What is the life of ENT like?

[eyesupply]

Forgive the newbie question.

I know the life of the surgery intern first hand. Busy, occasionally abused, sometimes scared. I also know the life of my own surgical specialty.

But how is ENT?

My guess is that it is busy, particularly if one has to take facial trauma call. Is it malignant like some general surgery programs or it is a bit more collegial.=? Very program dependent, I presume, but are there a lot of malignant programs?

How is it like after one is in practice? My guess is that it is no where near as busy as general surgery internship but one occasionally has to go in. When one covers the practice, there may be calls from recent post-op patients. What kind of urgent problems will someone covering just their practice and not the hospital for that week encounter?

I was asked this of a first year med student and I really couldn't answer. In medical school, they tried to brainwash med student by exposing me to lots of FP but not even a day of ENT.

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[OR smurf]

i have the same question as eyesupply and would really appreciate it if someone could shed some light on this topic...

In addition, i have a few other more specific q's

1) How intense is ENT residency? Is it at the same level as general surgery?

2) How long are the longest procedures (i.e. duration?). I've heard the longest surgeries are usually the head&neck cases...is that true and if so, do all ENT surgeons deal with such cases or simply the head and neck surgeons?

3) Overall...does it offer a good lifestyle? (not always on call, are part-time options available)?

Sorry if some of these questions seem really obvious...it's just that I've always been big on wanting a good lifestyle once i'm done with school but recently I discovered how much i really like ENT so I'm really torn...any input would REALLY help!

 

[DoctwoB]

i have the same question as eyesupply and would really appreciate it if someone could shed some light on this topic...

In addition, i have a few other more specific q's

1) How intense is ENT residency? Is it at the same level as general surgery?

2) How long are the longest procedures (i.e. duration?). I've heard the longest surgeries are usually the head&neck cases...is that true and if so, do all ENT surgeons deal with such cases or simply the head and neck surgeons?

3) Overall...does it offer a good lifestyle? (not always on call, are part-time options available)?

Sorry if some of these questions seem really obvious...it's just that I've always been big on wanting a good lifestyle once i'm done with school but recently I discovered how much i really like ENT so I'm really torn...any input would REALLY help!

I'm just a med student but I've done a fair amount of ENT shadowing/forum browsing and it seems to be that
1. ENT residency is one of the easier surgical residencies, probably easier than Neuro, Ortho, and general and equivalent to Uro. That being said it is still a surgical residency and you'll be working your tail off.
2. Head and Neck cases and skull base cases can be ~10 hours +. These are almost exclusively done in academic centers by H&N fellowship surgeons.
3. "Early nights and tennis" = Very good lifestyle. Once again this is in comparison to other surgeries, its tougher than most non-surgical specialties

That being said, input from actual practicing ENTs would be much more helpful, and i'd love to know if and where I'm wrong here.

 

[Leforte]

I am not sure where you've been shadowing, but aside form Neurosurgery, our residents are among the hardest working in the hospital (probably tied with Ortho). They know this coming in, and I suspect choose to come to a place with a high surgical volume in residency knowing that their hours will be long. Yes, you can choose to rank programs that offer better hours, but you would be sacrificing your training for a temporary convenience.

That being said - as has been said multiple times before - once you have completed your residency +/- fellowship, you set your own hours and can choose to work as hard or as little as you want. No one is looking at your weekly hours, nor is anyone there to ensure that you get a certain number of days off per week. In general, ENT offers a very friendly lifestyle with fewer issues that require you to come in on call than other surgical specialties. But at the end of the day, you are a surgeon, and surgical emergencies do exist. The last average hours I think I saw mentioned that ENT work ~50 hrs per week. Anesthesiologists, on average, work more than we do (and is one of the ROAD specialties). They also, on average, get paid more, too.

Most ENTs that I've been involved with, both attending and residents in training, seem to be very well balanced with vocational and avocational interests. Those who choose to work harder do so because they want to. Those that work less, usually choose to work less and spend their time with other outside interests. This is the same for nearly all fields of medicine.

What does make our field unique, I feel, is that it offers such diversity in our clinical and operative practices and also allows the ability to change interests into less "hard core" things later on. A new board certified surgeon may choose to do tons of H&N, otology, reconstructive surgery, etc and as they get older and desire more time with family or other outside interests, can translate easily into a more clinic/surgery center based practice (allergy, sinus, laryngology). We share this a few other surgical fields, but of course I am biased towards ENT.

As far as time for procedures, these can range for < 5 minutes for tubes to 12-16+ hrs for major resections and reconstructions. Again, if you don't like the long cases, don't do them when you are done with your training. if you don't want to do them in training, choose a program that offers few of these in their training.

 

[OR smurf]

thanks for the responses! it really does put things into perspective for me!

