Tonsils, sinuses, hearing, voice and head and neck cancer. Officially otolaryngology, one of the most varied surgical specialties.
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Pay, the path, pros and cons and the facts on one printable page. Counsellors: send it to a student from your own email in one click.
The median pay is about $419,000 a year. Across everyone in the job it runs from about $144,000 at the lower end to about $767,000 at the upper end. The source is listed under Sources at the end of this page.
12 to 15 years after high school, on the usual route.
$74,500 to $167,000 all in for tuition, fees, exams and kit. Living costs are not counted.
Yes. It is a regulated job, so you need a licence or registration before you can work.
Good demand nationally, from government outlook data. Demand varies by region, so check your area.
Or read the whole thing here
What you earn and what it costs to get there.
Median
$419,000
Lower end
$144,000
Upper end
$767,000
These are Job Bank (the Government of Canada job site) figures for all surgeons together, a year, from 2023 to 2024. Job Bank pools every surgical specialty in one group, so this is not an ENT (ear, nose and throat) figure. Most ENT surgeons bill the province per operation and clinic visit, and a large office practice means higher costs. Pay varies by province and billing model.
About $550,000
Median gross clinical payment, ear, nose and throat surgeons, 2024 to 2025
CIHI (Canadian Institute for Health Information) counts 847 doctors in this group. The middle 60% were paid $291,000 to $843,000. This is billing before office, staff and other practice costs, not take-home pay. Read from CIHI's data tables, downloaded in a browser with Claude in Chrome on 6 November 2026, because cihi.ca refuses our checker.
$73,000 to $99,000
A year in Ontario from July 1, 2025, in postgraduate years 1 to 5 (PGY1 to PGY5), over the 5 years of residency
Set by the 2023 to 2026 agreement between PARO (Professional Association of Residents of Ontario) and Ontario's teaching hospitals, which ran to June 30, 2026. These are its latest published rates. Other provinces have their own agreements and pay scales. Call covers airway emergencies, nosebleeds that will not stop and facial trauma.
Clinic work is billed too
Scopes, ear procedures and allergy work are billed per visit
ENT (ear, nose and throat) surgeons bill for scopes and ear procedures done in the office, not only for operations, so part of the work does not depend on scarce hospital operating time.
Roughly, all in
$74,500 to $167,000
Tuition, fees, exams and kit. Not rent, food or travel
The low end is a three year undergraduate degree at cheaper tuition, a medical school at the low end of Canadian fees, and the national medical exam plus the specialty exam. The high end is four years of undergraduate study, an expensive medical school, and the top of every exam fee. The five year surgical residency is paid, and a fellowship adds one or two more years at roughly resident pay, so the long training is income rather than cost. Office scopes and equipment are left out here because they are the cost of running a practice later, not of qualifying, and they run into tens of thousands of dollars.
Many graduates finish medical school with a large debt. Fellowships add 1 to 2 years at roughly resident pay.
No employer pension
Most surgeons are self-employed and save through a professional corporation.
Private-pay options
Cosmetic nose surgery and some sleep and allergy work are paid by the patient.
On-call stipends
Extra pay for covering airway emergencies overnight.
Malpractice coverage
Through the CMPA (Canadian Medical Protective Association), partly reimbursed by provinces.
The exact path from high school to qualified.
Same road as every surgeon. The official name is otolaryngology, head and neck surgery.
High school
Grades 11 and 12
Top marks in biology, chemistry, math and English. A very high average is the entry ticket.
Bachelor's degree
3 to 4 years
Any major, usually life sciences. High GPA, research, volunteering. Write the MCAT (medical school admission test).
Medical school, the MD (doctor of medicine)
3 to 4 years
Most applicants are not accepted. Electives in ear, nose and throat surgery plus research in your final year decide the match.
Otolaryngology residency
5 years
Matched through CaRMS (the residency matching service). Paid, supervised. Ear surgery under a microscope, sinus surgery through a camera, cancer surgery of the neck, kids' tonsils and ear tubes.
Royal College exam, licence, often a fellowship
1 to 2 years
Pass the Royal College of Physicians and Surgeons of Canada exam, register with your provincial College of Physicians and Surgeons. Many add a 1 to 2 year fellowship.
Biology and chemistry
Required for nearly every pre-med path.
Physics
Sound, hearing and airflow are physics. Also on the MCAT (medical school admission test).
Calculus and functions
English
You will explain voice, hearing and cancer to patients of every age.
