ENT and Rads

[nuclearrabbit77]

did anyone consider ENT then change to Rads? just curious....

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[samsoccer7]

Up until october, I was DEFINITELY doing neurosurg, then I heavily thought about ENT, and now, b/c I'm so interested in the nervous system, I'm gonna do neurointervention, ultimately.

 

[Whisker Barrel Cortex]

One of my residency classmates was set on ENT until very late (I think November) when he decided to do radiology. He seems pretty happy. As are most radiology residents.

 

[nuclearrabbit77]

any tips on how i should approach deciding? i was so gung-ho about ENT, and by no means am i ruling it out but i'm starting to realize that radiology is sexy.

 

[ktat72]

did you have Surgery yet? If not, try and see if you can do a week of ENT to get the exposure to it and see if it for you. I you have already done it or your Surgery rotation does not offer a week or month of a surgical specialty, try and see if you could shadow an ENT during some of your free time.

 

[nuclearrabbit77]

thanks for the advice. i've actually shadowed ENT alot before i even went to med school and i've been involved in all this research junk in ENT since the last two years. (i'm a second year). i've contacted the radiology department and i'm going to try to work on some project and do some clinical stuff with them. hopefully i'll have a better idea after that.

 

[Whisker Barrel Cortex]

I think you reallly need to decide how much you will love operating and seeing patients.

Yes, we do some procedures in radiology, but the majority of it is not patient care. If seeing patients get better, having them thank you, having the satisfaction of "curing" them is important to you, than radiology is not for you. Even the interventional radiologists out there get little follow up on their patients and as one of my staff told me, only 2 of his patients in the past 10 years has sent him a letter or contacted him to thank him for his work.

In radiology, you need to enjoy the intellectual side of medicine. Lots of reading, lots of thinking through the findings on an exam to try to determine whats happening. Mix that in with a healthy dose of memorization.

Its pretty cool stuff overall. I like seeing cases from every specialty, not just limited to one part of the body or one type of patient. I like the role of consultant and actually enjoy helping clinicians sort through difficult imaging findings (unless its the 3rd time I've done it on the same patient). I like the occasional procedures, even on non interventional rotations.

So you need to decide what drives you. If its the work you do with patients and the feeling of helping them, radiology is not for you. If its interesting cases, cool technology, and lots of reading, than radiology will suit you. Good luck.

 

[nuclearrabbit77]

well it looks like im going to be working on some interventional case study. should be cool.

 

[Flankstripe]

ENT is a wonderful field. Tons of diversity, medical and surgical treatments for any age group from peds to the elderly, and of both genders. You could run a primarily medical clinic, and stay out of the OR, or if you love the OR, you can dig into very fine detail with otologic surgery or microvascular work, play with endoscopes all day in rhinology, get into all sorts of interesting laser and implant applications in laryngology, hack through big cancer cases in head and neck, and if you get tired of the above, go into cosmetics via Facial Plastics or General Plastics like so many ENT graduates these days.

All this in a very laid-back field with nice working hours (outside of residency) which in many areas is very immune to turf wars. Yes, you compete with Plastics, Ophtho, OMFS, and Derm for cosmo, and General Surgery for thyroids, parotids, and the like, but no one is going to mess with the ear (neurosurgery doesn't do PE tubes, mastoids, nor ossicular stuff, nor BAHA's or cochlears), nor the sinuses, nor the larynx, nor most of the big head and neck ca. The number of ENT graduates each year is also very low, so there is an abundance of jobs available in North America.

I've yet to meet a bitter ENT surgeon.

On the other hand, if doing lots of clinics doesn't spark your interest, then ENT may not be for you. By definition, a lot of ENT patients are healthy patients (except the head and neck ca guys), and that means lots of outpatient clinics and outpatient followup. In a larger and more global approach, if working with patients just isn't your thing, than ENT may not be the best fit for you.

Radiology is also a super-cool field. It is by a long shot the most technologically-involved specialty. There's new stuff coming out all the time, whether that be bigger magnets, faster CT's, physiologic imaging using PET, all sorts of newer, faster, and bigger gadgetry. No office, no overhead (unless you own an imaging center, which can be a great adjunct to hospital-based work), lots of people contact and clinician contact (just not patient contact, unless you want it), and even more than ENT, huge diversity in the possibilities of practice.

As a general radiologist, you need to know all diseases for all age groups for all organ systems in both genders, and you need to know this for every imaging modality. If you subspecialize, you'll be expected to know the anatomy and path as well as, if not better than the subspecialist surgeon in that area, if you want to generate the most useful and helpful reports. You can do diagnostics, or interventional, or both.

Is this field as well-protected as ENT, probably not. It will be very interesting to see how Radiology responds to clinicians who can self-refer imaging studies to their clinical group to bypass the radiologists. It will be very interesting to see how Radiology responds to the possibility of outsourcing, and all the associated politicoethicomedicolegal BS that will result. If radiologists do not continue to read all studies in a timely manner (and this ability is only going to get worse as imaging usage increases further and the older baby boomer radiologists retire) you will see a nice big void that the clinicians and outsourcers will only be too happy to try to fill.

