A Resident’s View of AI in Otolaryngology

But even with these advancements, that whiteboard question stays with me: “Why can’t AI solve this?” because it reflects both the promise and the limits of these tools.

The limits are most apparent to me in two arenas: the operating room and face-to-face conversations with a patient. The breadth of otolaryngology–head and neck surgery demands improvisation and creativity. This past year, I have spent hours learning how to trace out the end branches of the facial nerve and use the thinnest suture to anastomose arteries and veins. Every operation is individualized, shaped by anatomy, prior treatment, and patient goals, requiring delicate precision that is not yet replicable by a machine. Likewise, in clinic, every patient encounter is sacred: reassuring someone their cancer has not returned, counseling about reconstruction, or offering empathy after bad news. These discussions rely on connection, not computation. For a surgical patient, reassurance comes from a subspecialty expert at the bedside: hands, headlight, endoscope, careful review of imaging, and real listening.

As we think about what “good enough” looks like in deployment, Dr. McCulloh offers a simple threshold: “AI does not need to be perfect. It needs to reliably do better than manual processes replete with human error. Baseline existing decisions and diagnoses against clinician consensus; if AI performs reliably better and removes some human error, we should seriously consider integrating it into practice.”

Thoughtful integration and adoption are critical to its success in clinical practice. As Dr. Ramanathan notes, this means “working with faculty champions within your institution to help make the transition.”

AI will continue to expand its role in medicine. As a resident, I’m part of the first generation of surgeons to enter practice with AI already in the background. It’s not a question of if we will use these tools or if they will replace us, but how responsibly we can integrate them into our clinical and surgical training. Used well, AI may reduce burnout, streamline care, and advance innovative research. But when patients look for guidance, reassurance, and surgical expertise, they are not asking for an algorithm, large language model, or generative output. They are asking for a trusted otolaryngologist.

Dr. Berges

Dr. Berges is a PGY-4 resident in the department of otolaryngology–head and neck surgery at Johns Hopkins University in Baltimore and a resident member of the ENTtoday editorial board.