STUDENT GUIDE TO SECURING A RESIDENCY
IN OTOLARYNGOLOGY-HEAD AND NECK SURGERY
WHY SHOULD I CONSIDER OTOLARYNGOLOGY AS A CAREER CHOICE?
HOW DO I FIND OUT IF I LIKE OTOLARYNGOLOGY?
HOW DIFFICULT IS IT TO MATCH IN OTOLARYNGOLOGY?
DO I NEED TO DO A RESEARCH PROJECT?
HOW DO I APPLY FOR AN OTOLARYNGOLOGY RESIDENCY?
APPLICATIONS
LETTERS OF RECOMMENDATION
TO HOW MANY PROGRAMS SHOULD I APPLY?
TO WHICH PROGRAMS SHOULD I APPLY?
WHAT IF I AM THINKING ABOUT AN ACADEMIC CAREER?
DO I NEED TO DO AN EXTERNSHIP?
INTERVIEW INVITATIONS
INTERVIEWS
POST GRADUATE YEAR 1 MATCHING
OTOLARYNGOLOGY MATCHING PROCESS
WHAT IF I DON'T MATCH?
ADVISING
TIMETABLE
LOCATIONS OF RECENT UMMC STUDENTS IN OTOLARYNGOLOGY RESIDENCIES
WHY SHOULD I CONSIDER OTOLARYNGOLOGY AS A CAREER CHOICE?
Otolaryngology-Head and Neck Surgery is a regional medical and surgical subspecialty.
We have no medical counterpart; therefore, we are responsible for the
entire management of patients with head and neck problems.This allows you to have the best of a
medical and surgical subspecialty. Most
otolaryngologists divide their time equally between seeing patients in the
office and performing surgery. You get
to make the diagnosis, treat it medically or surgically, and then follow the
patient. Furthermore, the specialty has
no arbitrary age or sex limitations as we see patients from neonates to
geriatrics and, obviously, both sexes.
The field is much broader than you might imagine
if you think only of Ear, Nose, and Throat. The specialty includes: head and
neck oncology, facial plastic and reconstructive surgery, otology/neurotology,
rhinology/sinus, bronchoesophagology, pediatrics, speech and swallowing
disorders, facial nerve disorders, balance problems, maxillofacial trauma, and
taste and smell disorders. As you can
see, there is something to interest everyone in this specialty.Obviously, none of our names really
describes all that we do. The wide
diversity is reflected in the fascinating anatomy of the head and neck, which
keeps one constantly learning.
Although no one can accurately predict the
future of health care, otolaryngology is estimated to be one of the surgical
subspecialties with the closest number of practitioners compared to need. The lifestyle of an otolaryngologist is
manageable compared to all other surgical subspecialties and many other fields
of medicine. The residency, while
demanding, generally requires much less in-house call and results in
fewer sleepless nights than a typical surgical residency. Private practitioners have few emergencies to
bring them in at night and such rarely interrupt their office schedule. Schedules in otolaryngology practice
generally allow you to balance personal and professional goals.
HOW
DO I FIND OUT IF I LIKE OTOLARYNGOLOGY?
If you are a second year medical student, you
can request a rotation on Otolaryngology as part of your Surgery rotation in
the third year. If you are a third year
student and did not get to rotate on Otolaryngology during your third year or
need more exposure to the specialty, you should do a one-month elective on the
Otolaryngology service in your senior year. During that time, we will attempt to expose you to the
entire spectrum of otolaryngologic care. We encourage you to do the rotation in
the first few months of your senior year to allow time to make a considered
decision about your specialty choice.
HOW
DIFFICULT IS IT TO MATCH IN OTOLARYNGOLOGY?
Last year, 82% of U.S. seniors interested in otolaryngology obtained a
residency slot. This number has ranged
from 75-85% over the last few years.