You need a licence from your provincial College of Physicians and Surgeons to practise, and specialist certification in otolaryngology from the Royal College of Physicians and Surgeons of Canada to work as an ENT (ear, nose and throat) surgeon. Hospitals grant operating privileges only with both. Licences transfer between provinces with paperwork and fees.
In Quebec you apply to medical school straight from CEGEP (public college), with no bachelor's degree first.
Finish Secondary V
Age 16 or 17
With Secondary V math (Technical and Scientific, or Science option), chemistry and physics. These are the entry courses for the CEGEP (public college) science program.
Science DEC (Diploma of College Studies)
2 years
A 2 year CEGEP (public college) program (200.B1), offered in English at Dawson and the other English colleges. Take the biology and chemistry courses medical schools ask for.
Medical school, straight from CEGEP
4 to 5 years
No bachelor's degree needed. McGill and Montréal start with a 1 year preparatory year, Laval and Sherbrooke do not. You need a top R-score (the CEGEP ranking score), the Casper test and interviews.
Otolaryngology residency
5 years
Matched through CaRMS (the residency matching service). At McGill it is in English: 1 year of general surgery, then 4 of ear, nose and throat surgery. Montréal and Laval run it in French.
Royal College exam and CMQ (Collège des médecins du Québec) permit
End of residency
Pass the Royal College exams. The CMQ, the Quebec college of physicians, then issues your permit and specialist certificate once you show French. A Quebec high school diploma counts.
Get a hospital position
Before you start
Every specialist working in a Quebec hospital must hold a spot in its PEM (plan d'effectifs médicaux, the medical staffing plan). The health ministry approves how many each hospital gets.
Montréal and Laval set a minimum R-score (the CEGEP ranking score) of 33 for CEGEP applicants in 2026. McGill's Med-P year is only for recent CEGEP graduates.
Things you don't need, but that help.
Head and neck cancer
Big operations removing tumours of the mouth, throat and neck, often rebuilding with tissue from elsewhere.
Ear and hearing (otology)
Cochlear implants and microscopic ear surgery.
Sinus (rhinology)
Camera-guided sinus surgery, some skull base work with neurosurgeons.
Pediatric
Airway problems, tonsils, ear tubes and hearing in children.
Facial plastics
Nose reshaping and facial reconstruction, partly private-pay.
Voice (laryngology)
Singers, teachers and anyone whose voice has failed.
Electives and research in ear, nose and throat surgery
Reference letters from the specialty decide the match.
Fine motor skills
Ear surgery works on bones the size of a grain of rice.
Comfort with kids
A large share of patients are children.
Comfort with cameras and scopes
Much of the specialty is done through an endoscope on a screen.
A community ENT (ear, nose and throat) surgeon does tonsils, sinuses, ear tubes, nasal surgery and office scopes, with decent hours and light call. An academic head and neck cancer surgeon at a teaching hospital does 10-hour operations and takes heavier call. Most residents pick a lane by their final year.
Day to day, pros and cons, where you'd work.
Surgery days: 8:00 a.m. in the operating room (OR) for a run of short cases, tonsils, ear tubes, a sinus surgery through the nose, or one long neck cancer case. Clinic days: 30 to 50 patients, scopes through the nose to look at the throat, ear cleaning under a microscope, hearing results. Call is a few nights a month: a blocked airway, a deep neck infection, a nosebleed that will not stop.
The good
The hard parts
Things people don't tell you.
Ear tubes and tonsil removal are among the most common operations performed on Canadian children. An ENT (ear, nose and throat) surgeon may do several before lunch, each in under half an hour.
The three bones of the middle ear are smaller than a grain of rice. Ear surgeons repair and replace them under a microscope, and a cochlear implant bypasses them entirely to restore hearing.
Voice specialists in otolaryngology treat professional singers, actors and teachers. They look at the vocal cords with a strobe light to see them vibrate hundreds of times a second.
Otolaryngology, head and neck surgery is the official title. Even doctors say ENT (ear, nose and throat). It comes from the Greek words for ear and larynx, the voice box.
Every list is built from the same numbers shown above, so you can see where this career sits next to the others.
Surgeons first, then the rest of the field. See every career in health.
Last checked November 2026. Pay figures are typical full-time annual amounts in Canadian dollars, based on Government of Canada Job Bank wage data and published salary grids. They vary by province, employer and experience. Tuition is for domestic students. How every figure on this site is sourced and checked.
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