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Careers

For anyone considering a career in surgery, ENT is a fantastic choice. It is an interesting and varied specialty, and much more flexible than traditional surgical careers. There is a wide range of surgical procedures to master from the routine adenotonsillectomy and grommets to the highly complex skull base surgery.

The mixture of medical and surgical conditions and treatments sets it apart from most other surgical specialties and we treat all ages, including children. Emergency work ranges from the common (head and neck infections / abscesses, epistaxis, removal of foreign bodies) to more exciting situations (airway emergencies, neck stabbings). Once at Registrar level, on calls are usually done from home which adds to the “family-friendly” reputation of ENT and can be particularly attractive to female surgeons.

– Joanne Rimmer, AOT Past President

Training Pathway

For those at Medical student / Foundation level of training who are keen to pursue a career in ENT, it is always worth talking to your local friendly ENT team! When applying for your rotations, those with ENT as an option are obviously ideal, but other specialties with close overlap include Maxillofacial surgery, Plastic surgery, Neurosurgery, Paediatric surgery, Paediatrics, GP, A&E, Upper GI surgery and Ophthalmology. A short rotation in any of these would be beneficial. The Diploma of Otolaryngology-Head & Neck Surgery (DOHNS) has changed to incorporate MRCS Part 1 as the primary exam and it is useful to complete this earlier in training.

The selection process into an ENT training post is currently at ST1 or ST3 via National Selection and the application form and person specification are subject to a slight change each year. There are five stations including portfolio station, management station, a clinical scenario, communication skills and a technical skills assessment (technical skills ST3 only). Marks from the stations are be ranked, and previously declared preferences will be taken into account.

Once through this bottleneck, ST3 trainees will embark on a 6-year training programme in general ENT as well as exposure to sub-specialist ENT as listed above. ST1 trainees will still need to complete the general core training requirements but have ENT themed posts in their early years. During this period trainees are expected to undertake audit as well as publish and present research projects. The option of studying for a higher degree is there, either as “time out” from training or on a part-time / distance learning basis whilst continuing normal clinical activities. The FRCS exams are usually taken in the 5th year of registrar training after which fellowships have been encouraged however the pathway is soon changing to deliver more ‘in deanery’ subspecialty training.

Fellowships in ENT are optional with many trainees travel abroad to centres of excellence in Australia, Canada and across Europe after CCT. These are advertised nationally and are appointed on merit at interview. They include Head & Neck, Skull Base, Airway & Voice, Rhinology & Advanced FESS and Facial Plastics.

ENT is a great career, and it is worth the hard work needed to pursue it.

– Joanne Rimmer, AOT Past President. Edited and updated by Summy Bola, AOT Co-Scretary 2019.

Sub-Specialisation

There is the opportunity to proceed with sub-specialist training within ENT:

  • Rhinology: the management of sinonasal disease, the surgical removal of sinus malignancies and septorhinoplasty.
  • Otology: diagnosis and management of impaired hearing, removing destructive diseases of the ear and implantable hearing devices.
  • Neurotology / Skull base surgery: Ranges from the medical management of the dizzy patient to the image-guided surgical removal of skull base tumours.
  • Head & Neck Surgery: the treatment of benign and malignant diseases including laryngectomy, thyroidectomy, neck dissection, salivary gland excision, and reconstructive surgery.
  • Paediatric ENT: diagnosis and treatment of congenital abnormalities to highly complex airway reconstructive work.
  • Facial plastic surgery: ranges from simple skin lesion removal to resection of malignancies and reconstruction of facial / nasal defects.
 
– Joanne Rimmer, AOT Past President

Further Reading

For students and Foundation doctors, Students and Foundation Trainees in Otolaryngology (SFO UK) is the official group for ENT. It is a sub-group of ENT-UK.