Surgical specialty
Otolaryngology–Head and Neck Surgery (ENT): Salary, Residency & Career Guide
Medical and surgical management of ear, nose, throat, airway and head and neck conditions.
Typical Training
5 years
Five-year ENT and head-and-neck surgery residency.
Attending Compensation
$549,810
Average Total Compensation
Employment outlook
Not isolated
Projected Job Growth
Relative Competitiveness Index
70 / 100
Competitive
Start in Medical School
M1 to M4 Preparation
Practical experience, projects and rotation planning.
See the Medical School RoadmapAttending Compensation and State Wages
U.S. Attending Compensation
$549,810
Average Total Compensation
BLS does not publish a separately matched state wage series for this specialty.
Resident Pay by Institution
Five-year ENT and head-and-neck surgery residency..
2026–27 salaries, five published training-institution examples.
Selected institution
University of Michigan, Ann Arbor, MI
$77,049/ year
Pay varies by institution and postgraduate year.
Schedules and Work Setting
Schedule and Call
A rhinology clinic and planned sinus OR list can be predictable; head-and-neck reconstruction, airway emergencies and trauma consultations add nights and complex cases.
Practice Settings
ENT clinics, ambulatory surgery, major operating rooms and head and neck oncology services.
Procedures and Clinical Work
- Endoscopic sinus surgery
- Airway endoscopy
- Head and neck cancer surgery
- Ear surgery
Fellowship Training
Fellowship Expectation Index
3 / 5
Fellowship Options
Common Fellowship Duration: 1–2 year(s) beyond residency. Head and neck oncology, rhinology, otology and facial plastics are common focused routes.
General otolaryngology is viable after residency, while neurotology, head and neck oncology, pediatric airway and facial plastics can require dedicated preparation.
Direct Practice
General ENT clinic, sinus care, common head/neck and otologic procedures.
Specialized Practice
Advanced cancer, cochlear implant and otologic practices may favor or require specific fellowships.
Choosing a Path
Evaluate the operations and clinic populations you want before choosing a narrow surgical track.
Potential Fellowship Pathways
- Head and neck surgical oncology
- Rhinology
- Otology/neurotology
- Facial plastic and reconstructive surgery
Preparing in M1 Through M4
ENT includes endoscopy, oncology, pediatrics, airway emergencies and outpatient care. Comparing those services is a better test of fit than one sinus procedure.
Research or QI
A hearing rehabilitation outcome study, head-and-neck oncology project, sinus surgery QI project or airway clinic audit offers specific questions.
Common Mistake
Treating ENT as exclusively elective outpatient surgery and failing to observe airway emergencies or cancer care.
Preparation by Year
- 1Observe a routine rhinology clinic and a head and neck cancer tumor board; compare their diagnostic questions.
- 2Find a mentor familiar with specialty-specific signals and visiting-student rotation timelines.
Ask a resident this: How many urgent airway cases does a resident manage, and how is case mix distributed among oncology, rhinology and otology?
MD vs DO Match Outcomes
339 of 414 matched to their preferred specialty
26 of 41 matched to their preferred specialty
MD vs DO difference: 18.5 percentage points
Applicant Considerations
2024 ENT outcomes showed a meaningful difference between MD and DO cohorts, with relatively few DO applicants. Strong clinical exposure and detailed ENT evaluations help establish fit.
DO Application Strategy
Identify ENT programs with DO trainees, review USMLE/COMLEX policies and arrange accessible rotations early if your school lacks a home department.
Job Outlook
N/A
Projected Employment Growth
2025 to 2035, BLS occupational projection
No distinct employment forecast is published for this exact specialty.
AI and the Specialty
Potential Workflow Changes
Endoscopic image guidance, speech analysis and documentation may benefit from AI; surgery and airway management require clinical expertise.
Sources & Data Notes
Reviewed . National attending compensation uses Doximity's 2026 specialty survey (2025 pay) where available, then verified specialty-specific Medscape, Marit or Salary.com estimates. Doximity, Medscape and Marit report total compensation; Salary.com models base salary. Survey averages, modeled salaries and BLS wage medians measure different populations and must not be interpreted as identical metrics. BLS May 2025 state wages are shown separately and exclude self-employed physicians. The ophthalmology BLS category excludes pediatric ophthalmologists. State figures may be missing, top-coded, or suppressed. Job outlook uses BLS 2025–2035 occupational projections; it is not a local vacancy forecast. Resident stipend examples reflect published institutional scales for 2026 to 2027, by postgraduate year, not specialty. Stanford includes housing in its reported base salary; other institutions handle allowances differently.
The Relative Competitiveness Index uses a fixed score of 25 plus 1.75 times the 2024 U.S. MD preferred-specialty unmatched percentage, rounded, then applies the same 1.225 multiplier to every specialty. Neurological Surgery is 98/100; the score is not the applicant's chance of matching. It is not a 2026 estimate or DO-specific score. The MD and DO percentages compare different unadjusted applicant cohorts who ranked that specialty first. They do not account for application strategy, program selection, scores, or geography. Ophthalmology and urology have separate specialty match processes; other pathways may lack suitable NRMP cohorts.
The 1–5 Fellowship Expectation Index is an editorial assessment of customary career paths, not a measured participation rate or requirement. For residency profiles, compact training labels put specialty years before the clinical base or preliminary year; e.g. 3+1 means three specialty years and one clinical base year, even though the clinical year comes first. Fellowship-defined careers are presented in the separate fellowship explorer. Schedules, procedural scope, preparation suggestions, and potential AI effects depend on the program and practice setting; they are qualitative descriptions, not guaranteed outcomes or forecasts of physician replacement.
For Otolaryngology–Head and Neck Surgery (ENT): Doximity 2026, Average Total Compensation, reported under “Otolaryngology (ENT).” The national estimate must not be treated as a state-specific compensation figure.
Otolaryngology–Head and Neck Surgery (ENT): Editorial estimate of how fellowship shapes a career path. No observed fellowship uptake percentage is implied. Specialty-specific roadmaps describe illustrative activities, not mandatory publication, shadowing-hour, rotation, or skill requirements. Common fellowship routes: Head and neck oncology, rhinology, otology and facial plastics are common focused routes.