Hidden genetic disorders in children that may present to the otolaryngologist

Background Among the many hundreds of children presenting to the otolaryngology clinic are a few whose symptoms are due to an underlying genetic condition. In most cases the underlying syndrome is obvious and has already been diagnosed, such as the...

Leadership in academia

I went into medicine with the clichéd view of wanting to help people. I found that by doing surgery I could help a small number of people, albeit usually to a large effect. Then, I recognised that by engaging in...

Clinical leadership and management: the ‘Darzi’ experience

The Fellowship in Clinical Leadership programme, more commonly known as the ‘Darzi Fellowship,’ commenced in 2009. It was designed to provide junior doctors at the registrar level with postgraduate training in clinical leadership and change management in order to develop...

Time to professionalise medical leadership

For a profession proud of its adherence to an evidence base, medicine has been remarkably slow to acknowledge and to act on the evidence which underpins the value of good leadership to patients and the healthcare system. Mr Robert Francis...

Clinical leadership and management: developing world ENT

I have been asked to share some of the initiatives I have been involved with to address ENT-related challenges in Africa and the developing world. Developing countries constitute the majority of the world’s landmass (Figure 1), are home to >50%...

ENT leadership

Challenges The first challenge is to agree what we mean by the term leadership because there are many different ways in which the term is used. What is, however, a consensus is that the key distinction between leadership and management...

Clinical management: 
a personal view

When Nigel Beasley approached me to write on my experience of clinical management, I was a little surprised. I see myself as primarily a clinician, but have had increasing involvement with clinical management within my Trust. I am now in...

Thoughts on war: von Clausewitz revisited

We few, we happy few, we band of brothers; For he to-day that sheds his blood with me Shall be my brother; be he ne’er so vile, This day shall gentle his condition: And gentlemen in England now a-bed Shall...

In search of courage; transition 
into Army

In search of courage. Well, that is how it all started. I was fairly advanced in surgical training not to mention age, when I decided to join the Territorial Army (TA). My peers, on hearing this couldn’t decide whether I...

Maxillofacial and neck surgery in Iraq and Afghanistan

Introduction Over the past 150 years, military personnel wounded in action had a survival rate of approximately 80% [1]. During the current conflicts in Iraq and Afghanistan, those servicemen wounded in action have a 90.4% survival rate [2]. During the...

Military otolaryngology and its impact on civilian trauma care

Over the centuries, military conflicts and wars have caused both death and injuries and led to improvements in the care of the combat wounded. Military otolaryngologist-head and neck surgeons have been at the forefront of these developments and advances. War...

Barotrauma

Barotrauma is an injury which is due to the effects of pressure upon an air-containing space. Healthy middle ear cavities and paranasal sinuses are normally in equilibrium with the atmospheric pressure, but if an individual moves away from the surface,...