COPING THE NEW CHALLENGES IN OTORHINOLARYNGOLOGY IN UNDER AND POST GRADUATE TRAINING AND ASSESSMENT

Challenges in Otorhinolaryngology

Abstract

Otorhinolaryngology is a rapidly advancing
specialty. It is important both at undergraduate
and post graduate levels. Challenges differ at
both the levels, for under graduates we and
PMDC focus on salient topics which are
important for a general practitioner in the
community especially emergencies in ENT for
example how to deal with a patient suffering
from epistaxis, respiratory tract obstruction,
sudden deafness, dysphagia or foreign bodies in
ear, nose and throat. Unfortunately, there is
decreasing importance given to ENT at
undergraduate levels. But one cannot ignore the
prevalence and increase of ear, nose and throat
diseases in the community. In this context it is of
paramount importance to review and expand the
curriculum1-3 of ENT. Curriculum must include
recent advances in otolaryngology as advanced
hearing management especially cochlear implant
and speech rehabilitation. Advances in rhinology
especially management of nose and sinus
diseases by functional endoscopic sinus surgery
cannot be under estimated. Voice rehabilitation
and use of laser in laryngology need to be
stressed. Management of infections and their
manifestations in ENT especially viral infections,
hepatitis B and C, and their impact on ear nose
and throat. Prevention of viral and bacterial
infections pre and post operatively should be
stressed. Because of rising use and increased
resistance of antibiotics their judicious use should
be encouraged. Early manifestations of cancer in
otolaryngology, its recent and advanced
management should be taught to the students.
Post graduate training and assessment4 in
otolaryngology requires thorough reconsideration
and renewal. Training requires
comprehensive revamp of the curriculum. From
the very beginning they must be trained not only
to become good general ENT and head and neck
surgeons with choice of super-specialty e.g.
otology laryngology or rhinology. The reason
being that now a days we have a lot of general
ENT surgeons but we lack super specialists. They
must be trained in their super specialty in local
institutes or they can be sent abroad according to
the national needs on soft loans from CPSP or by
govt of Pakistan. They must do their research
work according to their selected specialty. They
require structured training and assessment in all
the training years. The Residency Programme in
otolaryngology/head and neck surgery should
aim to train the residents in a comprehensive
manner and produce ethically sound and skilled
specialists, who should be the role model teachers
for the young trainees. The FCPS part-2
examination includes long case, short case and
TOACS examination. The examination must also
include Workplace based assessment5,6 to assess
their clinical skills in wards OPDs and operation
theatre and that should also be assessed by senior
local and international faculty. Moreover it is
suggested that every FCPS part-2 resident must
be exposed to two or more than two supervisors
so that his training may be strengthened, because
every supervisor is interested in different types of
cases and operations.
All the otolaryngologists who want to work
in tertiary care hospitals and choose to become
teachers, must be encouraged to do MCPS in
Medical education7 to enlighten themselves with
new teaching methodology and to master them
how to administer the examination material and
to conduct the different types of examinations
according to the national and international
requirements. So that our graduates should be
able to compete in the international markets.
Open Access Editorial
EDITORIAL
Challenges in Otorhinolaryngology Pak Armed Forces Med J 2017; 67(2):188-89
189
We must encourage research culture in our
institutions8. The research must be original,
authentic, and have major imapct on the concepts
and clinical management of the cases. The
environment in the colleges should be academic,
and conducive to learning.