Otolaryngology Residency in 4 Years – Outlook

[MDterminator]

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As an incoming MD student strongly considering otolaryngology, I’ve been keeping a close eye on the trajectory of the field. Interest in ENT is clearly rising, with over 550 applicants for just 361 spots in the 2025 cycle. At the same time, more medical schools—especially DO programs—are opening every year, further expanding the applicant pool. While the MD/DO merger was meant to streamline access, the reality is that many DOs still face limited access to ENT training, and overall GME growth hasn’t matched this surge in graduates.

The pressure to stand out is only growing. ENT now averages 17 abstracts and presentations per matched applicant, and many students are opting for a dedicated research year just to remain competitive. Programs have added tools like preference signaling to manage the overwhelming number of applications, but even that highlights how strained the system has become. With so many qualified applicants and stagnant program growth, strong candidates could still be left without a match simply due to numbers.

This isn’t unique to ENT—it’s part of a larger systemic issue in medical education. The AAMC recently published a piece titled “Residency bottleneck worsens as med school grads outpace GME growth”, which echoes the same concerns across all specialties. Unless significant investment is made into expanding residency training, especially in high-demand fields like ENT, students in my position may be facing even stiffer odds in just four ye

 

[AJS59]

Residency expansion, unfortunately, is mostly tied to Medicare funding. That's not to say that hospitals, states and local communities can't fund their own programs, but most health systems aren't looking to do that.

It seems politically unlikely atm for an expansion, although I think a bill was introduced into the house to increase positions. But, if I had to bet, the bulk of those new positions (even if created) will not go to ENT or other such competitive programs. New residency programs will be created based on market demands for attendings in that specialty, not what med students want to specialize in.

As for what to do about it the competitiveness - that I don't know. I would bet by the time you're applying that there's a good chance the number of research items will be capped for ERAS. Beyond that, I don't know

 

[operaman]

Yeah plan on it growing in competitiveness overall. There may be some cycle to cycle variation - I recall a few years ago there were two years where ENT had a couple of unmatched positions. There were articles in our journals about why students are losing interest and what we should do about it. And then it went right back to crazy competitive.

For us, program expansion is less about Medicare funding and more about adequate staff and case volume to meet training requirements. There aren’t too many places with a group of attendings busy enough and doing high level cases. You need big hospital and multiple fellowship trained subspecialists- not easy to put together. Most places that have it have already started programs.

 

[GoSpursGo]

It doesn’t feel good, but honestly students coming into med school planning to apply to highly competitive specialties need to make peace with the fact that they need a plan B. Going to med school means you get to be a doctor, but it doesn’t necessarily mean you get to practice your preferred specialty