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Otolaryngology - Head and Neck Surgery

An otolaryngologist-head and neck surgeon is a physician who has been prepared by an accredited residency program to provide comprehensive medical and surgical care of patients with diseases and disorders that affect the ears, the respiratory and upper alimentary systems, and related structures of the head and neck.

The otolaryngologist-head and neck surgeon has a command of the core of knowledge, skills, and understanding of:

  • The basic medical sciences relevant to the head and neck; the respiratory and upper alimentary systems; the communication sciences, including knowledge of audiology and speech-language pathology; the chemical senses and allergy/immunology, endocrinology and neurology as they relate to the head and neck.
  • The clinical aspects of diagnosis and the medical and/or surgical therapy or prevention for diseases, neoplasms, deformities, disorders and/or injuries of the ears, the respiratory and upper alimentary systems, the face, jaws, and the other head and neck systems. Head and neck oncology and facial plastic and reconstructive surgery are fundamental areas of expertise.

Residency programs in otolaryngology-head and neck surgery must be of five years' duration, with at least 9 months of basic surgical science training, followed by 51 months of progressive education in the specialty. The final year of training must be a chief resident experience and must be spent within institutions approved as part of the program.

For further information, visit the American Board of Otolaryngology.

The description of this surgical specialty was adapted from a description set forth by the American Board of Medical Specialties (ABMS).

Otolaryngology-Head and Neck Surgery as a Career

Otolaryngology-head and neck surgery is one of the most exciting areas for subspecialty training within surgery. It attracts some of the most talented and driven senior medical students year in and year out, and is therefore one of the most competitive fields for residency training. What makes it special, however, is the down-to-earth nature which characterizes most otolaryngologists both in academic and community practices. It is the same quality which medical students note quickly during their interviewing for otolaryngology training programs.

Otolaryngology-head and neck surgery encompasses many subspecialties. Areas for specific subspecialization include head and neck oncology and microvascular surgery, otology/neurotology, pediatric otolaryngology, and facial plastic and reconstructive surgery. In addition, the areas of rhinology and sinus surgery, general otolaryngology, laryngology, and basic science research are highly stressed in most residency programs. It is this wide field of potential diversity within one specialty that gives so much freedom of choice to otolaryngologists as they embark upon a surgical career.

One of the most appealing aspects of otolaryngology to those both experienced in the specialty and those first evaluating it, is the diversity of patient care that is available to the otolaryngologist. Depending upon the specialty chosen, an otolaryngologist may treat patients from the first days of life to the time of death. Otolaryngologists are able to treat both men and women, and they are able to apply both medical and surgical skills in the treatment of their patients. Clinical diagnosis requires both the utilization of tests, as well as the administration of a detailed and skillful physical examination. Otolaryngologists are fortunate in that many of their patients' conditions can be diagnosed primarily on physical exam. As such, otolaryngologists are able to maintain a very "hands on" approach to the care of their patients.

The surgery associated with the practice of otolaryngology-head and neck surgery is as varied as is the range of patients and potential subspecialties. The otolaryngologist may at times be a microsurgeon, doing microvascular reconstruction or neurotologic procedures, or may be an endoscopic surgeon, using endoscopy to diagnose and treat sinus disease and laryngeal disease. At times, the surgery could be limited to an area as small as the temporal bone, or as widespread as the entire neck with all of its complex and intricate anatomy. The anatomy of the head and neck with all of its complexity and variation is generally what first attracts people to the field of otolaryngology, and what keeps otolaryngologists young even after years of practice in the 21st century.

After completing an otolaryngology residency training program, many otolaryngologists decide to pursue subspecialty fellowship training. As noted above, there are many opportunities for such specialized training. A few individuals committed to primarily research careers will pursue further training in research, joining faculties, bringing the bench to the bedside with translational research. Approximately 10 to15 percent of those leaving residency will go into academic medicine, either directly or following fellowship training. Presently, there are multiple opportunities in academic medicine, with the ability to have a fulfilling practice and quality home life. Most otolaryngology graduates will pursue practices in the community, usually in group practices. Again, with such group practices, it is easy to find an area of specialty or expertise. One of the great strengths of otolaryngology is that the field is not over-crowded; and the job search for otolaryngologists is usually relatively open with multiple opportunities for practice depending upon the location. Otolaryngology is a highly sought after surgical career, with many reasons for its great popularity. Its greatest strength may be its diversity, which allows the otolaryngologist to begin and maintain a fulfilling surgical and medical career. Perhaps, in fact, this is the reason why most otolaryngologists are so down to earth and happy and why the field inspires so much camaraderie.

Brian B. Burkey, MD, FACS
Nashville, TN

Revised June 23, 2011