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When did you guys know when ENT was the right fit for you? During the head and neck section of anatomy? ENT rotation? If you were considering other specialties, what finally helped you chose?
Loved surgery. Finally had to decide between oto and ophtho. More variety in oto, in my opinion.
WOOOOOORRRRRRD!!!
no offense but the more i read your posts, the more weirded-out I become
EXPLAIN YOURSELF.
And then I did ENT and fell in love with procedures. More importantly, it was the only clinic I did that I actually enjoyed as a student.
Personally, I would like the idea of being a generalist in an academic setting provided that I could get as advanced as you want, with good peer support (which is not always the case).
And yes, peer support is sometimes tough as a general ENT in an academic practice. I nearly took a full-time faculty position, but would have been relegated to very few thyroids, very few sinus cases, and stuck with doing a lot of trauma and sleep apnea. Not exactly what I was looking for.
Peds: Tubes, tonsils, LN Biosies, occasional thyroglossal duct cysts, etc
Neuro-otology: Tympanoplasty, tympmastoids, BAHA, Basic OCR, tc
H&N: thyroids, parotids, anterior floor of mouth CA, neck dissections, etc
Laryngology: vocal cord medialization, VC microflaps, subglottic stenosis, etc
Facial plastics: Trauma, gold weights, skin lesions, septums, rhinoplasty
How do new ENTs streamline into one of these areas? Is it because they've completed a fellowship, or are these straight-from-residency graduates who themselves decided to focus on say H&N or facial plastics? I guess what I'm asking - do you have to be fellowship trained to subspecialize in academia? What about in PP?
Are there a multitude of vocal cord pathologies or is there one very common pathology? What size market is needed to have a successful laryngology clinic?
That's a pretty generic question for a highly specialized field which makes me wonder why you'd be asking it.
However, I guess the best answer is to say there is enough vocal fold (do not call it a cord if you're going into ENT) pathologies out there to have the demand for a subspecialty.
The size of the community? I'm not sure if there are true stats on that. The current thinking is that you need 1 general ENT per 35K people. So I'm going to guess that the "need" for a laryngologist (in order to remain busy) at the minimum is more on the order of 1 Laryngologist for every 5-7 general ENT's or in other words for every 175K-245K people. Certainly, if the laryngologist wants to focus on laryngology alone, he's going to need to be in a bigger population.
I have a good friend in a town of 220K in the midwest. He's a general ENT but focuses mostly on laryngology. Probably tries to keep 75%+ of his practice in laryngology alone. He can with that population. Another colleague about 40 miles north of him in a town of 400K is also a general ENT but tries to remain exclusively laryngology. He estimates about 90% of his practice is that way.
In general, you need a good referral system with lots of general ENT's to keep you busy if you want to exclusively do your subspecialty.
The reason I ask is because I've always been involved in vocal performance and just wanted some general information about the subspecialty. Sorry bout the terminology, I'm a first year who hasn't had head and neck anatomy yet. I appreciate the help resxn.
Seems like there's a lot of pet peeves in oto, huh. I've been told never to call an otolaryngologist an ENT, never to use the word "injected' when describing TMs, and now I know some people get pissed if you say "cord" instead of "fold"... All very interesting.
Someone should make a thread titled "How to fail your oto rotation in 10 days," and then you guys can list all the things that med students say that really, really annoy you.
or ?