Otolaryngology (ENT) is the specialty that deals with the diagnosis, evaluation and management of diseases of the ears, nose and throat including all aspects of cancer of the head and neck region. It involves dealing with patients of all ages and as a specialty Otolaryngology is responsible for surgical management of more paediatric patients than any other single surgical discipline.  Read more on the Intercollegiate Surgical Curriculum Programme website.

Entry into ST3 requires successful completion of IMRCS or equivalent at time of application as well as MBBS or equivalent medical qualification.
The syllabus is linked with a number of related surgical specialties during the first two years of training (themed training). Thereafter training is conducted solely within the specialty unless interface modules are taken during the final years.

The minimum objective of training is to produce specialist surgeons who are emergency safe and can manage the common conditions set out in the syllabus, from start to finish. At successful completion of training, CCT holders will also possess a depth and breadth of knowledge that permits accurate diagnosis and assessment of a wide range of conditions and onwards referral as appropriate.

ENT is taking over the lead role in head and neck oncology and the management of thyroid lesions. What’s more, exciting basic science research is changing the way ENT care is delivered, particularly with regard to the molecular basis of disease.

Advancements in training and techniques (particularly in surgery using operating microscopes and endoscopic magnification) now ensure the clinical management of otolaryngological diseases is safe, expert and highly competent.

Key Topics in Otolaryngology

Otology

• Congenital and acquired deformity of the ear and temporal bone
• Deafness in adults and children
• Disorders of the external ear
• Acute and Chronic middle ear disease including Otitis media with effusion
• Disorders of equilibrium
• Tinnitus
• Disorders of the facial nerve
• Cerebello-pontine angle tumours

Rhinology and Facial Plastics

• Rhinitis/Sinusitis ~ including allergy, inflammation and infection
• Congenital and acquired deformities of the facial and nasal skeleton
• Tumours of the nose and paranasal sinuses including skin tumours of the face, head and neck
• Epistaxis
• Facial pain

Head and Neck

• Congenital and acquired deformity of the larynx
• Voice disorders
• Disorders of the thyroid and salivary glands
• Head and neck cancer and other causes of neck masses
• Disorders of the pharynx and oesophagus including diseases of the tonsils
• Upper airway obstruction
• Infections of the soft tissues of the Head and Neck
• Sleep apnoea in adults

Paediatric Otolaryngology

• Deafness in childhood including congenital deformities of the temporal bone
• Upper airway disorders and sleep apnoea in children
• Neck masses in children
• Acute and chronic ear disease in children
• Disorders and deformity of the external ear

Links

• Royal College of Surgeons of England
• ENT UK
• Otolaryngology courses at The Royal College of Surgeons
• Intercollegiate Surgical Curriculum Programme (ISCP)

Training Programmes

South Thames

ENT training in South Thames links with Great Ormond Street Hospital and many trainees are able to spend six months there.  Within South Thames there are two rotations - one based on the hospitals in the east and one which utilises the hospitals in the west of the programme. Most trainees stay in the rotation which they start in, but, where it is better for their training needs, they may sometimes be able to swap from the east to the west rotation and vice versa.

As well as the training received within the hospitals, there are approximately 8 study days arranged each year in combination with North Thames - it is mandatory for trainees to attend these days and over the six years of higher surgical training most of the syllabus is covered. Trainees are also encouraged to attend national and international courses and conferences to further develop their knowledge.

The South Thames trainers aim to support the trainees and encourage them to develop their full potential. The training program directors are both supportive and accessible.  In 2009 a South Thames trainee was awarded the gold medal in the final FRCS examination, and a team from South Thames won the BACO University challenge competition.

To date, trainees in the South Thames scheme who have obtained their CCT have mostly moved on to consultant posts. There is increasing competition for consultant posts nationally, but the ratio of higher surgical trainees in South Thames to consultants in the area covered by the training scheme is lower than in some other training rotations.

The two South Thames rotations offer a high standard of training, good support for trainees, encourage individual career development and should be near the top of any aspiring ENT surgeons ' wish list ' when considering where they would like to train, especially if they have a preference for London and SE England in general.

North Thames

ENT training in North Thames is provided in high quality and internationally renowned departments including six teaching hospitals (St Bartholomew’s and the Royal London, Charing Cross, Royal Free, Royal National Throat Nose and Ear, St.Marys, UCH).  There are 6 major head and Neck units in the region, Royal Marsden, Charing Cross, St Bartholomew’s, Chelmsford, Northwick Park, UCH and a wide range of district general hospitals (West Middlesex, Northwick Park, Lister Stevenage, Basildon, Queens Romford, Southend, Chase Farm, Chelsmford).  Paediatric training is catered for in most general hospitals and the Great Ormond Street Hospital. Within North Thames the six rotations are organised for the first four years, although there is some choice in selecting units and subspecialties to augment training. The rotations are geographically-based and organised into an East & West stream though most will rotate to central London.  An ENT junior representative helps to represent trainee preferences and provide input into the organisation of the rotation.
 
As well as the training received in the trainees’ base-hospitals, there are approximately 8 Region-wide study days arranged each year within North Thames - it is mandatory for trainees to attend these days. Over the six years of higher surgical training, most of the syllabus will be covered. Trainees are also encouraged to attend national and international courses and conferences to further develop their knowledge.

North Thames trainees are encouraged to undertake research and audit during their tenure and a number of units offer postgraduate degrees, higher degrees or postgraduate courses. The trainees achieve a high rate of success in the intercollegiate examination and have won the gold medal for the last four years.

While the North Thames rotation offers a high standard of training in a number of prestigious units, trainees are encouraged to undertake out of programme experience with overseas fellowships, research and higher degrees.

In addition, a number of Academic Clinical Fellowships have been awarded to the Region.

The North Thames rotation has always been highly regarded and competitively sought by trainees as it offers many opportunities in the South East of England.

Local Education Providers

Barking, Havering & Redbridge Hospitals NHS Trust
Barts and The London Trust
Basildon and Thurrock Univ. Hospitals NHS Foundation Trust
East and North Hertfordshire NHS Trust
Great Ormond Street Hospital For Children NHS Trust
Imperial College Healthcare NHS Trust
Mid Essex Hospital Services NHS Trust
North West London Hospitals NHS Trust
Royal Free Hampstead NHS Trust
Royal Marsden NHS Foundation Trust, The
Southend University Hospital NHS Foundation Trust
West Middlesex University Hospital Trust
Whipps Cross University Hospital NHS Trust
Whittington Hospital Trust, The
Great Ormond Street Hospital For Children NHS Trust
Guy's and St Thomas' NHS Foundation Trust
Lewisham Hospital NHS Trust, The
South London Healthcare NHS Trust
St George's Healthcare NHS Trust