Mbarara ENT Faculty Rotation – Rhinology/Sinus Surgery Module

March 10-14, 2014

Dr. Eric Holbrook led the second faculty visit to Mbarara District Regional Referral Hospital (MRRH) in southwestern Uganda, focusing on improving competency in Rhinology/Sinus Surgery.  Over the course of the week, Dr. Holbrook worked with the ENT residents, overseeing improvements in clinical diagnostic capabilities, giving didactic lectures, and teaching Rhinology-concentrated surgical skills.

Holbrook 1

Dr. Eric Holbrook with Drs. Doreen Nakku and Milanes Pompa in the MRRH ENT outpatient clinic

The trip served as a continuation of the existing partnership between Mass Eye and Ear and the ENT Faculty at Mbarara University of Science and Technology to augment the ENT post-graduate program, one of only two in the country.  Dr. Doreen Nakku, the Head of the Department, had recently returned from an observorship with Dr. Brian Westerberg at UBC.  There she had the opportunity to increase her exposure to subspecialty training in otology and participate in a temporal bone course.

A theme of these faculty visits, thus far, has been the introduction of new clinical diagnostic techniques that take advantage of equipment previously donated but currently underutilized. In November, it was the use of flexible endoscopy for laryngeal examinations and, in March, the introduction of rigid endoscopy for sinus.  Use of rigid endoscopy during clinic has the added benefit of providing residents the necessary opportunity to hone techniques required for FESS.

As with previous faculty insertion, residents were given topic-related pre- and post-intervention clinical OSATs (rigid endoscopy) and mock oral examinations.  The data that has resulted from these assessments has been promising thus far and has contributed to ideas of how to better the program for future faculty rotations.


MUST/MRRH ENT Department: Drs. Jamilah Nabukenya, Esther Nakasagga, Doreen Nakku, and Victoria Nyaiterra

As part of an attempt to become better integrated with program and cause fewer disruptions to the hospital, operating time was limited to the assigned day for ENT.  As the program matures, it is hoped that it becomes further integrated in the curriculum framework and dialogue has begun with MRRH administrators to improve communications for future visits.

For future consideration:

  • Radiology modules on CT scan reading
  • Journal club
  • Refinement of outpatient data collection
  • June and November faculty rotations

Our thanks, as always, to Drs. Doreen Nakku and Pompa Milanes for their partnership and the surgical and anesthesia team led by Dr. Stephen Ttendo. 


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