THE RESIDENCY TRAINING IN OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY

Abstract

Introduction: The residency program in Otorhinolaryngology (ORL) is a supervised program for doctors wishing to become ORL specialists. The 
duration is 66months. This presentation traces the history and describes the current residency training program in ORL in Nigeria, discusses the 
challenges it faces and suggest ways forward.
Methodology: This study was conducted over a 4-month period (May-September 2023), during which the curricula in ORL of the West African 
College of Surgeons and that of the National Postgraduate Medical College of Nigeria were studied, physical and telephone interviews were conducted with the most senior ORL surgeons/Trainers in Nigeria. ORL accreditation visitation reports of West African College of Surgeons on twenty institutions visited over a 5-year period (June 2018-May 2023) were reviewed.
Results: An average of 14 ORL specialists graduated yearly in the years between 2018 and 2023 in contrast to 1 to 3 specialist per year prior to 
the year 2000. The curriculum of ORL has not undergone momentous change since commencement of the program nearly 40 years ago. There were 
244 ORL training slots allotted to twenty institutions over a 5-year period, 60% of institutions were yet to fill these allotted slots. The clinical 
rotations practically do not adhere to spelt out structure. There is adequate patient workload to sustain training in all training institutions. Three 
quarters of the institutions do not have fully functional Temporal bone dissection or Endoscopic Sinus Surgery (ESS) dissection facilities. No 
institution has facilities for advanced vestibular tests. Only 30% of institutions showed evidence of operative surgery in all core areas of 
Otorhinolaryngology. 
Conclusion and recommendation: The training in Otorhinolaryngology has grown steadily, but faster progress is required to provide the population with a reasonable number of ORL specialists. The available training slots in ORL are insufficient, yet even these few slots are not fully utilized and more needs to be done to ensure the enrolment 
of more trainees on the ORL training. Periodic curriculum review to keep up with best practices is recommended.  Investment in training centers should be a priority with some centers specifically upgraded and designated centers of excellence. Invitation of international Faculties to participate in local training should become a policy as part of these investments.