Ear, Nose and Throat Surgeon

What the pay looks like

Read this one carefully. Ear, nose and throat surgeons are not counted separately by the government wage survey. They sit inside a bucket called Surgeons, All Other, where the May 2023 survey published a bottom tenth of $78,000 and then refused to publish the median or anything above it, because the figure is at or above $239,200 a year. The middle and top here are therefore estimates: $414,010 is the published 2025 median for that whole surgical bucket, and $523,369 is the average for otolaryngology in a 2025 survey of over 37,000 full-time American physicians.

While you are a resident

Five paid years in the hospital at roughly a sixth of what the job eventually pays, while your medical school loans keep growing behind you.

Clinic and operating room both pay

Unlike most surgical specialties, a large share of this work happens in a clinic: hearing loss, sinus disease, hoarse voices, children with repeated ear infections. Procedures pay better per hour, but a full clinic feeds the operating list, so the two are not separable.

What it costs to get there

Bachelor's degree, in-state public university

Roughly $11,000 to $15,000 a year in tuition and fees

Medical school

Roughly $40,000 a year in-state public, around $65,000 a year private

Medical College Admission Test (MCAT) and applications

A few hundred dollars for the test, plus $3,000 or more applying and interviewing

Licensing and board exams

Three national licensing steps during training, then written and oral board examinations after residency

Roughly, all in

$195,000 to $335,000

Tuition, fees, exams and kit. Not rent, food or travel

The low end is the cheapest realistic route: a community college start, an in state public university to finish the degree, and an in state public medical school, plus the medical school entrance exam, the application round and the licensing and board exam fees. The high end is four full years at a public university followed by a private medical school. The five years of surgical residency after medical school are paid work, not tuition. Most graduates who borrow finish around 200,000 dollars in debt, which clears quickly at this income unless you take the academic route and use Public Service Loan Forgiveness instead.

Most medical graduates who borrow finish around $200,000 in debt. At this income it clears quickly, or you can use Public Service Loan Forgiveness after 10 years at a nonprofit or public hospital if you go the academic route.

Benefits

• Malpractice insurance paid

  Covered by the hospital or the group, and it is expensive cover for any surgeon.

• Surgery center ownership

  Many procedures in this field happen in outpatient surgery centers, and surgeons who own a share of one earn from the facility as well as the operation.

• Signing bonuses and loan repayment

  Common outside big cities, often six figures, because smaller hospitals struggle to recruit surgeons.

• A controllable schedule

  Most of the work is planned rather than emergency, so nights and weekends are lighter than in general or trauma surgery.

The path

Thirteen years after high school, and the residency match for this specialty is one of the most competitive in medicine.

1. 1

   High school

   Grades 11 and 12

   Biology, chemistry, physics and math, with the grades to get into a strong college program.

2. 2

   Bachelor's degree

   4 years

   Any major, as long as you finish the pre-medical science courses and sit the Medical College Admission Test (MCAT).

3. 3

   Medical school

   4 years

   Two years of science, two years of hospital rotations. You graduate as a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO).

4. 4

   Otolaryngology residency

   5 years

   Five years covering ears, sinuses, airway, voice, head and neck cancer and facial reconstruction. Assigned by a national computer match.

5. 5

   Board certification

   After residency

   Written and oral examinations from the American Board of Otolaryngology, Head and Neck Surgery.

6. 6

   Optional fellowship

   1 to 2 years

   One or two more years in a sub-area such as ear surgery, cancer, children or facial plastic surgery.

High school courses that help

• Biology

  The head and neck is the most anatomically crowded region in the body and you will learn every millimeter of it.

• Physics

  Sound, pressure and airflow are literally the subject matter of this specialty.

• Chemistry

  A pre-medical requirement everywhere, with no way around it.

• Art, music or anything with your hands

  Microsurgery on structures the size of a grain of rice rewards manual skill more than most jobs admit.

