I’m a third-year otolaryngology resident. I spent my year becoming a highly skilled surgeon.

As a third-year otolaryngology resident, Carly Clark, MD, is at the halfway point of her graduate medical training. In her first year (intern year), she figured out how to be a doctor – how to triage patients, treat them, and navigate the system. In second year, she started making care decisions. Now in third year, she is finding her groove with surgical ear, nose, and throat (ENT) cases.

This is more than the halfway point for Dr. Clark. It is a turning point in her training.

In the early stages of residency training, Dr. Clark started with smaller operating room (OR) cases such as “tubes and tonsils.” As University of Kentucky ENT residents progress into their program, they see broader cases and more patients, eventually working up to guide the care themselves.

As a third-year resident, Dr. Clark sees anywhere from three to 25 patients per shift, depending on her assignment in the clinic or the operating room.

While she works both days and nights, she finds herself with more opportunities to make decisions during night shifts. Essentially, she comes up with a plan that provides appropriate care for a patient. She discusses with the senior resident, and together, they formulate a plan and talk through with the attending.

“A lot of times they let you drive the management, but in more complex patients, you can lean on attendings for some advice,” she says. “Ultimately, they have the last say, but you can help schedule surgery, follow up, or refer out if needed.”

Students
After a patient visit, Dr. Carly Clark logs her notes to help with future follow-ups.

Each day, Dr. Clark finds herself thinking more like a senior resident.

“I feel like I’ve gotten more efficient when I’m on call,” she says. “I have a better sense of who needs to go to surgery, what’s an emergency versus what’s not.”

She has become highly skilled in procedures such as flexible laryngoscopy, which involves advancing a scope to the back of the nose so the care team can get a view of the airway from above. “It doesn't go in as far as people think it's going to, but it gives us a good view of the airway and the voice box” Dr. Clark says.

Asked how many she has done, it’s hard to count. 200? 500?

“I've done many, many, many scopes,” she says with a laugh.

Students
With this particular patient, Dr. Clark used a scope to rule out any sort of cancers or other serious diseases.

This year, Dr. Clark worked with a variety of attendings through rotations including neurotology, laryngology, facial plastics, pediatrics, rhinology, endoscopic skull base surgery, and head and neck cancer.

She has also seen more time in the OR, which she says is every surgical resident’s “happy place.”

“It’s what gets you through the training,” she says. “You ‘get your hands dirty’ and you’re directly impacting patient care. And then if you’re lucky, you get to see that patient in clinic and see the improvement firsthand.”

While her team completes a decent amount of simple procedures in the clinic, the OR is where they work on exciting, more complex procedures like sinus surgery, septoplasties (straightening the wall of bone and cartilage between the nasal passages), eardrum repairs, neck dissections, airway procedures, and cancer-related procedures including both removal and reconstruction.

Dr. Clark is in the OR one to three times per week. She says that the more reps she completes, the more comfortable she feels.

And she always prepares.

“The night before, you go through all your cases for the next day, talk with the attending, look at any imaging, look at the patient labs, what the attending’s plan is,” Dr. Clark says. “Then for newer cases you haven’t done as much, you do some reading on how the case goes, what to look out for, and key parts of the case.”

She says ear and sinus cases take the longest to prepare due to their complexity.

Dr. Clark works side-by-side with an attending. As residents progress they complete the majority of the case with the attending available to help as needed.

When she is in her fourth and fifth years, she will do more of what she calls, “double scrubbing.” This means as a senior resident, she will understand the case well enough to help guide a junior resident.

Students
Dr. Clark calls the operating room every surgical resident’s “happy place” because that’s where the action is.

In fourth year and beyond, Dr. Clark will have more of a teaching role. So she has spent her third year honing not just her operating skills and clinical bedside manner, but also her mentorship abilities.

“I’ve tried to work on thinking like a senior, not only what I would do for this patient, but if I was on call, how I could counsel the junior to help them work through this and figure out what to do,” she says.

The mentee is becoming the mentor.

Dr. Clark is the most senior female resident in the otolaryngology program. She feels a responsibility to serve as a role model for younger residents.

“I try to remind myself that I am a role model,” she says. “It’s been really nice to see the younger residents grow. We’ve all become really close.”

The women in the otolaryngology department call themselves the “She”-NTs, a play off of ENT.

Students
Dr. Clark is pictured with her fellow female otolaryngology residents at UK.

