ENT

Introduction

The Pan Thames London training region is the largest ENT training region the UK with 63 trainees. It offers high quality higher surgical training in all aspects of ENT. It comprises of a diverse group of training hospitals each offering complementary aspects of training which when combined over 6 years of higher surgical training (ST3-8) deliver a comprehensive programme and well trained otolaryngologists with a sub-speciality interest. Early years training may be supported by lab based simulated training. Institutional hands on technical training is supported by a comprehensive programme of regional study days. The study days are mapped to cover the curriculum in biannual cylces. Given the large consultant body and numbers of centres of excellence across the city the study day programme is delivered by leaders in their sub-speciality field. All trainees are encouraged to participate in research and activities that may enhance their development as a future teacher or leader in the field of ENT. The majority of trainees take time out of programme at some point to facilitate such development assuming adequate progression as a surgical trainee up to ST5 this is positively encouraged. Trainees can enter the programme through selection at core training ( ST1-2 run though), at National selection ST3 or through a formal academic pathway at ST3. The training programmes aim to encourage competency based progression with the achievement of all competences for CCT by ST7 in order to facility sub-speciality training in ST8. The training region in formally split in two North and South, with the former subdivided into North West and North East in order to produce rotations where hospitals are geographically co-located to allow trainees to settle in one part of the city and reduce traveling time to and from work.    

Head of School

Ms Celia Theodoreli-Riga is the Head of the London Specialty School of ENT Surgery.

Deputy Head of School

Mr Dominic Nielsen is the Deputy Head of the London Postgraduate School of Surgery. Mr Nielsen is a consultant orthopaedic surgeon at St George’s Hospital in London. His clinical interests are foot and ankle surgery and complex lower limb trauma. He is a keen advocate of surgical education and was previously the Training Programme Director for Higher Orthopaedics in South London.

Training Programme Directors

North West London: 

Mr Taranjit Singh Tatla, PhD, FRCS (ORL-HNS)

Current Clinical Post: Department of ENT-Head& Neck Surgery, London North West University Healthcare NHS Trust

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Mr Taran Tatla received First Class Honours (Intercalated) in Anatomy (1994) and gained MBBS at University College London (1996). In postgraduate years, he made rapid progress through highly competitive and comprehensive basic and higher surgical training programmes, incorporating posts at many of the renowned London teaching hospitals with FRCS awarded in 2006 from the Royal College of Surgeons in England. He commenced his substantial NHS consultant post in 2008 at London North West University Healthcare NHS Trust, specialising in ENT with Head and Neck (H&N) sub-interest. In 2018 he completed his PhD collaborating with the Hamlyn Centre for Robotics and Department for Surgery and Cancer at Imperial College London, as well as Applied Optics Group, University of Kent.

Mr Tatla manages a wide variety of adult and paediatric patients and contributes as a core member to the H&N Cancer and Thyroid Cancer (Chair) MDTs, providing secondary and tertiary care specialist services for NW London. He supports his clinical work with research, training and leadership roles.

At Northwick Park / St Mark’s hospitals and the Griffin Institute, NW London, he runs innovative national team-focused multi-disciplinary postgraduate courses, including for Head and Neck Imaging, Tracheostomy Care and LASER-application across Surgical Specialties. Core learning themes include optimised team working and provision of a unique environment for clinicians to learn with engineering students from Imperial College and University of Kent (Canterbury). Working as one of two HEE Training Program Directors for ENT higher surgical training in North Thames since 2018, he has co-responsibility for managing the largest ENT higher surgical training programme in the UK (45 trainees).

Mr Tatla has also been the ENT Specialty Clinical Research Lead for the NIHR NW London Comprehensive Research Network since 2012, mentoring trainee research champions.

He serves nationally as elected member of the British Laryngological Association since 2019 and as Honorary Secretary for ENT UK for the last year.