This is highly dependent on a number of factors, which we can discuss
together. We have typically been quite
successful in matching our students at programs around the country. If you are in the top half of your class and
have a Step I USMLE score greater than 220, you have a reasonable chance of
getting a residency position. We have
been able to successfully match students below this level on multiple
occasions, however. Obviously, the
higher your score the easier it is to get interviews; the average score was 238
for those who matched. Matching with a
spouse or significant other can create some challenges, but we have
successfully done this a number of times. It is advisable that you take both USMLE Step 2 CK and CS as soon as possible so those scores will also be a part of your application.
DO I NEED TO DO A
RESEARCH PROJECT?
It is not essential to do a research project,
but it may be helpful. A publication or
research project is one of many factors considered in granting you an
interview. If you have significant
research exposure in any area in the past that may well be adequate. If you have no exposure, you may want to
consider doing a project with us either as a separate block or during your
rotation. The residency directors are
simply looking to find the most motivated and curious students. Research work is one marker for this. By no means does the lack of a research
project exclude you as we have successfully matched a number of students
without any research background. There
are only a handful of programs in the country that would deny you an interview
on this basis alone. However, the topic
comes up frequently during interviews, and you may feel more comfortable if you
have done some type of project. We will
be happy to get you involved with a mentor if you are interested. Dr. Schweinfurth coordinates this effort.
HOW DO I APPLY FOR AN OTOLARYNGOLOGY RESIDENCY?
Otolaryngology
participates in NRMP and ERAS. You register with the NRMP via their web site http://www.nrmp.org. Registration for ERAS can be done at http://www.aamc.org/students/eras/start.htm. Both are in coordination with the Office of
the Associate Dean for Academic Affairs.
When it comes time to select programs to which you wish to apply, please
talk to our faculty members for guidance. You do not have to write each program in order
to apply to them, but you may still want to write and ask for preliminary
information about their program to help you reach a decision. However, most programs will refer you to their web sites which usually are very informative. You may get program addresses from http://www.acgme.org (Reports: Programs by
specialty) or http://www.ama-assn.org (Freida online).
A
few otolaryngology programs may directly contact you for additional information
once they receive your application. ERAS automatically creates a CV from the application information so you should not be asked to provide an additional one.
APPLICATIONS
The goal of applications is to show your best in
order to get interviews. Please allow
us to review your application prior to submitting it so we can help you project
yourself best. Reviewers are looking at
several areas including class standing, AOA status, USMLE Step scores, history
of research work or exposure, publications, community service, involvement in
outside activities, leadership roles, and the ability to write a coherent
personal statement. Most applicants
will not excel in all of these areas; we are just trying to maximize your positives. Your personal statement should not be
outlandish, but at the same time should serve to catch the attention of the
reviewer. Most applicants tell what
they like about otolaryngology and speculate on future career plans. We would encourage you to relate some
personal experience that will serve to distinguish you from other
applicants. At this point, you want to
be noticed in a positive way.
We
encourage you to stay on the early side of all deadlines since many program directors begin reviewing applications early. Getting applications in early suggests that
you are an organized person. Also, the
residency director may be able to pay more attention to yours than at the last
minute when a great number arrive all at once.
Finally, some programs give out interviews as the applications arrive
and this puts you in a better position.
LETTERS
OF RECOMMENDATION
You
need up to four letters of recommendation.
One
should definitely be from the chair of our department. All but one letter should be from someone
else in our department with whom you developed a rapport with during your
rotation. Your final letter is up to
you. It can come from someone on a
third year rotation that really liked you.
If you are instructed differently, please
let us know so we can advise students correctly. Be sure to politely ask all of your
recommenders if they are comfortable writing you a good letter of
recommendation. You do not want a
mediocre letter sent in. You should
request these well in advance of the deadline for applications. The Dean's letter will be sent on November 1st, but many programs extend interview invitations prior to receiving it.
We have matched our students all over the
country so geography is not necessarily a limitation. It is more important that
the people at other programs know us and respect our recommendations.
TO
HOW MANY PROGRAMS SHOULD I APPLY?