Time and money, at a glance

Years after high school

13, or 14 to 15 with a fellowship

How hard to get in

Medical school first, then one of the harder residency matches in the country

Total tuition

Roughly $200,000 to $350,000 across college and medical school

Paid while training?

Yes, from the first day of residency

State license, national exams

Every state licenses doctors through its own medical board, and you hold a license in each state where you work. The exams are national: the three steps of the United States Medical Licensing Examination during medical school and residency, then written and oral board examinations from the American Board of Otolaryngology, Head and Neck Surgery. The formal name of the specialty is otolaryngology, head and neck surgery, which is why almost everybody, including hospitals, says ear, nose and throat instead.

Fellowships that change the job

• Otology and neurotology

  Ear surgery, hearing implants and balance disorders. The most microscopic work in the field.

• Head and neck oncology

  Cancer of the mouth, throat, voice box and thyroid, with reconstruction afterwards. Long operations, serious stakes.

• Pediatric otolaryngology

  Children's airways, ears and tonsils at a children's hospital.

• Rhinology

  Sinuses and skull base surgery done entirely through the nose with an endoscope.

• Facial plastic and reconstructive surgery

  Reconstruction after cancer or trauma, plus cosmetic work. One of two routes into facial plastic surgery.

Nice-to-haves

• Research during medical school

  This residency match is competitive enough that research output is close to expected.

• Steady hands and good stereo vision

  Much of the work is through a microscope or an endoscope, in a space a few millimeters across.

• Comfort with cameras and screens

  Endoscopes turned this specialty into screen-guided surgery. If that appeals, it is a good sign.

• Patience for clinic

  If you only want to operate, look at another surgical specialty. Half of this job is talking to people in an office.

Who else works on ears and voices

You share these patients with people who trained far more quickly. Audiologists test hearing and fit hearing aids, and get there in about eight years. Speech-language pathologists treat voice and swallowing problems after six or seven. Hearing instrument specialists work with a license and far less school. If the subject interests you more than the surgery, those are real careers in the same clinic, and the surgeon is usually the person they refer to rather than the person doing most of the care.

A typical day

On an operating day you start early: perhaps a child having ear tubes and tonsils out in 40 minutes, then a sinus operation through an endoscope, then something long like removing a throat cancer and rebuilding what is left. On a clinic day you see 20 or more people: a hoarse teacher, a man who cannot breathe through his nose, a baby with repeated ear infections, an older patient losing their hearing. You scope noses and throats in the office all afternoon, and the interesting ones become next month's operating list.

The honest trade-offs

Work life

Typical hours

50 to 60 a week including call

Remote work

Some follow-up visits by video, nothing else

Physical demand

Moderate. Long hours standing, bent over a microscope

Unionized

Rarely, though resident physicians at some hospitals are

Similar paths

• General SurgeonThirteen years of training to become the person who opens someone up and fixes the problem.
• AudiologistTest hearing and balance, then fit the devices that give it back. A four-year clinical doctorate, and a job in every town.
• Speech-Language PathologistYou help people talk, be understood and swallow safely, from toddlers to stroke patients. A master's degree is the price of entry.

The government will not print the salary

The federal wage survey stops publishing a figure once it reaches $239,200 a year, so for this group it prints a footnote instead of a median. Every number you see quoted for surgeon pay above that line comes from a private survey, not from the government.

Ear tubes are one of the most common childhood operations

Putting tiny drainage tubes into the eardrums of children with repeated ear infections takes a few minutes per ear and is performed constantly. Tonsil removal is in the same category. A lot of this specialty is small operations done extremely often.

A surgeon can give someone hearing

Cochlear implants bypass a damaged inner ear and send signal straight to the hearing nerve. They are placed by ear surgeons, and for a child born deaf the device can mean growing up hearing speech.

Sinus surgery leaves no scar

Modern sinus and even some skull base operations are done entirely through the nostrils with an endoscope and a screen. Nothing is cut on the outside of the face, which is why the recovery is nothing like it was a generation ago.