How do I know if I like Otolaryngology before 4th year??

[78222]

Unlike a lot of my classmates, I didn't know by my 3rd birthday that I wanted to go into a certain specialty. So here I am, an M3, and on my surg rotation I realize "crap, I love surgery". However, I don't love the schedule and lifestyle of a general surgeon so I've been looking into surgical subspecialties and ENT is the one that seems coolest to me. However, the way my schedule works, it will probably be early 4th year before I actually have a chance to rotate in ENT. How can I possibly know that I really love ENT as much or more than gen surg if i can't rotate through until so late in the game? Right now I don't have any research, a 248 on Step I and fairly average grades for M1/M2 (all High Pass). If I am going to decide on ENT, I imagine I need to get some research under my belt asap. Any ideas on how to get an idea of whether or not it's for me a little earlier in the game?

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[Mariah246]

You can always ask to shadow during lighter rotations (psych, family med, post-call days, OBGYN just kidding)

I think your question is a good one that many applicants face in other very competitive fields.

For fields like ENT, plastics, derm, ophtho, rads, etc... etc... etc... a lot of applicants pour in the time to do research/make connections as early as 1st year.

I wonder how it feels to actually rotate through as a 4th year and find the field doesn't really live up to prior expectations. I guess you could always switch to something less competitive but it really puts you behind the eight ball in terms of pursuing another competitive field.

 

[TheThroat]

I agree about the shadowing thing. Really, if you like surgery, you need to figure out which field you want to go for by about mid-3rd year, so that you can get some research under your belt and make connections for LOR's.

 

[mary]

I would be very careful about going into ENT to avoid the hours and lifestyle of a general surgeon. It is a surgical residency and you will be miserable if there is any other non-surgical medical specialty that appeals to you and that is five years of your life. You still have to be prepared to eat, sleep, and breath otolaryngology for five years (flies by to you if you really love it, but if you are married or have SO then it crawls sometimes). As a fifth year otolaryngology resident, I am telling you that ENT residency is not an easy path to a surgical subspecialty and it is still a lot of hard work when you are out in practice, too, so choose very carefully. If lifestyle is more important to you than operating, you can consider IR or GI (although they sometimes work crazy hours, too, depending on the doc). I am not trying to discourage you, but you need to do some ENT rotations at some hard core institutions to get a true idea of what the speciality is like. I am not going to insult any general surgeons by saying we work as hard as they do during residency, because the GS here take a lot of in house call, but we stay extremely busy with work (work GS hours with home call which sometimes you just wish you stayed at the hospital) and then have tons of reading to do when not at work.

Just a heads up so you don't think ENT is any less demanding than GS, because it is not.

 

[78222]

I would be very careful about going into ENT to avoid the hours and lifestyle of a general surgeon. It is a surgical residency and you will be miserable if there is any other non-surgical medical specialty that appeals to you and that is five years of your life. You still have to be prepared to eat, sleep, and breath otolaryngology for five years (flies by to you if you really love it, but if you are married or have SO then it crawls sometimes). As a fifth year otolaryngology resident, I am telling you that ENT residency is not an easy path to a surgical subspecialty and it is still a lot of hard work when you are out in practice, too, so choose very carefully. If lifestyle is more important to you than operating, you can consider IR or GI (although they sometimes work crazy hours, too, depending on the doc). I am not trying to discourage you, but you need to do some ENT rotations at some hard core institutions to get a true idea of what the speciality is like. I am not going to insult any general surgeons by saying we work as hard as they do during residency, because the GS here take a lot of in house call, but we stay extremely busy with work (work GS hours with home call which sometimes you just wish you stayed at the hospital) and then have tons of reading to do when not at work.

Just a heads up so you don't think ENT is any less demanding than GS, because it is not.

Thanks for your input. I am aware that ENT isn't "easy" and that i will still have to work long hours during residency. However, I've talked to some ENT residents and compared what they've told me to what GS residents have told me and it sounds much lighter overall (especially in regards to call). I'm not afraid of hard work and one thing I've learned from my third year thus far is that 16 hours on a rotation you love is much much easier than 6 on one you hate.

 

[NPR]

I'm not afraid of hard work and one thing I've learned from my third year thus far is that 16 hours on a rotation you love is much much easier than 6 on one you hate.

I have yet to find anything in medicine that's worth 10 extra hours of work daily.

 

[-Goose-]

Have you thought about urology? I'd spend some time in both clinics/ORs. They are both pretty good specialties for people who like surgery, but want a slightly less demanding residency/post-residency lifestyle. From what I understand, urology is less focused on research whereas oto residency PDs like to see oto specific research.

