Why is ophthalmology better than ENT?

[34440]

I figured we needed the converse in this forum. I'm also interested to know what you guys really think, too.

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[Ophtho24]

These 2 fields are often considered very similar, but I don't think so at all. They are very different so I don't think one is really better than another. I went for ophtho over ENT because I don't like 5 hour surgeries where I tear off 80% of a guys face (our ENT actually told us he has had patients kill themselves after he removed a ton of their face to try and save them from oral cancer). I prefer the quick ophtho surgeries. If you go over an hour in ophtho and you aren't in retina or oculoplastics something has gone very wrong. This also makes for a much better lifestyle, in that a typical OR day for an ophtho may start at 8 and you are out by 3 (it is tough to cultivate enough 15 minute surgeries to fill an entire day). ENT maybe you fire up at 7 and get out at 6. I think ophthos are generally way more chill people. The OR with ophtho is very peaceful (no yelling at scrub techs) if you go in the OR with ENT it can get a little more ugly from my experience. I think ENTs take the more typical surgeon attitude. If anything is necessarily better though I would say lifestyle will probably be the big one. I guess ENT probably makes more money, but I think we can get by with an average salary of 200k (a lot of ophthos actually make less than this though.) Once you get into clinical rotations (is that what 2.5 means?) you will get a chance to see the differences first hand.

 

[PDT4CNV]

I figured we needed the converse in this forum. I'm also interested to know what you guys really think, too.

I found that quite a lot of medical students struggle with deciding between the two specialties. I know I did, I applied to both before I finally made up my mind and withdrew from the ENT match.

They are both excellent, but different. ENT clinic you will be treating a lot of colds, ear infections, sinus infections, sore throats, allergy, and cleaning ear wax out of ears. Most general ENTS do lots of tubes and tonsils, some sinus surgery, deviated septums, some skin ca, and the occasional larngectomy/neck case. There are subspecialties like neck, plastics, peds, otology/neuro, sinus, reconstructive/craniofacial. You will not see most ENTs in the community doing these huge cases neck/face cases that some of the fellowship trained academics do.

Ophthalmology clinic you will be refracting, treating allergic disease, glaucoma, diabetic retinopathy, macular degeneration, uveitis and other rheumatologic/inflammatory diseases, congenital/inherited dzes, and neurologic disease such as demyelinating diseases and tumors. Ophthalmologic surgery includes the well known refractive surgeries such as LASIK and PRK, cataract surgery, eye muscle surgery, glaucoma filtering surgeries and tube shunts, eye lid surgery and surgery of the lacrimal system and periocular area, and corneal surgery including corneal transplants. Usually orbital surgery, more complex lid and lacrimal surgeries and vitreoretinal surgeries are done by fellowship trained ophthalmologists in retina or oculplastics/orbit. There are a lot of laser procedures done by most ophthalmologists involving the cornea, anterior segment, and retina.

So as you can see, they are just completely different, although with some overlap, particularly in the oculoplastics relm. We operate in the nose, ethmoids, maxillaries, and mouth some. We even recently did some abdominal liposuction to harvest some fat for an orbital procedure. Anyway, you can't go wrong either way. The salaries are really quite similar too.

I disagree to some extent about the personalities and the length of cases. My experience has been that the personalities span the spectrum in both specialties. Myringotomy tubes can take 5 minutues. A deviated septum or sinus case may take 30-45 minutes. This is bread and butter ENT, not the 5 hour head and neck cases. Some retina cases in ophthalmology may take 5-6 hours, but this is not bread and butter ophthalmology. Most cataract cases take approx 20 minutues, eye muscle cases 45 -90 minutues, plastics/orbit cases 20 min-2hours, retina cases 45min-6hours, cornea cases 30 min-2 hours.

You probably know all of that, but there is my take.

Good luck.

 

[cdql]

I went for ophtho over ENT because I don't like 5 hour surgeries where I tear off 80% of a guys face (our ENT actually told us he has had patients kill themselves after he removed a ton of their face to try and save them from oral cancer).

Wow...I didn't even know they did things like that! I'd probably puke myself dry or pass out watching something like that!

 

[OphthalmicPilot]

My impresssion is that ENT residencies are harder than ophthalmology, particularly the ones that have a lot of facial trauma call or ones that don't have plastics or oral surgery to share facial trauma. ENT residents usually work harder than ophthalmology residents.

