ENT services in the UK are facing two fundamental challenges: the rising demand for services and the crisis in the ENT workforce. Against this backdrop, the problem is no longer how to expand services but how to adapt, through smarter workforce planning, smarter diagnostics and evolving therapeutic approaches. The plight of the ENT workforce has been a topic of discussion over recent years. At one end of the workforce crisis, attention has focused on increasing medical school places and on factors shaping medical student career choices.Reference Rehman, Gohari, Shafiq, Sarwar, May and Brennan1 Yet despite this increase in medical students, the British Medical Association survey 2025 recorded 52 per cent of Foundation Year 2 doctors had no job secured at the end of training.Reference Bowie2 At the other end, a substantial proportion of the workforce is approaching retirement, with many having already left during the coronavirus disease 2019 pandemic. This compounds the challenges of meeting the rising patient demand.
There is evidence that this ENT workforce crisis is not limited to the UK. Similar findings have been published in other countries, including North America and Canada.Reference Cottrell, You and Fung3 There has been a good deal of interest in trying to identify factors that influence the career choices of resident doctors, and the results are not surprising; career progression, geographical and family factors, on call and mentorship were commonly raised issues.Reference Ranta, Hussain and Gardiner4, Reference Mayer, Smith and Carrie5
This month’s issue brings ENT workforce planning into sharp focus. The shortages are not merely numerical, they have very real tangible consequences for ENT training across the UK, service resilience and timely provision of ENT care.
These workforce constraints can be a catalyst for change. Several articles in this issue emphasise the increasing role of diagnostic precision in improving efficient and effective management. Studies examining the radiological assessment of the styloid process, alongside evaluations of the diagnostic accuracy of nasal endoscopy compared with computed tomography and magnetic resonance imaging reflect a broader shift towards more targeted and evidence-based investigation.Reference Taskindere Abbasoglu, Gocmen and Firat6, Reference Lu, Gao, Wang, Wang and Xu7
Collectively, these studies suggest improving diagnostic pathways may help mitigate some of the pressures imposed by our limited workforce capacity.
Finally, rising demand and an insufficient medical workforce will inevitably result in prolonged waiting times and larger waiting lists. Unless this imbalance is addressed, the future of ENT is likely to be one of rising demand, longer waits and diminishing ability to deliver timely care.
ANN-LOUISE MCDERMOTT
JONATHAN FISHMAN
STEPHEN JONES
Senior Editors
