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Miss Claire Hopkins DM FRCS (ORL-HNS)

Here are some other stories from ENT surgeons across the country about their day to day life.

A career in head & neck surgery

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Electives

One of the most exciting ways of testing out a speciality is to immerse yourself in it on your elective. Below are some reports from medical students that have travelled far and wide but also close to home. They demonstrate the fantastic opportunity that electives provide not just to expand your knowledge of medicine but also as a life experience.

Click the links below to download Elective reports:

 

Sydney

Why did I choose Sydney?

Why ENT?

I was very keen to not waste my elective experience just being a tourist. First, I wanted to do a research project, preferably in a tertiary centre with good patient records for collecting data. Fortunately I had a contact in Sydney. Second, having previous lived in Australia for 6 years, I wanted to know what it was like to work in Australia as a doctor, with the view to possibly going back there one day. I wanted to learn about their healthcare system and training structure for surgeons. Finally, I wanted to go somewhere fun- I love outdoor culture, I love food, but I also like my comforts- and Australia had it all. And where better   to go than Sydney, the largest and most iconic city in Australia?

I have wanted to pursue a career in ENT since the end of year 3 at Imperial College. I’m often asked why? It’s often regarded as a small specialty, super-specialised, and thus receives little time (5 days at Imperial) allocated within the curriculum. But ENT, I believe, is one of the most diverse surgical specialties. It deals with all age groups from neonates (congenital airways) to the elderly (head and neck cancer). It involves both small surgery (stapes reconstruction) to huge surgery (neck dissection). Conditions may be acute emergencies (airways) to chronic disorders (voice and swallowing). For a surgical specialty it has a large medical component, and a good work-life balance.

First impressions

My first day in Sydney can be summarised by- sunshine, Westfield shopping centre, open spaces, Rugby league, starry night. I was staying at a host/private accommodation to the west of Sydney which is where my hospital, Concord Repatriation Hospital is based. It’s situated right on the Paramatta River. On a day with reasonable visibility one can see the Harbour Bridge to the east and the Blue mountains to the west. It’s quite an old hospital. It was originally built in 1941, to treat the war wounded. Since then it has been renovated with a glass facade which faces the river and has been serving the general public since the 1948. The ENT Department at Concord hospital is a tertiary centre in rhinology and consists of one SRMO, one registrar, and six consultants. Three of the six consultants subspecialise in sinus surgery and skull base surgery. My supervisor, Dr Kalish (surgeons in Australia are not “Mr”s) was one of these. My first day was well organised. I met the elective liaison early in the morning to receive my welcome package. She kindly took me to the ENT department, where is it ENT SRMO (equivalent of Core trainee) was helping with clinic.

What did I do?

Clinics

The clinics would consist of general ENT clinics, head and neck clinics, otology clinics, and rhinology clinics. During clinics my role was mostly procedural. I examined patients- neck exam, thyroid exam, using the otoscope to examine the tympanic membrane, using the Lacks tongue compressor to examine the oral cavity, using the Thudicum’s speculum to examine the nose. I also assisted the ENT surgeon, Sharing in the role of the ENT clinic nurse. I found this to be a surprisingly useful job. Doing the eight weeks I was able to learn almost all the names of the ENT instruments that are commonly used, as well as their location with in the ENT clinic. I was fortunate enough to feel extremely involved with the team. I saw a great deal of globus hystericus, or the sensation of something stuck in the throat, is one of these. Interestingly it posed a great deal of frustration to the ENT doctors. While some propose it is “all in the head”, it may also be a red flag for malignancy. So its a delicate balance. Tinnitus is similar in these regards. Compliance was another issue of frustration. Steroid washing post-sinus surgery is essential to the success of the operation and prevention of recurrence. However, aspects like cost and inconvenience were barriers. I recognised that good explanations to patients were key to ensuring they understand why they are taking them.

Useful links:

Australian fellowships – http://www.jlo.co.uk/ent-fellowships
UK Otology fellowships - http://www.aotent.com/awards.html