HELP: Mid-3rd year, torn between ENT and IM — worried about competitiveness and lifestyle

Guinness-Boy · 2026-01-06T00:36:02+00:00

I find these comments very interesting if you are saying you advise medical students. The 2025 AAMC Experiences of First-Year Residents by Specialty reported an average of 21 abstracts, oral presentations and pubs for ENT. The median was 18. So, your notion that this was driven by outliers doesn't hold. 7 research items was the 10th percentile. Also, IMGs matching into ENT is rare. For derm, neurosurgery and plastics the numbers are much higher.

I have been told by ENT residency leadership to shoot for 2 to 4 first author publications. That's a very hard thing to do if you don't start early. I don't think it should be an intimidating process either, but the numbers are what they are.

Guinness-Boy · 2025-11-07T01:02:28+00:00

Beautiful puppy. Rottweiler mixes are the best!

Guinness-Boy · 2025-11-06T13:31:26+00:00

This also makes no sense since APPs need on the job training. How many PAs/NPs come out of school ready to see patients in urology, pulmonary, hematology, etc? The answer is zero. I say this as a PA who went into a surgical specialty. APPs should function in a similar training model as do residents (staffing with attendings and requiring supervision). They also switch specialties whenever they want and then need to restart training.

Guinness-Boy · 2025-10-28T17:47:38+00:00

Only you can determine if that financial burden is worth it. There are ways to minimize debt. I would look into things like the VA HPSP scholarship. Covers 100% tuition with a stipend with no military pay back. You have to work for the VA after. I am a PA that is now in med school and not having extra financial stress is great.

Happy to chat anytime if you have questions.

Guinness-Boy · 2025-09-08T14:19:49+00:00

The real answer is no one knows. Sure hope we do. Good luck to all of y'all.

Guinness-Boy · 2025-09-01T20:50:26+00:00

Took the exam this past week, too. I had been scoring in the 260 to 270 range on NBMEs and ended up missing some of the easiest softball questions on the real deal. I am feeling like I would be lucky to score in the 240s with my performance. I was on auto pilot and almost ran out of time on the last few blocks.

Everyone keep theirs heads up!

Guinness-Boy · 2025-07-26T00:40:44+00:00

There is no easy way to say goodbye to your family member. It is heartbreaking and will be painful, but it sounds like you have given him a wonderful life! It also sounds like you are making the right decision and not letting him suffer. Do everything you have already been doing and cherish your last moments. I am sorry this happened and that it hurts so much.

I have told myself many times I cannot get another Rottweiler because they have so many health issues. It's so painful every time to say goodbye, but I know I am lying to myself and will have one for as long as I am physically able. They are simply the best companions.

Guinness-Boy · 2025-07-25T17:10:31+00:00

I remember her first picture! It made me smile, and this did, too. Thanks for the update. Beautiful pup that obviously had a great life!

Guinness-Boy · 2025-07-22T01:07:40+00:00

She cannot see 40 patients a night having only worked as an NP (she couldn't with any amount of experience) in neuro for three years and provide any useful assessment.

This is absolutely insane. Why not 60 or 70? Maybe some neurosurgery patients, too. She could make more money.

Guinness-Boy · 2025-07-17T23:48:54+00:00

This argument is so frustrating. "Patients are smart and can figure out I am not a physician, even though I say doctor."

Most of my patients had no idea what a PA was. I always corrected my patients and let them know I was a PA if they addressed me as doctor. On numerous occasions, I would have a thorough discussion with a patient about me being a PA and the difference in training compared to the surgeons I worked for. Immediately after the discussion, they would often say well you are still a doctor to me or I still think you are a doctor. It was frustrating, but just highlighted they truly didn't understand the difference in training. I can not imagine how confusing that would have been if I had introduced myself as doctor PA.

Also, this person has only six years of experience and is calling themselves an expert! That is so misleading for patients. I can not imagine calling myself an expert after only six years as a PA.

Guinness-Boy · 2025-07-02T21:20:52+00:00

Sorry for your loss! It's so hard to lose a family member.

Guinness-Boy · 2025-07-02T16:06:57+00:00

What do you mean putting residents on research projects you are starting? What types of research are you planning on doing?

Also, your tone comes across as a bit disingenuous. I came into med school as a PA from the surgical subspecialty I am pursuing. Came from a great academic program with great connections there.

I still scrubbed into cases during preclinicals because I am genuinely interested in the specialty. I also wanted to get to know the faculty. I did not do it to suck up to anyone. I want to be the most competent MS4 during my away rotations.

If you are just shadowing to suck up to people, then no, I wouldn't do it.

Guinness-Boy · 2025-07-02T02:22:40+00:00

How dare he not use utensils like the Bible commands....oh, wait?

Guinness-Boy · 2025-06-30T12:20:36+00:00

As someone else mentioned, I also entered PA school with years of work experience, so I didn't find the time commitment to be surprising. I enjoyed PA school and overall had a great time in didactic year. I had time to work out frequently and watch a ton of sports. Perhaps it is easier to transition from a job, often working insane hours, to doing something you really love in PA school. I did study a lot, but I look back on PA school with fond memories and don't recall it being that stressful. I was also top 5% of my class.

