Goals

 

The goals of MS course in ENT are to produce a competent Otolaryngologist who:

  • Recognizes the health needs of ENT patients and carries out professional obligations in keeping with principles of National Health Policy and professional ethics.
  • Has the acquired competencies pertaining to ENT that are required to be practiced in the community and that all levels of health care system.
  • Has acquired skills in effectively communicating with the patient, family and community.
  • Is aware of the contemporary advances and developments in medical science as related to Otolaryngology.
  • Is oriented to principles of research methodology.
  • Has acquired skills in educating medical and paramedical professionals.

 

1.Objectives

At the end of MS course in ENT, the student will be able to:

  • Practice the specialty of Otolaryngology in keeping with the principles of professional ethics.
  • Recognize the key importance of deafness control programme in the context of health priority of the country.
  • Take detailed history; perform physical and local ENT examination including Indirect Laryngoscopy, Anterior, Posterior rhinoscopy, otoscopy, audiometric assessment and interpretation.
  • Perform relevant investigative and therapeutic procedures for the ENT patient.
  • Interpret important imaging and laboratory results.
  • Diagnose ENT problems based on the analysis of history, physical examination and investigative work up.
  • Plan and deliver comprehensive treatment for ENT pathologies.
  • Plan and advice measures for the prevention of deafness, allergies, head neck cancers and to plan rehabilitation accordingly.
  • Manage ENT emergencies efficiently.
  • Demonstrate skills in documentations of case details and of morbidity and mortality data relevant to the assigned situation.
  • Demonstrate empathy and humane approach towards patients and their families and respect their emotions.
  • Demonstrate communicate skills in explaining management and prognosis, providing counseling and giving health education messages to patients and their families.
  • Develop skills as self directed learner, recognize continuing educational needs, use appropriate resources and critically analyze relevant published literature in order to practice, evidence, based otolaryngology.
  • Demonstrate competence in basic concepts of research methodology and epidemiology.
  • Facilitate learning of medical/nursing students, practicing physicians, Paramedical health workers and other providers as a teacher trainer.
  • Play the assigned role in the implementation of national deafness programs, effectively and responsibly.
  • Organize and supervise the desired managerial and leadership skills.
  • Function as a productive member of a team engaged in health care, research and education.

2.Syllabus

General guidelines: during the training period efforts will always be made that

adequate time is spent in discussing ENT problems of public health importance in the country.

3.1 Theory

Basic Sciences Ear

  • Anatomy embryology and ultrastructure of the human ear.
  • Physiology of hearing.
  • Assessment of hearing.
  • Hearing loss.
  • Physiology of equilibrium and its application to the dizzy patient.
  • Assessment of vestibular function
  • Eustachean tube anatomy and physiology
  • Facial nerve
  • Temporal bone

Audiology

  • Audiometry and masking.
  • Tympanometry
  • BERA

Nose and Paranasal Sinuses

  • Anatomy and Embryology.
  • Physiology.
  • Pathophysiology of the ears and nasal sinuses in flight and diving.
  • Nasal Septum.
  • Evaluation of the nasal airway (Rhinomanometry)

Oral cavity

  • The embryology /anatomy of mouth and related faciomaxilllary structure
  • Embryology/anatomy and physiology of salivary glands
  • Pharynx and oesophagus
  • Anatomy, embryogensis and physiology of pharynx
  • Anatomy and embryogenesis of eosophagus and its relations
  • Physiology of deglutination
  • Larynx and tracheobronchial tree
  • Anatomy and embryology
  • Physiology of respiration
  • Physiology of phonation

Skull base

Surgical anatomy

Clinical neuroanotomy

Neck

  • Facial spaces of head and neck
  • Lymph nodes of head and neck
  • Thyroid gland

Imaging and Radiology

  • Image taking and interpretation of Ultrasound
  • Angiography
  • Dacrocystography
  • X-rays
  • CT
  • MRI
  • Barium studies
  • Basic immunology
  • Microbiology as related to ENT
  • Wound healing principle
  • Intensive care in ENT patients
  • Anesthesia in ENT
  • Biomaterials used in ENT
  • Medical negligence in otolaryngology
  • Principle of chemotherapy
  • Principle of radiotherapy
  • Principle and use of nuclear medicine
  • Principles of laser surgery
  • Disorders: Their Medical/Surgical Management

