Real-life story - Dr Victor Osei-Lah

Audiovestibular medicine appealed to me as it is quite closely related to ENT surgery, and I wanted a specialty with a good work-life balance. There is no on-call commitment at all in this job. Although I had progressed quite a long way into a career in ENT surgery, I had to start training again in my new specialty. However I was certain I was making the right decision.

My job involves the diagnosis of hearing and balance disorders. I work with patients of all ages, including babies and children as well as adults and elderly people. One important part of my job involves being the medical lead for the Portsmouth and Isle of Wight Newborn Hearing Screening Programme.

Every baby born in the UK is routinely screened for hearing problems at or within four weeks of birth. If any problems are detected detailed testing is done by the audiologist. Babies with a confirmed permanent hearing loss are referred to me, and it’s my role to explore any underlying medical cause.

There are many reasons why babies have hearing loss and I undertake an initial history and examination to guide appropriate investigations. The investigations may include genetic testing, blood tests, CT and/ or MRI scans. I work closely with other specialists as part of a multidisciplinary team, which includes paediatricians, clinical geneticists, ENT surgeons and cardiologists.

Helping parents to accept that their child has hearing loss and encouraging them to accept treatment where possible is also part of my job. So there is an element of counselling.

Adults who are referred to me often have dizziness or balance problems, and may have been suffering for some years without an adequate diagnosis. I assess new patients using a variety of clinical examinations to determine the cause of their dizziness. For many patients the cause is an inner ear disturbance, for others something quite different such as migraine. I sometimes refer patients for further assessment by a neurologist. I also see children who suffer with dizziness.

Treatment can range from suitable medication to rehabilitation exercises that help the patient overcome their dizziness. I often refer patients to a physiotherapist who can help patients learn the exercises properly.

The other main part of my job is seeing adults with hearing loss. I investigate the underlying medical problems that may be the cause of their hearing loss, which can be very wide-ranging and include immunological problems.

Keeping up with my own professional development is an important part of my job as a consultant. As well as reading and reviewing research journals I attend and make presentations conferences.

Audiovestibular medicine is a very small speciality, and here at Portsmouth I don’t have any trainees to supervise. This would be different if I was working in London or Manchester, where most of the trainees are.

My job is extremely rewarding as I can often make a significant difference to patients’ lives, particularly those who have suffered from debilitating dizziness for many years. I am normally able to reassure patients that their condition is treatable, which is sometimes a surprise to them.

The main challenge in my job is fitting everything into the working day! I generally have seven outpatients’ clinics each week, which occupy a morning or afternoon session. New patients are allocated an appointment lasting 30 minutes and follow-ups are 15 minutes. If I am seeing new patients I usually see around six or seven in one clinic. Patients with dizziness often have quite complex problems, meaning it can be quite difficult to complete an assessment and diagnosis in the allocated time. My days are very busy, and I often work through my lunch break checking emails, writing letters and making phone calls. 

I am really happy in my job here at Portsmouth and have no plans to change. It is always important to strive to become even better, and I will take any opportunity to further develop my skills. At present we are doing some research into treatments for tinnitus with a pharmaceutical company. In the future I would like to do more research.

Top tips

• contact your local audiovestibular medicine department to arrange a taster visit, where you can sit in on a clinic and find out more about the work
• attend the British Association of Audiovestibular Physicians (BAAP) events such as the Annula conference, the Hallpike Symposium and national audit meetings