A Day In The Life: ENT

I have three days left of my ENT rotation -- and I've enjoyed it so much that having to move on is actually a little sad! I've certainly gained new respect for surgical residents. The ones I've worked with have been so easy-going, helpful, and positive despite the fatigue of frequent 18-hour work days fueled by four hours of sleep (and those aren't even call shifts!). There's no such thing as a post-call day. Essentially their residency is a five-year hospital sleepover. The fact that I've heard no complaints shows how dedicated they are to their field.

Because I'm not a surgical resident, I've definitely been babied a little on this rotation. I haven't had to do overnight call and I'm the last resident to show up in the morning and the first to leave at the end of the day. During nine-hour flap surgeries I'm told to scrub out halfway for a food and bathroom break (a kind offer in the surgical world!).

Here's what my typical ENT day looks like:

quiet hospital in the early morning

0600 h: I walk to the hospital and meet the residents on the ENT ward. We print patient lists and load all of the charts onto a trolley to push from room to room.

0615 - 0730 h: We round on the patients as a team. Tasks are divided amongst the residents and medical students: writing a brief progress note and orders in the chart, talking to and examining the patient, filling out a consult request or imaging requisition if needed, hooking up the doppler box (to check on blood flow at the surgical site), and removing dressings and drains. As most of the patients have tracheostomies, in the early post-op period they communicate with us by writing.

rounding on the ward

0730 - 0830 h: The ENT residents attend a teaching seminar. As most of the topics are not relevant to my specialty, I try to help out on the ward by phoning consultants, filling out forms, and dictating discharge summaries.

morning seminar

0830 - 1730 h: The rest of the day is spent either seeing outpatients in the ENT clinic, helping out on the ward, or doing day call. Here and there I've spent a day (mostly retracting) in the OR.

ENT clinic

Day call is the most unpredictable and potentially busy option. We answer pages from the hospital, as well as provide phone advice to other hospitals and clinics in the city and northern Alberta (because ENT physicians only work out of this hospital, sick patients from other places may need to be transferred over).

Common calls are about nose bleeds, ear infections, peritonsillar abscesses, sialadenitis, and suspected head and neck cancers. As these patients often need to be scoped or have a procedure performed (nasal packing, abscess drainage) I'm grateful that the ENT residents are always around and happy to take over!

you can identify an ENT resident by their nasopharyngoscope briefcases

lots of walking around the hospital on day call

1730 - 1800 h: At the end of the day I meet up with the residents on the ward to run through patient list again and check in on patients as necessary.

walking home

ENT Study Resources
Unfortunately I don't have any study resources to share for ENT, as I've spent the past month referring to two excellent guides written by residents in this program. For any other clinical questions I've turned to the usually helpful UpToDate.