Mahmood Bhutta, Chair in ENT, Brighton & Sussex Medical School, and Consultant Otologist, University Hospitals Sussex, UK
I was the grateful recipient of the 2020 Matthew Yung and Chris Raine scholarship, although due to the Covid pandemic and its aftermath I could not take up the opportunity until June this year.
I chose to visit the otology and neurotology department at Iowa University Hospitals, in particular to meet with Bruce Gantz, an early adopter of bony obliteration of the mastoid, himself inspired by the work of Ulf Mercke of Sweden who developed this technique in the 1980s. Despite this technique having existed and been practiced for over 40 years, it was not one I was really exposed to during my training. As a young consultant I taught myself the technique using YouTube videos (!) and have found it to be highly successful for primary and revision mastoidectomy. It is a technique I now use routinely in my practice in the UK, as well as in training surgeons in low resource settings, but it is always helpful and wise to learn from those with greater experience. The method used in Iowa utilized bony canal wall excision and replacement, often with soft tissue flaps, different to my technique of using only compressed bone pâté for obliteration.
Iowa is a small city but the hospital is leading in many aspects of medicine, and is a regional and national referral centre for otology and neurotology. My visit allowed me to experience lateral skull base surgery and to attend the specialist clinic for congenital hearing loss run by Alex Claussen (which uses genetic profiling to predict audiological outcomes). I was also able to see one of the first recipients of otoferlin gene therapy and to try my hand at the cochlear implantation robot developed in Iowa by head of department Marlan Hansen. 
I took the opportunity to indulge my love of cycling, including taking a fat bike to the Iowa countryside and going on a road bike cycle with Marlan. I hadn’t appreciated that Marlan was such a keen cyclist: our ‘little Saturday morning ride’ turned out to be cycling 110 miles into the next state! I have promised Marlan a visit to my hometown of Brighton, where I intend to return the ‘favour’.
It was a pleasure to experience the clinical and academic work going on in Iowa: a learning experience and good fun. And I can only encourage readers to apply for similar opportunities in the future. 
Photos
Top: University of Iowa Hospitals
MIddle: Fat biking in the Iowa Countryside
Below: At the end of a 110-mile cycle with head of department Marlan Hansen (second from the left)
