Category Archives: Uncategorized

ENT Instrument Vendors

Our OR is finally updating their ear instrument trays, and asked me what I wanted to replace the broken and missing instruments. When I went through my address book of Instrument salespeople none of them were selling ENT instruments any more. The info below what I’ve put together in my search to compile a list of vendors and manufacturers that make surgical instruments for ears.

Grace Medical 1.866.472.2363

Integra 1-866-854-8300
– Codman
– Microfrance
– Miltex

Bauch and Lomb
https://www.bauschinstruments.com/
(800) 325-9505 x3717

Karl Storz 800 421-0837

Stryker 763.463.1595

Leave a Comment

Filed under Uncategorized

Signaling in the ENT Match

I’m just now discovering that there is quite a bit of literature out there on signaling in matching systems.

The basic model is dating and suitors using a limited resource to woo the object of their affection.

Muriel Niederle has done some empirical work on this on an online-dating site. In this match, signals are sent with “virtual-roses”. https://web.stanford.edu/~niederle/Lee.Niederle.Rose.ExpEcon.2015.pdf

She reported that in that match, many suitors did not optimally use their roses and some did not even use all of their roses.

I’m a little skeptical about how analogous the online dating market is to the ENT match. The biggest difference I see is that the ENT match has dramatically asymmetric amounts of information. Applicants submit PSs, test scores, research experience, job history and other info. Programs make websites and video ads. Some list fellowship matches, but not all. All locations are known. Number of residents per year. Faculty names and Subspecialty. None list the number of fellows.

Doximity provides two rankings of programs. One is based on reputation. The other is based on research productivity of residency graduates.

Programs routinely have to sort through 200+ applicants.

Applicants have to sort through <200 programs to decide which to apply to and have to pay to apply to more programs.

So far much of this sounds reasonably similar to an online dating experience.

So what are the differences. First, online dating sites do not have a monopoly on romantic connections. The NRMP does. Second, online daters may have had a more serial monogamy approach to dating and so only sent out one rose at a time. This is very different from the ENT applicant cycle where applications are released on a single day. Finally, the problem of interview date competition is pretty much non-existent in an online-dating market.

Additional paper I didn’t have a chance to read yet.

https://web.stanford.edu/~niederle/SignalingPaper.pdf

Leave a Comment

Filed under Uncategorized

Trio Poster

The presentations at the Trio Combined Section Meeting this year (2021) were very nice. Unfortunately, the interface for viewing posters was…difficult. That’s the word I’ll settle on.

I uploaded a copy of our poster below for anyone interested in reading it. We will be submitting the article with a little more analysis soon, so stay tuned.

Leave a Comment

Filed under Uncategorized

Match Day for Interviews

An anonymous commenter on otomatch brought up an interesting solution to the ENT interview scrum that happens every year. Make a match for interview dates similar to the match for residency positions.

The problem:
How to optimally schedule applicants with interview spots and minimally disrupt applicants education during 4th year of medical school.

Applicants want to maximize the number of interviews, minimize costs, minimize amount of time and attention necessary to optimize interviews during fourth year of medical school. Applicants are VERY concerned about missing an interview invite that arrives via ERAS, email, cell phone, or text message and require an immediate response via ERAS, email, cell phone, text message, thalamus, survey monkey, interview broker, cell phone, text message or even postal mail.
Programs want to minimize the number of unused interview spots (late cancellations), minimize interview changes, and maximize the number of students interviewed that will rank their program highly.

Fairness considerations:
Prevent interview hoarding (booking multiple interviews for same day by single applicants)
Prevent dirty invites (sending out a mass of invitations to more applicants than available spots)

Parameters:
Atomicity of the Interview-Travel Day Pair
Applicants can only interview at 1 program per day and must take the day after the interview off to allow for travel to another interview.
Programs must conduct all interview activities on the day of the interview and the evening of the interview. No dinners or social events on the night before.

Single event
No trading of interviews by applicants or programs once results are released.

Other restrictions
Potentially a limit on the number of interviews per position (program side) and number of programs applied to (applicant side) could be implemented.

Current situation:

Residency interview offers are sent out over the course of 3-4 weeks every year. Applicants spend an extraordinary amount of time monitoring otomatch, reddit and slack for when interview invites are released by each program. They are also required to keep in constant contact with email, ERAS, and cell phone to allow them to respond within minutes to an interview invite due to fear of a dirty invite or interview date conflict.

Logistics

During the ERAS application process, students must rank the programs they are applying to in rank of preference when they submit applications. This is prior to the release of program interview dates.
Programs must submit their interview dates and the number of interviews per date prior to downloading applications. Interview dates must be during 8 designated weeks (Nov, Dec and 1st week of Jan excluding Thanksgiving, Christmas and New Years week). Interviews can be on any day of the week Sunday – Saturday).
Programs must submit a rank ordered list of applicants to interview 4 weeks after being able to download applications.

