Question about Osteopathic ENT residency programs

[JDoc9]

Hi all! Terribly sorry if this question is repetitive (I've tried looking around to make sure its not), but I have a burning question regarding the osteopathic ENT programs.

As I look into each program, they are all listed as "ENT/Facial Plastic Surgery". Now, I am not under the impression that they are some kind of combined programs or something (...right?), but what is the deal here? Do DO's coming out of these residency programs have the adequate training a Facial Plastic Surgeon should have? Can you legally call/advertise/market/etc yourself as a Facial Plastic Surgeon (specifically plastic, not cosmetic) after completing these programs? Thank you all in advance for your help!

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[ram006]

Isn't osteopathic medicine supposed to be holostic? Seems strange to have ENT/Facial plastics residencies.

 

[Pir8DeacDoc]

It's just nomenclature. The DOs just call theirs that. We call it "Otolaryngology-Head and Neck Surgery". I'm told the training is in theory the same. Never met a DO ent

 

[DrEnderW]

Isn't osteopathic medicine supposed to be holostic? Seems strange to have ENT/Facial plastics residencies.

First troll post I've ever seen from a resident on the physician forums...

Hi all! Terribly sorry if this question is repetitive (I've tried looking around to make sure its not), but I have a burning question regarding the osteopathic ENT programs.

As I look into each program, they are all listed as "ENT/Facial Plastic Surgery". Now, I am not under the impression that they are some kind of combined programs or something (...right?), but what is the deal here? Do DO's coming out of these residency programs have the adequate training a Facial Plastic Surgeon should have? Can you legally call/advertise/market/etc yourself as a Facial Plastic Surgeon (specifically plastic, not cosmetic) after completing these programs? Thank you all in advance for your help!

I know the AOA ENT program at St. Barnabas sees a decent amount of cosmic procedures but that's as far as my knowledge extends. It's not integrated in the sense that cardiothoracic is or a substitute for integrated plastics or plastics fellowship, but more of a nomenclature thing. Obviously, head and neck surgery will have a plastics component to it.

The link below has more of a description. Fellowships would allow for further training and specialization.

http://www.osteopathic.org/inside-a...uments/Basic-Standards-Otolaryngology-FPS.pdf

http://www.aocoohns.org/residency-resources/residency-documents-forms

http://www.kevinmd.com/blog/2012/02/plastic-surgery-part-ent-surgeon-repertoire.html

Never met a DO ent

Yeah, there's only about 20 AOA ENT programs so not many.

 

[ram006]

First troll post I've ever seen from a resident on the physician forums...QUOTE]
sigh

 

[ram006]

First troll post I've ever seen from a resident on the physician forums...QUOTE]

OMM, AT Stills, holistic medicine... pretty sure I'm not making that up. But if you wanna get all sensy about it I apologize.

 

[JDoc9]

Thank you so much for your responses! The links are very helpful! I guess my main question is more of a question on technicality/law. Can you advertise yourself as a Facial PLASTIC surgeon following the completion of these programs? Please not that I am not asking about Facial COSMETIC surgeon. This is because I am very interested in the facial reconstructive procedures in the FPS repertoire, and the facial cosmetic procedures also fascinate me. In short: I want to be a Facial Plastic Surgeon. Does completing the D.O. ENT/FPS residency allow me to be so? Thank you all!

 

[resident108]

if you want to do facial plastics, the best route is go to a MD school then do ENT residency for 5 years and facial plastics fellowship which is 1 year - you will be a well trained surgeon this way and well respected in the ENT community. You'll be able to do all facial reconstruction - from local flaps to free flaps.

The DO route doesn't make sense for this. Typically you'd go to a DO school if you can't get into MD schools. And if you do a DO ENT residency, then you may still need fellowship to do some of these procedures. DO ENT residencies are not common and not the major US cities (exception I can think of is Drexel in Philly).

You can market yourself as a facial plastic surgeon even after a general MD ENT residency.

 

[mwright24]

if you want to do facial plastics, the best route is go to a MD school then do ENT residency for 5 years and facial plastics fellowship which is 1 year - you will be a well trained surgeon this way and well respected in the ENT community. You'll be able to do all facial reconstruction - from local flaps to free flaps.

The DO route doesn't make sense for this. Typically you'd go to a DO school if you can't get into MD schools. And if you do a DO ENT residency, then you may still need fellowship to do some of these procedures. DO ENT residencies are not common and not the major US cities (exception I can think of is Drexel in Philly).

You can market yourself as a facial plastic surgeon even after a general MD ENT residency.

