Resident Attrition

[magictouch]

Hi all! I've heard of a number of residents switching to other specialties after starting in ENT. Obviously not a lot, but at several programs I was interested in I inquired about the reason the number of residents wasn't equal and heard different stories about how someone "realized they didn't like surgery" or other explanations for why they left the field. Attendings/residents - have you seen people leave ENT during/after residency, and if so how much of it was voluntary vs involuntary? And why?

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[OtoHNS]

This is true for all specialties to some extent. It's likely that resident attrition in ENT is lower than average, but I don't know for certain. You can probably find the data online somewhere.

ENT tends to attract nice people (mostly). You can put up with a lot if your faculty and co-residents are good people that you respect and enjoy being around.

I don't personally know anyone who left ENT residency for another specialty.

 

[HighPriest]

I've never met anyone who left ENT. I've never known a resident to leave voluntarily (I know one who was tossed). Obviously it happens, people leave specialties all of the time. I know three general surgeons who left, one radiologist. People sometimes realize they made a poor choice for themselves. I don't think it's more of an issue with ENT than anyone else. ENT tends to have a lower burnout rate than average. I can't quote data on that, but I've certainly read this in repeated studies over the years.

 

[VisionaryTics]

I know people that have left ENT as residents, all for different reasons. Usually a mixture of pre-existing personal issues and difficulty with the surgical learning process (i.e. your mistakes happen right before your eyes and you have to deal with that, over and over). For these people, leaving was also a mixture of "voluntary" and "involuntary".

ENT certainly seems to have happier residents and staff than other surgical fields, all being said.

 

[OtoHNS]

ENT certainly seems to have happier residents and staff than other surgical fields, all being said.

I had great co-residents and some of them are the most hilarious people I've ever met. There's plenty of pain in any surgical residency, but a lot of laughter and good times as well.

Where I trained, ortho seemed to have happy residents as well, though they probably worked more hours than us.

Urology is another one that generally attracts normal/fun/nice people, though the urology program where I trained might have been an exception to that rule

 

[HighPriest]

Most of the urologists I’ve ever met were very fun guys. Except one. That guy was coincidentally the most serious surgeon I’ve ever met. Very strange.

 

[Apollyon]

17 years ago or so, where I was a resident, there were 2 residents per year. In one year, both interns, and one PGY-2, all left. Coincidentally, all three were female (as was the remaining PGY-2). I knew one of them (we dated for a bit), but, now, I can't find any trace of her online, at all, as doctor, or just person.

 

[HighPriest]

17 years ago or so, where I was a resident, there were 2 residents per year. In one year, both interns, and one PGY-2, all left. Coincidentally, all three were female (as was the remaining PGY-2). I knew one of them (we dated for a bit), but, now, I can't find any trace of her online, at all, as doctor, or just person.

She was entirely in your head. Residency is tough, man.

 

[magictouch]

Anything you think medical students can do to tell if they are really cut out for it?

 

[HighPriest]

Find out what you love most about a specialty. But also find out what they spend most of their time doing. You don’t have to love the bread-and-butter, but you do have to be able to tolerate it. If you can’t handle two vertigo patients followed by a globus sensation and three tonsils on a daily basis, then you’re going to be unhappy. Of course, maybe you’ll do a fellowship and not see vertigo anymore. But you don’t know that up front. If you can handle the speciality at its worst, you’ll be fine. No specialty is perfect, man. Everyone has their dizzy patient analog.
Also, decide if you want to be the last stop for a patient, or if you prefer having a referral safety net. If you don’t like the idea of sending on anything complicated or if you like seeing things through to the end, you might not be good for primary care or ER. If you really appreciate being able to sift through your patient population and decide what you want to treat, then being a sub specialist may not be the best option. Of course keep in mind that there are subspecialists and there are subspecialists. Interest head and neck cancer, for example, but if it’s not worth my time or if it needs more than I can give, I send them to a fellowship trained guy.
Keep in mind that being the last stop can be very rewarding - you remove a tongue cancer, do an neck dissection, and get a cure. That’s great! But it often times means that you’re the guy telling a crazy person that their symptoms are psychosomatic because their NP said “well, I’m not sure. Let’s send you to a specialist to find out if there actually worms under your skin.” And sometimes they have a real problem, but it’s frustrating and time consuming to figure things out. And sometimes you hit the ball on a case, but not out of the park (like a bad sinus patient, for example) and that guy is yours forever. He’s as good as he’s gonna get but he’s not perfect, and you can’t send him back to his PCP for the same issue for which he sent him to you, even if there’s nothing more you can do.
And keep in mind that everyone has -something- about their job they’d rather not deal with. Anyone who say otherwise is either insane or one of those eternal optimists that you don’t want to interact with.