| Otolaryngology Otolaryngology Josh Kessler, ‘99 Otolaryngology is a field that offers many attractive opportunities and challenges. The typical otolaryngologist divides his or her time between the clinic and the operating room to suit his or her needs. It is a common thing to hear that ENT contains components of both medicine and surgery and I have never met an otolaryngologist who is unhappy with his decision to enter the field. With that said, Otolaryngology is a very competitive field to break into. There are relatively few spots in the country and they are in high demand. This is partially the result of the Academy’s determination to keep the numbers of otolaryngologists down to prevent job saturation. In the January 1999 match, 573 registered with the match, 389 submitted rank lists and 252 matched. 75% of graduating US seniors matched this year. Otolaryngology is an early match, with the deadline for having your rotations, application, and letters of recommendation completed in the second week of September. However, it is to your advantage to get yours in even earlier, like mid-late August. There are many components that programs use to evaluate who to select for an interview. These include letters of recommendation, third year grades, board scores, AOA status, and research. Some programs place high emphasis on research, while others may want only applicants with high board scores.
I cannot emphasize enough how important it is to have a letter from someone well known in the field. You will soon realize that everyone knows everyone else and that having a letter from a well-known chair will help you greatly. This means doing at least one or maybe two away rotations at a large academic institution with a well-known ENT department. I know personally and from others that UCSF, UPENN, and Hopkins are excellent places to do away rotations with attendings that will write letters. It is very important to work hard on these rotations and impress people so that they will recommend you highly. Other programs with excellent reputations include Michigan, Miami, Univ of Washington, Iowa, UCLA. It is also wise to get a letter from someone from BU or another well-known Otolaryngologist, and another letter from an attending in third year or from your surgery sub-I.
I believe that it is very important to do well in your third year. Honoring surgery and medicine go a long way and honoring the majority of your clerkships demonstrates interest and motivation. This is not to say that you should rule out ENT if you have not honored many third year courses, but you may consider a back up plan if this is the case.
You will hear that you need 235 on the boards to get into a surgical subspecialty and you will also hear that you only need to break 200. What is the truth? Who knows, but great board scores can only help you. I think that one should aim to break at least 220 and any score below 210 is probably a sign to prepare a back-up plan. Any score in the middle (like mine) may cost you some interviews but won’t count you out. If you don’t do well on the first step, take a vacation block in August and take step two in the fall if you think you can improve. This will allow you to bring your scores to interviews and you’ll be very happy in the spring while your classmates are studying.
Ah yes, the big mystery of AOA. You will hear that AOA is essential in surgery and surgical sub-specialties - and this is false. Of course, having AOA places you at an advantage above those that do not, but this is by no means essential. Many people without AOA get top spots at academic institutions in ENT and there are definitely people with AOA who do not match at all.
Many programs want to see some research, and I believe that it is an important complement to one’s application. It is very easy to get involved in case reports and some basic science research if you seek it out EARLY. You don’t want to do 10 months of bench work and not have your name on the paper. I suggest finding an attending you feel comfortable with in first or second year (preferably in ENT or surgery) and asking him/her if they have any small projects (case reports are cool, easy, and easy to publish) for you to work on. You may even get the opportunity to make a poster out of it and present it at a national conference in a cool city. While those without research still match, I believe more and more that research will really boost your chances. As I’ve repeatedly said, elements of the match regarding who does and who doesn’t are very hard to comprehend. You should never count yourself out but at the same time you should never think of yourself as a shoo-in. Although it is very difficult to have a back-up plan, unless you are willing to not match at all in 2000, I would suggest setting one up in a less competitive field if you have doubts about the strength of your application.
Visit http://www.sfmatch.org to log onto the matching program’s web site, and request an application to register. The OSA will also have these forms in the spring. Register with the match in the spring and write to some programs that interest you. Most programs have links in the web site as well so that you can print out their info rather than mail 50 different places. You should set up your fourth year schedule to do two ENT electives before September. If you can fit a sub-I in surgery, you may want to do that as well. I was able to do my sub-I in May, take step 2 of the boards, and do two rotations in ENT (one away) before I had to complete my application. You should also be preparing your CV and a personal statement in the late spring in order to give to your letter writers. Expect that it will take each writer 3-4 weeks to finish the letter. This way you won’t get caught waiting for a letter in order to complete in your application. Remember, it is essential to do all of this ASAP, and if you don’t get a schedule that allows you to, you must go and fight it out with the registrar to get one that allows you to have the best chance. Fill out the application in plenty of time to spare and show it to as many people that will look at it. Feedback only hurts if you take it personally, so don’t. It is important to get as many opinions as possible before you submit the final product. The personal statement should say how you got interested in ENT, what you do in your spare time, and what your goals are. While these do not need to be masterpieces, people do read them and a bad one may hurt you. Where? Apply to any place that you would consider going to. Now is not the time to hold back on your money. The average number of applications was 37 this past year, and it seems to go up every year. When people asked me why I applied to so many programs, I always said it was nice to turn down interviews rather than wishing I got more. I would advise applying to all of the big programs, but don’t only interview at the best places unless you are really outstanding. Go to a few places that you feel you have better shot at, as well. I think 10 interviews is enough, and over 15 gets to be a lot, but if you have the time and money, go for it. You will find that you may be canceling interviews to go on another, because many programs only interview on 1-3 dates and will not make exceptions. The interviews are arranged from late October to early December, many on weekends. You will spend a lot of money and get little sleep. You’ll also miss a lot of school, so don’t do the sub-I here. The vast majority of interviews are very laid back. You’ll see the same applicants at many different places. You will be asked how you got interested in ENT, what you like to do, where do you see yourself in the future, etc. Very, very few places will pimp you and only one make you carve the infamous soap. Just be calm and be yourself. You are on the same footing as everyone else at the interview. Always write down the names of those who interviewed you and what you talked about and write thank you letters as soon as you get home. Rank your programs according to your preference, not theirs. So you don’t think you’ll match at Hopkins but you get an interview? Rank them number one, and don’t be afraid to let them know that you intend to do so. Programs want people who want to be there, and writing them to tell them that you are very interested is perfectly legit. And don’t rank any program that you don’t want to go to, but don’t drop any that you would go to just because you feel confident. Also, don’t assume that just because you think your interview didn’t go as well as you wanted that your interviewer felt the same way. Many times I have heard people get into the programs that they felt they interviewed horribly at.
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