Ear

  • Etiology and management of inflammatory condition of external and middle ear
  • Pathology of cochlea
  • Pathology of vestibular ear
  • Diseases of external ear
  • Diseases of Eustachian tube
  • Ear trauma
  • Management of CSOM and cholesteatoma.
  • Complications of CSOM and their management
  • Otosclerosis etiopathogenesis and management
  • Menier’s disease etiopathogenesis and management
  • Sensorineural hearing loss causes and management
  • Vertigo
  • Otalgia causes and management
  • Tinnitus causes and management
  • Ototoxicity
  • Acoustic neuroma
  • Epithelial tumours of EAC and middle ear
  • Glomous tumour of ear
  • Facial nerve disorder, etiopathogenesis and management
  • Cochlear implants
  • Rehablitation of hearing impaired
  • Reconstruction of ear
  • Nose and paranasal sinuses
  • Conditions of external nose
  • Abnormalities of smell
  • Mechanism and treatment of allergic rhinitis
  • Food allergy and rhinitis
  • Infective rhinitis and sinusitis
  • Complications of sinusitis
  • Intrinsic rhinitis
  • Nasal polyps
  • CSF rhinorrhoea
  • Fracture of facial skeleton
  • Rhinoplasty
  • Epistaxis
  • Snoring and sleep apnea
  • Non healing granulomas of nose
  • Facial pain and headache
  • Aspects of dental surgery for ENT
  • Trans sphenoidal hypophysectomy
  • The orbit with relation with nose
  • Cysts,granulomas and tumours of jaws, nose and sinuses
  • Deviated septum and septoplasty
  • Neoplasm of nasal cavity
  • Neoplasm of PNS
  • Oral cavity and Salivary Glands
  • Common disorder of oral cavity
  • Tumors of oral cavity
  • Non neoplastic disorder of oral cavity
  • Neoplasm of salivary gland 1.bengin 2.malignant
  • Pharynx and Esophagus
  • Acute and chronic infection of pharynx
  • Neurological affective of pharynx
  • Pharyngeal pouches
  • Abscesses in relation to the pharynx
  • Angiofibroma
  • Nasopharyngeal malignancy
  • Tumours of oropharynx and lymphomas of head and neck
  • Tumours of hypopharynx
  • The oesophagus in otolaryngology.
  • Dysphagia
  • Foreign bodies of food passage

Larynx

  • Acute and chronic laryngitis
  • Disorders of voice
  • Management of obstructive airway and tracheostomy
  • Trauma and stenosis of larynx
  • Neurological affections of larynx
  • Tumours of larynx (benign & malignant)
  • Congenital lesion of larynx and stridor

Neck /Face

  • Benign disease of neck
  • Metastatic neck disease
  • The thyroid gland benign / malignant disorders
  • Tumours of infratemporal fossa and parapharyngeal space
  • Facial plastic surgery.
  • Plastic and reconstructive surgery of head and neck
  • Paediatrics Otolaryngology
  • Genetic factors and deafness
  • Causes of deafness
  • Testing hearing in children
  • Screening and surveillance for hearing impairment in pre school children
  • Otitis media with effusion
  • Acute and chronic suppurative otitis media in children
  • Surgery of congenital absence of external /middle ear
  • Management of hearing impaired child.
  • Cochlear implantation in children
  • Vesitublar disorder in children
  • Speech and language development
  • Foreign body in ear and nose
  • Congential anomalies in nose
  • Craniofacial anomalies
  • Nasal obstruction , rhinnohrea in infants and children
  • Tonsils and adenoids
  • Dental development ,orthodontics, cleft lip and palate
  • Sleep apnea
  • Stertor and stridor
  • Acute laryngeal infections
  • Home care of tracheostomised children
  • Branchial cleft anomalies, thyroglossal cyst and fistula.
  • Tumors of head and neck in children
  • The drooling child
  • Recurrent respiratory papillomatosis
  • Pediatrics anesthesia

3.2 Practical

History taking pertaining to Otolaryngology and examination like: 