ENT surgeries are more difficult that ophthalmology. Don't blame ophthalmologist, blame the eye. The eye can only tolerate so much unlike tougher tissue, such as the neck, abdomen, etc.

We shouldn't bad mouth ENT because we share the same professional ancestors, namely EENT.

 

[PDT4CNV]

My impresssion is that ENT residencies are harder than ophthalmology, particularly the ones that have a lot of facial trauma call or ones that don't have plastics or oral surgery to share facial trauma. ENT residents usually work harder than ophthalmology residents.

ENT surgeries are more difficult that ophthalmology. Don't blame ophthalmologist, blame the eye. The eye can only tolerate so much unlike tougher tissue, such as the neck, abdomen, etc.

We shouldn't bad mouth ENT because we share the same professional ancestors, namely EENT.

First, I haven't seen anything bad about ENT. ENT residencies with lots of facial trauma call can be bad as far as call goes. But don't forget that Ophthalmology gets consulted on most of these trauma and burn patients as well. Ocular and orbital trauma occur with high frequency with facial trauma. What you say about working harder than ophthalmology residents is debatable, but I would agree that the hours with ENT may be mildly worse because of the inpatients that ENT maintains.

ENT surgeries are definitely not harder than eye surgery. I've done a lot of ENT surgery as a medical student (thought I wanted to do ENT for a while, two ENT's in the family) and can say that it seems more difficult to learn ocular, orbital and lacrimal surgery. The difficulty of learning an individual surgery has little to do with the toughness of the tissue. What a ridiculous idea. There are easier and then more difficult cases in both specialties.

It is pointless to compare these specialties in terms of which one is more competitive or which one is harder. Work hours are location/program dependent. Being at a level 1 trauma/burn center makes for a very busy call night in both specialties. At my institution, our clinics see more patients/year than ENT and we do more surgeries/year than ENT. This obviously varies at each institution. ENT maintains many more inpatients than we do.

Both are excellent fields and you cant go wrong either way. They both have a good mix of clinic and OR time, medical and surgical management. And in both specialties the patients are usually very grateful for what you do. Do what you are more interested in. There is little else to say about this issue, and it should not be issue.

 

[Toadkiller Dog]

I decided against ENT after:

1. Watching an attending pull a 5-inch booger out of a patient's nasal cavity with a long pair of forceps.
2. Sitting through a loooooong surgery (approx 20 hours) for neck cancer.
3. Listening to a zillion patients in clinic compain about "Oh, my sinuses!" and "Oh, I'm so congested!" By the end of the day, I wanted to slap them and say "HEY! Go find something more important to compain about!" (Like, for example, vision! Vision is very important...... 🙂

 

[SteelEyes]

I hate the sound of gagging. ENT is all about shoving tubes down noses and throats, often on awake patients. I hate the sound of gagging. I don't even like to pass an NG tube.
I'll stick a needle in an eye, see eyes busted up hanging out and no problem, but if I hear someone gagging it's all over!

 

[NEIGUY]

Basically,
if your a pansy then you should go into ophtho(myself included).
I knew ENT was not for me when i stepped into the OR for a giant Neck dissection and got bitched at by the chief resident for being late. ok this seems reasonable but i was on outpatient PEDS at the time.....in general ENTers are a little more hardcore. the thing is they do really cool surgeries, so you goota decide what you like more and what your personalite is like. Im chill, with some ADD, if i dont work enough i get pissy, and i like nice clean delicate surgeries with out much blood. sprinkle a little outpatient medicine and some pretty pictures of the eye and i m happy. its just that simple. go with your gut!

 

[deleted6669]

I hate the sound of gagging. ENT is all about shoving tubes down noses and throats, often on awake patients. I hate the sound of gagging. I don't even like to pass an NG tube.
I'll stick a needle in an eye, see eyes busted up hanging out and no problem, but if I hear someone gagging it's all over!

so true...ent call is all about removing fb's, stopping epistaxis(although with the advent of the anterior/posterior rapid rhino I haven't called an ent for this in > 2 yrs, those things WORK, even in the 80 yr old htn pt on coumadin), and really grisly facial lac repairs when plastics is not on call(think pit bull vs nose of 5 yr old girl)......