Scope of practice: Otolaryngology offers a unique scope of practice compared to many other specialties lending practitioners exceptional flexibility within the field. Unlike other specialties, the realm of the otolaryngologist is not defined by a “body system” (as orthopedics is to bones, urology is to the urogenital system, dermatology to skin etc…) but instead is uniquely defined by an anatomic region. Because of this, the field of otolaryngology includes a range of subspecialty areas covering very different organ systems, each requiring a diverse surgical skill set (laser surgery, microsurgery (both microvascular and neurotologic), endoscopy, gross oncologic dissection, etc).
Additionally, otolaryngology is one of the few surgical subspecialties without a true medical counterpart (orthopedic surgery with sports medicine; neurosurgery with neurology and so on…). Not only does this increase the number of conditions the practitioner is comfortable managing, it also permits more career flexibility allowing the otolaryngologist to tailor his/her practice more toward either surgical or medical involvement.
Patient diversity: Depending on the area of specialty, otolaryngologists care for the entire spectrum of patient demographics: from the neonate with congenital airway disease to the septuagint with hearing loss, both males and females alike. “No one is immune to seeing the otolaryngologist”.
The anatomy: There is likely no other more surgically challenging area of the human body with respect to functional and aesthetic concerns than the head and neck. The anatomy of the head and neck is incredibly intricate and compact, containing numerous vital structures within a small space.
Life-style considerations: Everyone has likely heard the jokes regarding the ENT lifestyle: ENT stands for “early nights and tennis” or “easy not tough”. While these are obviously embellished, the field of otolaryngology does lend to a better lifestyle than many other surgical fields. Many of the procedures performed by the otolaryngologist can be so on an outpatient basis, and with the exception of patients with advanced oncologic disease, the majority of patients that do get admitted are generally healthy and have relatively short, uneventful hospital stays.
According to a 2002 report by the American Medical Association, Otolaryngologists averaged approximately 52 hours of patient care per week compared to roughly 60hrs/wk for general surgery, orthopedic surgery, and neurosurgery and 56hrs/wk for urology and plastic surgery. The average annual compensation for practitioners in the field is between 250-300k, but can vary widely depending on fellowship training, local geographic demand and whether one is primarily in an academic or private practice setting.
As previously mentioned, otolaryngologists are truly trained to be both medical and surgical specialists. Because the surgical portion tends to be more grueling with early mornings and less schedule predictability, it is not uncommon for many otolaryngologists later in their career to change to solely clinic based practices allowing for increased career longevity as desired.
Finally, when discussing life-style considerations the topic of supply must be discussed. The number of resident positions for otolaryngology – head and neck surgery is strictly guarded so that the field does not become over-saturated. While all surgical specialties physicians tend to disproportionately congregate in larger urban areas, currently the number of positions exceeds the number of active otolaryngologists guaranteeing all newly graduated residents great marketability with very little geographic restriction when searching for employment.
Great people: There are countless jokes centered on the unique stereotypes labeled to physicians within various medical and surgical fields. And while these traits are often extremely exaggerated and over simplistic, it is true that people of similar personalities tend to find themselves gravitating toward certain specialties. With running the risk of over generalizing, otolaryngologists tend to break the “malignant surgeon” stereotype and in general, they are easy going satisfied people that can just as easily talk about last nights baseball game as they can describe a radical neck dissection. Because the specialty lifestyle is often more permitting than other surgical fields, otolaryngologists tend to have other interests outside of medicine and are often married with families.
Related Articles:
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The impact of gross anatomy on the future head and neck surgeon. -
Otolaryngology residency training: resurgence of the specialty
Surgery: When deciding what career path to choose, the decision between surgical vs medical specialties is the first big decision applicants face. This entry could have been just as easily placed in the “positives” category above, depending on which side of the fence you are on. Since most otolaryngologists split their time relatively equally between surgery and clinical duties, you must obviously enjoy the OR to enjoy otolaryngology.
“phlegm, earwax, snot, and projectile trach secretions”: Most people in the medical field would find this entry funny, but there are some people who absolutely cannot stand being around the various secretions of the head and neck – for these individuals, otolaryngology is probably not the best fit. Obviously, all surgical (and most medical) fields deal with some sort of bodily fluids. You just have to decide which you are most ok with.
JOSE PEREZ
