ent vs urology practices

[boarditis]

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I am really torn between these two fields. What are the differences lifestyle wise as you guys see it?

It seems that more ent procedures are day surgery with patients you dont
have to round on. It seemed all the folks we took to the OR in urology ending up staying at least for the night.

How different are these lifestyles at the attending level. It seemed the ENT residents and attendings were leaving around 6 or earlier while the uro folks were there until 8.

Finally the dreaded question..from what i have been told ent and uro incomes are generally quite comparable? Anyone have comments on this?

 

[Leforte]

The lifestyles are similar.

The incomes are similar.

It seems nearly every med student now bases career decisions based on lifestlye and money. If you don't want to round on a post-op day #1 patient, and are basing career choices on this - don't go into surgery. If you are having difficulty deciding on a specialty because one averages $325k/yr and the other $350k/yr, a little perspective is needed. Are there any students who still have a passion for their perspective fields?

We have been having a rash of students rotating recently that want to know more about $$$ and time off, both during and after residency, yet haven't read about a single surgery they've scrubbed in on. That's OK, though - I can help make their decision for them 😡 Nothing wrong with scrambling into family med.

 

[DwightKShrute]

Are there any students who still have a passion for their perspective fields?

It's quite possible the OP has passion AND is interested in lifestyle/salary.

Besides with the board score the OP has, I'm not so sure you'd want to close the door on him/her so quickly.

 

[thedrjojo]

i kinda agree with LeForte on this one...

I'm a MSIII and kinda get sick and tired of seeing my fellow students whine and moan about the hours or effort we put into it, or are more interested in the salary/hours...

I might be young and nieve (I've only done 4 overnight calls (which ended up being about q7 for them) but i had a blast going into the OR at 3am (even if it was for an emergency C-section on OB) and then going into the OR again at 6am for a ruptured ectopic... I'd rather be interested and stimulated than sit and read a magazine while the surgeons did all the fun stuff on the other side (anesthesia) or sit in a dark room looking at a computer screen, getting called up all day to read a film (radiology)...

I think what the OP is also missing is that, once you are in practice, you create the practice you want. If you have an office based practice you can set your hours, probably in any field. Are you going to be resecting huge SCC in your office? No, but you can place 10 tubes by lunch and be done in time to see the kid's ball game? If you set your schedule like that, then sure.

And i think thats pretty bad that those student's didn't read up... bad yes, surprising, no... Are they seeing ENT as part of their general surgery clerkship, or is it as an elective they signed up for?

 

[Pir8DeacDoc]

Who cares what his board scores are??

As residents we all know people with top notch board scores and pedigree who suck as doctors and are painful to work with. A strong work ethic and devotion to your work makes you much better than someone who does well on standardized tests.


As far as lifestyle I'd argue that in residency ENT has it worse. What is the uro equivalent of our head and neck marathon cases? What sort of trauma do the Uro folks cover? I can assure you face trauma is more common than bladder injuries.

Overall it's what you see yourself doing. They are similar fields in terms of money and lifestyle. Lots of diagnostic procedures (cystos and flexible laryngoscopy). SO do what seems cool to you and the residents you could see yourself working with.

 

[boarditis]

Well I didnt meant to stir up such a storm here. I do love urology and surgery. I dont mind rounding on anyone. I ask the lifestyle issue because these things arent on my mind now but I have seen residents in both fields tell me they should be.

I have heard surgery residents in both urology and ent say "go derm". "even if you love this now you may feel differently in 10 yrs"

Trust me i am not someone only interested in lifestyle but after hearing all the complaining i have from residents I figured its something I should make myself aware of.

 

[Leforte]

No offense taken -

Residents, in general, like to complain. Let's face it, residency sucks no matter what field you're in - and the grass is always greener in another field.

When you complete your training, you can decide on what type of practice/lifestyle you wish to develop. If you want to work 40 hrs per week and do only outpatient surgery - you can. Send anything complicated to your partners (if they do it) or to a tertiary referral center. In general, the remuneration is higher if you do only bread and butter, and the lifestyle better. Hence, the reason why most private docs (at least in my field) do the easy, fast turn over, high volume, less risk surgeries. It is not that they weren't trained on the complicated stuff - just that they look at the economics and decide that their time is better spent on income generating activities. In academics, there are residents to take care of the post-ops, weekend rounding, ED consults, etc that are unavailable to the private docs. The academician is more likely to have a couple rooms running, with senior residents in one room taking care of the more mundane parts of a case, and can focus on a critical portion in another room. Because of this, their productivity goes up and remuneration increases due to increased volume to make up for the labor intensive/less pay per hour invested cases.

That being said - there are a few of our attendings who work long hours - most do not. I think that the private attendings, in general, work similar hours, but spend more time on administrative things (billing, coding, office management, etc) that the academician does not.

So to make a long story short - many ENT procedures are same day surgery (esp facial plastics, otology, laryngology) others pts spend a day + post op (head and neck) but I think that you'll find that once in practice, most spend the majority of their OR time in private practice with same day surgery and the occasional pt who stays overnight for a day or two. I can't speak about urology (never worked with them) - but I hear it is similar (a lot of cystoscopies in private, I'm told).

Go shadow a couple private guys in each field to get a feel of what they do in clinic and ask to see their recent operative cases to get a feel for their breadth of surgical practice. Most are keen to have an interested medical student and wouldn't mind showing you the ropes.

 

[TheThroat]

The way I look at it, it really comes down to this: how much do you like the penis?

(this, of course, is strictly from a medical point of view)

Personally, I've never been found the penis stimulating.

(also, purely stated from a medical standpoint)

 

[KitesurfDaEarth]

I was in the same position last year. I rotated thru both Urology and ENT services at my respective institution. (By the way, I am pretty sure I am pretty sure I rotated thru LeFort's Service) I've shadowed private practice ENT's and my father is a urologist in a private practice. The great thing about both fields is you can tailor your practice to suit your lifestyle. Ultimately the reason I picked ENT was because I found the surgeries more interesting, and I thought the fellowship options were much more diverse

 

[drivesmecraazee]

I was in the same position last year. I rotated thru both Urology and ENT services at my respective institution. (By the way, I am pretty sure I am pretty sure I rotated thru LeFort's Service) I've shadowed private practice ENT's and my father is a urologist in a private practice. The great thing about both fields is you can tailor your practice to suit your lifestyle. Ultimately the reason I picked ENT was because I found the surgeries more interesting, and I thought the fellowship options were much more diverse

What about the clinic in both specialities? Which one appealed more interesting to you? I think the medical side of both specialities is very important since you don't spend more than 3 days in the OR (maybe you do in academics but not in private practice)

 

[drivesmecraazee]

Anyone else deciding between this too or did rotations in both can feel free to answer my question...👍