Passing the ENT (Otolaryngology Written Boards)

ENT written

Preparation for the written Otolaryngology Boards starts with the beginning of your Otolaryngology training. Reading should become a daily routine. Pasha and K.J. Lee texts will help you to structure the framework of knowledge, and reading more comprehensive references (Cummings and Bailey’s) will fill in necessary details. Reading major Otolaryngology journals during residency also may allow you to master what may appear as “zebra questions” on the test. The exam is not very different from your annual in-service exam. Some questions may even overlap! The Home Study Course provides you with contemporary Otolaryngology articles and 50 questions per section, both of which are valuable resources for your preparation. What is provided in this course should be reviewed thoroughly during residency and at the time of Board preparation.

The Written Boards are 8 hours long and consist of 2 sets of 150 questions. Of these questions 100 are test questions that will not be used to grade the examinee. There is a less than an hour break between sections that may be longer if you finish your first section earlier than the allowed time. As you can see, the exam is very similar to the in-service.

The Otolaryngology topics are all important to master the Boards. The Highlights and Pearls chapter in K.J.Lee’s Essentials of Otolaryngology reviews high-yield topics for the test. Familiarize yourself with allergy testing and immunotherapy, including vial preparation, determination of appropriate dosing and management of anaphylaxis, as you may see several questions on this topic. Be prepared to answer hair restoration and surgical management of alopecia questions. Be aware of side-effects and mechanism of actions of common classes of drugs used in ENT including anesthetics, antibiotics, anti-emetics, and anti-reflux medication. Be aware of medications that affect the hearing and balance organs and their mechanism of action. Board freebies include questions on branchial cleft anomalies, syndromes, and head and neck cancer staging. Be familiar with audiograms. Be sure you can identify cranial nerve foramina, the vidian canal, the pterygopalatine fossa, the anterior and posterior ethmoid arteries, the carotid artery, and other exam-appropriate structures in the sinonasal cavity and anterior skull base on coronal and axial CT images. Make sure you know the arterial, nerve, and venous supply of free flaps used in head and neck reconstruction as well as donor site morbidities and indications for each flap. Be familiar with the pathologic appearance of common head and neck lesions, including lesions of the salivary glands. Parapharyngeal tumors, nasopharyngeal cancer, chemotherapy agents and setting (adjuvant, concurrent, and induction), sleep apnea (surgical options and longevity of results), airway fires, and academy guidelines are additional high yield topics. It is key to note that all topics are important.

Do not forget to do practice questions and to review the Home Study Course questions before the test. AcademyQ is an Apple Application provided by the Academy of Otolaryngology that consists of 500 questions. has several hundred questions online and a smaller set of questions available as a Mobile Application. “Otolaryngology and Facial Plastic Surgery Board Review: Pearls of Wisdom” is another reference with bullet point questions and answers that are very useful. There is a strong correlation with performance on these types of exams and the number of questions you take, so make sure to practice, practice, practice.

There are many valuable tools for Board preparation. Try to use as many as you can to prepare for the written exam. Stay calm, stay focused, and use the in-service preparation as a guide of how to prepare for the Boards!

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