Diploma of Otolaryngology Head & Neck Surgery

Course

St. Mary’s HospitalLondon

25 - 28th February 2008

St. Mary’s Hospital ENT DepartmentFounded by Joseph Toynbee in 1851

Faculty• Mr Charlie Huins (SpR)

• Mr Neil Tolley

• Professor A Narula

• Mr S Abramovich

• Mr A Parikh

• Mr A Arora (SpR)

• Miss E Blenke (Research SpR)

• Miss S Ifeacho (Senior SHO)

• Professor V Mahadevan (Barbers' Company Reader in Anatomy at RCS Eng)

• Mr G Mochloulis (Lister Hosp, Stevenage)

• Dr A Hartle (Anaesthetics)

• Mr S Liyanage (Radiology SpR)

• Tara Cleary

St. Mary’s DO-HNS Course

Monday

• Embryology, Otology, Paediatric ENT, Anatomy

• Course photo, then drinks at Steam Bar, Paddington Hilton

Tuesday

• Rhinology, Micro/Histo, Tips & Pearls, Anaesthetics, Radiology, Emergencies

St. Mary’s DO-HNS Course

Wednesday

• Thyroid, VII Nerve, Head & Neck, Exam techniques, MCQs

• Course Dinner, Stuzzico (Italian)

Thursday

• OSCE - non-patient & patient

Praed Street

Entr’acteBonne Bouche Bagel

FactoryLa Taaza

Costa

Steam Bar

Steam Bar, Hilton

The DO-HNS Exam

The Exam

• DO-HNS if fair

• Good pass rate

• Practical knowledge tested as opposed to minutiae

• Exam technique important

%

Source: RCS DO-HNS Exam Results 2007

2004 Apr 07 Sept 07

Exam Makeup

Part 1: MCQs & EMQs

• ?30 MCQs (T/F)

• ?20 EMQs (best match)

• 2 hours

• Pass mark varies each time

Part 2: OSCE

• 25 stations (5 clinical with actors), 3 rest, 7 mins each

•Emphasis on practical ENT

• 31/4 hours

• Pass mark 66%

MCQs & EMQs

Example:

The recurrent laryngeal nerve is intimately related to:

a. Cricothyroid joint

b. Oesophagus

c. Inferior thyroid artery

d. Internal carotid artery

EMQs:

• best match answerExample:

Match the following conditions that affect hearing with these PTA findings:

a. Otosclerosis

b. Hereditary (genetic) hearing loss

c. Presbyacusis

1. Hearing thresholds reduces particularly in middle frequencies

2. Air-bone gap, narrows at 2kHz

3. High-tone hearing loss

MCQs:

• True / False

• no negative marking

• single best answer

OSCE

• 25 stations, 3 rest, 7 mins each

• bell at end of each station - move to next & start IMMEDIATELY (no second bell)

• collect answer sheet for each station at each station - all into folder

• candidate number on each sheet

OSCEPrevious stations included:

• 5 patient stations

• 9 clinical photograph stations

• 3 clinical scenarios/short answer stations

• 3 clinical radiograph stations

• 2 anatomy prosections

• 1 audiogram station

• 1 histology photomicrograph station

• 1 surgical instruments station

OSCE ExamplesPatient-based:

• Consent for Superficial Parotidectomy

• Examine neck

• Take history from pt c/o anosmia

• Examine pt’s ears & write down findings

• choice of tuning forks etc

Non-patient OSCEs:

• Photo ear é vesicles, VII palsy

• 65yr man, epistaxis on Warfarin

• CT Sinuses / # Rt Temp Bone with dead ear on PTA

• Temporal Bone specimen

• PTA findings

• Surgical instruments

ENT Consent

CONSENTSC

O

N

S

E

N

T

S

condition & natural history

options / alternatives

name of procedure

side effects

extra procedures involved (PEG, Trachy)

named person operating

trial / training

second opinion

Enjoy the course!

Questions?

Charlie Huinsmail@dohns.org