In turn, Dr. Clark has strong mentors of her own to follow.

She was paired with Caitlin Fiorillo, MD, assistant professor of otolaryngology, at the start of her residency training. Dr. Fiorillo has provided valuable advice throughout the journey, especially as Dr. Clark garners more OR time.

They frequently meet one-on-one to go over specific career goals. “I’ve gone out to dinner with Dr. Fiorillo to discuss advice on getting through tough times in residency, navigating the job search, and things like that,” she says. “That’s been really helpful.”

Students
Dr. Clark calls Dr. Fiorillo (right) a valuable mentor who has taken extra time to help her succeed as a surgeon.

“Dr. Clark entered residency with some reservation about her abilities but has transformed into a leader among her peers. She joined our program at a time when there were no older female residents to provide mentorship but has turned that around and become an ideal mentor for our younger female residents. She reaches out to lift up other residents. She is kind, thoughtful, and has become an excellent surgeon as she has gained confidence in her own skills. She goes above and beyond for her patients and prioritizes their care above all else. She has been able to balance gracefully taking care of other residents, herself, and her patients, which is an extraordinary feat in otolaryngology residency!”

Caitlin Fiorillo, MD,

Assistant Professor

Dr. Clark also had the opportunity to boost her research portfolio this year.

She joined department mentors and fellow residents to develop a tutorial series for breastfeeding surgeons. Specifically, Dr. Clark organized the videos and put them together on a virtual platform.

The project was supported by UK HealthCare and funded by an American Academy of Otolaryngology-Head and Neck Surgery Women in Otolaryngology grant. Leaders of the project include Dr. Clark; Nikita Gupta, MD; Tessa London-Bounds, MD; and Brittany Levy, MD.

The series, published this year, is free and available to anyone.

“Working on this project amplified my appreciation for hard-working mothers, especially surgeons, and how much time they’re putting in,” Dr. Clark says.

Dr. Clark also led a few poster presentations this year on scientific topics related to otolaryngology.

During one of her department’s grand rounds, she presented on nebulizer treatments and demonstrated their usage in the ENT field. She discussed how different nebulized medications work, their indications, and contraindications.

She presented at both a local research symposium and an international conference about research she completed with one of her previous attendings. The study focused on female patients with larynx cancer and the different factors and outcomes seen in patients with that condition.

Dr. Clark also attended a teaching and learning course at Vanderbilt University in Nashville, Tenn., to go over temporal bone anatomy and surgical dissection.

Attending multiple professional development events this year has helped her build confidence as a doctor and a leader. Now, she feels much more ready to assume more teaching responsibilities in her final two years of residency training.

Students
Dr. Clark traveled to Canada for a head and neck surgical conference, presenting a poster about her project on females with larynx cancer, a project she worked on with UK faculty.

Dr. Clark has a strong support system of peers in the UK College of Medicine Department of Otolaryngology – Head and Neck Surgery.

ENT residents round together in the morning to see patients on their list, which helps them stay on the same page and bounce thoughts off of one another. They participate in their own teaching conference every Friday to teach each other about various topics in ENT in a low stakes environment. And they switch around with whom they take call, ensuring they all work with each other.

Beyond the confines of the OR, ENT residents at the University of Kentucky hold numerous social events across Lexington. When you spend countless hours with your fellow ENT residents, they become like family. Dr. Clark has made lifelong friends.

“We’re basically together more than anyone else,” she says. “I’ve grown close with all of them.”

Amid a busy schedule, it’s also important that Dr. Clark makes time for herself. If the OR is her happy place as a surgeon, the kitchen is a close second. “I love to cook, and to cook for others,” she says.

Dr. Clark has joined a book club this year, which she says has helped her “inner nerd” emerge.

She also loves to be outdoors. When she can, she rides her bike to work. She used to cycle competitively on a club team during her undergraduate training at Tulane University.

A North Carolina native, she enjoys camping and hiking. Someday, she hopes to make it out west.

Dr. Clark isn’t getting ahead of herself. She has a couple of years remaining in her ENT residency training before she practices medicine on her own.

The change she has made throughout her third year has been exciting. She sees her potential, not only to become an exceptional doctor, but to pave the way for young doctors who follow her footsteps.

“This has been an exciting chapter in my medical career,” she says. “I can only imagine what the future holds.”

Students
The UK College of Medicine Department of Otolaryngology – Head and Neck Surgery has become a second family to Dr. Clark.