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ENT Otolaryngology vs Dermatology -> 20 yrs from now

Home General/Welcome ENT Otolaryngology vs Dermatology -> 20 yrs from now

  • Avatar benign_user 
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    ENT is a surgical residency first and foremost. I’m an ENT resident currently on our cancer service and will be in at least three 8-9 hour surgeries doing complex resections and flaps this week. Plenty of rotations are not like that but nearly a quarter of your residency at most programs will be spent on the cancer service.

    If you want to do ENT because you think it is like Dermatology and a similar quality of life I don’t think you would be a good fit for our specialty.

    ENT can have a great quality of life after residency but you still take call for airway emergencies and other acute conditions. Not at all comparable to Dermatology in my opinion.

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    Most ENTs don’t do cancer surgeries. They refer the patients to tertiary centers where the ENTs are fellowship trained to do cancer surgery.

    #225254 Reply
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    Avatar Tim 
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    Lifestyle and income = derm
    One potential is that PE has been entering the space.
    I would view that as a bigger risk since mid levels still get a check, just a different EIN. That might change the lifestyle.

    Ortho is a grind but you really need to dive a little deeper. The sub specialties are practice wise substantially different. Hand, trauma,spine, sports, peds etc. lead to different practices. General ortho in a hospital employed is changing too. Suburb clinics with adjacent outpatient and hospital leaves opportunities in the suburbs. Private groups have more lucrative opportunities with outpatient surgery centers.
    Ortho you can build a broad or narrow practice. It’s easy to say, but it takes work to build the referrals base.7

    ENT-? I am ignorant. My neighbor is an ENT but doesn’t talk shop.

    If your job satisfaction comes from the OR, ortho gets paid for procedures. Each procedure is a really big deal in a patient’s life. If you prefer an office clinic, derm is for you.

    #225257 Reply
    Avatar Otodoc 
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    Joined: 01/23/2016

    ENT is a surgical residency first and foremost. I’m an ENT resident currently on our cancer service and will be in at least three 8-9 hour surgeries doing complex resections and flaps this week. Plenty of rotations are not like that but nearly a quarter of your residency at most programs will be spent on the cancer service.

    If you want to do ENT because you think it is like Dermatology and a similar quality of life I don’t think you would be a good fit for our specialty.

    ENT can have a great quality of life after residency but you still take call for airway emergencies and other acute conditions. Not at all comparable to Dermatology in my opinion.

    Click to expand…

    Most ENTs don’t do cancer surgeries. They refer the patients to tertiary centers where the ENTs are fellowship trained to do cancer surgery.

    Click to expand…

    it depends honestly on what you want to do.  i go to the state meetings and keep in touch with lots of colleagues.  I would say about a third of general ENTs still do a good bit on cancer work.  especially in rural parts of the state.  im at a rural hospital and do neck dissections and such routinely.  obviously free flaps go to the University.  now when it comes to ears–i send anything more than simple tympanoplasty to the Ivory tower.

    as to the OPs question, i think ENT is more insulated from NPs and billing changes from the government.  Derm bills a far smaller range of CPT codes, so cuts could effect them big time.  If they cut my sinus work, i do more laryngology, etc.

    Derm is far easier lifestyle and make far more money.  at least around here.

    #225766 Reply
    Avatar MrDerm 
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    Hello All,

    I’ve been in derm and in peds for almost 40 years, and obtained both boards. I was PT at a local med school until 2013, had my own practice and then retired to PT work in another state. That work however is ending soon.

    Derm has been a wonderful specialty. I enjoyed the mix of medicine (read autoimmune/immunology, fungal and bacterial infections, contact dermatitis), surgery and other procedures that derm provided. Of course there are also laser procedures, Botox, and fillers, as well as other cosmetic offerings that many of the younger derms are doing – however that all came in well after my training and practice, so I was never very much attracted to those services. In our large city however many patients did go for those services, which were provided by my younger partner (and former student at the med school). Eventually I changed my views on these cosmetic services somewhat, as I saw how good she was at them and how much the patients appreciated getting those services at our practice, where they had established trust since 1979.

    I could write more later, but family events call. That’s a start, though. I loved derm, and being a private practice pedi-derm was also very rewarding.

    Would be happy to discuss further…

     

    #228321 Reply
    Avatar NJDoc 
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    I’m an ENT and have just completed my 23rd year in practice. As has been said above, at it’s heart ENT is a surgical subspecialty, so if you love surgery then ENT beats Derm.

    Most of us started out doing the big head and neck cases and then transitioning to more minor cases. There are plenty of office procedures that are still quite lucrative and low risk. Overall we are a small specialty and tend to fly under the radar of big insurance changes. I also agree we are likely more insulated from the encroachment of NP’s/PA’s, although they are an advantage within your practice. Around here our income handily beats Derm, but that is certainly not the case everywhere.

    Call can be boring or hair raising, middle of the night airway disasters, post op hemorrhage, etc., so Derm beats ENT there.

    ENT is a rather broad field and I like the fact that as one ages you can craft and mold your involvement in different areas. You can also go non surgical in your later years.

    The range of Pathology, special organ systems and age range of patients from birth to advanced age make it an intellectually challenging field. We probably beat Derm there too..maybe.

    Work load and hours are probably similar , but every time I try to take my Derm friend fishing he says he has to work…

    I can tell you with all certainty, ENT is a great field and there is a need for general ENT’s in the suburbs and beyond. Too many residents get caught up in the fellowship track and I think that is a mistake. Stay in touch when you finish your program ( because I know you’ll choose ENT!) , I’ll need someone here in about 4-5 years.

    #228659 Reply
    q-school q-school 
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    glad there are some gray hairs that still love the practice of medicine!

     

    #228740 Reply
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    Avatar Anne 
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    Joined: 11/07/2017

    Work load and hours are probably similar , but every time I try to take my Derm friend fishing he says he has to work

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    He may just think fishing is really boring so that’s his excuse 😉

    #228820 Reply

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