On a designated date, applicants are sent their list of matched interviews.
On the same date, programs are sent their list of matched applicants with interview dates.

Potential Problems

Problem #1: travel logistics may make some sequences of interview dates impossible.
Solution: Day after interview is not available for applicant to interview. This will allow travel time for the applicant. This allows a theoretical maximum of 28 possible interview dates over the course of 8 weeks (8*7/2). Realistically, no applicant will be able to schedule and attend all 28 potential interview dates. An expected maximum would be 24 (three per week x 8 weeks). Typical for a highly competitive candidate would be 16 (two per week x 8 weeks).

Problem #2: applicants applying to multiple residency types
I don’t have a solution to this unless other less competitive residencies agree to be bound by the rules of ENT. They likely will not benefit from these rules and may even be hurt by these rules.

Problems #3: applicants enrolled in the couples match
Similar problem to multiple residency types. I don’t have a solution to this problem either.

Problems #4: applicants have less control over travel costs because they could be assigned sequential interviews in LA, NY, LA and then Philly with much higher costs than LA, LA, NY, then Philly.
Legit problem if travel is required. Potential ability to mitigate travel costs by grouping rank list geographically, and this would reflect an applicant’s preference for lower travel costs.
In the era of Zoom interviews, it’s not really an issue. In fact, the travel day could even be discarded, shortening the interview period to four weeks.

Leave a Comment

Filed under Uncategorized

Randall Church

Nov. 6,2020

Leave a Comment

Filed under Uncategorized

CHS EMR Links

HealthStream – Educational portal where you sign up for classes

Epicare Link – web based access to Epic

Haiku – phone app based access to Epic

Canto – Epic iPad app

ResMD – CHS PACS viewer

Leave a Comment

Filed under Uncategorized

Randall Church Live Video

Leave a Comment

Filed under Uncategorized

Some math about the ENT signaling system

This year the ENT match will allow applicants to send a signal to five residency programs as part of their application. These signals are supposed to allow applicants to tell a program that he/she is giving the program his/her top consideration. A concern among med students is will non-signaled programs even consider their application.

The information at the heart of this question is how many of the interview spots will be reserved for those that use one of their signals and how many non-signaled spots will be available.

Below are some stats, assumptions and an estimate of the ratio of signaled to non-signaled interview spots.

Applicant Side Stats
Number of applicants ~= 500
Number os signals per applicant = 5

Program Side Stats
Number of positions ~= 350
Number of interview days =299
Number of interviews per day ~= 15-30
Number of interviews ~= 4500-9000

Assume all signals will generate a guaranteed interview. This will overestimate the number of interview spots reserved for signalers.

Estimated Signaled Interview Spots = 2500

So at maximum, a little more than 50% of interview spots will be reserved for signalers. On the low end, it may be closer to 20%. This doesn’t answer the question of whether signaling will go into a program’s decision on how to rank the applicants they interview, but it does give some reassurance that programs will interview at least as many applicants that send them a signal as don’t.

In my opinion, the signaling system will give programs information they previously didn’t have about applicants. This may help them offer interview spots to applicants that are the most highly interested in their program. In the long term, this may even cut down on the number of applications per applicant but

However for this year’s cohort of applicants, I suspect that the interview number vs match rate curve will be very similar to past years. ENT is still a highly competitive field to match into. I am still advising medical students to apply broadly and take as many interviews as they can.

—sam

Leave a Comment

Filed under Uncategorized

Otomatch Articles

Izreig et al 2020. Otolaryngology Match 2020-21: Survey of Prospective Applicants in the Setting of COVID-19

Lee et al, 2019. Otolaryngology Residency Interviewing Dates and Practices: What Should an Applicant Expect?

Ward et al 2017 Applicant Perspectives on the Otolaryngology Residency Application Process

Kozin et al 2015 Analysis of an online match discussion board: improving the otolaryngology-head and neck surgery match

Leave a Comment

Filed under Uncategorized

CHS Epic Training

https://www.healthstream.com/HLC/chsbny

Catalog->search: Epic Curriculum->Epic ENT Provider INPATIENT CURRICULUM

Currently scheduled Classes

Epic STS ORDERS ENT LIVE ONLINE

  • LIVE CLASS
  • STATUS:Registered
  • LOCATION:Web Meeting
  • Oct 6, 2020, 5:00pm – 9:00pm ET

Epic STS ORDERS Provider Personalization Lab LIVE ONLINE

  • LIVE CLASS
  • STATUS:Registered
  • LOCATION:Web Meeting
  • Oct 7, 2020, 6:00pm – 8:30pm ET

Leave a Comment

Filed under Uncategorized