DNB ENT in India: Check out NBE released Curriculum

The National Board of Examinations (NBE) has released the Curriculum for DNB ENT.

I. PROGRAMME GOAL & OBJECTIVES:

1. PROGRAMME GOAL

The goal of the DNB ENT is to produce a competent ENT specialist who recognizes the health needs of ENT Patients.

2. PROGRAMME OBJECTIVES

At the end of DNB training the student should be able to:

• Practice the specialty ethically keeping in mind the requirement of the patient, community, and people at large.

• Demonstrate sufficient understanding of basic sciences related to the specialty and be able to integrate such knowledge into the Clinical practice.

• Diagnose and manage the majority of conditions in the specialty (clinically and with the help of relevant investigations)

• Plan and advice measures for the promotive, preventive and rehabilitative aspects of health and diseases in the field of ENT.

• Play the assigned role in the implementation of National Health Programs like National program for prevention and control of deafness and awareness of other National programs

• Demonstrate competence in basic concepts of research methodology and writing thesis and research papers.

• Develop good learning, communication, and teaching skills.

• Demonstrate communicative skills explaining management, prognosis providing counseling and health education to the patient

• Acquire in-depth knowledge of the subject including recent advances.

• Fully conversant with the bedside procedures and have knowledge of the latest diagnostics & therapeutics available.

• Manage ENT emergencies

• Demonstrate empathy and a humane approach towards the patient and their family and respect their emotions

II. TEACHING AND TRAINING ACTIVITIES:

The fundamental components of the teaching program should include:

1. Case presentations & discussion- once a week

2. Seminar - Once a week

3. Journal club- Once a week

4. Grand round presentation (by rotation departments and subspecialties)- once a week

5. Faculty lecture teaching- once a month

6. Clinical Audit-Once a Month

7. A poster and have one oral presentation at least once during their training period in a recognized conference.

The rounds should include bedside sessions, file rounds & documentation of case history and examination, progress notes, round discussions, investigations, and management plan) interesting and difficult case unit discussions.

The training program would focus on knowledge, skills, and attitudes (behavior), all essential components of education. It is being divided into theoretical, clinical, and practical in all aspects of the delivery of rehabilitative care, including the methodology of research and teaching.

i. Theoretical: The theoretical knowledge would be imparted to the candidates through discussions, journal clubs, symposia, and seminars. The students are exposed to recent advances through discussions in journal clubs. These are considered necessary in view of inadequate exposure to the subject in the undergraduate curriculum.

ii. Symposia: Trainees would be required to present a minimum of 20 topics based on the curriculum in a period of three years to the combined class of teachers and students. A free discussion would be encouraged in these symposia. The topics of the symposia would be given to the trainees with the dates for presentation.

iii. Clinical: The trainee would be attached to a faculty member to be able to pick up methods of history taking, examination, prescription writing and management in rehabilitation practice.

iv. Bedside: The trainee would work up cases, and learn the management of cases by discussing them with the faculty of the department.

v. Journal Clubs: This would be a weekly academic exercise. A list of suggested Journals is given towards the end of this document. The candidate would summarize and discuss the scientific article critically. A faculty member will suggest the article and moderate the discussion, with participation by other faculty members and resident doctors. The contributions made by the article in furtherance of the scientific knowledge and limitations, if any, will be highlighted.

vi. Research: The student would carry out the research project and write a thesis/ dissertation in accordance with NBE guidelines. He/ she would also be given exposure to partake in the research projects going on in the departments to learn their planning, methodology, and execution so as to learn various aspects of research.

III. SYLLABUS:

• Molecular biology

• Genetics

• Gene therapy

• Mechanisms of anti-cancer drugs

• Radiotherapy and radio sensitizers

• Apoptosis and cell death

• Stem cells

• Soft and hard tissue repair

• Skin flap physiology

• Biomaterials, tissue engineering, and their applications

• Immunology- Defense mechanisms

• Allergy: basic mechanisms and tests

• Evaluation of the immune system

• Primary immune deficiencies

• Rheumatological diseases

• Microorganisms

• Viruses and anti-viral agents

• Fungi

• Anti-microbial therapy

• HIV and otolaryngology

• Blood groups, blood components, and alternatives to transfusion

• Haemato-oncology

• Haemostasis: normal physiology, disorders of hemostasis and thrombosis and their management

