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Diploma of Otolaryngology

Head & Neck Surgery


Course
St. Mary’s Hospital
London
25 - 28th February 2008

St. Mary’s Hospital ENT Department


Founded by Joseph Toynbee in 1851
Faculty
• Mr Charlie Huins (SpR) • Professor V Mahadevan
(Barbers' Company Reader in Anatomy
• Mr Neil Tolley at RCS Eng)

• Professor A Narula • Mr G Mochloulis (Lister Hosp,


Stevenage)

• Mr S Abramovich
• Dr A Hartle (Anaesthetics)
• Mr A Parikh • Mr S Liyanage (Radiology SpR)
• Mr A Arora (SpR)

• Miss E Blenke (Research SpR) • Tara Cleary

• Miss S Ifeacho (Senior SHO)


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
Bonne
Bouche Entr’acte Bagel
Factory
La Taaza
Costa

Steam Bar
Steam Bar, Hilton
The DO-HNS Exam
The Exam
2004 Apr 07 Sept 07

• DO-HNS if fair

• Good pass rate

• Practical knowledge
%
tested as opposed to
minutiae

• Exam technique
important

Source: RCS DO-HNS Exam Results 2007


Exam Makeup
Part 1: MCQs & EMQs Part 2: OSCE

• ?30 MCQs (T/F) • 25 stations (5 clinical with


actors), 3 rest, 7 mins each
• ?20 EMQs (best match)
•Emphasis on practical ENT
• 2 hours
• 3 / hours
1
4
• Pass mark varies each
time • Pass mark 66%
MCQs & EMQs
MCQs: EMQs:
• True / False • best match answer
• no negative marking Example:
Match the following conditions that affect
• single best answer hearing with these PTA findings:

Example: a. Otosclerosis
The recurrent laryngeal nerve is b. Hereditary (genetic) hearing loss
intimately related to: c. Presbyacusis
a. Cricothyroid joint 1. Hearing thresholds reduces particularly in
b. Oesophagus middle frequencies
c. Inferior thyroid artery 2. Air-bone gap, narrows at 2kHz
d. Internal carotid artery 3. High-tone hearing loss
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
OSCE
Previous 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 Examples
Patient-based: Non-patient OSCEs:

• Consent for Superficial • Photo ear é vesicles, VII palsy


Parotidectomy
• 65yr man, epistaxis on Warfarin
• Examine neck
• CT Sinuses / # Rt Temp Bone
• Take history from pt c/o with dead ear on PTA
anosmia
• Temporal Bone specimen
• Examine pt’s ears & write down
findings • PTA findings

• choice of tuning forks etc • Surgical instruments


ENT Consent
CONSENTS
C condition & natural history
O options / alternatives
N name of procedure
S side effects
E extra procedures involved (PEG, Trachy)
N named person operating
T trial / training
S second opinion
Enjoy the course!

Questions?

Charlie Huins
mail@dohns.org

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