhere. I could care less of how much research money they had or how their chairman published a billion papers. I wanted to be in a place with cool people so that after work I could grab a beer and meet some girls. If you're in a big city, you'll meet plenty of residents within your hospital and from neighboring hospitals since a lot of the time, you hit up known bars/clubs.

So I'm guessing you were single at the time of your residency? What did women say after you told them you were an EMT resident? I'm sure you had no trouble getting women!

 

[Gurkhali]

This is just a general question but what exactly does getting AOA entail? I thought high grades meant you would get AOA? Also what amount/type of research would you say is good enough to land some solid interviews?

 

[drdoctor]

This is just a general question but what exactly does getting AOA entail? I thought high grades meant you would get AOA? Also what amount/type of research would you say is good enough to land some solid interviews?

AOA is usually around top 10-15% in your class. So its tough anywhere. You can still have good grades without being AOA. Research varies depending on other stats. If you're AOA with a top step score, its not as crucial - a case report or a poster would do. Obviously it ranges from a case report to a review paper or book chapter to survey studies to clinical research to a basic science project to a grant/year off to a phd. The most common is a few clinical papers/posters.

 

[drdoctor]

So I'm guessing you were single at the time of your residency? What did women say after you told them you were an EMT resident? I'm sure you had no trouble getting women!

ENT not EMT hah. i think certain medical fields definitely help in general and anything surgical never hurts...

 

[BombsAway]

Are there opportunities for shift work in ENT?

 

[fball22]

Salary? Do you practice in large urban area, or smaller?

 

[Gurkhali]

How big of a disadvantage would a lower tier school without a university hospital or main hospital be for residency? Would it create difficulty getting a mentor? The school has multiple affiliated hospitals and an ENT department within surgery.

 

[Ehwic]

What's the average recovery time for a septoplasty procedure?

 

[drdoctor]

Are there opportunities for shift work in ENT?

Not really. ENT is not a hospital based field so typically not a hospital employed physician like a hospitalist, intensivist, ED doctor, trauma surgeon, etc which are hospital employed. But advantage is you can make a good living even working 3 days a week 8-4...more than a hospitalist.

 

[drdoctor]

Salary? Do you practice in large urban area, or smaller?

Salary can google. Starting varies from 200-500 depending on location and experienced ones make typically >350

 

[meister]

clinical correlation recommended

Funny seeing a vascular surgeon repeat that trope, around these parts the duplex studies that the surgeons read will have this line 100% of the time.

 

[750335]

Salary can google. Starting varies from 200-500 depending on location and experienced ones make typically >350

Did you have to sacrifice on location to get the job you want, or can you pretty much get a job wherever easily? Someone told me most ENTs (or even most physicians) need to pick two of three in location, salary or work atmosphere, true?

 

[deleted738762]

Sorry for the delays!

LOL sorry folks. I just find this very funny.

 

[spikes]

Are you fellowship trained? Could you talk about the primary age range of your patient population (and do you prefer working with adults or children)?

 

[drdoctor]

There are jobs in every state - market is great. I personally didn't sacrifice location or job. I'm working near a big city and have a very flexible schedule. Yes salaries are higher in certain regions of the country but trade off is usually being more isolated.

I'm not fellowship trained - wanted to become a generalist so I can do everything that I want and the complex/painful stuff ship out to a subspecialist. I literally have seen a 8 day old and 103 year old in my morning clinic at least once a week. I have a good mix of babies, kids, teens, adults.

 

[Frogger27]

@drdoctor Tips for 1st year medical students interested in ENT? When is a good time to reach out to the department for shadowing experience, research, etc?

 

[Mednight]

What are some weird things that you've extracted out of someone's ear?

 

[Frogger27]

What is your favorite procedure that you do on a fairly regular basis (one of the bread and butter's). Why do you like it so much?

 

[drdoctor]

@drdoctor Tips for 1st year medical students interested in ENT? When is a good time to reach out to the department for shadowing experience, research, etc?

the sooner you start the better. I got advice from one of my seniors as a first year and would spend the first day of every block shadowing or spend a free afternoon during one of the blocks shadowing. Most of my shadowing I did between first and second year while doing a lab research thing. The earlier you start, the more facetime, and the better. I wouldn't go crazy with it since priority is doing well in coursework and prepping for step 1. But 3-4 times a year in first and second year is very dooable and they'll know you.

 

[drdoctor]

What are some weird things that you've extracted out of someone's ear?

worst thing was maggots infesting the entire ear canal/middle ear.

 

[drdoctor]

What is your favorite procedure that you do on a fairly regular basis (one of the bread and butter's). Why do you like it so much?

I really enjoy septoplasy and sinus surgery - technically fun, can be very easy to very challenging, a lot of different pathology in the sinuses, fun using scopes and various powered instruments. I also enjoy laryngeal surgery and using laser/microdebrider. On a typical OR day, I may do some pediatric tubes/tonsils, septoplasty/sinus, a tympanoplasty, and a laryngeal polyp removal using a laser. Other OR days, I slam with head and neck and do a few parotids/thyroids/submandibular gland excision.

 

[Frogger27]

@drdoctor thank you for your replies! What was your research output in medical school? What advice do you give students who are interested in ENT/other competitive specialties when it comes to research?