Otolaryngology (2016)

There are a number of online resources for Otolaryngology, available through e-lefENT. The Otolaryngology SAC has mapped individual syllabus topics to e-lefENT, which are available here. e-lefENT is a resource that can be used by both trainees and trainers to support continuous professional development. (Please note that the ISCP is not responsible for the content of external sites.)

The British Association of Endocrine and Thyroid Surgeons (BAETS), through the Royal College of Surgeons of Edinburgh, has produced a series of online case-based discussions covering endocrine surgery curriculum requirements for General Surgery trainees - this can be accessed here.

Users are able to set up a free RCSEd VLE account and access case-based discussions on: Management of adrenal swellings; Neck lumps; Parathyroid anatomy and physiology; FNA - the classification of thyroid nodules; Hypercalcaemia/hyperparathyroidism; Management of post thyroidectomy hypocalcaemia; Postoperative neck haematoma; Thyroid anatomy.

Initial Stage Overview

The purpose of the initial stage (early years) (CT1 - 2) is to allow the trainee to develop the basic and fundamental surgical skills common to all surgical specialties, together with a few surgical skills relevant to Otolaryngology ie the experience and opportunities necessary to successfully progress to ST3.

The outcome of early years training is to achieve the competences required of surgeons entering ST3. These competences include:

Competence in the management of patients presenting with a range of symptoms and elective and emergency conditions as specified in the core syllabus for surgery.
Competence in the management of patients presenting with an additional range of elective and emergency conditions, as specified by the Otolaryngology specialty specific component of the early years syllabus.
Professional competences as specified in the syllabus and derived from Good Medical Practice documents of General Medical Council of the UK

By the end of CT2, trainees, (including those following an academic pathway), will have acquired to the defined level:

Generic skills to allow team working and management of Otolaryngological patients
The ability to perform as a member of the team caring for surgical patients
The ability to receive patients as emergencies and review patients in clinics and initiate management and diagnostic processes based on a reasonable differential diagnosis
The ability to manage the perioperative care of their patients and recognise common complications and either be able to deal with them or know to whom to refer
To be a safe and useful assistant in the operating room
To perform some simple procedures under minimal supervision and perform more complex procedures under direct supervision

In addition they will have attained the knowledge, skills and behaviour as defined in the following (common) modules of the syllabus:

Module 1: Basic Science Knowledge relevant to surgical practice

(These can all be contextualised within the list of presenting symptoms and conditions outlined in module 2)

Anatomy
Physiology
Pharmacology - in particular safe prescribing
Pathological principles underlying system specific pathology
Microbiology
Diagnostic and interventional radiology

Module 2: Common surgical conditions

To assess and initiate investigation and management of common surgical conditions which may confront any patient whilst under the care of surgeons, irrespective of their speciality.
To have sufficient understanding of these conditions so as to know what and to whom to refer in a way that an insightful discussion may take place with colleagues whom will be involved in the definitive management of these conditions.
This defines the scope and depth of the topics in the generality of clinical surgery required of any surgeon irrespective of their ST3 defined speciality

Module 3 Basic surgical skills

To prepare oneself for surgery
To safely administer appropriate local anaesthetic agents
To handle surgical instruments safely
To handle tissues safely
To incise and close superficial tissues accurately
To tie secure knots
To safely use surgical diathermy
To achieve haemostasis of superficial vessels.
To use a suitable surgical drain appropriately.
To assist helpfully, even when the operation is not familiar.
To understand the principles of anastomosis
To understand the principles of endoscopy including laparoscopy

Module 4: The principles of assessment and management of the surgical patient

To assess the surgical patient
To elicit a history that is relevant, concise, accurate and appropriate to the patient's problem
To produce timely, complete and legible clinical records.
To assess the patient adequately prior to operation and manage any pre-operative problems appropriately.
To propose and initiate surgical or non-surgical management as appropriate.
To take informed consent for straightforward cases.

Module 5: Peri-operative care of the surgical patient

To manage patient care in the peri-operative period.
To assess and manage preoperative risk.
To take part in the conduct of safe surgery in the operating theatre environment.
To assess and manage bleeding including the use of blood products.
To care for the patient in the post-operative period including the assessment of common complications.
To assess, plan and manage post-operative fluid balance
To assess and plan perioperative nutritional management.

Module 6: Assessment and early treatment of the patient with trauma

To safely assess the multiply injured patient.
To safely assess and initiate management of patients with traumatic skin and soft tissue injury
chest trauma
a head injury
a spinal cord injury
abdominal and urogenital trauma
vascular trauma
a single or multiple fractures or dislocations
burns

Module 7: Surgical care of the paediatric patient

To assess and manage children with surgical problems, understanding the similarities and differences from adult surgical patients.
To understand common issues of child protection and to take action as appropriate.

Module 8: Management of the dying patient

To manage the dying patient appropriately.
To understand consent and ethical issues in patients certified DNAR (do not attempt resuscitation)
To manage the dying patient in consultation with the palliative care team.

Module 9: Organ and tissue transplantation

To understand the principles of organ and tissue transplantation.
To assess brain stem death and understand its relevance to continued life support and organ donation.

Module 10: Health promotion

General aspects
Obesity
Dementia
Exercise and physical fitness

Professional behaviour and leadership skills

To provide good clinical care
To be a good communicator
To teach and to train
To keep up to date and know how to analyse data
To understand and manage people and resources within the health environment
To promote good Health
To understand the ethical and legal obligations of a surgeon

In addition they will have attained the knowledge, skills and behaviour as defined in the Otolaryngology specific Initial Stage Modules as set out after the generic modules