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Have You Thought of This Option; OTORHINOLARYNGOLOGY?
Oto-rhino-laryngo-logy— this must be a heck of a name to pronounce just like many other medical patois, but have you ever thought of it as an option? Well, for any doctor going for post graduate residency training and hasn’t found a field yet, it is a subspecialty under surgery but then not quite as popular as General Surgery, Neurosurgery, Orthopaedic Surgery, and Urology. Hence, I decided to take a timeout from my routine schedule and find out more on this unique field of medicine.
As a Medical student, Medical intern, or Medical officer considering a domain in E.N.T, here are the 10 questions you may need to ask;
1) ARE THERE SUBSPECIALTIES IN E.N.T?
The answer is yes. As with other specialties, otolaryngology is becoming more and more subspecialized. The common subspecialties worldwide are:
• Otology, neurotology, and base of the skull surgery
• Rhinology (sinusitis, allergy, anterior skull base, apnoe and snoring)
• Laryngology (voice therapy, phono-surgery)
• Head and neck surgery (surgical oncology, reconstruction, endocrine surgery)
• Facial plastic surgery (facial cosmetic surgery, maxillofacial surgery, trauma)
• Paediatric otorhinolaryngology (velopalantine insufficiency, cleft lip and palate, the airway, vascular malformations, cochlear implant)
2) WHAT IS REQUIRED OF ME INORDER TO SPECIALIZE IN E.N.T?
Apparently nothing other than an M.B.B.S degree, certification of completed internship training, with discharge certificate from National Youth Service Corps (for Nigerians). An intending applicant would then sit for primaries in E.N.T surgery; this serves as an entrance examination into the residency program.
However, as a registrar in otorhinolaryngology, a combination of surgical and medical skills is vastly required, together with the ability to manage emergencies and demanding elective surgeries. In fact, a year specialization in general surgery is required ab initio in countries like the united state of America.
3) WHAT ARE THE PROBABLE CHALLENGES I MIGHT FACE?
One unique fact about E.N.T is that all medical and surgical aspects are covered, including everything from paediatrics through to major head and neck cancer. Otolaryngologists undertake some of the largest procedures undertaken in any surgical discipline, oops! Quite challenging indeed, I guess not any strange in the practice of Medicine.
4) WHAT ARE MY ROUTINES LIKE?
ENT departments can be busy during the daytime when elective work takes place and most emergency patients are seen. Out of hours work is generally quieter than other surgical specialties, but emergencies can be dramatic and life threatening. At the University of Ilorin Teaching Hospital, the department of ENT operates as head and neck surgery and shares a common accident and emergency unit in the hospital as Surgical A&E
5) WHAT IS THE NATURE OF THE CASES I MAY SEE ON DAILY BASIS?
Most ENT surgeons manage cases relating to problems of ear, nose and throat, including all aspects of cancer of head and neck region, seen in either outpatient clinics or theatre duties. On-call duties are relatively light for a surgical discipline, but can involve very serious emergencies such as severe epitaxis and airway obstruction. Specialists are based in theatre, outpatient clinics or on ward, although there is a common perception that ENT deals mainly with wax, snot, and spit, it is not widely realized that ENT has more separate surgical procedures than most other surgical disciplines. An operation can be as short as 30seconds (like inserting a grommet) or as long as 12hours (major head and neck resection with reconstruction).In addition, an otolaryngologist also manages all non-surgical care of their patients (as there is no sister medical specialty)
6) WHO ARE MY PATIENTS?
Patients seen can either be in the paediatric or adult age group. ENT is said to be a cradle to grave specialty, from neonates with airway problem to elderly patients with head and neck tumours. Otolaryngologists see more children than any other surgical specialty apart from paediatric surgeons.
7) AS E.N.T SURGEON, WHAT INSTRUMENTS WOULD I BE WORKING WITH?
Your instruments are usually specialised tools for procedures and surgeries involving the head and neck. A common instrument is the otoscope, which is used to access the external auditory canal and ear drum. It can also be used to remove ear wax. Other instruments include: laryngeal mirror, speculum, head mounted lights with head band, head mirror with head band, tongue depressor, and various specialised ENT forceps.
8) DO I NEED TO CO-WORK WITH OTHER SPECIALTIES?
The answer to this question is an emphatic yes! Experts in ENT work within multidisciplinary teams and alongside: audiologist, speech therapists, dieticians, radiologists, and pathologists.
9) ARE THERE ANY ATTRACTIONS CONCERNING THIS FIELD?
The ENT has a very proud tradition of clinical and basic research.
It is important to note that the lifestyle that ENT offers makes it attractive to women and flexible trainees, however private practice work is available only dependent on different regions.
10) WAIT A SECOND, WOULD THIS FIELD LEAVE MY FAMILY AT A LOSS?
My answer is, should any job put your family at loss? May be I was a little blunt this response, I think it all depends on the way you see it, while some ‘non-call’ days can be very busy and make you work late, other non-call days may only demand 6 to 8 hours out of your 24hours a day. Not also forgetting that your call days are fixed, frequency depends on the number of fellow registrars in the department, this gives you the opportunity to plan your family activities without putting your family at the losing end.
Hope to having you around for the next episode of Inside Doctors’ Study. Till then…