Wow this is a very condescending statement.I mean you don't see me saying don't go to an MD school unless you plan on being an A**hole upon graduation. There are plenty of fantastic ENT's that are osteopathic physicians, yes there are limited spots but it doesn't mean that their training is subpar compared to their allopathic counterparts. Several ENT surgeons I know do plenty of free flaps and various other intensive head and neck surgeries. Just research the programs and find out how many of the residents there go into fellowships.

I CHOSE to go to a D.O school over my states Allopathic school because of the class size and the patient centered health care.

 

[Pir8DeacDoc]

Then you made a bad decision

 

[VisionaryTics]

I CHOSE to go to a D.O school over my states Allopathic school because of the class size and the patient centered health care.

Lol. Let me guess, M1/M2?

Also, the quality of DO programs varies immensely. There are a handful of DO programs near the major city near me, and the case variety at each is very different. Some do no major head and neck, some do no major plastics, some have a peds experience limited to tubes/tonsils, none do skull base. If they need a free flap, they refer to us. They send their residents to us for one-month rotations so they can get experience in some of these areas.

ACGME accredited programs are held to a higher standard, simple as that. The quality of the education, conferences, and mandated surgical variety make sure every single ACGME program is pretty high quality. The AOA simply does not have those requirements. There are probably a number of good osteopathic training programs that produce competent ENTs, that doesn't mean their training is the same as MDs.

 

[mwright24]

Then you made a bad decision

Let me guess... attending physician that hates his life. Hates his family. Hates his career. Burned out...Classic Allopath

 

[mwright24]

Lol. Let me guess, M1/M2?

Also, the quality of DO programs varies immensely. There are a handful of DO programs near the major city near me, and the case variety at each is very different. Some do no major head and neck, some do no major plastics, some have a peds experience limited to tubes/tonsils, none do skull base. If they need a free flap, they refer to us. They send their residents to us for one-month rotations so they can get experience in some of these areas.

ACGME accredited programs are held to a higher standard, simple as that. The quality of the education, conferences, and mandated surgical variety make sure every single ACGME program is pretty high quality. The AOA simply does not have those requirements. There are probably a number of good osteopathic training programs that produce competent ENTs, that doesn't mean their training is the same as MDs.

Actually MS4- but yes it does vary. I agree with that. Just letting the question writer know that he can go into an osteopathic program and still pursue a career in ENT- facial plastics. If he wants to have terrible bedside manner and hate all of his classmates then go for the Allopath route.

 

[Pir8DeacDoc]

Really no reason for you to insult me personally. I'm hesitant to even reply because I don't think your tone or demeanor warrants it. However, against my better judgement I'll expound on my thoughts.

It's really just a simple numbers game. If you want to pursue something as a DO, you can. But statistically it's more challenging. There is almost no way you'll get allopathic ENT as a DO. It's hard enough for allopaths. If you are comfortable pursuing DO training, then go for it. I personally wouldn't trade a second of my training and would never want to be at a rural hospital trying to learn a specialty with as much depth and complexity as otolaryngology. I wanted the hard cases and rare cases in training. It makes a lot of the regular stuff that I do today that much easier. Our specialty prevents programs from popping up on every corner and the quality of our training and programs reflects that.

I wish you much success, but don't try and sell me some sunshine BS that people actually choose the DO route when they have an option of MD. It doesn't pass the sniff test. I mean no DO's do manipulation stuff in practice anyway so it's an alternative pathway with a lower barrier to entry than MD. Those are just facts supported by GPA and MCAT scores of incoming students.

 

[Postictal Raiden]

Within the coming few years, all of residencies will be overseen by ACGME. Current AOA residencies will either be converted to ACGME or shut down. Therefore, all this will be irrelevant, right?

 

[Pikevillemedstudent]

Really no reason for you to insult me personally. I'm hesitant to even reply because I don't think your tone or demeanor warrants it. However, against my better judgement I'll expound on my thoughts.

It's really just a simple numbers game. If you want to pursue something as a DO, you can. But statistically it's more challenging. There is almost no way you'll get allopathic ENT as a DO. It's hard enough for allopaths. If you are comfortable pursuing DO training, then go for it. I personally wouldn't trade a second of my training and would never want to be at a rural hospital trying to learn a specialty with as much depth and complexity as otolaryngology. I wanted the hard cases and rare cases in training. It makes a lot of the regular stuff that I do today that much easier. Our specialty prevents programs from popping up on every corner and the quality of our training and programs reflects that.

I wish you much success, but don't try and sell me some sunshine BS that people actually choose the DO route when they have an option of MD. It doesn't pass the sniff test. I mean no DO's do manipulation stuff in practice anyway so it's an alternative pathway with a lower barrier to entry than MD. Those are just facts supported by GPA and MCAT scores of incoming students.

I don't think your tone or demeanor is very professional in this thread, especially from someone who has never met a DO ENT.

