Field of ENT QUESTIONS

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OtoNEC1

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Hello all, long time lurker on here. I'm a m3 who will be apply for ENT next year. I wanted to get everyone's opinion on a couple questions I had about the field of ent.

1. What is the long term outlook of the field? Any changes or direction (good or bad) people feel the field is going?

2. What is it like for an ENT attending in terms of OR Vs clinic? I love the ability for an ENT to operate as much or as little as he or she wants. Is this still an option?

3. What is the long term realistic day in and day out life of an attending? Especially if you are a general ENT without subspecialty.

4. What is ENT residency like in terms of cases. Is it all H and N onc? Is it all complex head and neck anatomy? (I feel like I haven't covered the complex stuff since 1st year anatomy class)

4.5 Also what are the estimate hours like as a resident. We've all seen surgery residents work the "80hr" (really above that) or is the field one where it's pretty respected in terms of that? I am not afraid to work more hours I just want a realistic expectation.

5. Anything you wished you knew before going into residency and if you had to choose a field again in medicine would it be ENT?


Thanks!

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Hello all, long time lurker on here. I'm a m3 who will be apply for ENT next year. I wanted to get everyone's opinion on a couple questions I had about the field of ent.

1. What is the long term outlook of the field? Any changes or direction (good or bad) people feel the field is going?

2. What is it like for an ENT attending in terms of OR Vs clinic? I love the ability for an ENT to operate as much or as little as he or she wants. Is this still an option?

3. What is the long term realistic day in and day out life of an attending? Especially if you are a general ENT without subspecialty.

4. What is ENT residency like in terms of cases. Is it all H and N onc? Is it all complex head and neck anatomy? (I feel like I haven't covered the complex stuff since 1st year anatomy class)

4.5 Also what are the estimate hours like as a resident. We've all seen surgery residents work the "80hr" (really above that) or is the field one where it's pretty respected in terms of that? I am not afraid to work more hours I just want a realistic expectation.

5. Anything you wished you knew before going into residency and if you had to choose a field again in medicine would it be ENT?


Thanks!

1. What is the long term outlook of the field? Any changes or direction (good or bad) people feel the field is going?

Outlook is good. ENT is a small field with limited residency spots. Good jobs are still available throughout the country. More and more ENTs are employed in large specialty groups or hospital-owned rather than solo private practice, but this is not a unique feature ot ENT.

2. What is it like for an ENT attending in terms of OR Vs clinic? I love the ability for an ENT to operate as much or as little as he or she wants. Is this still an option?

Most ENTs are in clinic 3-3.5 days per week. You can do procedures in clinic and plenty of people are doing plastics or sinus stuff in the office. For fellowship trained ENTs (about 50% of new grads), some specialties skew more operative (head and neck, plastics) and some skew more clinic (otology, laryngology).

3. What is the long term realistic day in and day out life of an attending? Especially if you are a general ENT without subspecialty.

Varies incredibly by location,training, desire. You have a lot of freedom in ENT.

4. What is ENT residency like in terms of cases. Is it all H and N onc? Is it all complex head and neck anatomy? (I feel like I haven't covered the complex stuff since 1st year anatomy class)


Depends on program, but every program is required to give you a solid foundation in all aspects of ENT (the so-called "key indicator" cases). Inpatient ENT is dominated by H&N cancer and complex reconstruction because those are the patients that require post-op stays. Our skull base patients are mostly managed by neurosurgery and everything else is outpatient or consult-based. On pediatrics there are the airway kids, but at most places those aren't so frequent.

That being said, you will see a mix. My program is head and neck heavy (six months as PGY2, three months as PGY3/4/5) but it's still only a fraction of what I see in residency.

ENT is complex head and neck anatomy. That's why we like the field. You're going to learn way more than you ever thought was possible compared to M1 anatomy. Your value as a surgeon is tied to your unique mastery of head and neck anatomy.

4.5 Also what are the estimate hours like as a resident. We've all seen surgery residents work the "80hr" (really above that) or is the field one where it's pretty respected in terms of that? I am not afraid to work more hours I just want a realistic expectation.

Depends on program and depends on rotation. Most ENT programs aside from peds heavy are "home call" which can either mean a pretty quiet call schedule or being up all night every night with no post-call days.

This is not medicine where you get some cushy rotations (aside from research, lol) and some hard rotations. Every rotation should be busy. H&N and peds tend to busiest areas, so programs with a lot of those patients will keep you routinely at or over 80 hours.

5. Anything you wished you knew before going into residency and if you had to choose a field again in medicine would it be ENT?

Nothing specific. The importance of finding a program that fits you cannot be overstated. You'll spend 5 years with these people, and will see them more often than your friends or family. I love ENT and am incredibly satisfied with the field.
 
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1. What is the long term outlook of the field? Any changes or direction (good or bad) people feel the field is going?

Outlook is good. ENT is a small field with limited residency spots. Good jobs are still available throughout the country. More and more ENTs are employed in large specialty groups or hospital-owned rather than solo private practice, but this is not a unique feature ot ENT.

2. What is it like for an ENT attending in terms of OR Vs clinic? I love the ability for an ENT to operate as much or as little as he or she wants. Is this still an option?

Most ENTs are in clinic 3-3.5 days per week. You can do procedures in clinic and plenty of people are doing plastics or sinus stuff in the office. For fellowship trained ENTs (about 50% of new grads), some specialties skew more operative (head and neck, plastics) and some skew more clinic (otology, laryngology).

3. What is the long term realistic day in and day out life of an attending? Especially if you are a general ENT without subspecialty.

Varies incredibly by location,training, desire. You have a lot of freedom in ENT.

4. What is ENT residency like in terms of cases. Is it all H and N onc? Is it all complex head and neck anatomy? (I feel like I haven't covered the complex stuff since 1st year anatomy class)


Depends on program, but every program is required to give you a solid foundation in all aspects of ENT (the so-called "key indicator" cases). Inpatient ENT is dominated by H&N cancer and complex reconstruction because those are the patients that require post-op stays. Our skull base patients are mostly managed by neurosurgery and everything else is outpatient or consult-based. On pediatrics there are the airway kids, but at most places those aren't so frequent.

That being said, you will see a mix. My program is head and neck heavy (six months as PGY2, three months as PGY3/4/5) but it's still only a fraction of what I see in residency.

ENT is complex head and neck anatomy. That's why we like the field. You're going to learn way more than you ever thought was possible compared to M1 anatomy. Your value as a surgeon is tied to your unique mastery of head and neck anatomy.

4.5 Also what are the estimate hours like as a resident. We've all seen surgery residents work the "80hr" (really above that) or is the field one where it's pretty respected in terms of that? I am not afraid to work more hours I just want a realistic expectation.

Depends on program and depends on rotation. Most ENT programs aside from peds heavy are "home call" which can either mean a pretty quiet call schedule or being up all night every night with no post-call days.

This is not medicine where you get some cushy rotations (aside from research, lol) and some hard rotations. Every rotation should be busy. H&N and peds tend to busiest areas, so programs with a lot of those patients will keep you routinely at or over 80 hours.

5. Anything you wished you knew before going into residency and if you had to choose a field again in medicine would it be ENT?

Nothing specific. The importance of finding a program that fits you cannot be overstated. You'll spend 5 years with these people, and will see them more often than your friends or family. I love ENT and am incredibly satisfied with the field.

That was a great response! When did you know that ENT was the correct field for you/what do you love most about it??
 
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