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Home » Training & Assessment » Curriculum » Clinical Chapters » ENT, Oral and Facial Health

ENT, Oral and Facial Health

ENT, Oral and Facial Health (EN)

  • Ear, nose, throat (ENT), oral, and facial problems are commonly encountered in general practice(1) and span all age groups, from childhood to older age. These conditions range from acute infections such as otitis media and tonsillitis, to chronic issues like rhinosinusitis, hearing loss, tinnitus, and temporomandibular joint (TMJ) dysfunction. GPs are often the first point of contact for patients presenting with symptoms such as sore throat, earache, facial pain, hoarseness, and oral lesions; some of which may signal serious or underlying pathology. 

    Effective management of ENT, oral, and facial conditions in primary care relies on strong clinical examination skills, the appropriate use of investigations, and knowledge of when to refer. GPs also play a key role in early detection of red flag symptoms for head and neck cancers, ensuring timely referral via urgent pathways when necessary. Understanding the impact of these conditions on communication, quality of life, and overall wellbeing is essential to providing holistic care. 

    • EN1. Diagnose a wide range of acute and chronic Ears, Nose and Throat, Oral, and Facial conditions, considering the impact of systemic diseases, psychological factors, and other comorbidities.
    • EN2. Diagnose common and serious Ears Nose and Throat, Oral, and Facial conditions, recognising normal variations, avoiding unnecessary interventions, and providing appropriate patient education and support.
    • EN3. Identify potential head and neck cancers, understanding risk factors, red flag symptoms, early detection, and utilising appropriate referral pathways.
    • EN4. Assess balance disorders, ensuring accurate evaluation, diagnosis and management.
    • EN5. Empower patients with self-management strategies for chronic Ears Nose and Throat conditions.
    • EN6. Assess hearing loss, differentiating between sensorineural and conductive hearing loss, recognising red flag symptoms and understanding the implications for diagnosis and management.
    • EN7. Demonstrate a patient-centred and empathetic approach to managing Ears Nose and Throat, Oral, and Facial conditions, particularly for patients with chronic or difficult-to-manage symptoms such as tinnitus, hearing loss or vertigo.
    • EN8. Provide culturally sensitive and inclusive care for patients with hearing impairments, addressing communication barriers and advocating for their needs.
    • EN9. Coordinate care for patients with Ears Nose and Throat, Oral, and Facial conditions, including timely referrals to specialist services and community resources such as audiologists and speech therapists.
    • EN10. Recognise the potential impact of Ears Nose and Throat conditions on overall health and development, particularly in children including the effects of glue ear and obstructive sleep apnoea on speech learning and behaviour.

    For each problem or disease, consider the following areas within the general context of primary care:  

    • The natural history of the condition, including whether acute or chronic
    • The incidence and prevalence, including in different demographic groups
    • Typical and atypical presentations
    • Recognition of normal variations throughout life
    • Risk factors, including lifestyle, socio-economic and genetic factors
    • Diagnostic features and differential diagnosis
    • Recognition of ‘alarm’ or ‘red flag’ features
    • Appropriate and relevant investigations
    • Interpretation of test results
    • Management, including initial and continuing care, chronic disease monitoring and emergency care
    • Patient and carer information and education
    • Prognosis

    Signs, Symptoms & Presentations

    • Aural Discharge
    • Cough
    • Deafness
    • Earache
    • Epistaxis
    • Head and Neck Lumps
    • Hoarseness
    • Jaw Pain
    • Nasal Obstruction
    • Normal Lymph Nodes
    • Rhinitis
    • Salivation Problems
    • Sleep Apnoea
    • Smell and taste disturbance
    • Snoring
    • Sore Mouth
    • Sore Throat
    • Sudden Hearing Loss
    • Tinnitus
    • Vertigo

    Common and Important Conditions

    • Cranial Nerve Disorders - Facial Nerve/ Trigeminal
    • Head and neck cancers
    • Laryngitis
    • Mastoiditis
    • Otitis Externa
    • Otitis Media
    • Perforation of Eardrum
    • Rhinitis
    • Salivary Gland Disorders
    • Sinusitis
    • Tonsillitis
    • Vertigo
    • Wax impaction

  • Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

    Self-Directed 

    Blended Learning Resources (Education Platform)

    Essential ENT for GP

    Workplace Based Learning

    Workplace-based learning provides rich opportunities to develop practical skills and clinical confidence in managing ENT, oral, and facial problems. In general practice, trainees regularly encounter a wide range of presentations, including ear infections, sore throats, nasal congestion, dizziness, and oral lesions. Through supervised consultations, trainees refine examination techniques such as otoscopy, throat and nasal inspection, and assessment of neck lumps or facial pain. Case-based discussions and feedback from experienced GPs help reinforce diagnostic reasoning, appropriate use of antibiotics, and recognition of red flag symptoms requiring urgent referral. Some trainees will gain exposure to ENT rotations in the hospital where they should aim to get exposure to minor procedures; such as ear syringing, nasal cautery, management of nasal fractures or managing peritonsillar abscesses.

    Day Release

    Day release teaching offers a valuable opportunity to explore ENT, oral, and facial conditions in a structured and interactive environment. Using case-based discussions, guideline reviews, and clinical reasoning exercises, trainees can deepen their understanding of common presentations such as otitis media, sinusitis, tonsillitis, tinnitus, vertigo, and oral ulcers. Sessions can also focus on recognising red flag symptoms for head and neck cancers and refining decision-making around when to refer. Practical workshops or peer-led demonstrations (such as otoscopy technique or cranial nerve examination) can further enhance clinical skills. These sessions encourage reflective practice, collaborative learning, and the application of evidence-based care in the community setting.

    Registrar Tutorials

    Registrar tutorials provide an ideal forum for focused, case-based learning on ENT, oral, and facial conditions commonly seen in general practice. These sessions can cover both acute and chronic presentations, such as sore throats, ear pain, hearing loss, sinusitis, vertigo, and oral lesions, as well as important red flag symptoms indicating potential malignancy. Tutorials are well suited for reviewing examination techniques, exploring NICE or Irish College of GP’s guidelines, and discussing referral criteria to ENT or maxillofacial services. These sessions also offer valuable space to reflect on clinical uncertainty and improve decision-making in a primary care setting.

  • Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

    The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

    The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

     EPA 9: Manage the care of adults, including older people with acute presentations

    A patient presenting with persistent hoarseness and weight loss provides an opportunity to demonstrate EPA 9. If the GP Trainer observes the consultation and examination, including assessment for red flag symptoms of head and neck cancer and planning urgent referral, a PIP-C and PIP-P can be used to assess diagnostic reasoning and clear safety netting. A succinct case entry could be: “assessment of persistent hoarseness with red flags.” Reflection should explore early cancer detection, effective communication about serious diagnoses, and documentation of referral pathways.

    Core Knowledge Test (CKT)

    • Management of acute otitis externa.
    • Investigation of persistent hoarseness.
    • Red flag features for urgent ENT referral.

    Clinical Competency Test (CCT)

    • A smoker presents with a lesion under their tongue.
    • A patient presenting with right sided tinnitus.
    • A patient gets recurrent bouts of sinusitis and wishes to get some advice. 

    Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

    Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

    The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

    Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.

  • 1.  Ang JSJ, Tse E, Chan SW. The management of ear, nose, and throat (ENT) conditions in an Australian general practice. Australian Journal of Otolaryngology [Internet]. 2024 Aug 31 [cited 2025 Aug 18];7(0). Available from: https://www.theajo.com/article/view/4766