With that said, I'm a DO otolaryngologist. My residency training was better than most, MD or DO. Why? We had a faculty to resident ratio of greater than 3:1. I had an amazing variety of cases to chose from daily. Many cases went uncovered because we didn't have the residents available to cover.

We performed major H&N cancer surgeries including free flaps and otology cases including cochlear implants. We also had our own children's hospital. We did some away rotations in skull base and peds for the complicated airway reconstruction. Don't kid yourself into thinking you need a large skull base or airway reconstruction experience in residency. Those are fellowship trained cases nowadays. Also, our facial plastics case requirement is very high which is the reason why I'm officially board certified in otolaryngology and facial plastic surgery. I'm told our requirements for fps are much higher than our MD counterparts but I have no data to support that. Thankfully we had a fellowship trained facial plastics on staff to help us meet those requirements.

Our graduates have attained fellowships in all sub specialties of ENT including neurotology, rhinology, Head and neck, facial plastics, and laryngology.

Of course not all residencies are the same, DO or MD, but please don't make generalized statements regarding a subset of your colleagues that you really don't know that much about.

 

[DrBodacious]

I don't think your tone or demeanor is very professional in this thread, especially from someone who has never met a DO ENT.

With that said, I'm a DO otolaryngologist. My residency training was better than most, MD or DO. Why? We had a faculty to resident ratio of greater than 3:1. I had an amazing variety of cases to chose from daily. Many cases went uncovered because we didn't have the residents available to cover.

We performed major H&N cancer surgeries including free flaps and otology cases including cochlear implants. We also had our own children's hospital. We did some away rotations in skull base and peds for the complicated airway reconstruction. Don't kid yourself into thinking you need a large skull base or airway reconstruction experience in residency. Those are fellowship trained cases nowadays. Also, our facial plastics case requirement is very high which is the reason why I'm officially board certified in otolaryngology and facial plastic surgery. I'm told our requirements for fps are much higher than our MD counterparts but I have no data to support that. Thankfully we had a fellowship trained facial plastics on staff to help us meet those requirements.

Our graduates have attained fellowships in all sub specialties of ENT including neurotology, rhinology, Head and neck, facial plastics, and laryngology.

Of course not all residencies are the same, DO or MD, but please don't make generalized statements regarding a subset of your colleagues that you really don't know that much about.

The residency you describe sounds good, but there are a very few MD programs that do not meet or exceed what you describe. ACGME and ABOto set very high marks for MD ENT residency programs.

I suspect that DO boards and MOC are more lax, but I don't know much about the DO process.

You can be an excellent surgeon with mediocre training also, but it's obviously better to be well trained, and it's good to have your certications prove that you are well trained.

Certification from the American Board of Facial Plastic and Reconstructive Surgery, specifically, is a tough process. http://www.abfprs.org/applying/index.cfm

DO ENTs would not qualify, because they are not ABOto certified to begin with.

"To be eligible for certification, a surgeon must:

Have completed a residency program approved by the Accreditation Council for Graduate Medical Education or the Royal College of Physicians and Surgeons of Canada in one of the two medical specialties containing identifiable training in facial plastic and reconstructive surgery: otolaryngology/head-and-neck surgery or plastic surgery.

Have earned prior certification by the American Board of Otolaryngology, the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada in otolaryngology/head-and-neck surgery or plastic surgery.

Have been in practice a minimum of two years.

Have 100 operative reports accepted by a peer-review committee.

Successfully pass an 8-hour written and oral examination.

Operate in an accredited facility.

Hold the appropriate licensure and adhere to the ABFPRS Code of Ethics."

 

[Pir8DeacDoc]

nevermind

 

[koojo]

This turned into a DO vs MD thread..ENT specific. Yeay..

 

[DrBodacious]

This turned into a DO vs MD thread..ENT specific. Yeay..

The OP asked "what's the deal" with DO programs touting ENT/facial plastics.

The deal is the don't qualify for board certification by the ABFPRS. Maybe they have more requirements addressed in their residencies, but certainly not as high a bar as ABFPRS sets.

 

[Pikevillemedstudent]

The OP asked "what's the deal" with DO programs touting ENT/facial plastics.

The deal is the don't qualify for board certification by the ABFPRS. Maybe they have more requirements addressed in their residencies, but certainly not as high a bar as ABFPRS sets.

We have our own board and therefore board certification. So it's actually easier to be a "board certified facial plastic surgeon" through the DO route because you must only complete an otolaryngology residency and written and oral boards. But I agree that the standards compared to ABFPRS may be lower. I hate facial plastics so I never cared to compare the two. It's all BS marketing. I've found that most DO's interested in FPS usually seek additional training after residency.