Becoming an Ear, Nose and Throat Doctor (ENT/Otolaryngologist)

Think of how irritating it is when you feel like you have water in your ear, but you’ve been nowhere near a swimming pool. Or you are scheduled to give a speech and suddenly develop a raspy throat. What about not being able to smell the aroma of coffee, or taste the tartness of a lime? Then there’s the favorite irritant of a friend of mine – her husband’s snoring. These are all ENT (ear, nose and throat) issues.

Although the practice of otolaryngology (ENT) involves more than just the ability to use our senses, they are a substantial component. When our senses don’t work, we miss much of the life that goes on around us. That’s one reason why these surgical specialists are so crucial in the practice of medicine.

Besides alleviating stuffy noses and migraine headaches, these doctors also perform complex operations that restore hearing to the middle ear, opens blocked airways, and removes head, neck, and throat cancers. The ability to do surgery makes otolaryngologists unique among surgical specialists because they are trained in both surgery and medicine, which means they must treat patients medically and surgically. There is no need to refer patients to a surgeon if an operation is required. As a result, an ENT can recommend and provide the most appropriate care for each patient.

To be qualified to perform in this dual role, in addition to medical school, a person must undergo five to eight years of intensive, post-graduate training. Some ENTs say that in exchange for the years of education, they work within the best surgical subspecialty available in medicine. There is no equivalent counterpart in healthcare.

Listen to what an ENT says about this unique medical discipline: What’s an ENT?

ENT treats a range and severity of conditions for people of all ages. They include:

• Allergies and sinuses.
• Head and neck cancers.
• Hearing, which affects balance.
• Skin disorders.
• Sleep disruptions, which include snoring, breathing and sleep apnea.
• Swallowing, which interferes with speech.

Surgeries include:

• Cochlear implants (to restore hearing).
• Deviated septums (repair of areas of nasal passages).
• Plastic and maxillofacial surgeries.
• Tonsillectomies (removal of the tonsils and adenoids).
• Removal of tumors.
• Reconstructive surgeries.

Typical skills and interests

Like most doctors and surgeons, ENT’s need a unique skill set that incorporates personal qualities. These include:

• Ability to work as part of a team, and to manage and supervise others.
• Excellent vision and visuospatial awareness.
• Expert listening skills and the ability to work effectively with people who have communication difficulties.
• Good organizational capacity.
• Outstanding hand-eye coordination and manual dexterity.
• Stamina to sustain a busy and demanding role.

If you like working with your hands, and participating in a more action-oriented branch of medicine, you may discover ENT is the ideal healthcare profession for you.

ENT subspecialties

Some ENTs consider themselves to be in a general practice which means they don’t limit themselves to any one portion of the head and neck. They treat a variety of conditions. However, other ENTs consider themselves specialists in a specific area and obtain additional training to do so. If you’re interested in otolaryngology and want to focus within the discipline, consider one of the following specialties:

• Ears (otology/neurotology) – If you have difficult hearing, or have trouble balancing, you may have a problem in your inner ear. ENTs who focus their practice on the ear treat conditions like ear infections, hearing loss, dizziness, and tinnitus.
• Nose (rhinology) – Our noses help keep our airways clear by filtering out dust, allergens, and other agents. ENTs who specialize in treating areas of the nose can help with deviated septums, rhinitis, sinusitis, sinus headaches and migraines.
• Throat (laryngology) – If you’re unable to speak or swallow properly, you can imagine the impact on your life. ENT specialists see patients with sore throats, hoarseness, gastric reflux disease, throat tumors, and more.
• Head and Neck/Thyroid – Think about your head and neck and all the vital organs they hold. ENTs practicing this specialty treat cancers of the head and neck, enlarged thyroid glands, and other disorders affecting the head, neck and thyroid.
• Sleep – Lack of sleep, interrupted sleep and other sleep disorders plague many people throughout the world. When we don’t get enough rest, it is difficult to enjoy life and to focus on work. ENT sleep specialists treat sleep-disordered breathing, nasal and airway obstructions, snoring and sleep apnea.
• Pediatrics – Healthcare professionals obtain special education to understand the needs and development of children. In addition to tonsillitis, ear infections and allergies, ENTs who specialize in pediatrics also treat birth defects of the head and neck as well developmental challenges.

Typical practice characteristics

ENTs maintain a private, self-owned offices or hospital-based spaces. They can be self-employed or serve on the staff of a hospital or university. They see patients in their offices, but retain surgical privileges in outpatient clinics and hospitals. During a typical day, an ENT may see as many as 25-35 patients. Throughout the year they may perform 250-300 surgeries.

Income and outlook

According to the Medical Group Management Association (MGMA) 2013 Physician Compensation and Production Survey, the average annual income for ENTs is about $442,119. Since they are specialists and perform surgeries, ENTs are a

According to the American Association of Medical Colleges (AAMC), the job outlook for all physicians is stable, with shortages predicted through the year 2020 and beyond. The growing population in the U.S., as well as the increasing average age of the nation’s population are two primary factors contributing to this.

Education and training

Since otolaryngologists are medical doctors, they must first obtain a medical degree. In the United States, the education track for otolaryngologists takes about 15 years. The breakdown of credentials is as follows:

• Undergraduate degree, preferable in biology or science – 4 years.
• Medical degree – 4 years.
• Residency training – 5 years.
  • 3 years of otolaryngology residency.
  • 1 year of general surgery training.
  • 1 additional year of training.
• Optional fellowship training in an ENT subspecialty – 2 years.

Certification and licensure

Along with all other physicians in the United State, otolaryngologists must pass the USMLE (United States Medical Licensing Exam). Additionally, board certification in otolaryngology by the American Board of Medical Specialties (ABMS) is expected although not always required.

Like many healthcare professionals ENTs must also obtain a state license to practice medicine in the state where they work. Check with your individual state for requirements.

Ongoing CMEs (clinical medical education hours) are required for ENTs to maintain their license. There is also a license renewal process that must be completed routinely. Individual states and the specific ENT specialty boards set the renewal cycle, but it is generally every 7-10 years. Completion of minimum CME requirements are almost always included as part of the renewal, so keeping up with those hours is critical to maintaining your hard-won license.

American Board of Otolaryngology

Otolaryngology is one of the oldest medical specialties in the United States.

The American Board of Otolaryngology (ABOHNS) was established in 1924 and is one of the oldest medical specialty boards in the country. Their mission is to, “Serve the public by assuring that diplomates meet our standards of training, knowledge and professionalism through initial and continuing certification.”

In 1978, the ABOHNS changed its name so that it better reflected the field – otolaryngology – head and neck surgery. The change was needed to reflect all the kinds of head and neck surgery included in an ENT’s expertise.

In the ABOHNS, when you meet training requirements and have passed the qualifying and written examinations for otolaryngology, you are considered “board certified” by the ABOHNS and are referred to as a “Diplomate.”

Like many careers in the field of medicine, becoming an ENT is a rewarding and fulfilling profession. If you want to specialize as a medical doctor, studying to become an ENT is a great option.