• The pituitary gland: anatomy, physiology, imaging, and tests of function

• The thyroid gland: anatomy, physiology, tests of function, and imaging

• The thyroid: non-malignant disease

• The parathyroid glands: anatomy, physiology, tests of function and imaging Parathyroid dysfunction: medical and surgical therapy

• Head and neck manifestations of endocrine disease

• ENT Manifestations of Endocrine diseases

• Drug administration and monitoring

• Corticosteroids in otolaryngology

• Drug therapy in otology

• Drug therapy in rhinology

• Drug therapy in laryngology and head and neck surgery

• Preparation of the patient for surgery

• Recognition and management of the difficult airway

• Adult anesthesia

• Paediatric anesthesia

• Adult critical care

• Paediatric intensive care

• General Consideration of Anesthesia and Management of the Difficult airway

• Surgical management of the difficult adult airways

• Tracheostomy

• Overview of Diagnostic Imaging of the Head and Neck

• Pharyngitis in Adults

• Deep Neck and Odontogenic Infections

• Head and Neck Manifestations in the Immunocompromised Host

• Nasal Manifestations of Systemic Disease

• Laryngeal and Tracheal Manifestations of Systemic Diseases

• Oral manifestations of Systemic Diseases

• Autoimmune Inner Ear Diseases

• Otolaryngology in the Elderly

• Pain Management

• Sleep Apnea and Sleep Disorders

• Aesthetic Facial Analysis

• Scar Revision, Keloide, and Camouflage

• Facial Trauma: Soft tissue Lacerations and Burns

• Maxillo facial Trauma

• Reconstruction of Facial Defects

• Meatoplasty

• Otoplasty

• Nasal Septum

• Nasal Fractures

• Rhinoplasty

• Special Rhinoplasty Techniques

• Allergy and Immunology of the Upper airways

• Physiology of Olfaction

• Objective Assessment of Nasal Function

• Radiology of the Nasal Cavity and Paranasal Sinuses

• Epistaxis

• Non-allergic Rhinitis

• Fungal Rhinosinusitis

• Benign Tumors of the Sinonasal Tract

• Primary Sinus Surgery

• Revision surgery for Rhinosinusitis, causes for failure complications of endoscopic sinus surgery

• Management of the Frontal sinus

• Cerebrospinal Fluid Rhinorrhea

• Endoscopic Dacryocystorhinostomy

• Laryngeal and Pharyngeal Function

• Visualization of the Larynx

• Voice Evaluation and Therapy

• Neurological evaluation of the Larynx and Pharynx

• Neurological Disorders of the Larynx

• The Professional Voice and management of

• LASER Surgery: Basic Principles and safety considerations

• Benign Vocal Fold Mucosal Disorders

• Acute and Chronic Laryngitis

• Medialization Thyroplasty

• Arytenoid Adduction and Abduction

• Laryngeal Reinnervation

• Chronic Aspiration

• Laryngeal and Esophageal Trauma

• Surgical Management of Upper Airway Stenosis

• Diseases of the Esophagus

• Transnasal Esophagoscopy

• Zenker Diverticulum

• Tracheobronchial Endoscopy

• Human Papillomavirus and Epidemiology of Head and Neck Cancer

• Chemotherapy and Targeted Biological Agents for Head and Neck Squamous cell Carcinoma

• Integration of Palliative and Curative Care Strategies

• Management of Cutaneous Head and Neck Melanoma

• Malignancies of the Paranasal Sinus

• Physiology of the Salivary glands

• Diagnostic Imaging and Fine Needle Aspiration of the Salivary glands

• Inflammatory Disorders of the Salivary glands

• Benign Neoplasm of the salivary glands

• Malignant Neoplasm of the salivary glands

• Physiology of the Oral cavity

• Oral Mucosallesions

• Odontogenesis, odontogenic cysts and OdontogenicTumors

• Temporomandibular Joint Disorders

• Benign Tumors and Tumorlike Lesions of the Oral cavity

• Malignant Neoplasms of the Oral cavity

• Reconstruction of the Mandible

• Prosthetic management of Head and Neck Defects

• Tumors of the Nasopharynx

• Malignant Neoplasm of the Oropharynx

• Transoral Approaches to Malignant tumors of the Nasopharynx

• Reconstruction of Oropharynx

• Mechanism of Normal and Abnormal Swallowing

• Diagnostic Imaging of the pharynx and esophagus

• Neoplasm of the Hypopharynx and cervical Esophagus

• Radiotherapy and Chemotherapy of Squamous cell Carcinoma of the Hypopharynx and Esophagus