Interventional is facing a big onslaught by the cardiologists and vascular surgeons, in the same way that cardiac imaging has been taken over by the cardiologists and OB imaging has been taken away by the obstetricians. Maintaining our turf is going to be a big struggle for Radiology both now and in the future.

Still, it's a wonderful field as far as I can see as a fourth year med student who was once interested in ENT and is now heading full-tilt for a Radiology residency.

 

[samsoccer7]

Amen brotha'. I was full-tilt neurosurg, then 1/2 tilt ENT, and ultimately I'm planning on rads with neuroIR. I think the patient contact factor is overly expressed as reasons not to do radiology, and I think there's some truth behind it. My girlfriend, who is/was gung-ho internal med, is questioning it herself because she hates doing all that floor work, dealing with medically odd patients and micromanaging urine output and BUN levels. On the other hand, I think I would enjoy the neuroIR work because it DOES include significant patient care, although it doesn't consume as much time as it would for say a neurosurgeon, who spends all kinds of time in the SICU and MICU when not in the OR. Regardless rads seems pretty badass, and the more I learn about it, the more I want to learn even more about what's around the corner. Sorry for rambling...

 

[ktat72]

hey samsoccer7, i know of one guy from my school this year (he is a final year) who also wants to do neurointerventional radiology. thought i might tell you what he did this year - he applied to both neurosurgery and radiology programs - someone was telling me that the neurosurgery residency and a fellowship afterwards would take less time of training than radiology with interventional then neurointerventional. do not know many details about that, but you might want to find out from some faculty at your school.

 

[nuclearrabbit77]

flankstripe..thanks for your post. i feel the same way about ENT, and by no means am i discounting it..i'd feel lucky if i even got into a program it's so dang competitive these days. we'll see...i still have a way to go. guess first thing to do is get more exposure to both fields....particularly radiology.

 

[samsoccer7]

ktat72... I'm gonna say tell that person do go do neurosurgery, but the reality is this:

Neurosurgery - 7 yrs plus 1-2 neuroIR

Radiology - 5 yrs plus 2 neurorads/neuroIR

Do the math and you'll see. Of course, a neurosurgeon doing neuroIR will have all the patient control, but all that training in spine, VP shunts, muscle biopsies, etc. will become useless, whereas the training in rads will always be helpful when the newest technology and imaging standards show up, leaving the neurosurgeons with "old" technology. Don't know what turf will be like in the future, but it seems like there's plenty of work for everyone to be relatively happy. Opinions?

 

[Flankstripe]

I suppose the good thing is that if you have the numbers to be competitive for one, you have the ability to get into the other as well. I agree with you that getting as much exposure to the two of them ASAP is probably the best thing for you; it's going to be tough to give both specialties an equally strong representation on your CV. If you can set your sights on one of them only, that will make your job of getting accepted that much easier.

Still, if you're only in second year, keep your eyes open as you may very well find something in third year that you like better. Don't close any doors at this early a juncture. You may find that in third year that patient contact (especially big and high volume clinics, such as what is very prevalent in ENT) just isn't worth it to justify the rewards of going to the OR. I dislike clinic with a passion, and since being an ENT without doing them isn't a realistic possibility, decided that I could get enough of a procedural fix through Radiology while still having fun looking at CT's and MR's. One of the things I liked most about ENT was the fact that every single case gets preop imaging, whether that be middle ear, sinus, or head and neck ca cases. I found trying to do that mental 3D reconstructing of those axial and coronal images some of the most enjoyable parts about ENT (anatomy was by far my favorite subject in med school, and nowhere is the anatomy more complicated than in the head and neck).

 

[nuclearrabbit77]

In your reference about cranking your CV towards one specialty, will it be a disadvantage to have differing fields of interest on your CV? i'm supposedly working on projects in ENT and soon will also be on a radiology project. do you think this will come off as a non-committed applicant who vacillates between things?

 

[Flankstripe]

Well, in my own case, I applied to Radiology with an application heavily skewed towards ENT (I didn't figure out the Radiology gig until very late). I suspect that I would have gotten a lot more Radiology interviews had my ENT papers been Radiology ones, and my ENT conference presentations been at RSNA or some other Radiology conferences, and had I the time to develop better Radiology letters of reference.

Still, if you have high enough board scores to be very competitive for ENT, that should be enough to get you interviews at most Radiology programs. I still think ENT is a harder match than Radiology simply because there are so few spots in ENT. It's difficult to match even to the lowest tier ENT programs (if such a thing truly exists), while there are many more lowest tier Radiology programs out there.

 

[nuclearrabbit77]

aye. this sounds like what will happen to me as well. my most recent papers/conferences will be ENT. thanks for the info and i hope you do really well in your rads match.

 

[nuclearrabbit77]

on another note. i was noticing that my school has alot more matches in quantity and at good institutions in Rads versus than the quantity and quality of ENT matches for the last couple years.

 

[Docxter]

In our program, we have two former ENT residents who transferred after their PGY-2 ENT residency into radiology. They both believe they made a good decision.

