Graduate Training In Otolaryngology Has Room For Improvement

Editor's Choice
Main Category: Medical Students / Training
Also Included In: Ear, Nose and Throat
Article Date: 20 Sep 2011 - 1:00 PDT


A report published online by Archives of Otolaryngology-Head and Neck Surgery, one of the JAMA/Archives journals, looks at graduate training in otolaryngology (medical specialty focused on ear, nose and throat health). They conclude that although specialist courses in family medicine exist, more emphasis should be included on otolaryngology disorders that need multidisciplinary care, including more through instruction in diagnostic skills.

Background information in the article states that clinicians other than otolaryngologists are often the front line in care, especially for children with ear, nose and throat problems.

"Pediatricians and family practitioners are often the first physicians to evaluate otolaryngology-related complaints, and speech pathologists and audiologists play a crucial role in the habilitation of many otolaryngology-related conditions."

The authors including Samir Baig, M.D., from the Massachusetts Eye and Ear Infirmary, Boston, and Michael J. Cunningham, M.D., now with Children's Hospital of Boston, sent 682 online surveys via e-mail to directors of graduate programs in family medicine, audiology and speech pathology. They continue to affirm that although otolaryngology is a part of study for doctors:

"Despite such existent program requirements and the importance of such specialists in the care of children with ear, nose, and throat disorders, literature as to the depth and uniformity of otolaryngology training in these disciplines is limited."

Their nine-item surveys asked directors to separate methods of teaching otolaryngology-related material and to define how often otolaryngologists were involved in their curricula. The surveys also included three clinical scenarios involving pediatric hearing impairment and asked respondents to rate their graduate students' ability to manage these scenarios, using a rating scale from one to four, with four being the most proficient.

In Summary:  

Twenty percent of family medicine programs, 30 percent of audiology programs and 32 percent of speech pathology programs responded to the survey.

Virtually all family medicine programs included dedicated instruction in otolaryngology:

• 98 % by clinical rotation

• 70% didactic teaching by an otolaryngologist
• 
60% non-otolaryngologist 


Almost all programs (92 percent) of respondents included an otorhinolaryngology elective:

• 95% Audiology programs

• 55% Speech pathology programs

Most programs in all three disciplines appeared to teach otolaryngology-related diagnostic skills, but fewer confirmed skills acquisition. Ratings of trainees' competence (with 4 being highest) in managing hearing disorders averaged:

• 3.4 for audiology

• 2.7 for speech pathology
• 
2.6 for family medicine graduates

"In conclusion, while there is a concerted effort among respondent program directors of all three specialties that were surveyed to meet the guidelines set out by their professional societies, the development of a discipline-specific formal otolaryngology curriculum would substantially improve training in each of these fields," write the authors.

Written by: Rupert Shepherd Bsc.
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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