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Diploma in Otolaryngology, Head and Neck Surgery DO-HNS

By: Dr.Hiba Al-Reefy, Consultant ENT and Head and Neck Surgery
Who's it for?
ENT senior house officers and registrars as well as GPs with a special interest in ENT Surgery wishing to offer a minor ENT service.

When did I do it?


In 2005 after completing my basic surgical training and starting my ENT residency program. You can take it at any stage you would like in your career but you will require at least 6 months experience

Why did I do it?


As an SHO in ENT and head and neck surgery, the DOHNS forms an essential component in my training and provides a comprehensive review of common ENT conditions. As well improving my professional knowledge, I gained valuable clinical skills as well. DO-HNS is also an essential criterion when applying for SpR rotations in some deaneries.

How much effort did it entail?


The topics in the syllabus are all common conditions you have dealt with in the past or have recently come across, so dont be overwhelmed with the content. The syllabus is divided into two parts: Part 1 deals with principles behind good clinical practice including issues relating to clinical governance, ethical obligations, audit and general principles of clinical care. The clinical knowledge section including common topics associated with day-to-day practice of otolaryngology, at a year one SHO level. Topics include: applied anatomy and embryology, applied physiology, applied microbiology, and conditions affecting the ear, nose and throat.

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Part 2 assesses clinical competencies in performing a number of procedures which are assessed in the MCQ paper or in the OSCE section of the exam. These procedures include: initial epistaxis and its management, management of foreign bodies in ENT, myringotomy and grommet insertion and flexible nasendoscopy and examination of the post nasal space.

Is there an exam?
The exam consists of two parts: a two hour MCQ paper and an OSCE of about 30 stations, including a number of patient stations. You must pass the MCQ paper before attempting the OSCE. The pass rate is very high averaging at about 85%. The fee for the MCQ paper is 250 and 500 for the OSCE.

Did I go on a course?
The Practical Revision Course at the Royal National Throat, Nose and Ear Hospital covers most of the topics in the DO-HNS syllabus through a series of lectures over three days followed by a mock exam similar to the real thing. The fee for this course is 375 There are a number of other DO-HNS revision courses held in and around London including: - The Whipps Cross DO-HNS Refresher course is a three day course providing lectures, interactive OSCE sessions, appraisal of participants by consultants and a mock written paper and OSCE, the fees for the course are 350. - The DO-HNS Course at St. Mary's Hospital, Paddington: an excellent four day course comprising lectures, MCQ practice and OSCE training, the fees are 475. Top tips: Time should be set aside for revision with study leave, if possible close to the exam date. Attend a revision course Speak to previous candidates who have completed the exam and find out about the clinical cases and scenarios they were confronted with. Visit the College museum and study the anatomy jars on display, they are very helpful. Prepare for the exam in advance, I recommend reading from:

1: Key Topics in Otolaryngology (considered the DOHNS bible by many) 2: Total Revision: Ear, Nose and Throat 3: PAST test in Otolaryngology (S.Philips & L.Badia) Contact for further information: Examinations and Assessment Department The Royal College of Surgeons of England

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35-43 Lincoln's Inn Fields London WC2A 3PE dohns.exams@rcseng.ac.uk Tel: 020 7869 6281

Was it worth it?


Pros: The DO-HNS syllabus is well structured and comprehensive covering all relevant and pertinent topics in ENT and Head and Neck surgery and provides a systematic approach to examining and managing ENT cases. I found the knowledge and skills I gained extremely beneficial to my clinical practice and I have also gained confidence in performing various procedures. DO-HNS is a desirable criterion for short-listing SpRs in the London Deanery and shows commitment to ENT and Head and Neck Surgery.

Cons:
You may feel rushed during the OSCE, especially with the clinical scenario stations, however there is plenty of time. Practice the communication skills section as this will be challenging for overseas doctors who are not familiar with the NHS. Hiba Al-Reefy Consultant ENT and Head and Neck Surgery, drhibaalreefy@hotmail.com

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