The early exposure advantage: a prospective evaluation of a structured preclinical otolaryngology externship

Medical students often lack early clinical exposure to otolaryngology, limiting informed career decisions and potentially impacting residency application success. To address this gap, the Jefferson Otolaryngology Externship Program was developed to provide preclinical students with immersive, structured specialty exposure through a one-week extracurricular externship at a single academic medical center. First- and second-year students participated in a prospective cohort study, completing the externship during academic breaks. The program included experiences in the operating room, outpatient clinic, morning rounds, and resident-led surgical workshops. Pre- and post-program surveys consisting of 15 Likert-scale questions (1 = strongly disagree; 5 = strongly agree) assessed career interest, otolaryngology knowledge, and confidence in clinical and surgical settings. Data were analyzed using Wilcoxon matched-pairs signed-rank tests. Among 36 participants across six cohorts, 34 (94.4%) completed both surveys. The mean age was 24.4 years; 58.8% identified as female. Post-program scores were significantly higher than pre-program scores for understanding of otolaryngology as a career ( p < 0.0001), head and neck anatomy knowledge ( p < 0.0001), and operating room confidence ( p < 0.0001). The median total survey score increased from 31 [IQR: 24.5–35.5] pre-intervention to 44 [IQR: 40.0–45.0] post-intervention ( p < 0.0001). After the program, 82.4% reported increased interest in otolaryngology; 94.1% indicated greater interest in pursuing otolaryngology as a career. Participation in this novel, student-driven externship was associated with increases in preclinical students’ self-reported knowledge, confidence, and interest in otolaryngology. Among the first formally evaluated programs of its kind, its structure and low-resource demands support replicability across institutions.