C Johnson. Book Review: Your First ENT Job- A Survivor's Guide. The Internet Journal of Otorhinolaryngology. 2005 Volume 4 Number 2.
Last year when I started my first ENT job as an SHO, I looked for an introductory guide to the subject. I found they were few to non-existent. I couldn't find a guide based on the NHS system so settled on “Otolaryngology Survival Guide” by Layland and Lin, published by the Washington Manual Survival guide series. It was with some excitement I found published this year “Your First ENT job- a survivor's guide” by Lyons and Singh, Radcliffe Publishing.
Lyons and Singh's book is divided into four main chapters, headed Ears, Nose, Throat and Pre-admission requirements. These may be read in order or dipped in and out of at will. The chapters are written clearly, concisely and well-illustrated with photographs and diagrams. The first three chapters begin with the anatomy of the area concerned, followed by questions that should be asked about problems and explanations on how to deal with the problems themselves. I found the explanations dealing with the common problems seen in A & E and emergency clinics particularly helpful such as trauma to the ears and nose, foreign bodies (in all three orifices) and epistaxis.
Each of the first three chapters also explained what was involved in common ENT operations, the risks involved that needed to be consented for and offered practical and helpful tips for seeing patients in clinics and on the wards. I wish I had had the suggested minimum dataset for recording the results of a fibreoptic flexible nasopharyngolaryngoscopy when I first started.
The last chapter helps a junior doctor ensure the correct investigations have been ordered pre-operatively. I found the list of operations with their appropriate radiological procedures needed very helpful.
However, the book is written in a large text and too well-spaced. This means it is not as small or as portable as it could have been. It cannot fit into a pocket unlike The Washington Manual. The anatomy is quite basic even for a beginner in the subject; I would have liked more particularly on the inner ear and laryngopharnx. I also feel the ear chapter would benefit from an explanation of how audiometry measures hearing loss and a diagram illustrating normal, conductive and sensorineural hearing loss- but this is a minor criticism.
This book would be very suitable not just for foundation year doctors beginning their ENT job but also for doctors and nurses in A & E, nurse practitioners, doctors providing cross-cover for ENT and medical students. Lyons and Singh have done well to produce a book for the first ENT job which includes all the important and necessary information but remains easy to read, understand and practise. It is a practical guide to the subject, very readable and I would like to see it in all ENT departments.