1. ENT careers and skills evening with SCRUBS
Not just tonsils, wax & snot
ENT careers and skills evening with SCRUBS
Nottingham University Medical School
September 2017

2. AIMS
Overview of the specialty Subspecialties Career path for ENT Getting involved in ENT as an undergrad SFOUK

3. ENT – What’s it about?
Neonates to elderly Routine surgery to highly complex Multidisciplinary Medical & surgical
ENT aka otorhinolaryngology
EN Tcovers a broad range of diseases
patients of all ages - from a baby with airway obstruction, through to an elderly man with throat cancer.
The skills needed to manage patients are therefore diverse.
Medical skills are required for accurate diagnosis and non-surgical management of conditions. Surgical skills range from microscopic surgery for middle ear conditions, through endoscopic surgery for nasal conditions to more traditional open surgery for head and neck cancer.
Due to the diversity of the case load, otorhinolaryngologists – head and neck surgeons work closely with a range of professionals including audiologists, speech and language therapists, oncologists, endocrinologists, dermatologists, neurosurgeons, maxillofacial surgeons and plastic surgeons.
Ex utero intrapartum treatment

4. ENT – What’s it about?
ENT has lots of variety ENT surgeons manage non-surgical care of their patients More clinics than other surgical specialties – carry out procedures and medically manage patients Good gadgets in clinic and theatre
ENT see more children than any other surgical specialty apart from paediatric surgeons.
ENT surgeons also manage all the non-surgical care of their patients (as there is no sister medical specialty).
Consultants have on average four clinics a week and can deal with a variety of problems. Audiology, allergy, sleep disorders, voice pathology, balance disorders, and rhinological disorders can all form part of a clinic workload.
ENT examination is specialised and uses lots of gadgets. These range from a simple head mirror and torches to a microscope for examining ears.

5. ENT – What’s it about?
More separate surgical procedures than other specialities Operations can last minutes to 10+ hours Range of cancer and benign surgery Surgery that helps improve communication and works with the senses
Despite a common perception that ENT deals mainly with wax, snot, and spit, it is not widely realised that ENT has more separate surgical procedures than other surgical disciplines.
An operation can be as short as 1 min (inserting a grommet) or as long as 12 hours (major head and neck resection with reconstruction).
Advanced technology forms an integral part of the modern ENT surgeon's collection - from the use of laser surgery in laryngeal lesion excision to cochlear implants for hearing restoration – forward thinking speciality
Common procedures undertaken include tympanoplasty, mastoidectomy, endoscopic sinus surgery, thyroidectomy, rhinoplasty and salivary gland surgery. Tertiary referral centres undertake cochlear implantation, resection of head and neck cancers, skull base surgery and complex airway surgery

6. ENT - Elective vs Emergency
Generally busy day time with elective work Emergency work ranges from common conditions (epistaxis, FB) to dramatic and life threatening Usually registrar and consultant non-resident on calls
 ENT departments can be busy during the daytime when elective work takes place and most emergency patients are seen.
Common elective procedures undertaken include tympanoplasty, mastoidectomy, endoscopic sinus surgery, thyroidectomy, rhinoplasty and salivary gland surgery. Tertiary referral centres undertake cochlear implantation, resection of head and neck cancers, skull base surgery and complex airway surgery
Emergency work ranges from common conditions such as head and neck infections, epistaxis and removal of foreign bodies through to the urgent treatment of airway obstruction and penetrating neck trauma.
Out of hours work is generally quieter than other surgical specialties, but emergencies can be dramatic and life threatening. The lifestyle that ENT offers makes it attractive to women and flexible trainees. Private practice work is available, but there is variation between regions.

7. ENT – Subspecialties
Otology, neurotology, and base of skull surgery Rhinology Laryngology Head and neck surgery Facial plastic surgery Paediatric otolaryngology
Like most surgical specialties, ENT is becoming more sub specialised

8. ENT – Otology Treatment of ear disease, improving hearing and balance
Toys! Microscopes, endoscopes, drills, hearing implants
Otologist performs surgery on:
external ear e.g. for stenoses or cosmesis
middle ear e.g. for hearing or cholesteatoma
inner ear e.g. for hearing or balance
Skull base surgery e.g. acoustic neuroma & CSF leaks

9. ENT – Rhinology
Treatment of all aspects of nose and sinus disorders Including infection, inflammatory conditions and tumours Management of epistaxis to septoplasty/rhinoplasty to trans-sphenoidal hypophysectomy, Facial plastics – skin cancer surgery and facial skin flaps, and cosmetic surgery Dynamic– endo-nasal management of skull base tumours
Opposed to craniotomy through sphenoid sinus

10. ENT – Laryngology
Treatment of diseases of the larynx and throat e.g. vocal
Cord augmentation, and cancers
The voice is a fundamental component of communication
Patients often include teachers, singers, actors and
politicians
Injections, microscopic procedures, open procedures, laser
surgery
The voice is a fundamental component of communication –
individual personality and social interaction
Fast-growing technological advancements

11. ENT – Head & Neck
Treatment of benign and malignant diseases of the H&N: larynx, lymph nodes, salivary, thyroid and parathyroid glands Simple to complex surgery e.g. cancer resections and flap Reconstruction Anatomy clearly demonstrated Multidisciplinary Trans-oral laser and trans-oral robotics - advancing function and quality of life
advancing the post resection function and quality of life for
patients

12. ENT – Paediatric
Some ENT conditions are congenital Starts at birth! EXIT procedure – ENT surgeon in the delivery room Variety – H&N surgery, sleep, apnoea, airway surgery, tympanomastoid/cholesteatoma surgery… Reward of making a significant difference in the quality of a child’s life

13. Career path in ENT
Results

14. What to do now Get in touch with your local friendly ENT department
Talk to consultants – ask about projects
Do an ENT SSC
Arrange an ENT elective
Try and secure an ENT job at foundation
Join SFOUK!
Discussion

15. D Demonstrates commitment to specialty
SFOUK
Demonstrates commitment to specialty
SFOUK annual conference (September) - platform to present
Eligibility to enter SFOUK Essay Prize
ENT podcasts
ENT elective information
Student membership is only £20
Discussion

16. D
SFOUK
Discussion

17. WHAT TO DO NOW
Not to early to plan ahead for national recruitment in ENT
ST3 selection hosted by Yorkshire and Humber Deanery
Discussion

18. Surgical training is changing…
Discussion

19. Thank you
Any questions?