Courses & Conferences to Attend
- Mandatory courses, which I recommend booking onto as early as possible, include BSS, CCRISP, and ATLS.
- Other useful courses to attend (for learning rather than for portfolio points) included temporal bone courses, FESS courses, and head and neck dissection days
- Also consider attending training the trainers, NOTTS, APLS, and any other courses of interest
I would recommend getting onto ATLS and BSS as early as possible to make core surgical training easier for you. Try to attend a temporal bone course and FESS course before starting ST3. Other useful options include coblation courses, laser safety courses, endoscopic ear surgery courses, and paediatric airway skills courses.
How to Maximise Your Portfolio
Find motivated registrars or consultants with a track record of delivering outputs. Make your targets and goals clear from the outset so that you can identify useful projects together. Get clarity from the start as to what your role will be in the project.
Maximise the value from each project you do, e.g., an audit should have multiple cycles and can be turned into a QIP, which can be presented, potentially winning a prize, and even published.
Try to focus on only one or two projects at a time so that you can aim to complete them all, rather than embarking on multiple projects that are all left unfinished.
Making the Most of Your Day Job
Try to get involved with the ENT team as much as possible – attend clinics with the registrars and consultants once you are familiar with the basics of the emergency clinic. Use this as a chance to learn about subspecialty interests and see common ENT presentations, such as two-week waits, dizziness, and common rhinology complaints, such as chronic rhinosinusitis. You will have less exposure to this as an SHO, but you will be expected to deal comfortably with it as a registrar, so the earlier you start, the better.
Attend theatre where possible to gain confidence with basic operations such as tonsillectomy, grommets, direct laryngoscopy, and simple excisions. Don’t neglect developing your clinic skills in the process, though.
Making the Most of ENT ST3 Placements
Tell the registrars and consultants that you are geared towards ENT, and they will help identify opportunities for you, such as audits and interesting cases to learn from. Let them know you’d like to attend theatre so they can call you when there is a tracheostomy or a paediatric ENT list.
Show you are motivated by gaining independence with the basics such as microsuction and flexible nasoendoscopy, and help to mentor colleagues who are fresh to ENT- your registrar will appreciate this as it lightens the workload on them, and they will hopefully reward you with additional training opportunities.
What About Non-ENT ST3 Placements?
Allied specialties such as A&E, paediatrics, GP, plastic surgery, upper GI surgery, thoracics, and paediatric surgery are important for developing your ENT portfolio score and also for gaining important clinical skills. Once you start ENT ST3, you will have limited opportunities to work in other specialties, so make the most of this learning while you can. Other surgical specialties will have a slightly different approach to basic surgical skills, which is useful to learn. Try and get some exposure to working with children and assessing sick children so that this does not faze you as an ENT registrar.
Top 3 Tips for Getting Into ENT ST3
- Identify your goals early and make a plan to achieve them.
Start with what your deficiencies are, in terms of your portfolio and your clinical/surgical skills. Find out how you can improve in these areas and allocate specific time in the year to achieve this.
- Make sure you really want to do ENT.
ENT training is stressful and requires personal sacrifice in terms of commuting and changing location frequently. The training pathway is competitive and can also be expensive. Make sure you enjoy the bread and butter of ENT practice and are fully committed to the career by shadowing as much as possible and learning about all aspects of ENT outside of theatre, including general ENT clinics and on-calls.
- Find some mentors who can help you.
These should be from all career stages, e.g., core trainees when you are in your foundation years, newly appointed registrars, senior registrars, and also consultants. Each will have different but useful advice for how to develop your career, and will be essential in saving you time and effort when building your portfolio and your surgical skills.