 

[thedrjojo]

Yeah, As a MS3 i just finished a 2 week elective in ENT... i gotta say, being at the hospital from 7am (rounds) until 12:30am (when we rolled the Composite Resection patient into recovery room and the ent resident said, good job, see you at 7 tomorrow) as an MS3 makes me confirm that the life of an ENT resident isn't all that light... yeah, the team usually rounds at like 6, 6:30 instead of 5 like GS, but GS doesn't have marathons like the composite resection or a thyroidectomy that turns into a sternotomoy because the CT didn't show the met extending into the mediastinum (another night ending at 10:30pm in the same week as the composite). What might of soured me on ENT after this 2 weeks isn't the operations they do (those were a blast) but the clinic work... as someone who really doesn't want to spend much time in clinic, the more medical heavy specialties (Uro, ENT) seem to be falling out of favor compared to the more surgical specialties (Neurosurg, CT surgery)

 

[montypython]

Yeah, As a MS3 i just finished a 2 week elective in ENT... i gotta say, being at the hospital from 7am (rounds) until 12:30am (when we rolled the Composite Resection patient into recovery room and the ent resident said, good job, see you at 7 tomorrow) as an MS3 makes me confirm that the life of an ENT resident isn't all that light... yeah, the team usually rounds at like 6, 6:30 instead of 5 like GS, but GS doesn't have marathons like the composite resection or a thyroidectomy that turns into a sternotomoy because the CT didn't show the met extending into the mediastinum (another night ending at 10:30pm in the same week as the composite). What might of soured me on ENT after this 2 weeks isn't the operations they do (those were a blast) but the clinic work... as someone who really doesn't want to spend much time in clinic, the more medical heavy specialties (Uro, ENT) seem to be falling out of favor compared to the more surgical specialties (Neurosurg, CT surgery)

The 2 days of clinic a week give you a break from the other 3 days of free flaps. I used to despise the clinic as a MS3 but I looked forward to them as a MS4 knowing that my day would end in time to still get dinner from some place that does not only serve burgers and fries.

 

[DrBodacious]

Thanks for your input. I am aware that ENT isn't "easy" and that i will still have to work long hours during residency. However, I've talked to some ENT residents and compared what they've told me to what GS residents have told me and it sounds much lighter overall (especially in regards to call). I'm not afraid of hard work and one thing I've learned from my third year thus far is that 16 hours on a rotation you love is much much easier than 6 on one you hate.

One of my theories is: given that ENT residents are often top-notch, intellegent, interesting people (due to the intense selection process), they make the hard work they do in residency LOOK easy. Personally, I thought ENT looked a lot easier when I was first exposed in my 3rd year of med school. But, after doing sub-Is and a rotation as an intern, I found ENT residents actually work just as hard as general surgery residents - especially on head-and-neck services.

This is assuming you are at a program that has a decent volume and good training, i.e. enough so that you get exposed to some rare/complex cases. There are some ENT programs I saw on the interview train where it seemed you operate less, and thus you would have shorter hours, but I didn't rank them highly.

Obviously, as an attending you can make a better living working less hours in ENT vs gen surg. You also have the opportunity to do more clinic procedures and same-day-surgery cases. Thus, there is a better lifestyle.

If you really like the field, and you really want to be good at what you do, you are going to work hard at it throughout your career.

 

[hypersomniac_]

Even doing a sub-i may not help. There are like 8+ different ENT services at my school (one of the largest ENT departments in the country). In the oto sub-i, we pick three. I thought peds was boring, h&n was awesome and laryngology was pretty cool. Where the hell does that leave me? I have no idea how to consider ENT as a whole.

 

[dgruntledmizzou]

I would be very careful about going into ENT to avoid the hours and lifestyle of a general surgeon. It is a surgical residency and you will be miserable if there is any other non-surgical medical specialty that appeals to you and that is five years of your life.

Anyone else feel similarly?

 

[kilroth]

Anyone else feel similarly?

I'm an ENT intern it is definitely true. My hospital is extremely busy and we get a lot of emergent airway consults (quite frightening on your first day). There may be more variability with some ENT programs not being as busy as others, with all general surgery residencies being difficult. However, you want to be pretty busy to get good training. Not that I want to pull my hair out, but I want to operate a lot as a 2.

 

[resxn]

I don't know what all these residents are talking about.

I work like 15 hrs a week doing cases, 5 hrs a week in clinic, but I have NP that sees all the patients--I just sign the charts and operate. I mostly surf the internet during clinic. I make the NP round on the consults and I dictate whatever she says the pt has. In the OR, I've never had a single complication because ENT patients are all essentially totally healthy.