South London:

Mr Richard Oakley

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Chair Pan Thames Higher Surgical Training Scheme Otolaryngology for Otolaryngology Head and Neck Surgery

HEE Training Programme Director for ENT Higher Surgical Training (South London)

Mr Richard Oakley BDS FDSRCS MBBS FRCS (ORL-HNS) PGCert (Med Ed) is a Consultant Head & Neck Surgeon at Guys and St Thomas specialising in Head and Neck Surgical Oncology of the larynx, oropharynx, salivary glands, oral cavity and mid face. 

Richard graduated from the University of London in Dentistry and Medicine. He undertook his training in Dentistry at Kings College London and in Medicine at The Royal Free Hospital, there he received Prize Walter Culverwell Prize for best student of Anatomy, Bursary from The Richard Newitt Fund (2005 & 2006), Esther Frances White Memorial Prize for distinctions in Pathology, Clinical Pharmacology and Surgery in Final MBBS. As a dual qualified Surgeon in dentistry and medicine also while at medical school he completed his Fellowship in Dental of the Royal College of Surgeons in 1996. After basic surgical training at Cambridge University teaching hospitals he trained in the South Thames ENT Training Programme, working in several centres including Guy’s and St Thomas’ and Great Ormond Street Hospitals. During his training he developed specialist skills in minimal access surgery for cancers of the larynx, pharynx and oral cavity. He obtained the Intercollegiate Fellowship in Otolaryngology (FRCS ORL-HNS) in 2006.

Richard worked at Stanford University Hospitals and Clinics from 2008-2010 as a clinical instructor in head and Neck Surgical oncology Stanford University a post recognised by the American Academy of Otolaryngology Head and Neck Surgery (AAOHNS) as a fellowship in Head and Neck/Anterior skull base Surgery. He was awarded the Department Otolaryngology HNS Teacher of the year award (Clinical Instructor) and a second year of combined clinical and head and neck cancer stem cell research was supported by Stanford Cancer Centre Developmental cancer research award in translational Science of $50, 000.

Richard has been a consultant in Head and neck surgical oncology since 2010. He was Clinical Lead for Head and Neck cancer surgical oncology at Guys from 2011 to 2020 and Chair of the SELCN from 2017 to 2021. Through higher surgical training he was the training representative for the South Thames region and formalised his interest in training by undertaking a post graduate certificate in medical education by correspondence with the University of Dundee. With the abolition of the South Thames training scheme in 2011 with colleagues on the training committee he conducted a feasibility study for the establishment of a South London Training scheme, following this exercise he submitted a successful bid for Guys and St Thomas to be the lead provider for ENT Higher surgical training in South London before being appointed as TPD in 2012.

As both a consultant and trainee he has developed a number of courses for ENT and Anaesthetic training including an SpR interview preparation course in 2000 which still ran in 2021. He is and has been a faculty member and convenor of a number of courses run at GSTT in ENT Head and Neck surgery ranging from Enhanced recovery for head and neck surgical oncology to complex airway management for anaesthetists. He examines for the European Board Examination (EBEORL)

Mr Oakley’s primary surgical interest lies in ablative Head and Neck Oncological Surgery. He has a specialist interest in optimising outcomes in salvage surgery of the upper aerodigestive tract through the introduction of an enhanced recovery programme, smoking cessation through utilisation of the teachable moment and the impact of a community psychiatric nurse on outcomes for head and neck cancer patients with mental health and addiction problems.

Mr Oakley is a senior member of the multidisciplinary team in Head and Neck cancer working closely with his plastic surgery and lateral skull base surgery to treat advanced cancer of the external auditory meatus and salivary glands. He also performs transoral laser surgery for management of complex airways due to benign disease.

Training programme

NW London - ENT Higher Surgical Training Posts

Imperial College Healthcare NHS Trust

8 Posts covering: Charing Cross, St Mary’s, Hammersmith and Royal Brompton Hospitals.

Full breadth of paediatric / adult ENT and Head and Neck (benign and cancer), general and sub-specialist services, Skull base and Reconstructive surgery offered including National Airway Reconstruction service and linked allied health / rehabilitative support services. Posts include anterior / lateral skull base surgery, complex / extended endoscopic sinus surgery, trans-oral LASER and Robotic surgery, Thyroid and Parathyroid surgery, minimally invasive surgery for salivary gland disease, complex rhinoplasty and facial plastics, combined rhinology / allergy / vasculitis clinics, combined swallow and voice clinics. Academic programme supports CTs and HSTs for a variety of OOPT and OOPR experiences.

