Education and training
Training in audiovestibular medicine (AVM) is regulated by the Specialty Advisory Committee for Audiovestibular Medicine within the Joint Royal Colleges of Physicians Training Board. There are few posts below specialty trainee level in AVM and accordingly most trainees have little prior knowledge of the specialty. Entry into AVM training is possible following successful completion of both a foundation programme and core training programme (core medical training, acute care common stem – acute medicine, general practice training or level 1 paediatric training). Entry is also possible for trainees in otolaryngology who have obtained MRCS (ENT) or MRCS plus DOHNS (Diploma in Otolaryngology – Head and Neck Surgery). Only two deaneries, the London and the North Western Deanery, offer training in audiovestibular medicine. The curriculum is regularly reviewed. The trainees are expected to do part of an MSc in audiology, covering basic auditory and vestibular science. There is a monthly educational day for all AVM trainees, which is video-linked to facilitate attendance and reduce time and cost in travel.
Many audiovestibular consultants provide a single-handed service. The development of regional specialty groups, which provide peer review and audit as well as education, is a necessity to support continuing professional development (CPD) leading to improved clinical practice.
The British Association of Audiovestibular Physicians (BAAP) holds a number of yearly educational meetings to provide specialty relevant CPD; the annual conference, the Hallpike symposium and the national audit meeting.
Audiovestibular physicians also take part in other professional educational meetings providing CDP. Examples include the:
- Bárány Society
- British Association of Paediatricians in Audiology
- British Society of Neuro-Otology
- British Society of Audiology
- British Academy of Audiology
- American Academy of Audiology
- International Association of Physicians in Audiology.
A full-time consultant should ideally have a minimum of two PAs to fulfil CPD requirements.
All audiovestibular physicians are involved in education, training and supervision of specialty trainees (STs), which is crucial to provide them with adequate experience and confidence. Many consultants are also involved in undergraduate teaching. Audiovestibular physicians are also actively involved in education and training of the multidisciplinary team as well as junior doctors, STs and consultants from other medical specialties, eg GPs, ear nose and throat surgeons, geriatricians, neurologists and paediatricians.
Audiovestibular physicians are major participants in national educational programmes to drive up standards of care/services for hearing and balance disorders. The dizziness course, the paediatric vestibular course and the aetiological investigations for hearing loss in children courses have set excellent standards of education for the whole multidisciplinary team.
AV physicians provide advice to allied health professionals in development of their standards and have recently offered support and guidance to audiologists in formulation of their curriculum as part of modernising scientific careers.
The Academy of Medical Royal Colleges (AoMRC) has produced a cost of training document setting out the mandatory costs of training involved in college enrolment fees, examination costs and GMC fees. Published in October 2017, it has been compiled to help pre-specialty doctors make fully informed career selections, with a clear understanding of the mandatory costs of their future training pathway.