For graduating medical students, securing a residency in otolaryngology-head and neck surgery has become exceedingly difficult. This commentary explores the ways that applicants and residency programs are reacting to the increasing competitiveness in applying to, interviewing for, and matching to an otolaryngology residency. The commonly held perceptions of applicants are compared to perspectives held by residency program directors and resident selection committees. Unintended consequences of the growing trend for medical students to add a research year to their curriculum are presented. Some cautions and suggestions about how to improve the application and selection process are offered.

Stromal and cellular components within the tumor microenvironment significantly influence molecular signals mediating tumor growth and progression. We recently performed a screen to evaluate critical mediators of melanoma-endothelial communication and identified several molecular pathways associated with these cellular networks, including Notch3. Here, we evaluate the nature of melanoma-endothelial communication mediated by Notch3 and its functional significance. We find that Notch3 is specifically upregulated in melanoma-endothelial cell cocultures and is functionally associated with increased Notch signaling in melanoma cells. Furthermore, induced Notch3 signaling in melanoma cell lines leads to enhanced tumor cell migration without associated increases in tumor cell growth. Additionally, Notch3 expression is specifically associated with malignant patient samples and is not evident in benign nevi. We conclude that Notch3 mediates melanoma-endothelial cell communication and tumor cell migration and may serve as a meaningful therapeutic target for this aggressive malignancy.