Hi everyone, wondering what type of cases are done by newly graduated ENTs. It seems so I’ve heard most head and neck is going to tertiary centers (parities/thyroids)? What type of cases can we expect in PP? Also, do PP ENTs still get pediatric cases?
Cases usually done by general ENT
- Thread starter OtoNEC1
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I do thyroid and (i assume) parotids cases all of the time. I also do cancer cases as long as they don’t need a free flap. I choose who gets sent to tertiary centers from my practice, so they only get what I send to them. I’ve never met an ENT who doesn’t do pediatric cases unless that is by choice.
Here’s the thing: by and large your primary care colleagues don’t know what goes where so mostly it all comes to you and you decide what you want to keep and what you don’t.
Here’s the thing: by and large your primary care colleagues don’t know what goes where so mostly it all comes to you and you decide what you want to keep and what you don’t.
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You can do whatever you're comfortable with. Some things can be a bad idea in general unless you have established infrastructure - free flaps, airway reconstruction, complex peds, cochlear implants to an extent.
Thyroids and parathyroids absolutely should not be sent to a tertiary referral center. I mean, general surgeons do it - how hard can it be? (Kidding....kind of).
The majority of general ENTs do pediatrics (up to 40% of a general practice from what I've read is going to be peds).
Types of common cases - FESS, septoplasty, tympanoplasty, neck node excision, biopsies of various things, thyroidectomy, parotidectomy, BAHA, tonsillectomy/UPPP, ear tube placement. That's probably 90% of what I've done so far as a generalist.
Thyroids and parathyroids absolutely should not be sent to a tertiary referral center. I mean, general surgeons do it - how hard can it be? (Kidding....kind of).
The majority of general ENTs do pediatrics (up to 40% of a general practice from what I've read is going to be peds).
Types of common cases - FESS, septoplasty, tympanoplasty, neck node excision, biopsies of various things, thyroidectomy, parotidectomy, BAHA, tonsillectomy/UPPP, ear tube placement. That's probably 90% of what I've done so far as a generalist.
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Just curious, about how many go on to complete a fellowship vs remain a generalist? Is it like 50/50?
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From what I understand it's about 50/50 but not positive.
Agree with above.
I would add microlaryngoscopy with biopsy/vocal fold lesion excision/vocal fold injection to the list as well.
I also do a lot of office nasal procedures- balloon sinuplasty, turbinate reduction, Clarifix, Vivaer, etc.
@slowthai , I believe a majority go into fellowships now. I looked at my residency program's alumni page, and about 60% do fellowships out of those who graduated since the early 2000s.
I would add microlaryngoscopy with biopsy/vocal fold lesion excision/vocal fold injection to the list as well.
I also do a lot of office nasal procedures- balloon sinuplasty, turbinate reduction, Clarifix, Vivaer, etc.
@slowthai , I believe a majority go into fellowships now. I looked at my residency program's alumni page, and about 60% do fellowships out of those who graduated since the early 2000s.
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I wonder if it depends if you mean FELLOWSHIP or fellowship. Meaning: did they do a 1 year facial plastics fellowship just to be more competitive, or so they actually come out of it doing more facial plastics than they would have otherwise? Two of my partners are facial plastic trained and I do more facial plastics than both of them combined.
I never understood this. Especially for facial plastics. Most FPRS fellowships you are basically the equivalent of a shadowing med student. At least do some facial plastics afterwards if you're going to subject yourself to that misery for a whole year.
I do know a few people who did pediatric ENT fellowships to get more overall OR experience (especially otology cases) and now treat all ages. That makes more sense.
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I do know more than a handful of people who came out of a research-heavy residency just not feeling comfortable operating. They spent most of their time in a lab or watching cases at best and felt like they couldn’t work independently and feel safe. So they did a fellowship. Of course, they mostly wanted academic jobs so there’s another reason to do it. But if you actually ask them, the CV bullet isn’t the only (or even necessarily primary) motivator.
Another one I never understood was “ablation-only” head and neck fellowships. I guess just to have more experience? I’ve never really felt uncomfortable cutting out tumors and getting margins or doing necks. The recon is the hard part. Maybe there’s more to it than I think there is. I dunno. I would understand it if you needed to do TLM, but everyone does TORS now (or just sends them to chemorads is more accurate) and you can learn TORS without a fellowship.
Another one I never understood was “ablation-only” head and neck fellowships. I guess just to have more experience? I’ve never really felt uncomfortable cutting out tumors and getting margins or doing necks. The recon is the hard part. Maybe there’s more to it than I think there is. I dunno. I would understand it if you needed to do TLM, but everyone does TORS now (or just sends them to chemorads is more accurate) and you can learn TORS without a fellowship.
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Would echo a lot of the above.
You can do as much as you and your hospital can handle or as little. It's really your call.
Most of my surgery days look like: septum, turbinates, FESS, tubes, tonsils, biopsy or excision of lesion, random tympanoplasty. And my main OR is thyroid, parathyroid, parotid, younger kids needing admission after tonsillectomy, etc. A few times a year I'll have a branchial cleft cyst or thyroglossal duct cyst. Mostly when I refer it's for patient preference, large tumors that need flaps, TORS (no robot here), and cholesteatoma (just not very enjoyable surgery for me). Good luck!
You can do as much as you and your hospital can handle or as little. It's really your call.
Most of my surgery days look like: septum, turbinates, FESS, tubes, tonsils, biopsy or excision of lesion, random tympanoplasty. And my main OR is thyroid, parathyroid, parotid, younger kids needing admission after tonsillectomy, etc. A few times a year I'll have a branchial cleft cyst or thyroglossal duct cyst. Mostly when I refer it's for patient preference, large tumors that need flaps, TORS (no robot here), and cholesteatoma (just not very enjoyable surgery for me). Good luck!