I definitely agree that the diversity offered in ENT is a huge plus and one of the main reasons as to why I'm leaning towards the field. I really enjoy the anatomy of the head and neck area as well

So I'm guessing that with such great flexibility that the field has to offer, that most ENT doctors are pretty content with their choice and life?

 

[ZagDoc]

i have the same question as eyesupply and would really appreciate it if someone could shed some light on this topic...

In addition, i have a few other more specific q's

1) How intense is ENT residency? Is it at the same level as general surgery?

2) How long are the longest procedures (i.e. duration?). I've heard the longest surgeries are usually the head&neck cases...is that true and if so, do all ENT surgeons deal with such cases or simply the head and neck surgeons?

3) Overall...does it offer a good lifestyle? (not always on call, are part-time options available)?

Sorry if some of these questions seem really obvious...it's just that I've always been big on wanting a good lifestyle once i'm done with school but recently I discovered how much i really like ENT so I'm really torn...any input would REALLY help!

I think the fact that ENT residents are considered surgical peers by their GS brethren instead of "pansies" speaks to the amount of hours they work. At least at my institution, the head & neck heavy months definitely are comparable to gen surg's most brutal rotations. Sure ENT has it's lighter months, but so does GS.

That being said, between my sub-i and my aways, I have found otolaryngology residents/attendings on the whole to be much "nicer" than certain surgical specialties. An old grey beard general surgeon once remarked to me that ENT is a "gentleman's specialty"... and I agree, there tend to be a lot of gentlemen/gentlewomen and very few if any a-holes.

But as you'll find out when you get into the clinical years that the whole "lifestyle specialty" meme amongst all the first and second year students is a load of crap. If you're bored at work, a 40 hour work week can feel like 80. If you love what you're doing, an 80 hour work week can feel like 40. The flexibility otolaryngology offers you when you're out in practice is fairly unique to the field IMHO, but the residency is still a surgical residency... it's hard. It's supposed to be hard because it's supposed to turn you into a competent surgeon. But if it's what you love, you shouldn't let a few hard years push you into something you'll be bored with.

 

[kilroth]

I'm finishing my 3rd year of ENT residency and it has been truly brutal. The hardest years of my life. The senior years are much better, however. A lot of people get depressed due to the intensity of our program. I'm not sure how it differs in other programs but it couldn't be a whole lot different. I think we're known as one of the harder residencies though. As an intern on general surgery I once remarked to the general surgery chief resident how excited I was to start on ENT.

His response.."Dude, you're going to get your ass kicked."

That being said... the lifestyle once you are done is really great.. and I would rather be prepared and have seen everything in residency. So, I wouldn't change a thing (except to fast forward the next 2 months to become a senior resident!)

Kil

 

[womp]

I think the fact that ENT residents are considered surgical peers by their GS brethren instead of "pansies" speaks to the amount of hours they work.

Um so what are the pansy ones? Urology and OBGYN?

GS, Ortho and ENT are all about the same level, and NS is in its own league.

 

[bassvp]

So,

For those who are in "harder" ENT residencies, are the hours always pushing the 80-hour mark? What would someone say is the range of hours for an "easy" week vs. the hardest ones?

 

[ZagDoc]

So,

For those who are in "harder" ENT residencies, are the hours always pushing the 80-hour mark? What would someone say is the range of hours for an "easy" week vs. the hardest ones?

Depends on what service you're on. Most programs have lighter services (i.e. the FPRS/sinus/laryngology-heavy months) and busier services (H&N and peds-heavy months). Some programs break up rotations by subspecialty (i.e. the "Head & Neck service", the "otology service", etc - skull base tends to get thrown in wherever). Some break them up by location/hospital, which typically have a mix of faculty but with different a emphasis at each location.

Call is always a factor. A lot of places are home call now (often due to covering multiple hospitals off campus) but some still do in-house for the juniors. Home call can be worse than in-house depending on the program and how many hospitals and EDs you are covering. Face trauma always ups your hours, and the frequency depends on how your department splits it with plastics and/or OMFS. Then there's consults, which can often keep you late, and different programs have different ways of handling consultations (some have a dedicated consultation service/rotation, for example, while others rotate which service takes the consult pager on a given day).

Most places will say their residents live right around 80-hours on the head & neck months, peds can also be heavy depending on the volume and # of faculty. FPRS, laryngology, otology are more 6-to-6ish given the elective nature of their procedures. But when you throw in call, trauma, and consults, I'd say most residents live above 70 hours a week for most if not all of their junior years. Senior years you have less of that stuff, but more administrative responsibilities which can more often be taken care of at home but still fill your evenings (most chiefs will tell you they work more hours as a chief than they did as a junior, it's just less floor/ED work). And you still have to come in for the emergent stuff.