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Any questions about ENT? A lot of discussion about match issues at otomatch.com, but I haven't seen a lot of general discussion here.
ENT questions
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Do programs usually have a minimum Step 1 score requirement (like, they won't look at an app unless it's above a certain number)?
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Some programs might.
However, no program has stated officially that there must be a minimum Step I score.
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Originally posted by doc05
any chance of matching without AOA?
Yes.
what's the typical caseload like in private practice? Is it all tubes and tonsils?
No.
I'm working with a private practice physician right now. He does tubes, tonsils, septoplasties, FESS, parotidectomies, keloid excisions, panendoscopies, vocal cord stripping, excisional biposies, tracheotomies, blepharoplasties, inferior turbinate reductions, UP3s, simple tympanoplasties, simple mastoidectomies.
There's quite a variety.
Bottom line: if you want to do major head & neck cases, become a faculty member. Private practice life can be as lucrative/financially draining and easy/hard as you want it.
any chance of matching without AOA?
Yes.
what's the typical caseload like in private practice? Is it all tubes and tonsils?
No.
I'm working with a private practice physician right now. He does tubes, tonsils, septoplasties, FESS, parotidectomies, keloid excisions, panendoscopies, vocal cord stripping, excisional biposies, tracheotomies, blepharoplasties, inferior turbinate reductions, UP3s, simple tympanoplasties, simple mastoidectomies.
There's quite a variety.
Bottom line: if you want to do major head & neck cases, become a faculty member. Private practice life can be as lucrative/financially draining and easy/hard as you want it.
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I am also doing a private practice rotation right now, and they do everything but cochlear implants, free flap reconstruction, acoustic neuroma, and peds airway recon. They do thyroidectomy, head and neck cancer resection (did partial glossectomy/bilateral neck dissections a few weeks ago), all of the cases that neutropeniaboy listed above, rhinoplasty, facial skin cancer excisions, etc. Have done stapedectomies here as well.
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if your step one is below 180, most places wont look at your application. i've been told this by several program directors so you can pretty much bank on getting rejected if you're below 180 on step one and in the bottom 10 percent of your class, or if you've committed a felony lately.
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im a second year doing some ENT clinic shadowing. i want to get a text that is manageable. which one should i get? going to post this on otomatch as well.........
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Depending on your level of interest:
"I want to cover my bases" -- Lucente's Essentials
"I want to impress" -- ENT Secrets
"Damn the other students!" -- Pasha
Both Lucente and Pasha will fit in your coat pocket. Secrets is more of an "at home" read.
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thanks alot neutropeniaboy =)
could anyone describe some aspects of the different post-graduate fellowships available after finishing an ENT residency (facial plastics/head-neck oncology/ped/etc.....)
1)career pathways i.e. (academic/private)
2)salary
3)competitiveness to enter
4)pros and cons of each
could anyone describe some aspects of the different post-graduate fellowships available after finishing an ENT residency (facial plastics/head-neck oncology/ped/etc.....)
1)career pathways i.e. (academic/private)
2)salary
3)competitiveness to enter
4)pros and cons of each
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how popular is it to do externships for ENT? how many? i've heard some good arguments against doing them. what do you guys think?
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None are required.
However, I recommend you do at least one. I've continually told students that it can help you tremendously to get letters from other program directors to augment your application to ENT residencies. Furthermore, it can assist you in getting a good feel for what residency (and career) of an otolaryngologist is like and specifically how certain programs operate.
In short: do them.
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I think they are very important. You should consider doing 1 or 2 externships. A strong externship will help your application at a program more than anything else will, it is essentially a month long interview.
I did an externship at a program (not my residency program) and was told at my interview that if I ranked that program #1, I _would_ go to that program.
If your step 1 scores or application is borderline, it is ESSENTIAL to do externships to give you a heels up when you apply.
One thing to consider also is not doing externships at TOP TOP programs, just do them at midrange programs that you would enjoy training at. Your chances there will probably be better as they won't have as many externs rotating there.
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Head and Neck--really trains you to do microvascular recon (free flaps). Generally 1 year long. You will have lots of sick patients, and patients who will stay in the hospital for long periods of time (occasionally weeks at a time). Think, you are operating on 50-80 year olds who have smoked their whole lives, have heart and lung disease, diabetes, and now you give them an upper aerodigestive tract malignancy. Great chances for cure, you will have lifelong patients who will praise your name and bring you food, but it is a commitment worth thinking about. There are many who believe that a free flap surgeon only has a set "free flap life" before they burn out. Not too many doing free flaps in private practice. Not as competitive as other fields
Facial plastic surgery -- $ $ $, 1 year after residency. You have to be willing to put up with patients with psychological problems, many of these patients are unpleasable and you start monkeying around with their noses and eyelids and faces. More possibility for ca$h here than with other fields. Mostly private practice, some programs have academic facial plastics folks who run fellowships. Top fellowships are competitive
Peds -- 2 years, you really do this to learn peds airway reconstruction (laryngotracheoplasty, cricotracheal resection, cricoid split, etc). Everything else in peds oto can be done by a well trained general oto person. Mostly academic or associated with a childrens hospital. There are some in private practice. Top fellowships are Cincinnati and Pittsburgh, others not as competitive
Otology-Neurotology - 2years, you do this to learn acoustic neuroma resection, skull base surgery, complex skull base approaches, refine your ability to do complex otologic surgery and cochlear implants. Many folks are in academics, some in volunteer clinical faculty posts and private practice. Top fellowship is House Ear Clinic in LA, others not as competitive
Sinus -- high potential for $, largely 1 year fellowships. Not too many out there.