London North West University Healthcare NHS Trust

5 Posts covering: Northwick Park, Central Middlesex, Ealing and Hillingdon Hospitals

Volume exposure to emergency and elective general paediatric and adult ENT, includes integrated head and neck, salivary gland, thyroid cancer and swallow services. Reconstructive surgery supported by OMFS-head and neck surgery colleagues for free flaps. Posts include (x1) rhinology, linking with OMFS and oculo-plastics for facial trauma, thyroid and other eye disease, (x1.5) otology including extended cholesteatoma and stapes surgery, and (x2) minimally invasive thyroid / parathyroid surgery, trans-oral LASER and Robotics surgery. One post covers general / paediatric ENT, rotating after 6 months to Great Ormond Street hospital. Combined multidisciplinary Laryngology services cover voice and swallow disorders, as well as Tracheostomy management (busy Regional Rehabilitation Unit for brain-injured patients located at Northwick Park). Outreach ENT support provided for linked specialist hospitals in outer NW London (Harefield for cardiothoracics and Royal National Orthopaedic, Stanmore), as well as spoke peripheral DGH and community training clinics across Harrow, Brent, Ealing and Hillingdon.

Chelsea & Westminster Hospital NHS Foundation Trust

2 Posts covering: West Middlesex University Hospital

General adult and paediatric ENT services, including West Middlesex and Chelsea & Westminster hospitals

The Royal Marsden NHS Foundation Trust

2 Posts covering: Royal Marsden Hospital

Complex, tertiary national / international cancer patient cohort, combining ENT-OMFS-Head and Neck ablative and reconstructive surgery experience. Upper aerodigestive tract, maxillofacial, salivary and thyroid gland cancer focus with world-class clinical research trials. Transoral robotic surgery in volume, posts linking to outreach clinics in Sutton, SW London.

Great Ormond Street Hospital for Children NHS Foundation Trust

1 Post: Paediatric ENT linked between Northwick Park and Great Ormond Street Hospital. 

 

London Multi-Disciplinary Team Head & Neck Imaging Course

(Lectures, CBD Tutorials, Dry-Lab Simulation)

CTs, HSTs in ENT, OMFS & Radiology, Ultrasonographers

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London Multi-Disciplinary Team Tracheostomy Course & Cadaveric Workshop

(Lectures, CBD Tutorials, Dry and Wet-Lab Simulation)

CTs, HSTs in ENT, OMFS, Anaesthetics & Intensive Care Medicine, Nurse Specialists, Speech Therapists, Respiratory Physiotherapists, Community Care and Hospital HCAs

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London Multi-Disciplinary Team LASER Safety & Surgical Skills Course

(Lectures, Dry and Wet-Lab Simulation)

HSTs & SAS in ENT, OMFS, Urology & Anaesthetics, Theatre / Ambulatory Care Nurses and ODPs

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South London - ENT Higher Surgical Training Posts

Evelina Children’s Hospital London

2 HST post sub-speciality training in paediatric Otolaryngology

Great Ormond Street Hospital for Children NHS Trust

1 HST post sub-speciality training in paediatric Otolaryngology

Guys and St Thomas’s NHS Trust

5 HST posts Comprehensive subspecialist training in all aspects of general ENT/ otology rhinology  laryngology: including lateral skull base (at National Hospital Neurology Neurosurgery Queens square and Kings College Hospital Neurosurgery Units), middle ear surgery, cochlear and middle ear implant, rhinology, facial plastics and laryngology tracheal stenosis and reconstruction surgery,  Head and neck oncological surgery, major ablative open resection with reconstruction, gastric transposition, free tissue transfer, benign H+N, salivary gland surgery, combined plastics free flap reconstructive surgery.

