AN OVERVIEW OF THE SPECIALTY
Our wheelhouse lies in the surgical management of head and neck tumors, ranging from malignant to benign. There isn’t a part of the head and neck we don’t work on. We are the go-to subspecialty for all of otolaryngology, with surgical approaches ranging from the superior mediastinum to open craniofacial procedures to endoscopic skull base surgery. Many of our fellowships are now structured to provide training in microvascular reconstruction, broadening the scope of surgical expertise to the extremities to create surgical solutions to devastating problems. Do you want a dynamic, challenging career? Welcome! Head and Neck Surgery is an attractive career option for a host of reasons. First off, the technical intricacies of the surgeries we perform are at times large scale, complex and extensive and at other times, minimally invasive using robots, endoscopes or anything we can get our hands on. With the requirement of such a wide breadth of surgical acumen, the challenges are endless.
Second, the opportunities to develop deep, lasting relationships with your patients are perhaps the greatest driver for the passion that many of us have for this subspecialty. Look no further for evidence than this litmus test - next Holiday Season, take a look around the office at the number of patient gifts at each of the subspecialty working stations. Hands down, Head and Neck takes the fruitcake. We are afforded the opportunity to follow survivors for years, and at times help families cope with loss when survival is not an option.
The third advantage of Head and Neck over other otolaryngological subspecialties is the collaborative environment of cancer care. Working with medical and radiation oncologists, speech pathologists, physical therapists, etc results in a team approach that affords us the opportunity to care for the whole patient.
The typical work week/month can have incredible variation depending on your personal life and type of practice you want to have. There are both private practice and academic surgeons that specialize in head and neck surgical oncology. Due to cases that are often lengthy, high clinic volume and complexity of care--the commitment and time invested-- can be significant. I have a traditional model of two full OR days and two full clinic days with one dedicated research day. In clinic I see anywhere from 25-35 patients per day, running from 7:45-6pm. Likewise, my OR will traditionally last from 7-6pm with multiple complex, interesting cases. Of all the subspecialties in otolaryngology, Head and Neck has the highest inpatient census, again due to the complexity of disease and surgery.
If you are up for the challenge, here is what you need to know about matching into a Head and Neck surgery fellowship: Applications and interviews happen during the spring of your 4th year of residency. Mentorship becomes critical in this phase of your training. By the spring of your 3rd year you should be making the subspecialty decision to allow you time to focus your efforts prior to interviews and establish strong faculty support (the late comer is not excluded, just not as prepared). The earlier you publish during your residency the less stressful fellowship pursuit will become. Having a solid platform of research (regardless of the topic early on) can only help. So all you 4th year medical students that worked like gangbusters to show the world of oto that you are superstars, do not leave your research unfinished after you match!! Too often we see the motivation disappear and completion becomes less important since you’ve snagged the golden egg. If you finish the project and publish the work – you are better prepared for the next phase. Fellowship directors want to see ‘finishers’. It doesn’t matter if you work over PPI’s for globus sensation, just finish the manuscript. If you’re motivated by the right ambitions, the rest will be history. Welcome to the club!
Adam Luginbuhl, MD
Medical School: University of Connecticut School of Medicine
Residency: Thomas Jefferson University
Fellowship: Vanderbilt University
Current Location: Thomas Jefferson University
- American Head & Neck Society Resident & Fellows Corner
- American Head & Neck Society Fellowship Programs
*Last edited 2/8/2016. Please contact us with any expired links.