• Reconstruction of the Hypopharynx and Esophagus

• Diagnostic Imaging of the larynx

• Malignant tumors of the larynx

• Management of Early Glottic Cancer

• Transoral LASER Microsection of Advanced laryngeal tumors

• Conservation laryngeal surgery

• Total laryngectomy and laryngopharyngectomy

• Radiation therapy for cancer of the larynx and hypopharynx

• Vocal and speech rehabilitation after laryngectomy

• Diagnosis and management of tracheal neoplasms

• Differential diagnosis of Neck masses

• Revision Rhinoplasty

• Allergy and Immunology of the Upper airway

• Physiology of Olfaction

• Objective Assessment of Nasal Function

• Radiology of the Nasal cavity and Paranasal Sinuses

• Epistaxis

• Non allergic Rhimitis

• Fungal Rhinosinusitis

• Training, accreditation and the maintenance of skills

• Communication and the medical consultation

• Clinical governance: Improving the quality of patient care

• Medical ethics

• Medical jurisprudence and otorhinolaryngology

• Epidemiology

• Outcomes research

• Evidence-based medicine

• Critical appraisal skills

• Recent Advances in Technology

• Functional magnetic resonance imaging: Principles and illustrative applications for otolaryngology

• Positron emission tomography and integrated PET/computed tomography

• Image-guided surgery, 3D planning, and reconstruction

• Ultrasound in ear, nose, and throat practice

• Interventional techniques

• Laser principles in otolaryngology, head and neck surgery

• Electrophysiology and monitoring

• Optical coherence tomography

• Contact endoscopy

• Pediatric ENT-Introduction

• The pediatric consultation

• ENT input for children with special needs

• Head and neck embryology

• Molecular otology, development of the auditory system, and recent advances in genetic manipulation

