The Team at Birmingham Children’s Hospital include 8 consultants, clinical fellow, 3-4 registrars, 2 junior stuff doctors and advanced nurse practitioner. The team provides a wide service including airway, head and neck, otology, rhinology and general paediatric ENT. Aside from regular clinics and elective theatre lists, the team also provide service for the emergency department situated in the hospital and support other hospitals in the west midlands for complex paediatric ENT cases.

At the beginning of the program, fixed schedule alongside learning objectives are defined with the assistance of the fellowship coordinator. Learning objectives can then be changed based on the Trainee’s desire and the team’s requirements after 6 months. The program schedule includes 4-5 theatre sessions, 4 clinic sessions and 2 sessions for research and administration. Also, the fellow is required to participate in the on-call rota together with the junior trainees which cover the Children’s Hospital only.

During the program, the clinical fellow is expected to take active part in morning rounds which are conducted by the registrars and junior doctors. Also, the clinical fellow is expected to take active role in teaching (SHO and registrars) and team meetings (airway meeting and MDT meeting) and is encouraged to take active part in audits and ongoing research.

Throughout my program, I participated in multiple different clinics and expanded my knowledge in regard to decision making and clinical management of complex children (e.g preterm babies, craniofacial syndromes, rare genetic disorders). I have also had the great opportunity to learn more about tracheostomy care and NPA management from the SLT and nursing team who works closely with the ENT department. I was fortunate to participated in 500 surgical procedures. Aside from general paediatric ENT cases, I had the privilege to take active part in complex airway surgery (endoscopic and open), head and neck surgery (e.g thyroidectomy, excision of lymphatic malformation, thyroglossal and branchial anomalies, lymph node excision) paediatric rhinology (e.g choanal atresia, FESS, nasal dermoids), and endoscopic ear surgery. I also received wide exposure in the clinical and surgical management of acute paediatric ENT cases such as inhaled foreign body, acute stridor, acute mastoiditis, periorbital abscess and head and neck trauma.

Teaching and feedback is a fundamental part of training. The consultants were happy to discuss and elaborate any case I found challenging and provided constant feedback on my activities. The team encouraged me to participate in courses (e.g., FESS course, airway course) and conferences (e.g., BAPO, BACO, ESPO) and introduced me to leading international paediatric ENT surgeons. I am confident the knowledge and tools I received during my clinical fellow program at the Birmingham Children’s Hospital will assist me greatly in the future and for that I will be forever grateful.

Chilaf Peled