So guys, I'd like to hear the straightforward answer to why you think oto is so great, and why you chose it/are considering it as a career.
What is it about life as an oto that attracted you so much?
Were there a lot of outpatient type procedures? Less sick patients? Less likely to get sued than in another surgical specialty like ortho?
How is the residency as compared to general surgery or internal medicine in terms of hours? Varies from program to program or is it pretty consistently less intensive (time wise) than gen surg?
What's the life like being an OTO in private practice?
What's the compensation potential like? Most of the survey's I've seen (Merritt Hawkins, etc.) usually put the otos at a lower median salary than other surgical specialties like ortho, optho, as well as rads, cardiology, and gastro. Is this a product of small sample size or do you think that's a pretty legitimate assessment?
Frank question: Is there an overarching theme in the type of personality ENT surgery tends to attract?
I'd just like you guys to be as straightforward as possible. If you like ENT because the hours are easy, just say so. If it's because the pay is actually out of the world, I'd like to hear it.
That's a big list of questions. I'll answer them in the order you asked. And I will answer them from the perspective of a general otolaryngologist, obviously a HNS is going to answer them differently.
1 - that will be answered throughout the other questions
2 - a) In my practice, 70% of my surgical volume is outpt, but in terms of time in OR, I'd say 45-50% is spent on inpt surgical procedures. b) "sick" is a very subjective word to use, but I'd say pt's typically present to a general ENT with less life-threatening conditions than they would to say a neurosurgeon or pulmonologist. Having said that, I see a fair share of patients with life-threatening cancers, trauma, etc. It's just not overwhelming in my practice. c) ENT's in general are less-likely to get sued than mostany other surgical specialities and that's why our malpractice is on average lower, but the threat remains high. There are a number of reasons for this which are outside the scope of this discussion. In general many of the surgical procedures in bread and butter ENT are for quality of life and not absolutely necessary unless the patients want it (septos, some tonsils, some FESS, all cosmetics, many middle ears, etc).
3 - The hours thing is a irrelevant comparison these days. There is an 80 hour work restriction regardless of speciality. I trained before the work hour restrictions went into effect. Only in my R-2 year did I routinely break that hour level anyway. R-3 and up I'd knock on the door frequently but rarely go over. In my internship, I rarely was under 80 and during CT surg for 2 months I did 130 or so hours a week taking call every other (40 on 8 off 40 on. . .). General slavery is worse for most programs than ENT but there are obviously exceptions.
4 - Life as a general private ENT is vastly different from practice to practice. It depends on whether you're solo, small single-specialty group, large single-specialty group, multi-specialty group, within an HMO, salaried or not, call schedule, number of hospitals covered, cover trauma or not, etc. You'd just have to ask individuals and find out what their respective experience has been.
5 - Compensation also varies greatly. Here is info from the 2004 American Academy of Otolaryngology/Head and Neck Surgery. For some reason, the link to 2005 is broken.
a - mean number of weeks/year worked = 48.64
b - mean number of pt office visits/wk - 90.65
c - how hours are divided per week = 27.6 in office, 10.9 in OR, 4.2 administrative activities, 3.7 hospital/ER rounds, 2.7 calling pt's
d - almost perfectly evenly divided 1/3 said their salary is higher, 1/3 said salary unchanged, 1/3 said salary increased from the previous 2 years
e - 2003 net median income by region = Pacific $240,150, Mountain $230,880, North Central $276,140, South Cenral $266,380, New England $247,500, Mid Atlantic $269,170, South Atlantic $248,330. I'm not going to wast my time looking up other specialties are even care what others make. The singular gold standard for salary and physician compensation comes from the MGMA data. Use that rather than salary.com or Merrit-Hawkins type places for your best info regardless of specialty. Most starting physician salaries is based on MGMA data.
f - Median overhead 50.91% (of which 42.0% is staff salary, 15.2% is office occupancy, and 9.2% liability insurance
g - median medical liability insurance premium = $22,591, mean = $28,038
h - median age of planned retirement 65.2
6 - ENT attracts well-rounded people who have lives signficantly active outside of medicine. They are among the smartest in their respective med school classes, but are also among the most well-liked. I'm sure this will offend some people who hate pigeon-holing personalities based on specialty, but I agree there is a personality associated with specialited. They don't have as severe the stereotypical ego associated with CT surgeons, Neurosurgeons, Plastics, and General Surgeons. They're not the gruff thick necks you hear about in orthopods. As one of the leaders in our field has said multiple times (Dr. Kennedy), "It's hard not to like an otolaryngologist."
7 - Straight-forward. I like the mix of medicine and surgery. I like that surgery involves some plastics, some cancer, some ortho, some endo, some peds, and some reconstruction. I like that for the most part my patients get better and I'm not just helping them linger on a little longer. I like that I make good money. I like my colleagues. I like that I have a life outside medicine. I love the anatomy. I love our gadgets. I like that there are new gadgets doing new things all year long. As a med student, I realized that ENT clinic was about the most interesting clinic in which I did things. That hasn't changed. I'd hate sitting in a medicine clinic all day handing out scripts and reviewing labs. I could not be as happy in any other specialty.
Geez, that was a book.