INTRODUCTION
Over 20% of primary care complaints are related to otolaryngology, however, overall exposure to otolaryngology in medical school curricula is variable and limited.1,2 A survey of accredited United States (U.S.) allopathic medical schools revealed that fewer than 40% of responding institutions include otolaryngology concepts in their core curriculum. Additionally, while many medical schools offer optional third- or fourth-year clerkships in otolaryngology, only 2-7% require students to complete a rotation in this specialty.3,4 As a result, students must actively seek out opportunities to gain exposure to the field in various ways.
Exposure to otolaryngology through innovative educational approaches, such as team-based learning, simulation, and online modules, can boost student engagement without burdening clinical faculty.5 Similarly, mentorship programs that connect medical students with otolaryngologists early in their training, offering opportunities for relationship building, shadowing, and hands-on clinical experience, have been shown to increase students’ confidence and foster greater interest in the field.6,7
Given the high prevalence of otolaryngologic pathologies and limited medical curricular exposure, it is essential to implement and evaluate educational strategies that improve otolaryngology teaching and encourage interest in the field. The primary purpose of this study was to determine whether a short, single-skill instructional event could stimulate medical student interest in a career in otolaryngology.
METHODS
This study was conducted at a flexible laryngoscopy workshop event at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, following approval from the University at Buffalo Institutional Review Board. The event took place on Monday, November 6, 2023. Pre-clinical medical students were recruited through the institution’s email listservs, and University at Buffalo otolaryngology residents were contacted through their institutional email addresses.
The workshop consisted of two back-to-back sessions, each accommodating 15 preclinical medical students. Each session began with a 10-minute presentation delivered by a senior otolaryngology resident, who provided an overview of laryngeal anatomy, indications for laryngoscopy, and common pathologies identifiable through the procedure. Following the presentation, students participated in a 20-minute resident-assisted, hands-on session passing a flexible laryngoscope on an airway demonstration model. Per session, students were divided into smaller groups of five students, each supervised by two otolaryngology residents. Throughout each hands-on session, one resident facilitated the review of photos illustrating various laryngeal pathologies—such as vocal cord polyps, nodules, laryngomalacia, and laryngeal tumors—while the other resident provided hands-on guidance to students using the flexible laryngoscope (Figure 1). The event was supported by an Ambu Sales Representative, who supplied three Ambu aScope 4 RhinoLaryngo scopes and TrueCorp AirSim Bronchi for the workshop (Figures 2 and 3). This workshop structure allowed for personalized instruction and hands-on practice for all medical student participants.
Paper surveys were administered to all participating medical students both before and after workshop completion. These surveys collected demographic data and assessed students’ familiarity with laryngoscopy indications, common pathologies identifiable via the procedure, and laryngeal anatomy. Participants rated their familiarity on a scale of 1 (“unfamiliar”) to 5 (“well-versed”). Interest in otolaryngology was also rated on a scale from 1 (“not at all interested”) to 5 (“extremely interested”).
Statistical analyses were conducted using SPSS (Version 30.0, Armonk, NY: IBM Corp, 2024). Continuous variables were summarized with means and 95% confidence intervals (CIs), while categorical variables were summarized with frequency counts and percentages. Wilcoxon signed-rank tests were used to compare non-parametric data. Statistical significance defined was as p<.05.
RESULTS
A total of 30 students attended the workshop, and 26 completed both the pre- and post-workshop surveys. The majority of participants were first-year medical students (N=19, 73.1%). Demographic characteristics of all survey respondents are summarized in Table 1.
Students’ familiarity with laryngoscopy indications increased from an average of 1.8 to 4.0 (p<.00001, Table 2), familiarity with pathologies detected via laryngoscopy increased from an average of 1.7 to 3.8 (p<.00001, Table 2), and understanding of laryngeal anatomy increased from an average of 2.6 to 3.7 (p<.0001, Table 2). Following the workshop, interest in otolaryngology also increased from 3.3 to 4.0 (p<.01; Table 2). All 26 students (100.0%) expressed interest in participating in similar workshops in the future.
DISCUSSION
This study demonstrates the impact of a brief, hands-on flexible laryngoscopy workshop on preclinical medical students’ understanding of laryngeal anatomy, laryngoscopy indications, and pathologies, as well as their interest in otolaryngology as a career. By showing that a single, focused educational session can significantly improve both knowledge and enthusiasm for a specialty, this study highlights the potential of targeted workshops to address gaps in medical education. Such initiatives are particularly valuable in specialties like otolaryngology, which are underrepresented in medical school curricula. The findings suggest that integrating similar workshops into preclinical education could provide a practical, scalable approach to introducing students to surgical subspecialties, fostering early interest, and guiding career decisions. This approach enriches the learning experience and ensures students are exposed to a broad range of medical fields.
