Is the Training and Cost of a Fellowship Worth It? Here’s What Otolaryngologists Say

Private Practice Options

All that being said, however, there is room for fellows in private practice. Many smaller practices staffed mainly with general otolaryngologists typically refer more complex cases to academic centers with fellowship-trained physicians, but an evolving market for fellowship-trained otolaryngologists is emerging within the growing number of larger otolaryngology practices. These larger private practice groups or hospital-employed groups employ a full complement of fellowship-trained otolaryngologists who are able to provide a similar level of care to that provided by academic medicine, according to Christopher Le, MD, associate professor, rhinology and skull base surgery, department of otolaryngology–head and neck surgery, University of Arizona College of Medicine, Tucson, Ariz.

My primary motivator for doing a fellowship was that I really liked rhinology and that by completing a fellowship I could hopefully narrow my future practice, to some degree, whether that be in private practice or academics. —Lauren Cass, MD, MPH

One advantage of a fellowship, he said, is becoming an expert in a subspecialty that provides a private practice group and patients a higher level of care not available outside of an academic practice group. “This subspecialty training can increase the productivity and referral base for the private practice group from primary care providers and even other general otolaryngology groups in the community,” said Dr. Le. “Overall, fellowship training in an area that a private practice group is looking to expand will make a residency graduate more marketable compared to a graduate who was not fellowship trained.”

For those who are interested in research, the large private practice group Glazer oversees includes a clinical research division in which there are currently 10 clinical research studies being conducted by both general and subspecialty otolaryngologists. With over 900,000 patients seen each month throughout ENT and Allergy Associates’ network, Glazer said that the practice is ideally situated to perform clinical research using all the patient data it captures. 

Glazer does hire fellowship-trained otolaryngologists and typically will place them in a location within ENT and Allergy Associates’ network where their particular subspecialty may be needed. Of the 175 otolaryngologists within the group, up to 65% are general otolaryngologists, with the rest made up of fellowship-trained subspecialists in neurotology, laryngology, rhinology, facial plastics, and sleep. Glazer tries to have a mix of general otolaryngologists and subspecialists in each of the 43 offices within the practice network.

That said, Glazer emphasized that for fellowship-trained subspecialists within their private practice, it will generally take years to build up their specialty focus within the practice and said that they should expect to see a lot of general otolaryngology cases. “Realistically, for example, you can become the go-to rhinologist within a larger group private practice setting, but that would probably take seven to 10 years, at which time your patient population may be between 55%-75% of the subspecialty and the rest a mix of general otolaryngology,” he said.