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If you are thinking of embarking on a career in surgery, otorhinolaryngology - head and neck surgery (usually referred to as ear, nose and throat or ENT surgery) is an exciting and challenging option.
ENT surgery is a unique specialty where a broad range of diseases will be encountered in patients of all ages: from a baby with a threatened airway, to an elderly man with extensive throat cancer. The skills needed to treat patients are also diverse, ranging from microsurgery to treat middle and inner ear conditions to major surgery of the head and neck. Rhinoplasty, grommet insertion, adenoidectomy and tonsillectomy are only part of a diverse range of surgical procedures.
A large part of an ENT surgeon's practice is outpatient-based, which is where many procedures are carried out and diagnoses are made. Surgeons will use the latest technology, such as rigid endoscopes, flexible fibre-optic endoscopes or microscopes.
The career path
Following house officer posts in medicine and surgery, a basic surgical training course must be taken to pass the membership of the Royal College of Surgeons (MRCS).
You will need to have worked in at least four six-month posts as a senior house officer (SHO) to take the exam.
The list below shows posts in other specialties that are relevant to a career in ENT surgery:
- General surgery
- Accident and emergency
- Plastic surgery
- Ophthalmology
- Neurosurgery
- Paediatric surgery.
To be eligible to apply for a specialist registrar post in ENT surgery, you should have up to 18 months' experience as an SHO in ENT. During this time you will learn the management of many emergency conditions and how to use most of the diagnostic equipment. At the end of this period you should be proficient at myringotomy, grommet insertion, adenoidectomy and tonsillectomy. You will be encouraged to join in research projects and to publish any interesting case reports in surgical journals.
Specialist registrar rotations are regional and usually take place in a major teaching hospital, where the emphasis will be on academic teaching. Time will also be spent in a district general hospital where the emphasis will be on acquiring surgical skills.
As a specialist registrar, teaching will be available in your hospital department and also regionally on a regular basis. Teaching is supplemented by national courses, many of which are held at The Royal College of Surgeons. You will learn about subjects specific to ENT, such as anatomy, and enhance your practical surgical skills.
The career of a consultant ENT surgeon
The general otorhinolaryngologist
Doctors who train as ENT surgeons will either work in a district general hospital or a teaching hospital and can expect to see patients with a range of diseases. Some specialism does occur in larger hospitals and the development of a specialist interest is encouraged. At least one in three outpatients seen will be children and approximately one in eight of all patients will be listed for surgery. Patients are also treated medically with a wide range of therapeutic agents, which often means regular visits to outpatients.
The appeal of the practice is the wide variety of clinical cases. More complex cases are often referred to a specialist in an ENT practice at the nearest large hospital.
Specialisation
Specialisation means training and working primarily in one area of ENT practice. This is becoming the normal practice for a consultant ENT surgeon in a teaching hospital or a large district general hospital. Examples include:
Paediatrics, which may be divided into paediatric otology and audiology, and the treatment of airway and head and neck diseases of childhood.
Head and neck surgery, which is the treatment of benign and malignant disease of the mouth, tongue, pharynx, larynx and upper oesophagus and neck.
Otology, which is the treatment of middle and inner ear disease and may include cochlear implantation or skull base surgery.
What to do next
If you would like more information on how to embark on a career in surgery, contact the training department at the Royal College of Surgeons.
Also see the leaflet published by ENT.UK:
Otorhinolaryngology - Head and Neck Surgery (E.N.T) an Excellent Career Choice
This can be purchased at a cost of 45p Order Form
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