• Hearing loss in preschool children: screening and surveillance

• Hearing tests in children

• Investigation and management of the deaf child

• Paediatric cochlear implantation

• Congenital middle ear abnormalities in children

• Otitis media with effusion

• Acute otitis media in children

• Chronic otitis media in childhood

• Management of congenital deformities of the external and middle ear

• Disorders of speech and language in pediatric otolaryngology

• Cleft lip and palate

• Craniofacial anomalies: genetics and management

• Vertigo in children

• Facial paralysis in childhood

• Epistaxis in children

• Nasal obstruction in children

• Paediatric rhinosinusitis

• The adenoid and adenoidectomy

• Obstructive sleep apnoea in childhood

• Stridor

• Acute laryngeal infections

• Congenital disorders of the larynx, trachea, and bronchi

• Laryngeal stenosis

• Paediatric voice disorders

• Juvenile-onset recurrent respiratory papillomatosis

• Foreign bodies in the ear and the aerodigestive tract in children

• Tracheostomy and homecare

• Cervicofacial infections in children

• Diseases of the tonsil

• Tonsillectomy

• Salivary gland disorders in childhood

• Tumours of the head and neck in childhood

• Branchial arch fistulae, thyroglossal duct anomalies, and lymphangioma

• Gastro-oesophageal reflux and aspiration

• Diseases of the oesophagus, swallowing disorders, and caustic/acid ingestion

• Imaging in pediatric ENT

• Medical negligence in pediatric otolaryngology

• Anatomy of the nose and paranasal sinuses

• Nasal endoscopy

• Physiology of the nose and paranasal sinuses

• Measurement of the nasal airway

• Classification and differential diagnosis of rhinosinusitis

• Allergic rhinitis

• Nonallergic perennial rhinitis

• Occupational rhinitis

• Food allergy and intolerance

• Rhinosinusitis

• Fungal rhinosinusitis

• Specific chronic infections

• Medical management of chronic rhinosinusitis

• Surgical management of rhinosinusitis

• The frontal sinus

• Mucocoeles

• Complications of rhinosinusitis

• Nasal polyposis

• The relationship between the upper and lower respiratory tract

• The septum

• Nasal septal perforations

• The management of hypertrophied turbinates

• Epistaxis

• Nasal fractures

• Fractures of the facial skeleton

• Cerebrospinal fluid rhinorrhoea

• Granulomatous conditions of the nose

• Abnormalities of smell

• Orbital and optic nerve decompression

• Dacryocystorhinostomy

• Conditions of the external nose

• The diagnosis and management of facial pain

• Medical negligence in rhinology

• Surgical anatomy of the neck

• Examination and imaging of the neck

• Neck Trauma

• Benign neck disease: infections and swellings

• Anatomy of the mouth and dentition

• Benign oral and dental diseases

• Abnormalities of taste

• Salivary gland anatomy

• Physiology of the salivary glands

• Imaging of the salivary glands

• Non-neoplastic salivary gland diseases

• Cysts and tumors in and around the jaws, including sarcoma

• Anatomy of the pharynx and oesophagus

• Physiology of swallowing

• Functional investigations of the upper gastrointestinal tract

• Acute and chronic pharyngeal infection

• Causes of dysphagia

• Globus pharyngeus

• Pharyngeal pouch

• Oesophagal diseases

• Neurological disease of the pharynx

• Dysphagia: management and intervention

• Management and treatment of intractable aspiration

• Anatomy of the nasopharynx

• Benign conditions of the nasopharynx

• Anatomy of the larynx and tracheobronchial tree

• Assessment and examination of the upper respiratory tract

• Physiology of the larynx

• Voice and speech production

• Objective evaluation of the voice

• Disorders of the voice

• The professional voice

• Speech therapy in ENT practice: scope, science, and evidence for intervention

• Phonosurgery

• Acute infections of the larynx

• Chronic laryngitis

• Laryngeal trauma and stenosis

• Introduction of Airway Obstruction

• Recurrent Respiratory Papillomatosis

• Upper airway obstruction

• Tracheostomy

• Physiology of sleep and sleep disorders

• Obstructive sleep apnoea: medical management

• The surgical management of snoring

• Epidemiology of head and neck cancer

• Aetiology of head and neck cancer

• Staging of head and neck cancer

• Data collection in head and neck cancer

• Prognostic indicators and serum markers

• Skin cancer of the head and neck

• Mucosal malignant melanoma

• Nasal cavity and paranasal sinus malignancy

• Juvenile angiofibroma

• Nasopharyngeal carcinoma

• Benign salivary gland tumours

• Malignant tumors of the salivary glands

• Tumours of the parapharyngealspace

• Oral cavity tumours including the lip

• Oropharyngealtumours

• Tumours of the larynx

• Rehabilitation after laryngectomy

• Tumours of the hypopharynx and oesophagus

• Thyroid cancer

• Management of the patient presenting with neck lymphadenopathy and an unknown primary carcinoma

