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Advice for early medical students who may be interested in this field?
Ask an ENT attending anything
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What's the longest booger you have seen?
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Did it come from a fly laying eggs there?
Its important to have at least 1-2 clinical research projects in the field of ENT - a retrospective study for example. Case reports are easy to do but are not enough. Some people spend a year doing basic/clinical science projects. This is great if you're interested, have the luxury of time, and/or need something to distinguish yourself if slightly lacking on step 1 or grades.
Research has become a way of distinguishing yourself from other candidates since anyone can study for school/step 1 and do relatively well. Also having a few posters/papers, conference attendance can get you introduced to different faculty in the field. I did two clinical projects and some basic science stuff which definitely helped me get many of my interviews.
probably, underlying cancer of the ear canal.
If there is an ENT residency program at the hospital then you're set. If there is not, then it will be more difficult. It will be even more crucial to do some research project and present at conferences, and several away rotations. A lot of the times, a home program is helpful to have since if you're decent, you can rely on staying in most cases.
What are some qualities that an applicant should look for in a residency program or when comparing different programs (excluding location)? For example, I've heard that going to places with lots of fellows takes away OR experience, especially when you're a junior resident.
1. what/where do graduates do/go? private vs academics, well represented subspecialties, research/no research
2. all subspecialties represented in faculty
3. various rotations - specialty run rotations versus various hospitals. This can provide you with lighter/heavier months, different experiences VA hospital versus academic versus private group, etc.
4. Fellows can actually enhance the experience depending on the role of the fellow/culture of the program. In some "powerhouse" ent programs, fellow get complex cases and this is a lost opportunity. In some places, fellows take general call, do their own cases and usually let the residents do all of these. And take you through complex cases.
5. resident happiness is extremely important and can shape your future dramatically. The 5 years of residency can wear you out versus motivate you. See how much the residents are involved - do they all skip interviews/show up, see how tired or happy they look.
6. Case volume is nice to see - look for variety of cases
7. Ask chief residents how comfortable they are with head/neck, otology cases
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It's not that that otology is not in demand - most people after residency do general because they're done training, are already a pretty specialized surgeon and enjoy doing variety which attracts most people to the field. Otology is a niche field so few fellowship spots as well, definitely has demand. General ENT by far has the most demand. The subspecialists in demand are really otology, head/neck microvascular, and pediatrics. There's no real increased demand for rhinology/laryngology/plastics.
Most fellowship grads will practice with generalists in a large multi subspecialty hospital employed group or academic center. Some will join a private group understanding that they'll be taking general call and doing a lot of general ent as well.
No. I live in a part of the country with few DOs. I'm also unfamiliar with DO training, do not know any DOs who completed a MD ENT residency. I also don't understand the idea of a DO ENT. Isn't that just someone who didn't get into a MD school trying for ENT making them less qualified?
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Hi, Thank you for creating this thread and answering all these questions.
Are most of the procedures evidence based in ENT? I understand that there was some controversy in the variation in rates of tonsillectomy across regions. Would we find similar differences in other bread and butter cases for ENT?
Are most of the procedures evidence based in ENT? I understand that there was some controversy in the variation in rates of tonsillectomy across regions. Would we find similar differences in other bread and butter cases for ENT?
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What's the future of ENT looking like (from a compensation and practice standpoint)? The medscape compensation came out with the average oto making $398k, which is up 10% from last year (relatively small sample size though).
It seems to be a field where they do a great job of limiting the number of residencies so that the market doesn't become oversaturated. They also have a monopoly on most things above the clavicle (excluding ophtho and some plastics) and don't have to deal with competition from other specialties for certain operations.
It seems to be a field where they do a great job of limiting the number of residencies so that the market doesn't become oversaturated. They also have a monopoly on most things above the clavicle (excluding ophtho and some plastics) and don't have to deal with competition from other specialties for certain operations.
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I feel like you just trolled me so hard haha.
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There are so few DO's in ACGME ENT residencies that the data doesnt exist.
http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Osteopathic-2016.pdf
There are a small number of AOA ENT programs .
Residency Information
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Someone better tell neurosurgeons (and oral surgeons, if we're counting dentists) that they can't do anything above the clavicle.
I didnt mean to be rude. Just thought I was stating the obvious. I'm sure there are some DO ENTS who are doing great work. I'm just not familiar and my understanding is they work in the Midwest primarily. Not best coast or east coast.