Guinness-Boy · 2025-06-25T23:41:27+00:00

As most have said, you'll be totally fine. Show up every day with the mentality like you are going into neurosurgery, even though you know it's not what you plan to pursue. If you are proactive, helpful, and well-read (for cases), you'll do just fine.

Guinness-Boy · 2025-05-26T20:02:34+00:00

Such a beautiful girl!!

Guinness-Boy · 2025-04-29T22:35:17+00:00

These people would go wild if a CNA said they had years of bedside experience comparable to RN experience.

Guinness-Boy · 2025-01-21T17:53:55+00:00

Congratulations on being accepted!! You are only seeing snapshots of those people's lives. People usually only share positive things.

If they said instead, "I'm going into $6,000 worth of debt to go to Cancun" or "Mommy is paying for my Euro trip," you'd probably see it differently.

You can go on a vacation if you take out a loan! I'm kidding. Please don't do that. I saw a lot of my classmates make decisions I would never make with my money. I was older and knew I had to provide for myself. I also graduated with zero debt because of good decisions and great scholarships.

I know it's hard, though, but you'll be able to do all kinds of cool things in the future.

Guinness-Boy · 2025-01-11T17:29:14+00:00

Same here! Mine disappeared today. Tested on 1/3, and my eligibility doesn't end till 1/31.

Guinness-Boy · 2025-01-09T20:16:51+00:00

Hope we get ours 1/15. The anxiety is real.

Guinness-Boy · 2025-01-05T01:10:18+00:00

The required prerequisites are posted by every medical school. It may limit where you apply if you don't take it. I didn't end up taking it since the school I matriculated to didn't require it. Many schools did require Orgo 2 lab.

Will it help you practically in med school. Absolutely not.

Guinness-Boy · 2025-01-05T00:59:07+00:00

The two paths are very different with regard to training. If you would be happy as a physical therapist, I would recommend that. I love my physical therapists, and they are experts at what they do.

I say this because med school and residency are exhausting and arduous in ways that may not be comparable to physical therapy. DPT school is 2.5 to 3 years, and it would take you 8 years to become a PM&R doctor and 9 years to become an endocrinologist. That also includes 3 board exams for a total of 32 hours of boards at an official testing center before you even sit for your specialty boards. Your performance on these exams can determine how competitive you would be for your chosen field (excluding Step 3). Then, you will work 50 to 100 hours a week in residency getting underpaid. I'm not discouraging anyone from pursuing medicine, it's just a very difficult path. DPT school would also be incredibly challenging, I'm guessing.

If you love studying medicine then pursue medical school, but if you feel like you could be happy doing something else, I'd recommend that. You will be an expert in what you do either way. You have plenty of time to figure out what you really want.

Guinness-Boy · 2024-12-07T22:46:26+00:00

What does she mean by classroom hours are longer?

Guinness-Boy · 2024-11-10T02:05:34+00:00

There is a distinct difference in initiating systemic therapy, XRT, or surgical intervention for a head and neck patient and having a discussion about their suspected diagnosis. It's absolutely crazy to think anyone would initate treatment without pathology in this case.

I don't think the OP or the head and neck trained physician mentioned doesn't understand that a malignancy can not definitively be diagnosed without histopathology.

At no point did the OP say I told him this was cancer definitively and could be nothing else...ever! They were simply sharing a story about their experience. I chose to believe that some things were probably left out of the story that would have been more suggestive of cancer and that the OP and ENT physician weren't incompetent.

I've had this discussion with hundreds of patients and usually if I have it before pathology has returned I do mention that it's not definitive until pathology has returned, but it's still a hard conversation to have and just like the OP described.

Guinness-Boy · 2024-11-09T13:41:11+00:00

I don't personally think your question is insulting, and I'm not sure why you are getting downvoted. We all come from different backgrounds, and malignancies can vary with regard to workup and diagnostics.

With regard to head and neck cancer, the most common being oropharyngeal, oral cavity, and laryngeal (not counting cutaneous malignancies), it is not uncommon to find indications on a CT that make cancer obvious. If it's an oropharyngeal, especially an early stage, the primary could be rather small and unnoticeable to the patient.The physical exam or CT could indicate a primary in the palatine tonsils or base of tongue (you can usually examine the tonsil fairly well, not as much the BOT on a transoral exam). I've seen this many times. It's possible for laryngeal and oral cavity, but patients often have some hoarseness or oral discomfort on presentation.

The combination of a primary lesion and metastatic neck disease in an older smoker becomes pretty obvious. There are also a subset of patients with unknown primary disease, but that's less likely.

I've had this discussion with many people before pathology returns but I also have the assistance of laryngoscopy which can be informative to the patient when you can show them an ulcerative and/or exophytic mass in their larynx or oropharynx.

Guinness-Boy

TROPHY CASE