Princess Royal University Hospital, Farnborough.

1 HST post: Thyroid , benign H+N, general ENT, otology rhinology facial plastics

St Georges University Teaching Hospital

6 HST posts Comprehensive subspecialist training in all aspects of general ENT/ otology rhinology laryngology: including lateral skull base (Neurosurgery Unit), middle ear surgery, cochlear and middle ear implant, rhinology, facial plastics. Head and neck oncological surgery, major ablative open resection with reconstruction, gastric transposition, free tissue transfer, benign H+N, salivary gland surgery, combined plastics free flap reconstructive surgery. Also a trauma centre with busy emergency dept, some specialist trauma, infection  and acute surgical workload.

University Hospital, Lewisham

3 HST posts Thyroid, benign H+N, general otology rhinology facial plastics and paediatrics.

 

North East London - ENT Higher Surgical Training Posts

University College London NHS Trust

Royal National Ear Nose and Throat  Eastman Dental  Hospital 10 HST posts

Comprehensive subspecialist training in all aspects of general ENT/ otology rhinology  laryngology: including lateral skull base (at National Hospital Neurology Neurosurgery Queens square), middle ear surgery, cochlear and middle ear implant, rhinology,  facial plastics and laryngology tracheal stenosis and reconstruction surgery,

Head and Neck unit 2 HST posts provide training in Head and neck oncological surgery, major ablative open resection nwith reconstruction, gastric transposition, free tissue transfer, benign H+N, salivary gland surgery, combined OMFS free flap reconstructive surgery.

Barts Health NHS Trust

The Royal London St Bartholomews Hospitals 5 HST posts provides subspecialist areas including head and neck, salivary gland, thyroid, robotic surgery, paediatrics airway, and general ENT including middle ear tympanomastoid surgery, lateral and anterior craniofacial  skull base surgery, rhinology, facial plastics. Laryngology/tracheal stenosis and reconstruction surgery. As a trauma centre- busy emergency dept, some specialist trauma, infection  and acute surgical workload .  craniofacial trauma work combined with OMFS. Cervicomediastinal surgery at St Bartholomews Hospital.

Whipps Cross  Newham University Hospitals3 HST posts general posts with breadth of cover in rhinology, otology, H+N surgery general paediatrics.

Barking Havering and Redbridge University Hospital NHS Trust

Queens Romford University / King Georges Hospitals 3HST posts

Thyroid , benign H+N, general otology rhinology facial plastics and paediatrics.

Royal Free NHS Trust Barnet and Chase Farm Hospital

Royal Free 1 HST post general rhinology, otology, thyroid and paediatrics.

Great Ormond Street Hospital for Children NHS Trust

Linked to RNENTED 2  HST posts subspecialist posts with a link to general adult work by 6 month swap

 

Specialty Training Board Information

The London Specialty School of Surgery holds Specialty Training Board meetings three times per year. The purpose of this group is to bring together specialty leads from postgraduate medical training programmes across the three London local education and training board areas to consider issues of mutual interest in relation to surgical training, and to foster and share good training practice on a pan London basis.

Vision

The vision for the London School of Surgery is to provide the highest quality of training using the vast wealth of clinical resources across London. London has a population of almost eight million. With its rich variety of cultures, nationalities and social backgrounds, the capital offers any trainee a full and rewarding experience in emergency medicine.

The London School of Surgery also seeks to provide:

  • World class education for world-class healthcare
  • Excellence of postgraduate training and education
  • Producing clinical leaders of tomorrow

Useful Information and Links

Curriculum - https://www.gmc-uk.org/education/standards-guidance-and-curricula/curricula/otolaryngology-curriculum

ePortfolio https://www.iscp.ac.uk/

Exams https://www.jcie.org.uk/content/content.aspx?ID=1

JCST Guidelines and Checklists - https://www.jcst.org/quality-assurance/certification-guidelines-and-checklists/