Job market is great in future. Unlike other fields our residency spots have barely increased. There is demand everywhere
Compensation is changing in every field in medicine. Those numbers give ballpark figures...let me just say $ won't be a tie breaking factor in deciding a field if you're choosing between surg/procedural specialties since they all compensate well. The key are your hours for that compensation (emergencies, call burden, clinic vs or time, stress, etc). And that's why certain fields are more competitive
Some evidence based stuff when it comes cancer or other tumors for example but a lot of subjective medicine when dealing with nasal congestion allergies snoring sinus surgery. Not like cardiology where there are guidelines and evidenced based standardized care for pretty much everything
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Gotcha gotcha. Just curious if maybe your colleagues were DOs. I've seen some DO ENTs i believe but yeah just wondering. Thanks!
Generally healthy patients undergoing elective surgery. Exception is cancer where things are done regardless. Most sick patients getting complicated stuff done gets sent to the academic centers but remember as a private practice you can be the first stop in seeing/recognizing sick people
1) How is the lifestyle of a pediatric academic ENT?
2) If you work very hard in residency, do you feel like a capable surgeon by the end of it?
3) What was the hardest part of residency?
4) How much reading/studying do you have to do now to keep on top of new developments/etc?
5) Which years of residency are the easiest? I.e. if you study/work hard during years 1-3, do the remaining years get better?
2) If you work very hard in residency, do you feel like a capable surgeon by the end of it?
3) What was the hardest part of residency?
4) How much reading/studying do you have to do now to keep on top of new developments/etc?
5) Which years of residency are the easiest? I.e. if you study/work hard during years 1-3, do the remaining years get better?
1. Pediatric lifestyle is typically better - academic lifestyle in general is busier than in private. Pediatric ENT is broad as well - lifestyle depends on how busy of a children's hospital you work in and whether you're doing cochlear implants or laryngeal tracheal reconstruction. Generally days are standard 8-5 but Call weeks although less frequent can be very busy.
2. Yes if you go to a busy residency you'll feel comfortable doing most things at the end of it.
3. Hardest part of residency is managing time, studying, and trying to have a family/social life
4. Now in practice you can do as little or as much as you want. You're required to do CME so that helps keep you on top of relevant things.
5. In ENT, the last 2 years you know what to expect and time management is better as well as call but they are long days and you're learning as much as possible. My toughest months were in my chief year since you're managing a team of junior residents and students while learning, operating into the night, preparing for tumor board, case conference, etc.
2. Yes if you go to a busy residency you'll feel comfortable doing most things at the end of it.
3. Hardest part of residency is managing time, studying, and trying to have a family/social life
4. Now in practice you can do as little or as much as you want. You're required to do CME so that helps keep you on top of relevant things.
5. In ENT, the last 2 years you know what to expect and time management is better as well as call but they are long days and you're learning as much as possible. My toughest months were in my chief year since you're managing a team of junior residents and students while learning, operating into the night, preparing for tumor board, case conference, etc.
Thanks so much! Couple other questions:
1) how often do you have to attend to life threatening conditions? And how often do you lose patients?
2) What is the worst part about your job?
3) Which subspecialties (in order) are the most chill?
My uncle is actually a DO ENT. He has been very successful and yes he practices in the midwest.
Favorite part of ENT is the variety in pathology. I also enjoy going between the OR and clinic.
I’d pick ENT all over again definitely. Otherwise I’d strongly consider ortho or neurosurg but both have lifestyles which are not as good despite better compensation.
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Wonder if you have interacted with med students at residency. What kind of med students impress you the most? What should we do on our clinical rotations, especially auditions.
I'm also curious about the basic science research you did. Was it mentioned during your interviews?
I'm also curious about the basic science research you did. Was it mentioned during your interviews?
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would you call podiatry students medical students?
Podiatry students are not medical students but podiatry students
The students who are genuinely interested, make an effort to work hard, stay late, ask questions, study the cases for the day. Having a good, calm personality is important. Students who are frazzled, tardy, unprepared, lazy, and annoying always stand out.
Life threatening conditions can occur on call - allergic reaction, awake tracheostomy for obstructing laryngeal cancer, post-op tonsil bleeds in children. Fortunately it is a field with few deaths except with cancer but typically these patients die on palliative chemo and followed by medical oncology.
Worst part of the job is treating conditions with good treatment sometimes - tinnitus, vertigo, post nasa drip. The emergencies can also be difficult when on call.
Subspecialties in ent from most chill to least chill with regards to attitude/lifestyle are facial plastics, rhinology, peds, laryngology, otology, head/neck cancer/recon.
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Lol, I'm surprised you answered my post. That was originally a joke post as around the time I posted there was a huge thread going on about whether podiatry students are medical students. Sorry to have wasted your time.
