Otorhinolaryngology (Ear, Nose & Throat or Head & Neck surgery)
A Career In Otorhinolaryngology
Formerly known as 'ENT surgery' (Ear Nose and Throat surgery), Otorhinolaryngology encompasses a wide range of clinical conditions and age ranges. The 'surgery' part of the name is misleading, as a large part of the specialty is out-patient based and surgery only involves about 1 in 6 of all referrals.
This specialism is a growth area: approximately 15-20 referrals per thousand population per year are made to secondary care and yet we have one of the lowest numbers of specialists per head of population in the Western world (currently approx 1 per hundred thousand). Some surveys of general practice suggest that up to one in six of all consultations involve ENT but it is certainly under-represented in the undergraduate curriculum.
As with all other surgical disciplines, the training programme involves a period of Basic Surgical Training (now being modified under the MMC programme) followed by 6 years as a Specialist Registrar. The UK has about 230 SpR posts which are all monitored in the same way as other higher training schemes.
The spread of clinical activity ranges from neonates with respiratory difficulties - requiring bronchoscopy and/or tracheostomy - to the elderly with hearing impairment or head and neck cancer. The surgery ranges from the fairly straightforward - such as grommets and tonsils - to combined neurosurgical procedures on the lateral and anterior skull base and also major mouth / neck resections with free flap repair. In addition, for those with a more medical bent, there is great scope to specialise in hearing impairment or vertigo.
The clinical activity usually revolves around 3 out patient sessions and 3 operating lists per week although this varies from dept to dept. Out of hours commitments are not particularly onerous although being on call for airway emergencies - especially for children - certainly concentrates the mind.
For further information and details take a look at the following websites:
> British Association of Otorhinolaryngologists (Head & Neck surgeons)
> British Association for Paediatric Otorhinolaryngology
Professor A. Narula
Last updated 25/12/06
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