The factors that influence medical students to pursue a surgical career are complex and multifaceted. Early exposure to surgical procedures and opportunities to practice technical skills are among the most impactful.10,11 For instance, Hicks et al. demonstrated that programs like the Surgical Exploration and Discovery (SEAD) initiative significantly improved students’ understanding of surgical subspecialties and training pathways while increasing interest through hands-on experiences and mentorship.11 Similarly, intensive one-day surgical skills courses, like those described by Seo et al., show that even short, focused training sessions can significantly enhance participants’ confidence and enthusiasm for surgical specialties.10
Mentorship further reinforces these effects by providing role models and positive clinical experiences. Shah et al. found that structured mentorship programs boost medical students’ confidence in clinical knowledge and performance while familiarizing them with departmental faculty.12 Additionally, students actively participating in operating room tasks, such as suturing or operating an endoscopy camera, were significantly more likely to consider surgical careers, especially when guided by supportive residents or attending surgeons.13 These findings highlight the critical role of mentorship and active engagement in shaping career decisions.
Despite these positive influences, concerns about lifestyle and work-life balance also weigh heavily on these decisions. While some students are deterred by the long training periods and demanding schedules associated with surgical careers, others are drawn to its intellectual challenges and technical nature. Erzurum et al. found that students motivated by role models, career opportunities, and academic potential were more likely to pursue surgery, whereas those with concerns about lifestyle often chose alternative paths.14 Addressing these barriers, particularly for underrepresented groups, could improve recruitment into surgical specialties and create a more diverse workforce.
Within the broader field of surgery, otolaryngology faces unique challenges due to its limited representation in medical curricula. Despite its relevance to approximately 25% of primary care complaints, most medical schools provide minimal exposure to the specialty.5 Boscoe and Cabrera-Muffly reported that only 7% of US medical schools require a mandatory clinical rotation in otolaryngology, leaving many students without sufficient opportunities to explore the field.4 Scott et al. further noted that the majority of clerkship students reported minimal exposure to otolaryngology in both classroom and clinical settings.15 This lack of exposure limits students’ understanding of the specialty’s scope and significance. To bridge this gap, targeted educational interventions such as workshops and mentorship programs have been implemented. Spiers et al. demonstrated that a one-day otolaryngology course significantly improved students’ confidence and understanding of the field, highlighting the value of focused, interactive opportunities.16 Integrating such initiatives into medical curricula could enhance interest in otolaryngology and other underrepresented specialties, ultimately improving the breadth and diversity of medical training.
Access to mentorship, research, and curriculum that expose students early to otolaryngology remains limited. Various organizations and institutions have developed innovative strategies to promote interest. With available residents, faculty, and community providers, mentorship programs can effectively prepare students for otolaryngology and residency applications. Sethia et al. found that early mentorship boosted preclinical students’ confidence in clinical performance and interest in the field.6 Similarly, Nellis et al. utilized faculty mentorship during clinical and research clerkships to increase interest among underrepresented minority medical students.7 Student interest groups can further address hurdles in awareness of otolaryngology as a career at both institutional and national levels. Hu et al. showed that such groups facilitate early exposure, dispel common misconceptions, and provide research and mentorship opportunities.17 Farsar et al. expanded this concept by creating the National Otolaryngology Interest Group (NOIG), aimed at supporting students without home otolaryngology residency programs, osteopathic medical students, and underrepresented minorities. This program provides mentorship, fosters scholarly activity, and offers early clinical exposure in the field.18 Continued development of innovative initiatives like these can effectively generate student interest in the field.
Limitations
The present study has limitations that should be acknowledged. First, the workshop had a relatively small number of students who participated and completed the survey, which may introduce sample bias and limit the generalizability of the results. Second, the unique equipment used during our workshop study may limit the applicability of our results to other settings where such resources are unavailable. Additionally, the study was based on a one-day event with a capacity limit of 30 participants, which may not capture the impact of longer or larger-scale programs. Lastly, no model can fully replicate human anatomy. However, we believe this experience offered a valuable opportunity to focus on the technical aspects of flexible laryngoscopy and simulated a procedure that otolaryngologists routinely perform.
CONCLUSIONS
This hands-on workshop significantly improved medical students’ knowledge of laryngoscopy, while also increasing their interest in pursuing a career in otolaryngology. Similar events could be a valuable addition to the pre-clinical curriculum, offering increased exposure to the field. By incorporating targeted workshops, mentorship programs, and student interest groups into medical education, institutions can foster early enthusiasm and create pathways for students to explore surgical subspecialties.