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BACKGROUND AND OBJECTIVE: There is great heterogeneity in the methodology and evaluation in specialized health training (SHT) in otorhinolaryngology in our country. The figure of the resident tutor is the cornerstone on which the ESF system is based and the regulation and recognition of this figure varies. This article aims to take a snapshot of the current situation of the ESF in Spain and to describe the activity of tutors. MATERIALS AND METHODS: During the month of September 2023, a survey was sent in a Google Forms® format through the Spanish Society of Otolaryngology and Head and Neck Surgery. The survey consisted of 8 multiple-choice questions and 4 questions in which they were asked to rank a series of 5 weaknesses, threats, opportunities and strengths selected by the authors, in order to perform a SWOT analysis. RESULTS: A total of 103 responses were obtained, of which 81 corresponded to accredited tutors. 63% of the tutors indicated that they did not have enough time to carry out their teaching work and 48% did not carry out a regular assessment of their residents. 64% of the tutors believe that the quality of otorhinolaryngology training in Spain is good and 61% are satisfied with their job as tutors. The main weakness was the short duration of the training programme, and the pressure of care was found to be the main threat. An experienced training system was considered the main strength and the creation of a national network of tutors was seen as an opportunity for improvement. CONCLUSIONS: The creation of a common and transversal otorhinolaryngology training pathway for all accredited centres and the creation of a network of mentors and residents are necessary to address the problems of SHT. The role of the tutor must be recognised and reinforced to improve specialist training.
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Introducción, objetivos y métodos: El organismo humano está relativamente bien adaptado a los cambios de presión a los que se somete durante las actividades aeronáuticas e, incluso, las subacuáticas. Pequeñas alteraciones anatómicas o funcionales que no constituyen un problema a una presión atmosférica habitual, pueden originar complicaciones al someter al organismo a medios hipobáricoshiperbáricos. El objetivo de este capítulo es hacer una revisión de los criterios de aptitud en la legislación vigente, valorar las contraindicaciones para la práctica de buceo o actividades aeronáuticas y repasar las exploraciones necesarias en el área otorrinolaringológica (ORL) que permitan detectar procesos patológicos. Resultados: La valoración anatómica y funcional ORL nos permite descartar candidatos con distintas alteraciones que contraindican la práctica de estas actividades. No está tan claro cómo explorar las alteraciones funcionales y si hay relación entre los hallazgos y la posibilidad de aparición de complicaciones. La legislación vigente es poco clara en las actividades subacuáticas. Contraindica la actividad en personas con afectaciones que pruebas científicas recientes muestran que podrían ser aptas. La legislación en cuanto a pilotos y tripulantes de cabina de pasajeros de aeronaves comerciales estipula perfectamente las revisiones que se deben realizar, así como las contraindicaciones para la concesión de certificados de aptitud. Conclusiones: Es necesario realizar reconocimientos médicos en las personas que se someten a cambios de presión. En el área ORL, las exploraciones permiten hacer una buena valoración de los posibles problemas que pueden aparecer en los distintos candidatos (AU)
Introduction, objectives and methods. The human body is relatively well adapted to the pressure changes experienced during flying and even diving. Small anatomical or functional alterations that would not cause problems at a normal atmospheric pressure can cause complications when the body is subjected to hypobaric-hyperbaric environments. The present article aims to provide a review of the criteria for fitness to dive or fly according to current legislation, to evaluate the contraindications for the practice of diving or flying, and to describe the otorhinolaryngological (ORL) examinations that allow abnormalities to be detected. Results. Anatomical and functional ORL examination allows candidates with various alterations that contraindicate the practice of these activities to be excluded. Less clear are the methods for examining functional alterations and whether there is a relationship between these findings and the possible development of complications. Current legislation on diving is unclear. Subaquatic activities are contraindicated in persons with certain alterations, although recent scientific tests show that they may be fit to dive. Legislation on the pilots and cabin crews of commercial airplanes stipulate the examinations that should be performed as well as the contraindications for issuing certificates of fitness to fly. Conclusions. Medical examinations should be performed in persons undergoing changes in atmospheric pressure. ORL examinations allow the possible problems that may develop in distinct candidates to be thoroughly evaluated (AU)