  • anterior and posterior rhinoscopy .
  • oral cavity examination
  • indirect laryngoscopy
  • otoscopy
  • neuro-otology testing .
  • tuning fork testing .
  • audiometry .
  • impedance and vestibular function testing
  • examination of Eustachian tube .
  • functional examination of nose.
  • transillumination test
  • Neck examination .
  • examination of cranial nerves .
  • Examination of cervical lymph nodes .
  • Nasal endoscopy .
  • flexible fibreoptic laryngoscopy
  • micro-ear examination (according to the facilities available in the
  • department). .
  • Monitoring skills .
  • Temperature recording
  • Capillary blood sampling
  • Arterial blood sampling
  • Cardio-respiratory monitoring
  • Post-operative patient monitoring and management accordingly, .
  • Tracheostomy care
  • Blood gas analysis.
  • Airway management.
  • Therapeutic skills
  • Tracheostomy,
  • Anterior/posterior nasal packing
  • Ear packing, syringing, .
  • Foreign body removal from ear/nose/throat,
  • Airway management .
  • Nasogastric feeding .
  • Endotracheal intubation .
  • Cardiopulmonary resuscitation .
  • Administration of oxygen
  • Venepuncture and establishment of vascular access .
  • Administration of fluids, blood, blood components, parenteral nutrition .
  • Common dressings
  • Abscess drainage
  • Basic principles of rehabilitation.
  • Diagnostic skills
  • Interpretation of X-rays/CT/MRI of Head, nose and paranasal sinuses, ear, neck & chest
  • Understanding of audiograms, ENG. BERA, ultrasonographic abnormalities.

Surgical skills:

The first year resident observes the general layout and working of the OT,understands the importance of maintaining sanctity of the OT, scrubbing,working and sterilization of all the OT instruments, know-how of endoscopes,microscopes and laryngoscopes. He/She is responsible for shifting of OT patients, for participating in the surgery as second assistant and for post op management of the patient in recovery and in ward. The second year resident is responsible for the pre-op work up of the patient, surgical planning and understanding the rationale of surgery. He/She is the first assistant in surgery and is responsible for anticipating intra-op and post-op complications and managing them. The final year resident should be able to perform minor/medium surgeries independently and assist in medium and major/extramajor surgeries. He/She should be able to handle all emergencies and operative complications independently and is responsible for supervision and guidance of his/her juniors. The residents are provided with the facilities for temporal bone and cadaveric dissection which are checked periodically.

 

4. Teaching Program

4.1. General Principles

Acquisition of practical competencies being the keystone of postgraduate medical education, postgraduate training is skills oriented. Learning in postgraduate program is essentially self-directed and primarily emanating from clinical and academic work.The formal sessions are merely meant to supplement this core effort.

4.2. Teaching Sessions

Bedside Teaching Round

Seminar

Journal Club

Case discussion

4.3. Teaching Schedule

Suggested departmental teaching schedule is as follows:

Journal club/Seminar -Once a week Speciality clinic

1. Tuesday—Cochlear and Hearing Implant Clinic

2. Wednesday—sinus clinic

3. Thursdayvertigo clinic.

4. Friday—voice clinic.

5. Saturday—sleep clinic.

Thesis meeting—once a week

Seminar/Case Presentation-once a week

Seminar/Case Presentation-Once a week

Central session -Once a week

  • All sessions are to be attended by the faculty members. All PGs are supposed to attend the sessions except the ones posted in emergency.
  • All the teaching sessions are assessed by the consultants at the end of session.

EXAMINATION PATTERN

  • theory and practicals will be equal.
  • The pass percentage is 50%.
  • Candidate have to pass theory and practical examinations separately.

