Awareness of dyslexia and its challenges in ENT training may enhance support for future trainees and trainers alike.
Receiving a diagnosis of dyslexia or neurodivergence can be daunting, especially for a resident doctor with aspirations to pursue an ENT career. This article details experiences of four neurodivergent ENT consultants who discuss the impact on higher surgical training and early consultant life.
Max Osborne, BSc (hons), MBChB, MRCS, MAcadMEd, FRCS (ORL-HNS), PhD,
Consultant, Department of Otolaryngology, The Dudley Group NHS Foundation Trust , UK.
When were you diagnosed with dyslexia?
I was diagnosed at 11 years old. I struggled at school and was made an example of how not do to things; constantly told that I was stupid. The diagnosis was accompanied with an intelligence test which revealed my potential. This was a turning point for me. I was given support and vastly improved as a student.
How has being dyslexic impacted your training?
My biggest challenges were the Membership of the Royal Colleges of Surgeons (MRCS) and Fellowship of the Royal Colleges of Surgeons (FRCS) written exams, which each took four attempts. The FRCS multiple choice questions paper (MCQ) took its toll on myself, my family and my work, taking two years to pass. Around this time, my son was born and the exam preparation took me away from his early years, which is time that I can’t get back. I felt as though the difficulties faced with this exam defined me and I became known as the trainee who wasn’t passing the FRCS.
What are the challenges you experienced through your training due to dyslexia?
I found writing the operation notes stressful; creating operation note templates with my supervisor allowed me to understand the important steps in a procedure, and was less stressful. I still use many of these templates today.
What are the benefits you’ve experienced from being dyslexic in the workplace?
Being dyslexic organises my mind differently. It improves spatial awareness and visual learning, which is great for operating. I can often find novel ways to solve a problem, beneficial for service improvement projects, time management and how I perceive and analyse data in research.
Do you think there is room for better support for ENT surgical trainees?
Absolutely! Currently there is little awareness and understanding for individuals who struggle with MCQ. Dedicated, focused support needs to be formally developed. You’re entitled to reasonable adjustments for the exams. Ask for them early, don’t wait to fail and then seek help. The professional support unit can also provide input.
Prof Bindy Sahota, MBChB, DoHNS (Eng.), MD, FRCS (ORL-HNS),
Professor of Head and Neck Cancer, University of Derby, Consultant Head and Neck/ENT Surgeon, University Hospitals of Derby & Burton NHS Foundation Trust, UK.
When were you diagnosed with dyslexia?
Aged 29. During my MD research journal club, it would take me four hours to process a paper, whilst others only took 30 minutes. This was a pivotal moment for me and prompted me to seek a diagnosis.
How has being dyslexic impacted your training?
I failed the MRCS three times, and this cost me around £8000. The financial hit was enough for me to never want to repeat the experience. For the FRCS, I was determined to pass first time. I approached the exam in a way that suited my dyslexia: mind-maps, colour-coded notes and videos. This led me to pass first time and as the gold medallist.
What are the challenges you experienced through your training due to dyslexia?
Writing in full sentences is often challenging, so using bullet points is more practical for me, and writing important points in capital letters helps me focus on the salient points.
What are the benefits you’ve experienced from being dyslexic in the workplace?
In the surgical field, I’ve found that my visual 3D appreciation and spatial awareness of moving objects are better than those of my neurotypical peers. I also believe that my dyslexia has enhanced my communication skills with patients.
Do you think there is room for better support for ENT surgical trainees?
It is crucial to identify neurodivergent trainees early to provide the right support. Support needs to be visible and readily available, and efforts made to reduce stigma. There are alternate ways to learn besides through a book. Acland’s Video Anatomy Atlas, podcasts and other videos can be beneficial.
Anonymous ENT consultant.
When were you diagnosed with dyslexia?
I was diagnosed with dyslexia and ADD aged 23. Since becoming a consultant, whilst a few colleagues know that I’m dyslexic I have not shared that I have ADD.
What are the challenges you experienced through your training due to dyslexia?
I would forget verbal instructions quickly (working memory) and trainers would sometimes comment on my need to write everything down. I would verbalise my thoughts, which sometimes came across as blunt to others. Clinically, writing letters took a long time and there were often spelling mistakes, even though I had checked it three times. When I noticed the mistakes, my self-loathing could be intense.
What are the benefits you’ve experienced from being dyslexic in the workplace?
I’m used to working harder than others so, in general, long hours don’t phase me. I can think laterally. I can formulate good research questions and make connections between data that others don’t.
Do you think there is room for better support for ENT surgical trainees?
Yes. I would highly recommend coaching because, very simply, your brain is wired differently.
Lulu Ritchie, BSc, MBChB, MRCS, FRCS (ORL-HNS), MD,
ENT Consultant, St Georges Hospital, UK.
When were you diagnosed with dyslexia?
I was diagnosed at medical school.
How has being dyslexic impacted your training?
I had to be more fastidious about looking after myself. If I don’t eat healthily or get enough sleep, it affects how I perform. Clinical work such as letters, test results and prescribing require extra concentration and time to avoid mistakes, which can be tiring.
For the FRCS, I approached it with military precision and fortunately passed first time. I sought mentorship from Mr Max Osborne on how to approach the exam, as he had created a course aimed at dyslexic trainees taking the FRCS.
What are the benefits you’ve experienced from being dyslexic in the workplace?
I’m sure that there have been benefits but I have worked very hard to get to where I am now.
Do you think there is room for better support for ENT surgical trainees?
Yes. Colleagues and I have already identified a gap in support and so we are setting up a society for neurodivergent ENT trainees.
My thoughts
Dyslexia impacts individuals in a variety of ways. However, there are beneficial traits including 3D awareness, big-picture thinking and narrative reasoning [1]. For many dyslexic and neurodivergent trainees, the risks of burnout, anxiety, depression and imposter syndrome are higher than those faced by neurotypical trainees [2]. Dyslexia is not a barrier to success if appropriate support and a wider understanding is fostered. Should you be affected by neurodiversity in your training and you would like a copy of a free support sheet, please contact the ENT Dyslexic Network at: ENTdyslexia@gmail.com. For informal, peer support, there is a private Facebook group: Association of Neurodivergent Doctors.
References
1. Cole C. Strengths of dyslexia. Dyslexia Support South.
https://www.dyslexiasupportsouth.org.nz/
parent-toolkit/emotional-impact/strengths-of-dyslexia/
[Link last accessed April 2025].
2. Shaw SC, Anderson JL. The experiences of medical students with dyslexia: An interpretive phenomenological study. Dyslexia 2018;24(3):220–33.
Declaration of competing interests: None declared.