 

[Docxter]

samsoccer,
The path to neuro IR is:

5 years radiology + 1 year diagnostic neuroradiology + 1-2 years Neuro IR

5-7 years neurosurgery + 1-2 years neuroIR

 

[samsoccer7]

I doubt you can find a 5 yr neurosurgery program these days. And 6 yrs is quite rare too considering the research year-year.5. And yes, NeuroIR is 2-3 extra, but there are several 2 yr fellowships these days, with the 3rd yr usually being reserved for research dawgs.

 

[Whisker Barrel Cortex]

Something else to think of is having a life during that residency period. In radiology, you will have time during residency to enjoy your life. In neurosurgery residency, you will not.

 

[samsoccer7]

Whisker, shhhhh Let him go do neurosurgery!! The residency lifestyle is a big issue for me, considering I can only be in my 20's once (mid-life crisis not included), and even though I'll be working a lot, it'll be nowhere NEAR what I was preparing for in nsurg.

 

[ktat72]

i know that i want to go the radiology route - might think of doing neuro IR but know i will enjoy radiology residency

 

[samsoccer7]

I second that Ktat. I don't like a lot of the stuff neurosurgeons do, to be honest. I like the vascular and tumor stuff, and neuroIR is doing more and more as technology advances, especially the tumor chemo and embolization, ultimately requiring nsurg services anyway, but it's still fairly rewarding I think. I also like the fact that I would have to spend time on the floors, mainly in the ICU, making sure coiled patients (and others) are recovering as expected. Don't forget the stroke patients either, that will be hella rewarding.

Does anybody notice I have lots of time off on my rotation right now?

 

[halwani]

ENT is a wonderful field. Tons of diversity, medical and surgical treatments for any age group from peds to the elderly, and of both genders. You could run a primarily medical clinic, and stay out of the OR, or if you love the OR, you can dig into very fine detail with otologic surgery or microvascular work, play with endoscopes all day in rhinology, get into all sorts of interesting laser and implant applications in laryngology, hack through big cancer cases in head and neck, and if you get tired of the above, go into cosmetics via Facial Plastics or General Plastics like so many ENT graduates these days.

All this in a very laid-back field with nice working hours (outside of residency) which in many areas is very immune to turf wars. Yes, you compete with Plastics, Ophtho, OMFS, and Derm for cosmo, and General Surgery for thyroids, parotids, and the like, but no one is going to mess with the ear (neurosurgery doesn't do PE tubes, mastoids, nor ossicular stuff, nor BAHA's or cochlears), nor the sinuses, nor the larynx, nor most of the big head and neck ca. The number of ENT graduates each year is also very low, so there is an abundance of jobs available in North America.

I've yet to meet a bitter ENT surgeon.

On the other hand, if doing lots of clinics doesn't spark your interest, then ENT may not be for you. By definition, a lot of ENT patients are healthy patients (except the head and neck ca guys), and that means lots of outpatient clinics and outpatient followup. In a larger and more global approach, if working with patients just isn't your thing, than ENT may not be the best fit for you.

Radiology is also a super-cool field. It is by a long shot the most technologically-involved specialty. There's new stuff coming out all the time, whether that be bigger magnets, faster CT's, physiologic imaging using PET, all sorts of newer, faster, and bigger gadgetry. No office, no overhead (unless you own an imaging center, which can be a great adjunct to hospital-based work), lots of people contact and clinician contact (just not patient contact, unless you want it), and even more than ENT, huge diversity in the possibilities of practice.

As a general radiologist, you need to know all diseases for all age groups for all organ systems in both genders, and you need to know this for every imaging modality. If you subspecialize, you'll be expected to know the anatomy and path as well as, if not better than the subspecialist surgeon in that area, if you want to generate the most useful and helpful reports. You can do diagnostics, or interventional, or both.

Is this field as well-protected as ENT, probably not. It will be very interesting to see how Radiology responds to clinicians who can self-refer imaging studies to their clinical group to bypass the radiologists. It will be very interesting to see how Radiology responds to the possibility of outsourcing, and all the associated politicoethicomedicolegal BS that will result. If radiologists do not continue to read all studies in a timely manner (and this ability is only going to get worse as imaging usage increases further and the older baby boomer radiologists retire) you will see a nice big void that the clinicians and outsourcers will only be too happy to try to fill.

Interventional is facing a big onslaught by the cardiologists and vascular surgeons, in the same way that cardiac imaging has been taken over by the cardiologists and OB imaging has been taken away by the obstetricians. Maintaining our turf is going to be a big struggle for Radiology both now and in the future.

Still, it's a wonderful field as far as I can see as a fourth year med student who was once interested in ENT and is now heading full-tilt for a Radiology residency.

Hey! What made you switch from ent to rads out of curiosity. Current rads resident and just wondering what made you make the switch.

 

[Cognovi]

Hey! What made you switch from ent to rads out of curiosity. Current rads resident and just wondering what made you make the switch.

You are asking a user who hasn't posted on this forum in 13 years.