 

A. Theory

Title Marks

Paper 1: Basic Sciences as related to Ear, Nose & Throat diseases. 100

Paper 2: Principles & Practice of Ear, Nose & Throat diseases. 100

Paper 3: Operative Surgery & Principles of General Surgery as applied to ENT. 100

Paper 4: Recent advances in ENT diseases. 100

Total  400

 

B.Practical

One Long Case = 225

Three Short Cases each = 225

Table- 150( two tables)

TOTAL- 600

 

8. Job Responsibilities

During first year the resident will work under direct supervision of the 2nd/3rd year resident/senior resident and consultant on call. He/She will be responsible for taking detailed history, examination of patients as per the file record and send appropriate investigations as advised by seniors. Initially all procedures are to be observed and then done under supervision of seniors and during 2nd/3rd year can do procedures independently. In year, resident is posted in specialty clinics and is also 3rd responsible for making of discharge cards including referrals. In year, the resident is encouraged to make independent decisions in management of cases.

He/She is also involved in teaching of undergraduate students in OPDs.

The first year resident observes the general layout and working of the OT, understands the importance of maintaining sanctity of the OT, scrubbing, working  and sterilization of all the OT instruments, know-how of endoscopes, microscopes and laryngoscopes. He/She is responsible for shifting of OT patients, for participating in the surgery as second assistant and for post op management of the patient in recovery and in ward. The second year resident is responsible for the pre-op work up of the patient, surgical planning and understanding the rationale of surgery. He/She is the first assistant in surgery and is responsible for anticipating intra-op and post-op complications and managing them. The final year resident should be able to perform minor/medium surgeries independently and assist in medium and major/extra major surgeries. He/She should be able to handle all emergencies and post operative complications independently and is responsible for supervision andguidance of his/her juniors.

 

10.FACILITIES IN OUR DEPARTMENT

 

  • We have opd functional 6 days a week.We have nine consultant in department which consists of 1 professors , 2 associate professor , 6 assistant professors.
  • We are members of NPPCD PROGRAM and we are giving training to doctors working at primary health centre and anganwadi workers.
  • We have two wards E6 (male) and F6 (female) for indoor patients
  • We have fully equipped operation theatre F5 with three opearating tables.
  • We are also providing service as geriatric opd, central jail specialist opd and Kapdiwad opd
  • We are also providing on call duty for vvip persons.
  • We are also providing services during natural calamities and emergencies.
  • We are also providing super speciality clinics at evening (3-5):-
  1.  Tuesday—Cochlear and Hearing Implant Clinic
  2.  Wednesday—sinus clinic
  3. Thursday—vertigo clinic.
  4.  Friday—voice clinic.
  5. Saturday—sleep clinic.

11.TEACHING STAFF INFORMATION

  • PROFESSOR
  1.  DR. RAJESH VISHWAKARMA
  • ASSOSIATE PROFESSOR
  1.  DR. BELA .J. PRAJAPATI
  2.  DR. NEENA BHALODIA
  • ASSISTANT PROFESSOR
  1.  DR. B . K .KEDIA
  2.  DR.KALPESH PATEL
  3.  DR.DEVANG GUPTA
  4.  DR.NIKHIL PATEL
  5.  DR.DIPESH DARJI
  6.  DR. VIRAL PRAJAPATI

 

OPD DAYS AND EMERGENCY DAYS

Our department has opd that functions 6 days a week and we have a total of 9 faculty memebers consisting of 1 professor , 1 additional professor , 1 assosiate professor and 6 assistant professors.

It also has 21 resident working round the clock under the supervision of faculty member in the hospital, ward and emergency.

 

OPD DAYS AND EMERGENCY DAYS..

 

UNIT

DESIGNATION

NAME

OPD AND EMERGENCY DAYS

OT DAYS

ENT 1

 

PROF & HOD

 

ASST PROF

 

ASST PROF

DR.RAJESH VISHWAKARMA

DR.KALPESH PATEL

DR.DIPESH DARJI

TUESDAY & FRIDAY

MONDAY & THURSDAY

ENT2

ASSO PROF & HOU

 

ASST PROF

 

ASST PROF

 

DR.BELA PRAJAPATI

 

DR.B.K.KEDIA

 

DR.NIKHIL PATEL

 

MONDAY &

THURSDAY

WEDNESDAY &

SATURDAY

ENT3

ASSO PROF & HOU

 

ASST PROF

 

 

ASST PROF

 

DR.NEENA BHALODIA

 

DR.DEVANG

GUPTA

 

DR.VIRAL PRAJAPATI

 

WEDNESDAY &

SATURDAY

TUESDAY & FRIDAY