• Metastatic neck disease

• Developments in radiotherapy for head and neck cancer

• Quality of life in head and neck cancer

• Palliative care for head and neck cancer

• Medical negligence in head and neck surgery

• The history of reconstructive surgery of the head and neck

• Grafts and local flaps in head and neck surgery

• Pedicled flaps in head and neck surgery

• Free flaps in head and neck reconstruction

• Keloids, hypertrophic scars and scar revision

• Principles of osseointegration and the role of prosthetics

• A combined prosthetic and surgical approach to head and neck reconstruction

• Aesthetics, facial proportions and digital planning in facial plastic surgery

• Reduction rhinoplasty

• External rhinoplasty

• Augmentation rhinoplasty

• Revision rhinoplasty

• The deviated nose

• The nasal tip and nasolabial angle

• The nasal valve and its management

• Nasal reconstruction

• Total reconstruction of the pinna

• Blepharoplasty

• The aging face

• Facial reanimation

• Medical negligence in facial plastic surgery

• The anatomy and embryology of the external and middle ear

• Form and ultrastructure of the cochlea and its central connections

• Anatomy and ultrastructure of the vestibular organ

• Sound vibrations and waves

• Physiology of hearing

• Physiology of equilibrium

• The perception of sound

• Psychoacoustic audiometry

• Evoked physiological measurement of auditory sensitivity

• Prevention of hearing loss: scientific principles

• Clinical examination of the ears and hearing

• Conditions of the pinna and external auditory canal

• Furunculosis

• Bullous myringitis

• Granular myringitis

• Benign necrotizing otitis externa

• Malignant otitis externa

• Keratosis obturans and primary auditory canal cholesteatoma

• Acquired atresia of the external ear

• Otitis externa and otomycosis

• Perichondritis of the externalear

• Relapsingperichondritis

• Exostosis of the external auditory canal

• Foreign bodies in the ear

• Haematoma Auris

• Osteoradionecrosis of the temporal bone

• Herpes zoster oticus

• Conditions of the middle ear

• Acute otitis media in adults

• Otitis media with effusion in adults

• Chronic otitis media

• Tuberculosis of the temporal bone

• Otosclerosis

• Paget's disease

• Ear Trauma

• Otalgia

• Conditions of the cochlea

• Age-related sensorineural hearing impairment

• Noise-induced hearing loss

• Autosomal dominant nonsyndromic sensorineural hearing impairment

• Ototoxicity

• Idiopathic sudden sensorineural hearing loss

• Tinnitus and another dysacusis

• Management of hearing impairment

• Hearing aids

• Bone-anchored hearing aids

• Cochlear implants

• Middle ear implants

• Accessory devices

• Balance disorders

• Pathology of the vestibular system

• Evaluation of balance

• Vertigo: Clinical syndromes

• Vertigo: clinical management and rehabilitation

• Medical negligence in otology

• Retrocochlear and facial nerve disorders

• Retrocochlear hearing disorders, including auditory dyssynchrony

• Central auditory dysfunction

• Disorders of the facial nerve and Rehabilitation

• Anatomy of the skull base and infratemporal fossa

• Clinical neuroanatomy

• Evaluation of the skull base patient

• Vascular assessment and management in skull base surgery

• Natural history of vestibular schwannoma

• Surgical management of vestibular schwannoma

• Gamma knife stereotactic radiosurgery

• Patient with neurofibromatosis2

• Management of non-acoustic cerebellopontine angle tumors

• Middle fossa surgery

• Jugular foramen lesions and their management

• Petrous apex lesions

• Approaches to the nasopharynx and Eustachian tube

• Tumours of the temporal bone

• Tumours of the facial nerve

• Squamous cell carcinoma of the temporal bone

• Pituitary tumors: medical and surgical management

• Anterior and anterolateral skull base and craniofacial surgery

• Complications of skull base surgery

• Medical negligence in skull base surgery

• Hearing loss in the Elderly

• Biomedical waste management

• Biostatistics

• Recent Advances in Technology

Biostatistics, Research Methodology, and Clinical Epidemiology

Ethics Medico-legal aspects relevant to the discipline

Health Policy issues as may be applicable to the discipline

IV. COMPETENCIES:

SKILLS

Describe embryology, physiology, pathology, clinical features, diagnostic procedures, and therapeutics including preventive methods, (medical/surgical) pertaining to Otorhinolaryngology - Head & Neck Surgery

Pharmacology of the drugs used in ENT, their pharmacokinetics adverse effect and pharmacy-vigilance

Clinical decision-making ability & management expertise: Diagnose conditions from history taking clinical evaluation and investigations and develop expertise to manage medically as well as surgically the commonly encountered disorders and diseases in different areas

• Otology & Neurology: External, middle and internal ear diseases, deafness, facial nerve palsy, tinnitus, vertigo and tumors of the region and other related conditions

• Rhinology: Nose and Paranasal sinus disorders and diseases. Acquire surgical skills to do septoplasty, septorhinoplasty, functional endoscopic sinus surgery (FESS) etc. Develop the capability to do oncologic diagnosis and therapy planning for proper management of such patients in collaboration with radiotherapists and medical oncologists.

• Laryngology: Able to diagnose and manage benign lesions of the larynx including voice disorders, pharyngeal and nasopharyngeal diseases; Capable to do diagnoses of oncologic conditions such as laryngeal carcinoma and plan its therapy strategies, etc.

