Head & Neck fellowship -> private practice?

[turboE36]

Hi,

Is it worth doing a head & neck fellowship for the sole purpose of further developing surgical skills (namely neck dissections, parotids, thyroids) with the end goal being private practice? I worry because I come from a middle of the road institution where volume isn't particularly high and we only have 2-3 H&N attendings (one of which is only 1 year out of fellowship). Overall, I'm not sure how I comfortable I will feel in the neck by the time I graduate. My overall goal is to become an expert surgeon, however I don't see myself pursuing academics long term for a multitude of reasons.

---

Members don't see this ad.

 

[clinicallabguy]

I'm not sure how far along you are in residency so you may find you get much more comfortable with these cases in PGY4-PGY5. You can discuss this with your co-residents from your program and graduates of your program. Are graduates from your program doing necks/thyroids/parotids in private practice?

If you foresee Head and Neck Onc dominating your practice, then doing a fellowship may make sense for you. Ultimately, it will be you that has to decide of course.

 

[turboE36]

How do fellowship directors view applicants who wish to do private practice in the long term? Does that put one at a disadvantage?

Also, is a H&N fellowship trained ENT compensated more than a general ENT in private practice (admittedly a very, open-ended question)?

 

[Pir8DeacDoc]

Have you considered an endocrine fellowship? Head and neck fellowship is for jaws, tongues, totals, flaps. Not for someone that wants to do a nice parotid or thyroid.
At least in my area in private practice, necks are rarely done. I do one or two a year. Most everyone gets radiated now. And post radiation neck is not for the weak at heart.

 

[turboE36]

Have you considered an endocrine fellowship? Head and neck fellowship is for jaws, tongues, totals, flaps. Not for someone that wants to do a nice parotid or thyroid.
At least in my area in private practice, necks are rarely done. I do one or two a year. Most everyone gets radiated now. And post radiation neck is not for the weak at heart.

I've never heard of this. Is this something that exists in the US? I'm assuming this is different than a endocrine surgery fellowship that gen surg residents do.

 

[Pir8DeacDoc]

Fellow In Thy And Parathy

first one that pops to mind. I am sure there are others.

 

[OtoHNS]

Fellow In Thy And Parathy

first one that pops to mind. I am sure there are others.

There's also a prominent fellowship in thyroid surgery at Medical College of Georgia (David Terris).

Though personally, I'd rather shove an icepick into my eyeballs repeatedly than spend a whole year just doing thyroidectomies every day.

 

[TonsilPlucker]

Hi,

Is it worth doing a head & neck fellowship for the sole purpose of further developing surgical skills (namely neck dissections, parotids, thyroids) with the end goal being private practice? I worry because I come from a middle of the road institution where volume isn't particularly high and we only have 2-3 H&N attendings (one of which is only 1 year out of fellowship). Overall, I'm not sure how I comfortable I will feel in the neck by the time I graduate. My overall goal is to become an expert surgeon, however I don't see myself pursuing academics long term for a multitude of reasons.

Define what is "worth it"? If your goal is to practice advanced Head and Neck Oncologic surgery in PP, then it is certainly worth it to pursue a fellowship and feasible to have a H/N practice. A lot of the private H/N guys do the extirpation and leave the recon to plastics, your mileage may vary depending on what you want and what the plastics guys want to offer. Now, if you just want another year of surgical experience and don't plan on doing any surgeries that general guys pass on (as others mentioned totals, mandibulectomies, post-radiated surgeries, TORS, central necks), then I'd think hard before considering fellowship. I don't think the practices hiring you would be very happy either if you come in offering one thing and end up just doing what all the other guys were doing anyways.

Just in the major metro area that I am in, I can think of several private H/N guys working either in true PP or multi-specialty groups (think Kaiser). And yes, there are several major academic programs with residencies and fellowships nearby as well and nobody seems to be hurting in business.

 

[TonsilPlucker]

Hi,

Is it worth doing a head & neck fellowship for the sole purpose of further developing surgical skills (namely neck dissections, parotids, thyroids) with the end goal being private practice? I worry because I come from a middle of the road institution where volume isn't particularly high and we only have 2-3 H&N attendings (one of which is only 1 year out of fellowship). Overall, I'm not sure how I comfortable I will feel in the neck by the time I graduate. My overall goal is to become an expert surgeon, however I don't see myself pursuing academics long term for a multitude of reasons.

Another thing to consider is what year you are at in training. 5th year really is where most things come together. At more top heavy programs, your advanced operative experience will occur at that time. Even as a know it all end of year 4th year, I was amazed at how much more I learned as a chief... and continue to do so in practice.

If you are a 5th year and are feeling this way, maybe some sort of fellowship is the better choice. If you are not, then give it time. I know people who did a few years of PP and the went back for a fellowship. The pay cut sucks but most were pretty happy with their choice.

Sent from my SM-N950U using Tapatalk

 

[tubes12]

On a related note, what are your thoughts on Rhinology or Otology fellowships if someone ends up doing hospital employed or PP? Do either help with marketing, or can they actually make you less desirable for a PP?