How do you decide?

[shnuffles]

I'm an M1 who has been interested in this field for some time, and my recent experience with head and neck anatomy has greatly heightened my interest in this specialty. It seems like the perfect fit for me in a lot of ways- I love the balance that oto strikes btw surgery and medicine, and I find the procedures interesting and rewarding.

However, I am concerned with the idea of operating in such small areas, often microscopically. I loved dissecting the intricate structures of the head and neck, but of course we had the heads bisected and the structures we were learning about were very visable. How do I decide if this is a specialty that I would enjoy? Without being able to "try out" the surgical procedures, how do I know that I will enjoy operating on teeny, tiny structures that are not splayed out in front of me?

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[BOOURNS]

Go hang out in the OR.

 

[modelslashactor]

the truth is, as i am quickly learning as a third year, there is a very low chance that you'll ever be 100% sure what field to go into. ENT is a great field, go see some surgeries, rotate through it your third year, maybe you'll change your mind maybe you won't.

since ent is competitive, the best thing you can do now is set up some research for this summer in your ent dept. that way you'll meet some faculty and maybe get some abstracts/pubs out of it that will help you immensely when applying. then spend your second year studying because your step 1 score is the first thing residencies will see. if you can do that then you'll be very well set up to go into ent or any other field if you decide to change your mind.

other than that, have as much fun as possible and worry about this stuff in 2 years.

 

[neutropeniaboy]

Without being able to "try out" the surgical procedures, how do I know that I will enjoy operating on teeny, tiny structures that are not splayed out in front of me?

My recommendations:
1. Call up the ENT department. Ask if there is an attending (or attendings) who would be willing to let you follow them around for a couple of weeks. Unless you've got a department full of a**holes, this should be easy to arrange. Nothing fulfills a surgical attending more than having an entourage. Hang out in clinic. Hang out in the OR. You'll make a good impression if you are there from start to finish, so don't schedule to go to someone's clinic and then leave because you have to go to a "mandatory" student meeting -- whether it is true or not.
2. Once you decide on ENT as something you would like, start doing research. Ask if there are some case reports you can help with. Ask if there are some bench projects you can do. Anyone doing a chart review? You're all over that one.
3. Lastly, you need to slam dunk Step I. 230 ain't good enough any more. 240 isn't safe any more. These are average sores now.

I'll be frank with you. I just reviewed about 150 applications for residency. Most people have Step I scores above 240, probably about 1/3 of them in the 250 to 260 range. It is rare to see an applicant who doesn't have some form of research under their belt. Most have research; about half have ENT research/projects. Obviously, the later is more impressive. However, if you have a Howard Hughes fellowship or got some NIH project going, that's pretty impressive too.

It's unfortunate, but you have to figure it out pretty fast. So, if ENT is for you or you think it might be, better start now. If you're not sure, better rule it out quickly so you can apply the above to whatever other field you are interested in. True dat.

-nb

 

[blz]

Step 1 scores are so key for ENT. Seriously, nowadays with Goljan and USMLEWorld, people are scoring very high. I would aim for atleast a 250 and preferably 260+ if you want any option to where you do residency. I know my home program has a cut off of 250 for interviews (although they give courtesy interviews to those who rotated through the service).

 

[neutropeniaboy]

Step 1 scores are so key for ENT. Seriously, nowadays with Goljan and USMLEWorld, people are scoring very high. I would aim for atleast a 250 and preferably 260+ if you want any option to where you do residency. I know my home program has a cut off of 250 for interviews (although they give courtesy interviews to those who rotated through the service).

Wow.

Those look impressive. I just searched Google for those two things. And to think: I just sat in the library and re-read my books. How old school...

 

[lipofuscin232]

Please do not let the above posts discourage you from ENT. Although it is a pretty competitive field, you will have plenty of time to figure it out. Right now I am interviewing for residencies and I had no idea it was the field for me until the very end of my third year. The only way you will know is if you spend time in the field. I would recommend doing this during your third year...you do not know enough about the pathology and disease processes as a first year to truly appreciate clinic. Spending time in the OR is not a bad idea...but right now you should really focus on your 1st and 2nd year courses because the boards are going to be very important for your application (no matter what field you choose), then I would worry about doing extra things like shadowing. If you have spare time during your first and second year to pick up a research project then that's great...However, I never did any research in medical school and I am still interviewing at many top tier programs. My point is, do not stress about this decision, you will have plenty of time to figure out what's for you (that's really what 3rd year is about) and all the pieces will eventually fall into place. If you have any questions about ENT in general, please don't hesitate to PM me. It truly is a fantastic field with lots of possibilities

 

[ORLHNS41]

I agree with Neutropeniaboy. First off, he knows everything... secondly, as someone who matched last year, I know how important it is to get involved in your department early. Not only will it set you in the right path, it will also keep you motivated. Not that I'm lazy, but knowing I really wanted to do ENT as an MS1 kept me on my game throughout med school. I spent a good amount of time in the OR when I could as an MS1 and it made a big difference. From there I got involved in research and kept in touch with the residents (an appropriate, not annoying amount), so when I was a 3rd year, they knew who I was and knew I had been working hard towards applying. Another great thing to do is attend grand rounds. I went all of second year because they were at 7am and classes didn't start until 8. That also made a good impression based on feedback I was later given. Grades and board scores are important, but it's hard to stay motivated to work hard at those things if you don't have something you know you want to do. The worst thing is to get to the end of third year and realize you aren't competitive for the field you want to apply to. Believe me, you will know people in that position when you get there.

Good luck!

 

[shnuffles]

Thank you all for your great advice! I have set up times to start doing some shadowing, and have found out about a couple interesting research projects that are going on that I might try to get involved in. Best of luck to everyone, and I might be PMing some of you soon