• Oral cavity and salivary glands: Learn about diseases of the oral cavity, Parotid gland and Sub-mandibular gland, Minor Salivary gland diseases and their management etc.

• Head/Neck conditions/diseases: Learn about head and neck tumors, diseases of the thyroid gland, neurogenic tumors neck space infection and their management, etc.

• Broncho-esophageal region: Learn about broncho-esophageal diseases/disorders such as congenital disorders, and diagnosis of foreign bodies in wind/food pipes with their management policies. Capable to performing Panendoscopy for oncologic evaluation in the head-neck region, including esophageal malignancy etc.

• Plastic reconstruction of congenital defects of head & neck region and acquired defects following major head-neck surgery & trauma. Acquire general principles of reconstructive surgery and its referral needs and Recent Advances in ENT including surgical methods etc.

• Traumatology & Facio-maxillary Injury: Acquire knowledge in the management of Traumatology in general and facio-maxillary injury in particular, including nasal fractures.etc.

• Speech Audiology and Rehabilitation: Be capable of identifying and diagnosing of audiological & speech-related disorders. Perform different audiological and neuro-otological tests for diagnosis of audiology/vestibular disorders/diseases and be capable to interpret these findings and incorporating their implication in diagnosis and their treatment along with the rehabilitative methods in audiology and speech pathology including hearing aids and other assistive and implantable devices etc.

• Early diagnosis of malignancies and creating awareness in the community/society to eventually get better cooperation from people in health management etc.

• Psychological and social aspect: Some elementary knowledge in clinical Psychology and social work management to be acquired for the management of patients, especially those terminally ill and disabled persons and interacting with their relatives, etc.

• Radiology in ENT: Acquire knowledge about radiology/imaging and to interpret different radiological procedures and imaging in Otolaryngology-Head and Neck including skull base region. There should be a collaboration with the Radiology department for such activities etc.

• Pediatric Otorhinolaryngology: Diseases of the Ear, Nose, and Throat in children including Bronchoesophagology, foreign body, etc.

• Allergy, Immunology, and Autoimmunity in relation to ENT

• Knowledge of LASER and fiberoptics

• Principle of cancer immunotherapy and immune modulation Knowledge of Chemotherapy and Radiotherapy in ENT and head and neck tumors along with radiotherapy, chemotherapy, and immune modulation

• Principle of Radiotherapy and its application in ENT, Head and Neck Neoplasia

• Principle of Nuclear medicine in relation to ENT

• Endocrinal disorders related to ENT

• Role of Genetics and gene therapy in ENT Disorders

• Hematology in relation to ENT

• Should have knowledge of ENT disorders in Geriatrics including Deafness due to aging and its management.

• Principles of Jurisprudence and Ethical issues related to ENT

• Basic knowledge of anesthesia-related to ENT

• Knowledge of devices and prosthesis in ENT

• Should have basic knowledge and principle of general surgical skills, suture material used in surgery, sterilization technique, wound healing, Shock and Fluid management etc.

• Should have knowledge of blood transfusion and adverse reactions and its management.

• Should have knowledge of relevant simulators to acquire diagnostics and management skills.

• Research: Develop the ability to conduct a research inquiry on clinical materials available in Hospitals and in the community.

• Patient-doctor relation: Develop the ability to communicate effectively with the patient and his/her relatives pertaining to the disease condition, its severity, prognosis, and options available for the treatment/therapy.

• Preventive Aspect: Acquire knowledge about prevention of relevant conditions such as middle ear and sinus infection, other hereditary deafness and early diagnosis of head-neck malignancy etc. Hence, residents should know about preventive Otorhinolaryngology(ENT)

• Presentation of Seminar/paper: Should develop the public speaking ability and should be able to make presentations on disease conditions/research topics to fellow colleagues in a Seminar/meeting/conference using audio-visual aids.

• Research paper writing: should be capable to write case reports and research papers for publication in scientific journals.

• Teamwork: To develop Team spirit in patient management, working together in OPD, OT, and ward and sharing responsibility with colleagues such as doctor, nurses and other staff.

• Teaching of Under-Graduate, Paramedical, and other Staff of hospitals/institutions.

