FFinalistSouthampton · 2027
All procedures
GMC #04/Assessment of patient needs taught ENT / clinical skills

Otoscopy

Perform basic otoscopy and identify common abnormalities.

Target · Perform independently0% ready

Do it yourself on a patient, with support available if you need it — the GMC’s highest new-grad level (“indirect supervision”).

Overview

Examination of the external canal and tympanic membrane, often paired with hearing tests (whisper test + Rinne & Weber tuning-fork tests). GMC-required. No dedicated Southampton resource folder was archived — a materials gap (likely taught within ENT/clinical-skills teaching).

Key numbers

  • Use a 512 Hz tuning fork for Rinne & Weber (mid-range — audible yet decays slowly)ENT UK / clinical practice
  • Weber lateralises to the affected ear = conductive; away = sensorineural. Rinne: air>bone = normalENT UK
No dedicated Southampton resource was archived for this GMC-required skill — a materials gap to fill. External guide linked below.

Indications

  • Otalgia (ear pain)
  • Otorrhoea (discharge)
  • Hearing loss
  • Suspected foreign body / wax

Equipment

Otoscope (working light)Disposable specula — choose the **largest** that comfortably fits512 Hz tuning fork (for Rinne & Weber)

Step by step

Otoscopy
  1. 1Inspect the pinna and around the ear first (skin, mastoid)
  2. 2Examine the *normal* (or less symptomatic) ear first
  3. 3Pull the pinna up and back in adults (down and back in young children) to straighten the canal
  4. 4Hold the otoscope like a pen, bracing your hand against the cheek to avoid trauma if the patient moves
  5. 5Inspect the canal (wax, discharge, otitis externa) then the tympanic membrane
Identify the TM
  1. 1Normal TM: pearly-grey, translucent, cone of light antero-inferiorly, handle of malleus
  2. 2Acute otitis media: red/bulging TM, loss of light reflex
  3. 3Effusion (glue ear): dull TM ± fluid level/bubbles
  4. 4Perforation; cholesteatoma (attic crust)
Hearing tests
  1. 1Whisper test: mask the other ear (rub the tragus), whisper a number ~60 cm away and ask them to repeat it
  2. 2Weber: strike a 512 Hz fork, place on the forehead midline — lateralises to the affected ear in conductive loss, away from it in sensorineural loss
  3. 3Rinne: fork on mastoid (bone) then at the meatus (air) — air > bone = normal (“Rinne positive”); bone > air suggests conductive loss

Complications

  • Trauma to the canal/TM if the patient moves — hence bracing the hand

OSCE tips

  • Bracing hand + “largest speculum that fits” = key safety/technique marks.
  • Pinna direction differs in children — say it.
  • Interpret Weber + Rinne together — never one alone.

Read

Otoscopy (ear examination) — OSCE GuideGeeky Medics

Sources & credits

Authored to UK finals standard and verified against UK guidance (ENT UK) and Geeky Medics OSCE guides . Southampton teaching materials © University of Southampton. Always follow current local policy.