The key to this entire game is getting
interviews. If you get less than five interviews
you are unlikely to match. If you get
nine or more interviews, it is almost certain you will match unless you throw
up on the interviewer's desk or something like that. Most students find that interviewing at eight to twelve places is
adequate. It actually gets old after a
while and can be quite expensive.
Preferably, you want to end up in the position of being able to turn
down interviews. So how do you get to
this situation? The average student
applied to 40 programs this past year.
Many "experts" suggest that this is too many because it does
not change the total number of interviews granted. This is true since the number of programs is stable, as are
residency slots. However, a large
number of applications, in my opinion, increase your exposure to a greater
number of residency directors. If you
limit your number of applications, the program that might fit you best may not
review you. So, except for all but the
very top students, I recommend applying to at least 20-30 places. You can always turn down interviews, but you
can't get them after the fact very easily.
TO
WHICH PROGRAMS SHOULD I APPLY?
Obviously there are many considerations,
including geographic preference, spouse's needs, and type of city where the
program is located. Also remember not to be overly picky about applying, as you can always
turn down an interview. After you have
reviewed these issues, please come talk to us so we can give you a more personal
view of each program. Below is a
list of programs that have accepted our recent UMMC students.
The
basic requirement for training is five years of otolaryngology with the
following rotations required in the first year: up to three months of
otolaryngology, neurosurgery, critical care, emergency medicine, anesthesiology,
and at least five months on at least three services consisting of general
surgery, thoracic surgery, vascular surgery, pediatric surgery, plastic
surgery, and surgical oncology. Rare
programs offer or require an additional entire year of research. Instead, most programs have a several month
research experience during your residency.
Finally, you may wish to talk to our faculty,
residents, and recent graduates to get their perspective.
WHAT
IF I AM THINKING ABOUT AN ACADEMIC CAREER?
Most Otolaryngology programs are entirely
capable of turning out academicians and do so.
We will counsel you about a few programs with a strong reputation for
doing so. Overall, we think it is hard
to make such a decision so early in your career. But, we will make sure you go to the right programs to keep all
of your options open.
Most private practitioners do not do a
fellowship and are capable of doing most otolaryngologic surgery. Currently, most but not all, people going
into academics do a fellowship in some subspecialty of Otolaryngology such
as: Pediatrics, Otology/Neurotology,
Facial Plastics and Reconstructive Surgery, Laryngology, Rhinology, or Head and
Neck Oncology. This could decrease as
pressure increases to reduce subspecialization and financial support for
extended training decreases.
DO
I NEED TO DO AN EXTERNSHIP?
As a rule, you do not need to do an externship.
However, there are several reasons you may want to consider doing
one. If you absolutely need to go to
one city for some reason, you should do an externship there to make sure they
know you well. If your class rank and
USMLE scores are borderline, an externship may allow you to show your best side
in action, which might overcome your paper record. On the other hand, if you are a top student, you can only look
worse or as good as you do on paper.
Finally, some students enjoy doing an externship to simply gain a more
global view of otolaryngology.
Otherwise, you do not have to do an externship to match at most
programs.
INTERVIEW
INVITATIONS
You will receive invitations anywhere from September through November. As a general rule, accept all of the early invitations. Later on, if you receive a lot you can
afford to be choosy. We would suggest, in
fact, that you accept them immediately as some programs have been known to
"overbook" leaving you without a slot or on a less convenient
day. Once you have most of your
invitations, you will realize you may have to decline some due to
impossibilities in scheduling your travel dates. If you must cancel an interview, do so in a timely fashion so
that the program may fill all of its interview slots and your fellow students
may be granted the slot. Letting your fellow UMMC students know that you have
declined an invitation allows them to call and express interest. As you hear from programs, please come by
for guidance on which to accept.
Be aware that some programs may not be courteous
enough to send you a rejection notice.
