ENT without the "E"

[Dunce]

I'm trying to figure out if Otolaryngology is a good fit for me and if I really want to pursue it.

I would appreciate any advice that those of you who frequent this board might be able to offer. Hopefully, some others in a similar position might also learn something from your comments.

Please read on if you have a few minutes to spare. This is going to get lengthy.

This isn't one of those am-I-good-enough threads.
I'm not overly competitive but my grades are OK, step 1 is average for the field, and I have a handful of transplant surgery but non-ENT pubs from the year before medical school. If I end up applying I'll have to bust my tail just as much as the next guy.

Here's the main issue:

I'm in the middle of my 3rd year and I'm set on either ENT or general surgery and then likely a fellowship after that. I loved my surgery rotation but don't particularly care too much for taking care of the super sick patients who take up residence in the SICU for extended stays. I also would be perfectly happy to never again have the "opportunity" to go fishing around in someone's abdomen or anus for a few hours. Also I haven't yet had exposure to a surgical fellowship that grabs me like ENT and it's fellowship opportunities do.

I absolutely love head and neck anatomy, and that is certainly what first peaked my interest in otolaryngology.
What has me a bit hesitant is that I don't particularly find the Otology aspects of ENT to be very exciting. Admittedly, I have zero first hand exposure to this aspect of the field and am basing my decision on a lack of interest in what I know of the general pathophysiology of the ear and some of the treatments available for those disorders.

I find myself drawn primarily to the types of cases that would be handled by someone trained in Head&neck or in facial plastics and could easily see myself pursuing a fellowhip in either one.
Nasal and sinus disorders also have some appeal for me, but I just don't care too much for the ear. Are there others who have felt this way at some point and still decided that ENT was the right fit?

I really like what I have seen of ENT and read about so far; however my exposure is severely limited. Unfortunately, I don't have the opportunity to do a 3rd year ENT rotation at my school, so I would have to schedule all electives and aways at the beginning of my 4th year. Also my school doesn't have a residency program and really doesn't have an official ENT department for that matter.

I used every opportunity I could during my general surgery rotation to sneak into the OR with some of the ENT attendings for a few cases here and there. However, I won't likely have the opportuniy to continue doing so over the next few months on my other rotations.

I will have to start working on my 4th year schedule in the coming months, so I am trying to figure things out sooner rather than later and get hooked in with a good advisor at my school who can help me out.

Hopefully, some of you can also give some words of wisdom.
Thanks for reading if you made it this far. I appreciate all of the advice that has been offered on SDN.

---

Members don't see this ad.

 

[aggernodi]

I would suggest getting some exposure to otology first, especially the cool (and fairly simple) cases like cochlear implants, tympanomastoidectomies, tympanoplasties, mastoidectomies, to the more radical which may grab your interest more like temporal bone resections.

I initially was like you, but the more I got exposed to the ear (which wasn't until my PGY4 year), the more I came to enjoy it. If your ENT department has a temporal bone course, I highly recommend you participate.

Not that finances is or should be a concern, but ear cases also pay very well for the amount of time (I'm not talking about tubes, but the cases I listed above).

 

[resxn]

I find myself drawn primarily to the types of cases that would be handled by someone trained in Head&neck or in facial plastics and could easily see myself pursuing a fellowhip in either one.
Nasal and sinus disorders also have some appeal for me, but I just don't care too much for the ear. Are there others who have felt this way at some point and still decided that ENT was the right fit?

I loved most everything in ENT when I was in residency, but the way that my practice has panned out, I just don't see much significant ear disease these days. However, this is ok by me because of all the things in ENT, ear was probably my least favorite. It was the one surgical area that to me was just highly repetitive. I don't know if others feel that way or not. I do regular ear stuff like tubes, tympanoplasties, mastoids, BAHA's, but I've given up on revision mastoids, cochlear implants, otoplasties, stapes and other OCR's just because of the way my practice has developed. However, I don't mind it at all. In fact, I find that I enjoy not doing much in the way of ear surgery anymore. I am much more into thyroid disorders and sinus disease anyway, so it worked out well for me.

I know many people in residency who had a least favorite part of ENT, for some it was laryngology, for others cancer, for others peds. Didn't matter one bit for their overall happiness in training--but ours was a very well-balanced program. If you go to a program that is huge into ears, then it might be tougher.

Having said that, if you really are thinking of doing a fellowship it won't matter much. As a fellow in another area, you won't have to deal with otologic stuff that much. Even if you take general call as a head and neck surgeon or other fellowship-trained guy, it won't be often that you'll have to scrub an ear case--most can wait until your partner or colleague can handle the patient the following morning or later.

In any field, loving 2/3 ain't that bad.

 

[Dunce]

thanks for the advice

 

[TheThroat]

The thing I really like about oto is how diverse the surgeries are. Ear surgery (which I love, BTW), is really nothing like endonasal surgery, which is nothing like open neck surgery.

You can really tailor your practice to what you like and refer to partners what you don't. I send my partner any rhinoplasty surgery and he send me all of the ears he doesn't want to do.