Working as a fellow

[drivesmecraazee]

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I've heard that one the keys to succeed in a saturated market could be having a fellowship, now I do like the idea but wouldn't enjoy working with such a limited range of cases/disseases/treatments...one of the reason people choose ENT is because of the variety, so my question is:

Can an ENT have a fellowship and still work with some general ENT stuff?
For example: Work as an otologist fellow with complex cases and get some nose, sinus and larnyx (less complex) cases too? How common is that?

 

[neutropeniaboy]

I've heard that one the keys to succeed in a saturated market could be having a fellowship, now I do like the idea but wouldn't enjoy working with such a limited range of cases/disseases/treatments...one of the reason people choose ENT is because of the variety, so my question is:

Can an ENT have a fellowship and still work with some general ENT stuff?
For example: Work as an otologist fellow with complex cases and get some nose, sinus and larnyx (less complex) cases too? How common is that?

In my opinion, doing a fellowship strictly to be better at something is a waste of time and a loss of money for you. The right reason to do a fellowship is to position yourself as a specialist or an academic.

Having said that, you can make your practice what you want it to be. If you want to do a neurotology fellowship and end up doing general, you can do it. I don't see why you would, however. Many academics or private groups hire fellowship trained people to do exactly what they're trained to do, not the general stuff.

On the flip side, as you start to become more specialized, you need to constantly hone your skills in that specialty. If you do this consistently, your skills in other areas, sadly, decline.

 

[drivesmecraazee]

Well...yeah, you definetly have to FOCUS on your fellowship, but that doesn't stop you from doing some general stuff once in a while, besides why would you lose skills? It's obvious that when you're not constantly doing something, you lose some but still, would that affect your skills so much that you will never be able to do it again? We're talking about some basic stuff here.

By the way...do you have a fellowship?

Thanks for your answer. 👍

 

[drivesmecraazee]

Ooohh yeah, you are actually a fellow...I just read it on you signature and your nickname...my bad.
Feel kinda stupid...sorry...😳

 

[resxn]

There are several previous posts on the subject of fellowship-trained docs doing general ENT.

But I will make a couple of points. If you do a fellowship to get into a saturated market as a specialist, you're going to be hired to do the specialty stuff and not general--except perhaps on call.

If you do get in as say an otologist, and then want to do sinus stuff, all the docs that referred you ear cases will dry up rather fast because they'll see you as competition for their practice, not as a resource. Bad business decision making in that arena.

I know several docs that have fellowship training who do general. Often these are people who just wanted to have a better understanding of that particular area, often because they didn't get good training on it in residency. But they don't bill themselves as the "ear guy" or the "sinus guy" or whatever. Most of the time they don't even mention it. Now, I do agree with neutropeniaboy that it is probably not really financially worthwhile to do a fellowship to have a general practice.

As a solo ENT, you can be quite successful in general and miss one and even 2 areas. In other words, you could be in a general practice and not do ears or head and neck cases and still do well. Missing out on 1 area is not going to affect your bottom line, whereas missing out on 2 could depending on your practice setup. Missing out on more than 2 definitely will start to affect your yearly collections IMO. If you're in a group, missing 2 or more doesn't affect you as much because you can usually have your niche, but your partners may not necessarily appreciate it esp if they're doing some of the grunt work that you won't take (i.e. trauma).

 

[medstylee]

in terms of diversity of pathologies/procedures/surgeries/etc, how do the subspecialties of ENT compare to one another? (if that comparison can even be made)

i've shadowed the different oto faculty members at my school a few times each, especially the head & neck surgeon who has been my mentor for the past year. i'm really amazed by the range of cases he sees in the clinic and in the or. whereas, when i shadowed the laryngologist, it seemed much more monotonous (although certainly interesting). i'm guessing that this obviously has to do with the fact that the focus of laryngology is a lot more specific than the focus of head & neck. at the same time, i think this particular laryngologist tends to limit his practice pretty tightly to the confines of laryngology while my mentor takes the complicated head & neck cases but also mixes in a lot of the general stuff as well.

anyway, back to my original question - let me know what you guys think. i'm just curious. thanks again. 👍

 

[drivesmecraazee]

DIVERSITY...I think that would be one of the most important things for me when working as a physician