Robert Nash, Consultant Otologist, Great Ormond Street Hospital, London, UK.
The value of travel, and seeing clinical and academic practice in other departments, both similar and dissimilar, cannot be overstated. We all have things to learn, prejudices that are difficult to recognise, and reasons to be grateful for those parts of our practice that we prefer to other centres. Seeing clinical practice in person, unedited, with the opportunity to discuss techniques fully and frankly, and the way they transpose to clinic practice is invaluable.
So the opportunity to visit the team at SickKids in Toronto with the 2020 Matthew Yung & Chris Raine Otology Travelling Fellowship was clearly very appealing, and I was delighted and extremely grateful to receive the award. The hospital has a reputation for otology and implant surgery – with a number of clinicians and academics with national and international reputations. As an organisation, it shares many similarities with my hospital, but I was clearly very interested in the differences. Now clearly 2020 was some time ago, but the proposed June 2020 visit was rather delayed by the small matter of a global pandemic, but visiting in 2023, with a better idea of the strengths and weaknesses of my own practice, was in a way even better.
Particular areas for me to focus on include endoscopic ear surgery, which is a part of my practice, but it was great to see the practical way in which it can be made an almost exclusive approach to chronic ear surgery. Adrian James is a strong proponent of endoscopic surgery in children, and a recognised world leader in the field. Being able to discuss the advantages and disadvantages of the technique, and learn all manner of tips and tricks was very useful.
The other area to focus on was cochlear implantation – their team, and particularly Blake Papsin, Karen Gordon and Sharon Cushing, have a very academic approach, and research is closely integrated into their clinical practice. Seeing how this is practically achieved, with academics being closely involved with clinical practice, and clinicians close to academia was particularly useful. It was also interesting seeing different clinical aspects – CI for single sided deafness is routinely funded, they have a social worker integrated into the team, and they also have the confidence to decline implantation in candidates who they assess as having very limited benefit.
My visit coincided with their annual auditory implant away day, and also their regional trainee presentation forum. The legendary KJ Lee gave an oration in which he regaled us with tales of his meetings with presidents, stories about ENT as a specialty 50 years ago, and aphorisms for life and practice. He imbued the group with immense positivity for the future in ENT.
In summary, it was an inspiring and invaluable visit, and I will use this experience to try to develop the department I work and incorporate clinical tips into my practice. The trip ended with a few days at the combined otolaryngology spring meetings (COSM) in Boston – which is the North American equivalent of the BSO, BRS, BLA, BAHNO, BAPO and the RSM all rolled into one. This gave the opportunity to work on some research, make connections, and see what is happening in ENT throughout North America.
The Matthew Yung & Chris Raine Otology Travelling Fellowship is advertised in the ENT-UK newsletter, at which point applications are requested.
