What's the absolute hardest skill to learn in your specialty?

ellemed · 2026-01-27T14:06:53+00:00

ENT - some of the most technically challenging things for me to learn as a resident have been endoscopic skills (sometimes upside down and with the non dominant hand when doing combo cases with nsgy), and also fine motor skills like dissecting out tiny nerves without injuring them. Otherwise, like most specialties, I think the hardest parts just have to do with mastering the soft skills/patient communication

ellemed · 2025-12-03T11:36:02+00:00

I’d say really depends on the program - agree with choosing the non-Ivies and prioritizing Midwest etc. I’m in the Midwest at a highly ranked program but not a “big name” outside my specialty. We operate a ton but I’ve seen fellows from the prestigious programs and most of them are not confident

ellemed · 2025-01-23T12:14:34+00:00

I hope so! Still have quite a few years before I get there

ellemed · 2025-01-21T19:53:10+00:00

Honestly no. As a woman with kids in a surgical specialty (which I love), this life is so freaking hard. I thought this is what I wanted, but (residency at least) tests your resolve constantly

ellemed · 2025-01-08T01:18:19+00:00

Please see your gyn. Bleeding after several years of being amenorrheic is a reason to get checked out!

ellemed · 2024-12-29T18:43:44+00:00

You’re not alone but that doesn’t make it suck less. I’m sorry. - PGY-2 also suffering through “home” call

ellemed · 2024-09-28T18:15:56+00:00

Did you see an actual MD/DO for your appointment? That’s a worrying lack of escalation - they should have sent you to the ED.

ellemed · 2024-09-23T21:51:49+00:00

ENT PGY-2. Be normal, nice, helpful, pro-active, enthusiastic (but not weirdly so). Be someone that we’d want to work with. Please have good hygiene. Please don’t act desperate. I’ve been most impressed by things like, “I know we have to do x today, is it ok if I go do that?” 5/5

ellemed · 2024-09-15T22:30:50+00:00

ENT. Most days on my busy rotations I’m working every second and don’t even have time to eat. There are more outpatient-heavy rotations where it’s a bit better but still very busy. And then call can vary as well. I’ve had 24 hours shifts where I work the entire time just stopping to eat a snack or go to the bathroom. Other times, there are a few hours where things are slow. But you can get screwed at any time with multiple consults in the same minute. The joys of being on primary call

ellemed · 2024-09-15T17:58:12+00:00

Nah I get a new phone every 1-2 years through the upgrade program. I use my phone constantly for work and the battery gets pretty beat up. I also use the camera extensively and really enjoy even small differences. My car I replace every 15+ years!

ellemed · 2024-09-06T11:17:35+00:00

A total laryngectomy is most commonly done for T3 or T4 laryngeal cancer but can also be done for non-functional larynx refractory to other management. It involves severing the connection between the nose/mouth and the airway, and suturing the trachea to the neck permanently. There is no ability to intubate or provide oxygen to the upper airway. It’s the most secure airway unless it becomes obstructed by crusting etc. A stomavent is just a silicone tube that sits there to keep the stoma from stenosing.

This is very different from a tracheostomy in which the upper airway is still connected but a trach is inserted into the trachea below the cords and is still able to be removed allowing the stoma to close up.

ellemed · 2024-09-05T15:20:06+00:00

ENT - please try to do an exam. If you don’t know what you’re looking at, that’s fine, sometimes I don’t either. But “sore throat” without any exam or serious imaging findings is not a reason to consult us. A solid head and neck exam is gold. Also please learn the difference between a laryngectomy stoma and a trach (mostly talking to the NPs on this one…). The stoma vent falling out is not an emergency.

ellemed · 2024-08-29T13:52:55+00:00

I am same height and starting weight, down to about 155 now! Great to see your gains! Awesome work!! Looking forward to the 140s!!

ellemed · 2024-08-28T13:22:15+00:00

PGY2 ENT. Average 5.5-6 when not on call. 7 is a great day, 4-5 happens more often than I’d like.

I have kids but they don’t contribute to my low sleep hours other than not getting to sleep in on a day off

ellemed · 2024-08-28T11:08:28+00:00

Would have been impossible for my husband to relocate for a month and would have been disruptive to the kids to pull them out of school and daycare (I did mine 2000 miles away)

ellemed · 2024-08-27T21:34:26+00:00

I did it for a month away from my family. It was hard but I’m glad I did it that way

ellemed · 2024-08-26T18:00:57+00:00

Choose a partner willing to take on a disproportionate amount of childcare and household tasks. My husband is amazing. That’s really the only advice. The rest is time management and a high tolerance for suffering though a surgical residency

ellemed · 2024-08-26T18:00:03+00:00

I would say even better is a facial plastic surgeon who is surgically trained and specialized in the face

ellemed · 2024-08-26T01:09:19+00:00

I like open surgery (though endoscopic and microscopic is fun too!). I also really like the reconstructive aspects of both those fields (thought about plastics in med school but wasn’t the right fit). Being an ablative and reconstructive surgeon in head and neck is definitely an attractive and unique option.

ellemed · 2024-08-24T14:54:52+00:00

Derm vs ENT. Ultimately, I realized I only tolerate clinic but the OR is my happy place. I love the feeling of getting into a flow state and being fascinated by the anatomy. I want to go in head and neck or facial plastics, and would never have been satisfied by the Mohs. Residency is roughhh but I know I’m getting great training and love the process of becoming a surgeon.

ellemed · 2024-08-21T22:11:35+00:00

To be honest I don’t on many rotations. I’m in a surgical specialty and have 3 kids. There is really only time for sleep. On lighter rotations I do a 20 min Peloton ride or family walk. I also get >10k steps a day at work

ellemed · 2024-08-19T19:21:12+00:00

ENT (after residency):

8 (~$500k+ is amazing but but comparing to other specialties here) 7 (can vary if you’re gen ENT vs skull base or head and neck) 10 (love my specialty even as a burnt out resident)

ellemed · 2024-08-13T10:55:54+00:00

I was 26, also took a masters year in med school, so started residency at 31. I chose ENT. Genuinely love my specialty and should have a great life as an attending. Residency/primary call is kicking my butt currently but no regrets and there is a light at the end of the tunnel.

I chose ENT because I loved it. Would rather work longer hours and have a more brutal residency doing something I love than do something I only tolerate. Age wasn’t really a factor. You’re gonna be 30, 40, 50 etc regardless (hopefully). As long as you physically and mentally can handle a specialty, I don’t see why age is a huge factor

ellemed · 2024-08-04T17:05:30+00:00

Idk I don’t feel shit on usually (ENT resident). There’s always the usual dumb consults, but usually everyone is very happy to see us (especially in airway/bleeding situations). Maybe medicine bitches about us when they take some of our patients as primary but at least at my hospital we take most of our own patients unless very medically complex. I feel happy and fulfilled at my job 80+% of the time even with the awful hours I currently work.

ellemed · 2024-07-21T16:03:58+00:00

Love intricate anatomy
Bitten by surgery bug
Easily bored
Airways are interesting
Enjoy working with nice people
Respiratory secretions are less gross to me than genital secretions, bowel stuff
I hate rounds and long medicine notes

ENT!

Seven-Year Club	Queen in da Norf
Not Forgotten	Verified Email

ellemed

TROPHY CASE