PRACTICAL SKILLS

• History taking

• Anterior and posterior Rhinoscopy

• Oral cavity examination

• Otoscopy

• Neuro-Otologytesting

• Indirect Laryngoscopy

• Tuning fork testing

• Audiometry, Impedance Audiometry, and Examination of the Eustachian tube

• Functional examination of the nose

• Transillumination test

• Nasal endoscopy

• Examination of the ear under a microscope

• Neck Examination

• Examination of the cranial nerves

• Flexible fibro-optic laryngoscopy

• Examination of cervical, lymph nodes, and Thyroid

• Others

MONITORING SKILLS

• Temperature recording

• Capillary blood sampling

• Arterial blood sampling

• Cardiorespiratory monitoring

• Post-operative monitoring and management

• Tracheostomy care

• Blood gas analysis

• Airway management

• Others

THE THERAPEUTIC SKILLS

• Tracheostomy & Airway management

• Anterior/ posterior nasal packing

• Ear Packing and Syringing

• Foreign body removal from ear, nose, and throat

• Nasogastric feeding

• Endotracheal intubation

• Cardiopulmonary resuscitation

• Administration of oxygen

• Mini puncture and establishment of vascular excess

• Administration of fluids, blood, blood components, and parenteral nutrition

• Common dressing

• Abscess drainage

• Basic principles of Rehabilitation

DIAGNOSTIC SKILLS

• Interpretation of X-rays/CT/MRI of Head, nose and paranasal sinuses, ear, neck & chest

• Understanding of Audiograms, ENG. BERA, ultra-sonographic abnormalities and other diagnostic procedures

SURGICAL SKILLS

Basic surgical skills

• General layout and working of the OT

• Scrubbing, owning, and gloving

• Scrubbing sterilization of the OT instruments

• Shifting of patients

• Pre-operative workup of the patient and surgical planning

• Understand the rationale of surgery

• Post-operative care

Surgical Procedure to be assisted or Performed under Supervision

• Tracheostomy

• Tonsillectomy

• Adenoidectomy

• Myringotomy & Grommetinsertion

• Nasal Polypectomy

• Sub-mandibular salivary gland excision

• Incision/drainage of quinsy/other abscesses

• S.M.R. &Septoplasty

• Cortical mastoidectomy

• Modified radical Mastoidectomy.

• Be able to manage common emergencies like fracture of the nasal bone, stridor requiring a tracheostomy, epistaxis, Mastoid abscess Peritonsillar abscess and others

• Myringoplasty/Tympanoplasty

• Nasal biopsy

• Biopsy from a neck mass, such as an anode

• Direct Laryngoscopy & biopsy

• Nasophayrngoscopy & biopsy

• Flexible Bronchoscopy, Oesophagoscopy - Foreign body removal & biopsy

• Aural polypectomy

• Endoscopy examinations

• Inter anasalethmoidectomy

• External ethmoidectomy

• External front ethmoidectomy

• Maxillectomy (Partial and Total)

• Excision of thyroglossal cyst

• Superficial Parotidectomy

• Radical block dissection of the neck for metastatic nodes.

• Total Laryngectomy for cancer

• Laryngofissure

• Repair of laryngotracheal trauma

• Ligation of external carotid artery

• Others

Procedure to observe:

• Facial nerve decompression

• Pinna-Repair (Post-traumtic)

• Surgery of choanal atresia,

• External canal atresia-surgery

• Functional endoscopic/sinus surgery

• Stapedectomy

• Rhinoplasty for cosmetic purposes

• Tympanoplasty with mastoid surgery fire-optic bronchoscopy and oesophagoscopy including foreign body removal

• Cryo/LASER surgery in ENT

• Micro laryngoscopic voice surgery for vocal nodules, polyps/cysts, etc

• Phono surgery for cord palsy including type I thyroplasty.

• Skull base/parapharyngeal space surgery

• Thyroid surgery,

• Laryngotracheal stenosis - surgical correction,

• Facio maxillary injury etc.

Research methodology/Reporting on research

• Learns the basics in research methodology

• Problem-oriented record keeping including the use of computer

• Use of Medical literature search including through the Internet and Library

• Attends bio-statistics classes by arrangement

Research Report

• Writing including preparation of Protocol for Research/Thesis.

