Careers in ENT

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.

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

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 Maxillifacial 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 MRCS exam has changed to incorporate the Diploma of Otolaryngology-Head & Neck Surgery (DOHNS), for those seeking direct career progression.

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

Once through this bottleneck, trainees will embark on a 6-year training programme in general ENT as well as exposure to sub-specialist ENT as listed above. 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 Part 3 "exit" exams are usually taken about 18 months before the predicted CCT date, after which many trainees travel to other centres to become trained in more specialised procedures. These fellowships can be undertaken pre-CCT, particularly if travelling abroad to centres of excellence eg Australia, Canada, Europe.

Post-CCT fellowships are becoming more common and are now being introduced formally in England, hopefully with the rest of the UK to follow suit shortly. These are advertised nationally and are appointed on merit at interview. They include Head & Neck, Skull Base, Airway & Voice, Rhinology & Advanced FESS and Cosmetic Surgery.

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

Joanne Rimmer

Past President