The field of otolaryngology has one of the lowest rates of racial and ethnic diversity. An anonymous survey was distributed to members of the Student National Medical Association at different medical schools to identify factors that may contribute to this disparity. Responses were received from 104 students at 36 allopathic medical schools. Most respondents identified as black (86.5%). One-third of students (34.6%) noted that they were discouraged from pursuing otolaryngology due to lack of mentorship, and among these students, most noted that they lack mentors of the same race (75%). One-fourth of respondents (25%) indicated that they lack a home otolaryngology program. The most common reasons for participants’ disinterest in otolaryngology included competitiveness, inadequate exposure, research, and the high board scores needed to match. This hypothesis-generating, proof-of-concept study highlights potential barriers that may discourage underrepresented medical students from pursuing a career in otolaryngology.

Background Head and neck cancer patients are at risk for malnutrition, which can impact postoperative outcomes. This study evaluates the Malnutrition Universal Screening Tool (MUST) to predict outcomes in major head and neck surgeries. Methods A retrospective chart review included 275 major surgical procedures performed on 242 patients over the age of 18 years between May 2015 and May 2020. Results The majority of patients had a MUST score of zero (68.7%). Just under 17% scored 2 or greater indicating malnourishment. Having a MUST score of 2 or higher was associated with occurrence of a postoperative complication (p < 0.001). Patients with alcohol use disorder or depression were 5.2 (CI: 2.0–13.7, p = 0.001) and 2.75 (CI 1.1–7.0; p = 0.033) times more likely to develop a postoperative complication, respectively. Conclusions Malnutrition and comorbidities were associated with complications in our surgical cohort. MUST is a novel tool to identify patients who may benefit from nutritional interventions.

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Five succinct key points: -Otolaryngologists are at high risk for ergonomic injury, particularly in the neck and cervical spine region. - There is a need to use validated ergonomic assessment tools to quantify the amount of risk in specific otolaryngology procedures and identify alternative methods to decrease that risk. -The physical positioning of the senior author was studied using the RULA score during two different operative approaches to tonsillectomy: one using an endoscope and one using direct visualization without the aid of an endoscope. - The RULA score for the traditional, non-endoscopic approach was 5, with a Neck, Trunk, and Leg Score of 6 and a Wrist/Arm score of 1, demonstrating a high risk and suggesting a need for further investigation and change. The RULA score for the endoscopic-assisted approach was 3, with a Neck, Trunk, and Leg score of 4 and a Wrist/Arm score of 1. -An endoscopic-assisted approach to tonsillectomy allowed for a lower RULA score than traditional tonsillectomy. This study suggests that an endoscopic approach may decrease the potential for musculoskeletal strain and reduce occupational-related pain and injury seen in practicing otolaryngologists.

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