Skills and competencies that a new ENT specialty trainee year 3 should possess: a live Delphi study.

OBJECTIVE: The aim of this study was to develop a novel live Delphi method to obtain a consensus on the skills and competencies that a new ENT registrar (specialty trainee level 3) should possess. Developing a clear outcome set for core surgical trainees is important so that this phase of training can be directed at specific aims. METHOD: Attendees at the North of England meeting participated in this Delphi exercise. Participants comprised a range of ENT professionals from medical student to consultant surgeons. The main outcome measure of consensus was defined prior to the study as the median response value: strongly agree or more for positive consensus and strongly disagree or less for negative consensus. RESULTS: This study identified multiple areas that reached consensus relating to elective and operative skills and demonstrated agreement in areas relating to ENT specific and allied specialty experience. CONCLUSION: This study has highlighted a novel method for shaping surgical curricula.

Vitamin D and COVID-19 Infection.

INTRODUCTION: The COVID-19 pandemic has prompted the medical world to look at factors that may influence outcomes. There have been connections made between vitamin D and COVID-19, as vitamin D has previously been shown to play a role in the maintenance of immune homeostasis. MATERIALS AND METHODS: We performed a prospective cohort study on 103 patients at Wigan Wrightington and Leigh NHS Foundation Trust looking at serum vitamin D levels of patients with positive COVID-19 swabs. Results were collated and correlations were made to compare vitamin D levels with age; severity of illness; hospital outcomes; and frailty. Comparisons were also made between frailty and outcome. RESULTS: The results showed that there was a significant statistical difference between vitamin D levels and severity of infection: those who were treated in the intensive care units (ICU) (severe symptoms) had lower vitamin D levels than those treated on the ward (p=0.0446). There was also a correlation between vitamin D levels and frailty: those who were more frail had higher vitamin D levels than fitter patients (P=0.005). Vitamin D and frailty had no effect on hospital outcomes of COVID-19 infection. CONCLUSION: Ultimately, we concluded that low vitamin D can increase susceptibility of contracting COVID-19, increase severity of infection but does not affect mortality.

The ENT run through pilot: a questionnaire survey of 23 trainees.

OBJECTIVE: The ENT run through pilot was introduced in 2018 to improve early recruitment to the specialty. This study aimed to understand what makes a successful interview applicant and the experience of the run through trainees during the specialty trainee one and specialty trainee two years. METHOD: A questionnaire survey was sent to all ENT run through trainees. RESULTS: Twenty-three trainees responded. Of the successful candidates, 74 per cent held additional degrees prior to application. The median core surgical interview rank was 27 (range: 3-174). Trainees felt that being on the run through pilot had increased ENT trainer engagement. CONCLUSION: The ENT run through posts are highly competitive, and holding an additional degree may improve applicant success. The pilot programme has been successful by increasing trainer engagement at this critical stage of training. These results will enable development of the pilot programme and provide valuable information for those applying to an ENT run through post.

Epistaxis and atorvastatin: is there an association and are clinicians aware? A retrospective audit of 100 patients.

OBJECTIVE: Epistaxis is a common ENT presentation. The British National Formulary lists epistaxis as a common side effect of atorvastatin. This study aimed to better understand the relationship between epistaxis and atorvastatin use, and determine whether ENT doctors are aware of its side effect profile. METHODS: A retrospective analysis over 10 months identified 100 individuals who presented to hospital with epistaxis. A questionnaire of 24 ENT registrars was undertaken. RESULTS: Of the 100 patients admitted with epistaxis, 27 were receiving atorvastatin and 21 simvastatin. None of the 24 ENT registrars were aware that epistaxis was a listed common side effect of atorvastatin. CONCLUSION: There was no apparent difference in the proportion of patients admitted with epistaxis taking atorvastatin versus simvastatin. Epistaxis is an unknown side effect of atorvastatin; doctors have an obligation to be aware of the pharmaceutical literature and to consider alternatives, particularly in re-admissions cases.

Microbiology and antimicrobial susceptibility of otitis externa: a changing pattern of antimicrobial resistance.

OBJECTIVE: Otitis externa is a common presentation to secondary care otolaryngology clinics. Despite this, few studies have investigated the microbiology and antimicrobial resistance of otitis externa. This study aimed to examine these issues. METHODS: Analysis identified 302 swabs taken from 217 patients (100 male, 117 female), between 1 January 2015 and 30 March 2016, at our rapid access otolaryngology clinic. RESULTS: In total, 315 organisms were isolated; the most frequent was Pseudomonas aeruginosa (31.1 per cent), followed by candida species (22.9 per cent) and Staphylococcus aureus (11.7 per cent). P aeruginosa was sensitive to ciprofloxacin in 97.7 per cent of cases and to gentamicin in 78.4 per cent. CONCLUSION: Compared with studies worldwide, the relative proportions of different organisms causing otitis externa and the patterns of antimicrobial resistance differ. Increasing resistance of P aeruginosa to aminoglycosides demonstrates a changing pattern of antimicrobial resistance that has not been previously reported. Reassuringly, quinolone antibiotics remain highly effective when treating P aeruginosa.