• Writing an abstract/short paper/presentation style (Slide-making audio-visual aids).

• Preparation of a report on a Research project and Thesis.

Humanity/Ethics:

• Lectures on humanity including personality development, team spirit, and ethical issues in patient care and human relationship including, public relations, by Psychologists and public relations officers are to be arranged by the dept./college.

TEACHING METHODS

The following learning methods may be used for the teaching of the DNB trainees:

• Journal clubs

• Seminars

• Lecture/discussions: Lectures on newer topics by Faculty

• Case presentation in the ward and Special clinics (such as vertigo/otology and Tumor clinics) DNB Student will present a clinical case for discussion before a faculty and discussion made pertaining to its management and decision to be recorded in case files.

• Surgico-pathological Conference

• Combined Round/Grand Round

• Clinical teaching in OPD, Emergency, ICU, Operation Theatre, and others

• Community camps: For rural exposure and also for experience in preventive aspects in Rural situations/hospitals and schools. Patient care camps are to be arranged during 2-3 years, involving Candidates/Faculty.

• Emergency situation: Casualty duty to be arranged by rotation among the Trainees with a Faculty cover daily by rotation.

• Special Clinics: DNB Students should attend special clinics like Vertigo clinic, Tumor Clinic/Head and neck cancer clinic, Rhinology clinic, otology clinics, and others if available in the institute

• Death Reviews and Medical Audit

• It is recommended that the DNB trainee to be adequately exposed to Cadaveric dissection for learning surgical anatomy, different Surgical procedures, microscopic procedures, and endoscopic surgery

• Simulators dissection Lab: If the cadaveric dissection facility is not available then students should be exposed to Surgical Simulator labs

Note

• All sessions are to be attended by the faculty members. All trainees are supposed to attend the sessions except the ones posted in an emergency.

• All the teaching sessions are assessed by the Faculty at the end of the session and marks are given out of 10 and kept in the office for internal assessment.

• Attendance of the Trainees at various sessions has to be at least75%.

DETAILS OF THE SKILLS TO BE ACQUIRED DURING THE TRAINING PERIOD

Clinical procedures which the candidates must know

Investigations/tests that the candidates must know to interpret

V. LOG BOOK

A candidate shall maintain a log book of operations (assisted/performed) during the training period, certified by the concerned postgraduate teacher / Head of the department / senior consultant.

This log book shall be made available to the board of examiners for their perusal at the time of the final examination.

The logbook should show evidence that the before-mentioned subjects were covered (with dates and the name of the teacher(s) The candidate will maintain a record of all academic activities undertaken by him/her in log book.

1. Personal profile of the candidate

2. Educational qualification/Professional data

3. Record of case histories

4. Procedures learned

5. Record of case Demonstration/Presentations

6. Every candidate, at the time of the practical examination, will be required to produce a performance record (log book) containing details of the work done by him/her during the entire period of training as per the requirements of the log book. It should be duly certified by the supervisor as work done by the candidate and countersigned by the administrative Head of the Institution.

7. In the absence of the production of a log book, the result will not be declared.

VI. RECOMMENDED TEXT BOOKS AND JOURNALS

Books Recommended

• Logan Turner Diseases of Ear Nose Throat

• Otolaryngology, Otology & Neurotology by Paprella & Micheal

• Essentials of endoscopic sinus surgery by SS Bamberger

• Color Atlas of Head & Neck Surgery by Jatin PShah

• Scott Brown's Diseases of Ear Nose and Throat

• Surgery of the Ear - Glasscock, and Shambaugh

• Otolaryngology, Head, and Neck by Cummings

• Audiology by Katz

• Head and Neck Surgery by P M Stell and Maran

• Basic & Advances Biostatistics - Manju Pandey

• Oxford Handbook of Medical Biostatistics List of Journals

• Indian Journal of Otolaryngology and Head Neck Surgery

• Asian Journal of Ear Nose and Throat

• Ear, Nose, and Throat Journal

• Indian Journal of Otology

• Journal of Laryngology and Otology

• Otolaryngologic clinics in North America

• Int. J. of Pediatric Otolaryngology

• Laryngoscope

• Annals of Otolaryngology

• Otolaryngology Head Neck Surgery

• Archives of Otolaryngology