If you have heard nothing from a program you are interested in and you
have already been receiving other invitations, we encourage you to call and ask
the residency secretary the status of your file in a very polite fashion. Remember to treat the secretaries well; they
can help you or kill you. One or two
status calls to a program are fine, but don't be a pest. It also might help to send a note to these
late programs or tell them on the phone that you have a special interest in
their program. You never know, they may
be trying to decide between you and a few other students and this may sway
them.
Also, realize that you will get many
rejections. This is not an indictment
of you personally. There are many
outstanding applicants and a limited number of interview slots. It often becomes very arbitrary in making a
decision. However, we have often been
able to make calls and get you an interview with some of our friends. That is why it is so important to keep us
informed during this time.
INTERVIEWS
Interviews may stretch from late October through early February. You will find this to
be an enjoyable time although the travel can get old. Most interviewers are very benign and simply want to get to know
you. There are a few jerks, but you
probably don't want to go to their program anyway. Relax and let your personality come through. At this point, the programs have already
decided that you are academically qualified.
They may want to know a few fine points about your research project or
your academic record, but for the most part their intent is to get to know
you. The people interviewing on the same
day with you are just as competitive as you.
You want to set yourself apart in a positive fashion. Dress conservatively but don't blend into
the wall. Be positive, warm, and
enthusiastic. They are looking for
someone to work with for five or six years.
Say something positive about the program to each person you interview
with; they are human and will be flattered.
There is a fine line you don't want to pass over into
"brown-nosing". A simple
positive comment is fine. If you have
done something particularly interesting in the past, let them know. It helps them remember you better if they
can categorize you with some interesting aspect of your life.
Interview formats will vary but most will be
one-on-one. There will be a few
interviews with more than one interviewer and even several students and
interviewers at a time. Don't be
nervous; everyone is in the same boat as you.
On the day of your interview, you want to find
out if they have several basic prerequisites to provide you with good
training. These include: a relatively
stable faculty that covers all areas of otolaryngology, a mix between senior
and junior faculty members, adequate numbers of surgical cases and patient care
material, a research exposure opportunity, and a formalized teaching program. Most importantly, however, you want to find
out if the residents are happy overall (obviously not every day is perfect for
a resident) and if you feel like you fit in with the personality of the
program. Be careful of questions that
could be misinterpreted such as "How hard do you guys work?",
"What time do you go home?", and "What is call like?" They might think you are trying to look for
an easy program. You would be surprised
how minor some things are that determine your final rank. You can usually find these things out by
listening to other applicants' questions or informally discussing it with the
residents.
After your interview, send a thank you note
immediately. Say
something positive about their program but don't guarantee you are going to
rank them at some specific spot. Just
say something like "I know that I could be happy in your program."
POST GRADUATE
YEAR 1 MATCHING
The
PGY-1 year is now in the otolaryngology residency program. Programs have the option of incorporating
this year administratively into the otolaryngology department or leaving the
administration to the surgery department.
Each program will vary in its approach to this issue. The vast majority of programs arrange your
PGY-1 year for you at their institution without the need to apply or interview
separately. Rare programs may ask you
to apply to their surgery program separately or even interview with
surgery. Despite the merging of the
PGY-1 year into otolaryngology, you may need to match your PGY-1 year
separately through the NRMP due to existing and varying administrative
agreements between otolaryngology and surgery at each institution. Some programs have you rank them separately
in the NRMP for the PGY-1 year, but you are assured the spot. Other programs do not require you to
actually rank them in the NRMP but simply hold a one-year intern slot for
you. You should ask each program at
which you interview about this issue if they do not tell you.
OTOLARYNGOLOGY
MATCHING PROCESS
You
must turn in your ranking of programs by the middle of
February. In general, we urge you to
rank all programs at which you could possibly be happy. This hopefully will be a minimum of seven
programs. You need to decide early on
that your goal is to get good residency training, and this is possible at a
number of places. Again, you should
come talk to us at this point.
