ENT trainees' experience of redeployment during the coronavirus disease 2019 pandemic: a qualitative study.

BACKGROUND: As a response to the acute strain placed on the National Health Service during the first wave of coronavirus disease 2019 in the UK, a number of junior doctors including ENT trainees were redeployed to other clinical specialties. This presented these trainees with novel challenges and opportunities. METHODS: A qualitative study was performed to explore these experiences, undertaking semi-structured interviews with ENT trainees between 17th and 30th July. Participants were recruited through purposeful sampling. Interview transcripts underwent thematic analysis using Dedoose software. RESULTS: Seven ENT trainees were interviewed, ranging from specialty trainee years four to eight ('ST4' to 'ST8') in grade. Six core themes were identified: organisation of redeployment, utilisation of skill set, emotional impact of redeployment, redeployed team dynamics, concerns about safety and impact on training. CONCLUSION: The ENT trainees' experiences of redeployment described highlight some important lessons and considerations for future redeployments.

The Current State of the Otolaryngology Workforce.

A shortage of otolaryngologists is predicted for the coming decades, primarily because of an aging population and aging workforce. However, many factors affect the agility of the workforce to expand or contract. This article discusses what is known about factors of the current otolaryngology workforce, including trends in residency and fellowship training, diversity of the specialty, its geographic distribution, and the challenges of caring for an aging population. Predicting the shortage and possible solutions through modeling is complex and prone to errors caused by incomplete data and assumptions about otolaryngology's similarity to other specialties of medicine at large.

Otolaryngologists' Role in Redeployment During the COVID-19 Pandemic: A Commentary.

As otolaryngologists, we identify as subspecialists and fellowship-trained surgeons and may even identify as "super-subspecialists." The likelihood of being redeployed and drawing from knowledge learned during our postgraduate year 1 training seemed exceedingly unlikely until physician resources became scarce in some health care systems during the COVID-19 pandemic. More now than ever, it is evident that our broad training is valuable in helping patients and allowing the otolaryngologist to meaningfully contribute to the larger health care community, especially while the majority (70%-95%) of elective care is delayed. With our skill set, otolaryngologists are poised to support various aspects of hospital wards, intensive care units, emergency departments, and beyond.

Geospatial analysis of COVID-19 and otolaryngologists above age 60.

OBJECTIVE: The 2019 novel coronavirus (COVID-19) is disproportionately impacting older individuals and healthcare workers. Otolaryngologists are especially susceptible with the elevated risk of aerosolization and corresponding high viral loads. This study utilizes a geospatial analysis to illustrate the comparative risks of older otolaryngologists across the United States during the COVID-19 pandemic. METHODS AND MATERIALS: Demographic and state population data were extracted from the State Physician Workforce Reports published by the AAMC for the year 2018. A geospatial heat map of the United States was then constructed to illustrate the location of COVID-19 confirmed case counts and the distributions of ENTs over 60 years for each state. RESULTS: In 2018, out of a total of 9578 practicing U.S. ENT surgeons, 3081 were older than 60 years (32.2%). The states with the highest proportion of ENTs over 60 were Maine, Delaware, Hawaii, and Louisiana. The states with the highest ratios of confirmed COVID-19 cases to the number of total ENTs over 60 were New York, New Jersey, Massachusetts, and Michigan. CONCLUSIONS: Based on our models, New York, New Jersey, Massachusetts, and Michigan represent states where older ENTs may be the most susceptible to developing severe complications from nosocomial transmission of COVID-19 due to a combination of high COVID-19 case volumes and a high proportion of ENTs over 60 years.

Workforce analysis of practicing rhinologists in the united states.

OBJECTIVES: The objective of this study is to analyze the current rhinology workforce in the United States in terms of demographics, fellowship training, and regional distribution. METHODS: The American Rhinologic Society (ARS) member database was queried for workplace zip code, age, gender, and fellowship training of practicing U.S. rhinologists through 2017. The San Francisco Match data were examined for rhinology fellowships from 2006 through 2017. Each rhinologist was assigned to a specific hospital referral region (HRR) determined by the Dartmouth Healthcare Atlas to assess geographic distribution and market density. RESULTS: There were 296 ARS members self-identifying as rhinologists. Of those, 69.2% were fellowship-trained (FTR). The median age of FTRs and non-FTRs were 41 and 54 years, respectively (P < 0.001). Eighty percent of FTRs were male compared to 85.7% non-FTRs. Given the recent growth of rhinology fellowships, the number of FTRs is currently expanding at approximately 16% per year. HRRs with the most rhinologists were Los Angeles, Boston, and Manhattan, all with 14. Approximately 100 million people live in HRRs without a practicing rhinologist. A wide variation in rhinologist density was observed, ranging from 133,047 to 3,636,809 people per rhinologist, with a median of 747,864. CONCLUSION: There may be a need for rhinologists in select parts of the country. Whereas the ARS database is likely an underestimation of the growing workforce, under current training rates we could pass the ideal number of U.S. rhinologists within 5 years. LEVEL OF EVIDENCE: NA Laryngoscope, 130:1116-1121, 2020.

Cantidad y distribución de otorrinolaringólogos en los sectores público y privado de salud en Chile / Quantity and distribution of otolaryngologists in public and private health sectors in Chile

Introducción: Constantemente se menciona que existe un déficit de otorrinolaringólogos en Chile. Se desconoce la distribución entre el sector público y privado de salud. Objetivo: Determinar la cantidad y distribución de los otorrinolaringólogos que trabajan en el sector público y privado de salud en Chile. Material y método: Estudio de corte transversal para el que se usaron registros del Ministerio de Salud, Sociedad Chilena de Otorrinolaringología, Superintendencia de Salud y del Departamento de Estadísticas e Información en Salud. Resultados: Se aprecia que hay 152 especialistas que trabajan en el sector público, en contraste con los 405 totales del país, correspondiendo a 37,5% de los profesionales que trabajan en el sectorpúblico. Al evaluar el total de otorrinolaringólogos registrados a nivel nacionaly la población total se obtiene una relación de 1 otorrinolaringólogo/42.589 habitantes, mientras que la relación de otorrinolaringólogos que trabajan en sector público con población beneficiaria de FONASA es de 1 otorrinolaringólogo/85.162 habitantes. Discusión: El principal problema en Chile no es la cantidad de otorrinolaringólogos, sino su distribución, la que es muy asimétrica. Esto es considerando sólo el número de otorrinolaringólogos, no su carga horaria, ya que al evaluar esta relación probablemente la asimetría aumentaría aún más. Es necesario fomentar la permanencia de los especialistas en el sector público.

Introduction: Constantly there are mentions that there is a shortage of otolaryngologists in Chile. It is unknown the reality of the distribution between public and private health sector. Aim: The objective of this study was to determine the amount and distribution of otolaryngologists working in the public and private health sector in Chile. Material and method: A cross sectional study that used the records of the Ministry of Health, Chilean Society of Otolaryngology, Superintendent of Health, and Department of Health Statistics and Information. Results: There are 152 specialists working in the public sector, in contrast to the 405 total in the country, corresponding to 37,5(0)% of total professionals working in the public sector. In assessing the relationship between total otolaryngologists in the country with the total population, and otolaryngologists working in the public sector and the beneficiary population of FONASA, there is a relationship of 1 ORL/42.589 and 1 ORL/85.162 inhabitants, respectively. Discussion: The main problem in Chile is not the amount of otolaryngologists, but its distribution, which is very asymmetric between the private and public sector. It is necessary to promote the retention of specialists in the public sector.