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Thank you for doing this, love the AMAs on SDN. I’m in incoming M1 who doesn’t really know what he/she wants to pursue but am trying to get to know all the specialities.
1) how many aways are considered standard when applying to ENT, plus the home rotation. What about if you don’t have a home program?
2) At a typical medical school, what’s the best way to get early exposure to the field? I was thinking reaching out to the department for clinic and OR shadowing.
3) Fun question: does ENT have a particular stereotype or “culture” that many surgeons fit in like the surgical fields of neuro and ortho?
1) how many aways are considered standard when applying to ENT, plus the home rotation. What about if you don’t have a home program?
2) At a typical medical school, what’s the best way to get early exposure to the field? I was thinking reaching out to the department for clinic and OR shadowing.
3) Fun question: does ENT have a particular stereotype or “culture” that many surgeons fit in like the surgical fields of neuro and ortho?
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Lol no prob. I’ll answer anything!
Yes ENTs are the easy going nice surgeons for the most part and similar to urologists. It’s not all operate operate and we have a good mix of clinic. It’s typicaly not horribly stressful. It’s competitive because it’s interesting but likely because the lifestyle can be really great.
Thank you for doing this! I recently co-authored an abstract that was submitted to one of the larger national otolaryngology conferences. If I get accepted and have the chance to attend, how do you recommend I make the most of my time there? (I'm a student interested in ENT)
Try to introduce yourself to any program directors, ask questions after a talk. A small conversation can actually make a difference.
Residency can be very difficult and should be because that’s how you learn. Call can vary depending on the size of the program but can q2-3 sometimes to q8-10 in bigger programs. Days are long typically rounding 6-7, cases all day, days ending past 7 when there are bigger cases on head/neck or when the service is busy with inpatients. Consults are throughout the night in a busy academic program with a level 1 trauma center. Hours can easily be 80 and beyond depending on the week. In my opinion residency should be difficult- it’s how you see the full breadth and depth of the specialty, how you learn to multitask and be efficient. It’s a surgical field so you won’t get nice shift work like in medicine, peds, rads, anes, etc.
Once you’re done, life can be as difficult or as easy as you want it. A busy head and neck free flap surgeon will have 2-3 days clinic, 2 days OR, one day may be admin/academic, involvement in research/committees etc. private practice can be a 4 days work week with 1 day OR and days ending at 3 pm. It’s what your goals are in life that dictate how you set things up.
Once you’re done, life can be as difficult or as easy as you want it. A busy head and neck free flap surgeon will have 2-3 days clinic, 2 days OR, one day may be admin/academic, involvement in research/committees etc. private practice can be a 4 days work week with 1 day OR and days ending at 3 pm. It’s what your goals are in life that dictate how you set things up.
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What is the strangest case you have ever taken?
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What is your call schedule like as an attending? Are you rural, urban, suburban?
I also noticed you said you'd consider ortho or neurosurg if you couldn't do ENT. While in med school were you considering either of those strongly? I am interested in both ENT and ortho and which a lot of people found strange. Was lifestyle a big deciding factor for you?
I also noticed you said you'd consider ortho or neurosurg if you couldn't do ENT. While in med school were you considering either of those strongly? I am interested in both ENT and ortho and which a lot of people found strange. Was lifestyle a big deciding factor for you?
I’ve seen some crazy stuff as an attending and a notable one was a paraesophageal benign tumor
Call depends on how big your academic/private group is. It’s about q7 weeks for me. I’m in a city outside of a very big city on the coast so suburban.
Yes lifestyle was a big factor for me. You pick a specialty for the most part when single or just married, few people have young children but the key is to envision how you want to live life not when you’re 30 but when you’re 40-65 years old. Neuro does not have the lifestyle I want so I would do a disservice to the field. Ortho you have to love operating all the time - weekends and in your 60s. You can do that in ENT too BUT the key is you don’t have to. You can have a purely non-surgical ent practice working 2-3 days a week in the later stages of your career. I liked that flexibility. I also liked the variety of the field whereas bones/joint pathology just was not as interesting to me.
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When you say q7 weeks do you mean you are on call for the entire week 24/7? Is ENT call in your setting brutal?
Thank you for the response!
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One of the many reasons I'm interested in ENT is that you can work with both pediatric and adult patients. Is it necessary to do a pediatric fellowship to work with children? Or can you do so in general ENT? If so, would a general ENT work on less complex peds cases, and anything else would be sent to someone who is fellowship trained?
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