Specialty Profiles

What it’s like to specialize in otolaryngology: Shadowing Dr. Jones

Shawn Jones, MD

As a medical student, do you ever wonder what it’s like to specialize in otolaryngology? Meet Shawn Jones, MD, an otolaryngologist and a featured physician in the AMA’s “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties. Check out his insights to help determine whether a career in otolaryngology might be a good fit for you.

The AMA’s Specialty Guide simplifies medical students’ specialty selection process, highlight major specialties, detail training information, and provide access to related association information. It is produced by FREIDA™, the AMA Residency & Fellowship Database®.

“Shadowing” Dr. Jones (@ShawnCJonesMD)

Specialty: Otolaryngology.

Practice setting: Specialty group.

Employment type: Employed by a hospital-affiliated medical group. In private practice for 22 years previously.

Years in practice: 25.

A typical day and week in my practice: One of the things I liked about otolaryngology when I was evaluating residency options—especially compared with other surgical subspecialties—was the variety of procedures, patients and the variety inherent in the days. So to give you a typical day is difficult because there is a lot of inherent variability. I practice general otolaryngology and perform a relatively full menu of otologic, laryngologic, sinonasal, pediatric, and head-and-neck surgery procedures.

I generally arrive at the hospital around 6:30 a.m. On Monday, Wednesday and Friday mornings I start surgery at 7 a.m., using the 30 minutes to see the first few patients preoperatively that I have scheduled for surgery. I will, on average, perform between nine and 12 procedures a day depending on the length and complexity, as well as urgent or emergent cases that come from the ED or consults.

Typically, I may do several sets of tubes, an adenotonsillectomy, a sinus procedure, a laryngoscopy and biopsy, a thyroidectomy, a parotidectomy and excise several basal or squamous cell carcinomas of the face and perform reconstructive plastic surgery for closure. On Tuesdays and Thursdays, I see patients in the office all day. On average I will see 30–36 patients a day, but have help with a physician assistant and an advanced practice registered nurse. I start at 8:30 a.m. but use the hours before I begin for administrative tasks or rounding, etc. I might pick up an Americano at my favorite coffee shop on the way in.

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The most challenging and rewarding aspects of otolaryngology: Usually logistical and administrative issues to me are the most challenging. These include:

  • Obtaining precertification for the best medication for a patient.
  • Communicating with a patient’s family physician who practices in another city.
  • Finding out they do not have a primary care provider but need one.
  • Coordinating care on many levels for a patient who lives more than an hour away from my hospital system.
  • Most of the patient’s records are in another hospital system.
  • Making peer to peer calls from insurance denials.

The patient and family interactions are the most rewarding. I love the cards that some of the kids will make for me following a tonsillectomy. They have to really like you to make you a card following that surgery! I also like the instrumentation involved in otolaryngology, including the use of endoscopes, microscopes, nerve monitors, audiometers, and image guidance navigation systems just to name some.

Three adjectives to describe the typical otolaryngologist: Detail oriented, curious, personable.

How my lifestyle matches, or differs from, what I had envisioned: I was impressed in medical school at how genuinely satisfied the residents in otolaryngology seemed to be. In terms of lifestyle, I thought initially that my level of “busyness” after residency would naturally dissipate.

It did in some ways, but gradually as I became more established it became more and more difficult to reign in the demands of my practice. It was necessary for me to establish some boundaries like not operating on weekends unless it was emergent, limiting the number of cases in a day, using all of my vacation, for example. My wife is also a physician, so it was essential that we made our family a priority in order to have a life together.

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Skills every physician in training should have for otolaryngology but won’t be tested for on the board exam: An overall commitment to wellness, personally and professionally, because as leaders in health care we need to be dedicated to modeling a healthy lifestyle in order to be able to speak authoritatively to our patients.

Compassion, including self-compassion, because we can only give what we have possession of ourselves. Compassion provides a framework for understanding and can promote our own resilience in a demanding profession.

A sincere desire for excellence in the profession and a spirit of gratitude for the opportunity to care for other human beings.

One question physicians in training should ask themselves before pursuing otolaryngology: Do I like seeing patients in the office and being a proceduralist? Do I like seeing children and elderly patients? Do I think that I would enjoy quick operations where the vast majority of patients do very well? Would I also enjoy operating on more serious head-and-neck cancer patients? In other words, do I think that I would enjoy all of the variety inherent in the specialty?

Books every medical student interested in otolaryngology should be reading:

  • Daniel Friedland, MD, Leading Well from Within
  • Atul Gawande, MD, Better
  • Rita Charon, MD, PhD, et al., The Principles and Practice of Narrative Medicine

The reason for the choices will be obvious once read, but leadership, process improvement and understanding oneself—and oneself within the patient-physician relationship—are all critical elements to enjoying a truly successful career as a physician.

The online resource students interested in otolaryngology should follow: If you take one piece of advice from me, get this free e-book, Compassion: Bridging Practice and Science, by Tania Singer, PhD, and Matthias Bolz, MD.

Mantra or song to describe life in otolaryngology: Mewlana Jalaluddin Rumi: “The only lasting beauty is the beauty of the heart.”