June 30, 2010

A Guide For Clinical Year USM [ORL posting]

Peace be upon all of you,

In USM, this is a minor posting which takes 3 week duration including exam week same as Ophthalmology.

Bear in mind that Otorinolaryngology is a sub specialty program. Therefore, you only need to know about basic thing and principles of management.

However, it is a very common cause for patient visit to hospitals. Therefore you should understand it very well and take this opportunity to learn as much as you can.

This is what you should prepare for this posting

a) Guide book in ORL by ORL dept.

This book will be given on first day you are registered as 4th year med student. It will guide you on what topic to be stress on, nice to know topic and what should you study during this course.

b) Otoscope.

i. You DON’T HAVE to buy the otoscope. The quantity in clinic is more than enough for you to share.

ii. There is requirement for otoscopic examination in log book, I find it quite difficult to handle otoscope as compared to ophthalmoscope. But it’s a very important skill that you need to master

c) Reference book

i. Lecture note on ENT and Colour Atlas of ENT would be enough for you to know about basic disease in ENT.

ii. Some seniors would suggest Dhingra, Diseases of Ears, Nose and Throat. However, some lecturer are not comfortable with this book. But, all I can say, this book is just fine. Simple to undersand. Just beware with the management.

iii. Others may include Logan Turner’s Disease of Ear, nose and throat, differential diagnosis in otolaryngology by KJ Lee, Otolaryngology-Head & neck Surgery by Cummings.

Requirement for the Posting

a) Clinic

i. For me, this is the MOST IMPORTANT session that you should not miss. Rotate yourself so that each of you have a chance to join specialist clinic. Make sure you read before join specialist clinic because they may get irritate if you can not answer basic and simple question.

ii. Use this session to observe or perform procedures required in log book.

iii. Clerk patient and present it to the MO. This is not compulsory but it will show whether you are enthusiastic in this posting or not. It is a good habit to practice taking history and present it to the MO.


Divide your group into two small group. Each group will have chance to go to ORL clinic in HRPZ. It’s a very nice session and you will see more cases there.

c) Case presentation

You are expected to present one case per two person during teaching session. Please find your respective tutor for case presentation. Some of them might request you to provide power point.

d) Case write up

One case write up per person and submit it to your tutor during case presentation.

e) Log book

Log book is not really being emphasized in this posting but make sure it is not empty. At least show your enthusiasm.

f) Seminar

Each of you will be divided into small group to present seminar topic. Therefore, each of you will have a chance to do a presentation. Divide yourself accordingly and discuss with the tutor on what aspect you should cover.

Attendance is COMPULSARY.

g) Ward rounds

Go according to time table. Same as ophthalmology, I think it is less benefit compared to clinic and OT session

h) OT

There is no specific requirement on how much OT you should observe. Go accordingly and take this chance to learn as you will have no chance to observe it later.

i) End posting exam

i. Clinical (depend on lecturer either short case, long case or case discussion)

ii. MCQ

iii. Short essay question.

Notes: No on-call for this posting.

Others tips

1) Familiarize yourself with ENT equipment. You need to know the name and function of each of them.

2) important basic skills that you need to master is otoscopy, ENT examination, tuning fork, anterior rhinoscopy, neck examination, cranial nerve, posterior rhinoscopy, indirect laryngoscopy.

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