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thanks, that was very informative.
in regards to not doing externships at TOP skools, i understand the reasoning...but you could still end up with a good letter of rec from some big-honcho out of it couldn't you?
i was also curious to know how ENT residency program's are "ranked"...is it off the U.S. news hospital-ENT list? not like it matters that much to me..but how does a program named, Summa Health System, Akron, Ohio get ranked 32, while a bigger named school like Yale is 40. and...the cleveland clinic is ranked 9,.....so much higher than alot of other programs that i thought would be better...i.e. university of washington...wash U...and others. bah. FUK USNEWS. they didnt know crap about med schools i shouldnt expect them to know anything about hospitals as well.
http://www.usnews.com/usnews/nycu/health/hosptl/rankings/specihqotol.htm
odd...
in regards to not doing externships at TOP skools, i understand the reasoning...but you could still end up with a good letter of rec from some big-honcho out of it couldn't you?
i was also curious to know how ENT residency program's are "ranked"...is it off the U.S. news hospital-ENT list? not like it matters that much to me..but how does a program named, Summa Health System, Akron, Ohio get ranked 32, while a bigger named school like Yale is 40. and...the cleveland clinic is ranked 9,.....so much higher than alot of other programs that i thought would be better...i.e. university of washington...wash U...and others. bah. FUK USNEWS. they didnt know crap about med schools i shouldnt expect them to know anything about hospitals as well.
http://www.usnews.com/usnews/nycu/health/hosptl/rankings/specihqotol.htm
odd...
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i figure i'll apply everywhere and take it from there. i imagine that's how it goes for most people.
Hey guys,
Thanks for the great information. I'm new on the Oto trail as a third year and was wondering what is the time frame for applying for externships. I've heard you should contact the school around March-April. Is that too late, early? Thanks in advance.
~da shwam
Thanks for the great information. I'm new on the Oto trail as a third year and was wondering what is the time frame for applying for externships. I've heard you should contact the school around March-April. Is that too late, early? Thanks in advance.
~da shwam
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I wouldn't apply everywhere. You get a diminishing return for every dollar spent on each additional program to which you apply.
However, there is the school of thought that it would be MORE expensive to apply to programs again a SECOND time around.
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The US News and Word Report is one way of viewing hospitals from the standpoint of patients. That's how I've seen the reports framed. The reports obviously do not rank residency programs, and the authors certainly do not intend to do any sort of analysis with respect to how good the training facilities are, what the clinic/case load is like for residents, whether the residents get along, or what the program's rate of board passing/fellowship awards/etc. are.
There is some truth in the rankings, however. Yale is not spectacular. The quality of a school's medical school does not necessarily imply that their ENT program is of the same caliber. Take Duke, for example. Great medical school. Mediocre residency program. U. Penn: great school, great program. JHU: great school, great program. Ohio State: average medical school, kick ass program.
That's why it's really important to talk to your program director and to do away rotations.
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Yes but in my opinion that's not why you should do an externship. It might be a bonus, but the main reason should be to highly increase your chances of matching at that program. With the competitiveness of ENT, it's nice to know that you have a program where you are more likely to match, especially if you have gotten feedback about it during or after your externship
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do you guys know the average number of interviews a person who matches into ENT receives? also, how far down the match list is average?
just curious....
just curious....
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I'll start with cons. You deal with the head and neck and largely don't deal with other areas of the body. This is also one of the pros. There is a lot of clinic, which some dislike.
Pros:
1) Mix of medicine and surgery
2) Need for understanding of large amount of organ systems and physiologic/pathologic processes in the head and neck
3) Complex anatomy
4) Varied surgeries...everything from simple skin surgery to complex airway, head and neck tumor, ear , sinus, and skull base procedures
5) Many patients are dealt with as outpatients, lowering the inpatient load and therefore time expenditures (Head and neck is the exception)
6) Excellent compensation
7) Relatively more controllable lifestyle compared to other fields
8) Opportunity to sub-specialize and mold practice to individual tastes
9) Opportunity to branch out--some graduates choose to do general plastic surgery training
10) Generally healthy patients (head and neck is the exception)
11) Large amount of peds if you desire
12) Job market is outstanding, essentially controlled by the residency numbers (240-250 grads/yr), see #6
There are more