The
match occurs on the third Thursday in March and you will receive the results from
your Dean's office during Match Day ceremonies. If you do not match, you can
find out on the NRMP website on Monday of that week. Your Dean's office will also notify you. Beginning on Tuesday, the Dean's office will also notify us and
will work with you and us to attempt to find you a position. Don't be
disappointed if you get less than your first choice. In a couple of years you will never think twice about it, and
remember you are competing against a lot of equally qualified applicants.
WHAT
IF I DON'T MATCH?
If
we have done our job well, this will be a rare event. You will need to have a backup plan and you must decide if you truly want to do otolaryngology. You will be required to make decisions very quickly during match week. If you still want
to do otolaryngology after failing to match, we have two basic choices: a
one-year slot in surgery or research and try again. Here are the pros and cons of each.
The idea behind applying for one year slots in general surgery is that
you might be able to move into a vacancy that occurs in an otolaryngology
program at the close of the PGY-1 year.
If none opens up, you will be repeating several months of a general
surgery internship if you do match in otolaryngology the following year. The value of a regular surgery year has become
somewhat more questionable due to the fact that the PGY-1 year will now be in
otolaryngology. Regular surgery years
may not qualify as meeting the requirements of the PGY-1 year in otolaryngology
due to newly specified requirements during that year. You might end up having to repeat the PGY-1 year if you match
after that year or doing some extra rotations during your otolaryngology
residency. Also, when you reapply to
otolaryngology, your application looks very much the same other than a few
months of general surgery. Still a
general surgery year prepares you for entering other surgical fields if that is
a possibility for you. Alternatively,
you may be better off doing a research year to improve your application. Here may be some common scenarios in case
you don't match:
This
has become a very complicated and controversial issue, so come talk to us
personally about it.
ADVISING
As residency program director, student director, and chair, Dr. Franzese, Dr. Pitman, and Dr. Stringer are available to advise you about matching in Otolaryngology. Come by the office or call anytime (Office
601-984-5167). You
can easily reach us by e-mail at sstringer@ent.umsmed.edu, cfranzese@ent.umsmed.edu, or kpitman@ent.umsmed.edu. We also encourage you to talk to all of
our faculty members along the way for different perspectives and particular
knowledge they might have about individual programs. Mary Manasco, our program coordinator, is a great resource as well.
Our foremost goal is to obtain the best possible
Otolaryngology residency for you.
Obviously we like to recruit good students to come here also, but there
will never be any pressure for you to do so.
Also, if you decide along the way that Otolaryngology is not for you,
our feelings will not be hurt. We are
glad you took a look at our specialty.
TIMETABLE
| Spring of your third year |
Talk to us about otolaryngology and programs
Consider doing a research project in the summer or early fall |
| July through December |
Take the otolaryngology elective |
| August |
Ask for letters of recommendation |
| August through Mid-September |
Prepare and distribute your applications on ERAS |
| August |
Let us help you review your application
Give us a copy of the programs
to which you applied |
| August and September |
Register for the NRMP |
| September through December |
Invitations issued
Provide us a list of your interviews |
| October through February |
Interview
Provide feedback to us on the programs you visited |
| Mid February |
Rank list due |
| Mid March |
Match results
Have a good time! |
LOCATIONS OF RECENT UMMC STUDENTS IN
OTOLARYNGOLOGY RESIDENCIES
Residency
Program Current Practice Location
2008
Tara Lynn Rosenberg University of Mississippi
Matthew Seth Sitton Medical College of Wisconsin
2007
Ryan Case University of Mississippi
Shelby Topp Naval Medical Center,
Portsmouth, VA
Jay Young Vanderbilt University
2006
Jess Roberts Baylor College of Medicine
Courtney Shires University of Tennessee, Memphis
2005
Clay Borden University of Oklahoma
Ben Jeffcoat University of Mississippi
Chris Lee University of Arkansas
2004
Jason Guillot University of Mississippi
Andrea Furr University of Mississippi
2003
Jeff Cunningham Wake Forest
Melissa Scholes University of Colorado
Pearson Windham University of Mississippi
2002
Justin Garner University of Mississippi Columbus, MS
Lana Jackson Medical College of Georgia
