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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