All that and my take home is about $750k, but because I'm an s-corp I pay myself in dividends mostly and avoid significant taxes. If I were to really push myself and do like 30hrs/wk, I could probably make a million, but I have really gotten used to my schedule.

ENT is a cakewalk. I don't understand why every med student who wants the perfect lifestyle and who wants to just rake in cash isn't doing this.

 

[Got2BeENT]

I don't know what all these residents are talking about.

I work like 15 hrs a week doing cases, 5 hrs a week in clinic, but I have NP that sees all the patients--I just sign the charts and operate. I mostly surf the internet during clinic. I make the NP round on the consults and I dictate whatever she says the pt has. In the OR, I've never had a single complication because ENT patients are all essentially totally healthy.

All that and my take home is about $750k, but because I'm an s-corp I pay myself in dividends mostly and avoid significant taxes. If I were to really push myself and do like 30hrs/wk, I could probably make a million, but I have really gotten used to my schedule.

ENT is a cakewalk. I don't understand why every med student who wants the perfect lifestyle and who wants to just rake in cash isn't doing this.

Surely you are an exceptional case of what an ENT lifestyle can be like... Isn't the average private ENT salary around $300k? What kinds of procedures are you doing that rake in that kind of cash and only require you to work 20 hrs per week?

I could be wrong...I certainly haven't talked to many private ENT's about their lifestyle...but I would find it hard to believe that there are hundreds of ENT's living a cush life with a neurosurgeon's income.

 

[dgruntledmizzou]

Surely you are an exceptional case of what an ENT lifestyle can be like... Isn't the average private ENT salary around $300k? What kinds of procedures are you doing that rake in that kind of cash and only require you to work 20 hrs per week?

I could be wrong...I certainly haven't talked to many private ENT's about their lifestyle...but I would find it hard to believe that there are hundreds of ENT's living a cush life with a neurosurgeon's income.

.....

He's joking

 

[resxn]

Surely you are an exceptional case of what an ENT lifestyle can be like... Isn't the average private ENT salary around $300k? What kinds of procedures are you doing that rake in that kind of cash and only require you to work 20 hrs per week?

I could be wrong...I certainly haven't talked to many private ENT's about their lifestyle...but I would find it hard to believe that there are hundreds of ENT's living a cush life with a neurosurgeon's income.

It's frightening to me that people are so out of touch that they don't catch the sarcasm. Seriously frightening.

Honestly, and I'm sincerely asking this, would you for a minute think this is for real?

I'm not sure whether to be angry, sad, disappointed, shocked, or just disgusted and despondent knowing there's little I can do when medical students can have this perception.

 

[Sonnet]

I share resxn's surprise and disgust. They admit an awful lot of not-very-bright bulbs to med school these days. The future doctors of America....

 

[smq123]

Unlike a lot of my classmates, I didn't know by my 3rd birthday that I wanted to go into a certain specialty. So here I am, an M3, and on my surg rotation I realize "crap, I love surgery". However, I don't love the schedule and lifestyle of a general surgeon so I've been looking into surgical subspecialties and ENT is the one that seems coolest to me. However, the way my schedule works, it will probably be early 4th year before I actually have a chance to rotate in ENT. How can I possibly know that I really love ENT as much or more than gen surg if i can't rotate through until so late in the game?

Well, what interests you?

Do you like operating in the belly? Did you like Whipples, small bowel resections, hemicolectomies, etc? If you like operating in the abdomen, ENT might not be for you.

Do you like surgical oncology? Operating on cancer? ENT might be a great choice, because that's what a lot of them do.

You can't just look at lifestyle. You also have to look at what kind of things they need to know and what kind of cases they routinely do.

I LOVED ENT when I rotated through it as a 3rd year med student. Absolutely, totally loved the surgeries. I loved being in the OR with those guys - they have a lot of autonomy (attendings tended to run from room to room), so they let me do a ton of stuff. They even let me do 70% of an open trach (including making the incision and suturing it in place). The residents were really funny, hilarious guys that played their iPods all the time.

But I HATED ENT didactics. The only good thing about their didactic day was that there was free food and we got home at 2:30. Swallow studies? Vocal cord dysfunction? Vestibular dysfunction and vertigo? The anatomy of the head and neck? It's fascinating for some but for me.... The only thing I liked was the lecture on cancers of the H&N, because I like surg onc.

If you don't like even the basic stuff that they need to learn, there's no way you're going to be able to study it for boards and for patient care. So, flip through Schwartz and see which chapters you like best. If you like urology, take a look at that. If you like the head and neck stuff, look more into that. You have to like the part of the body that you'll be taking care of....not just the lifestyle of the people who are currently in practice.