My Letter To The Curriculum Development Fellow In Ireland

I have recently written to Karena Hanley the National Director of GP Training in Ireland, to request that GP’s cover the inner ear and vestibular disorders in more depth. Please read my letter and her response below:


Dear Curriculum Development Fellow,

I am writing in relation to a debilitating inner ear virus called ‘Labyrinthitis’. It is estimated that in Ireland alone 1 in 10 people have been diagnosed by General Practitioners with Labyrinthitis. Of those 1 in 10 sufferers, 30% will suffer with chronic inner ear dysfunction, due to damage of the Labyrinth or Vestibular nerve, as a direct result of the virus. Typically Labyrinthitis clears up as quickly as it starts within 2-6 weeks. However for chronic sufferers there is no end point without correct treatment. This is where General Practitioners fail these individuals. The nature of the illness means that symptoms include chronic fatigue, anxiety, trouble concentrating, slight memory loss and many sufferers report experiencing depression. Due to General Practitioners’ lack of knowledge regarding these chronic symptoms, sufferers can be given an incorrect diagnosis, no diagnosis at all or be prescribed medication which they do not need, all of which prolong recovery and waste valuable resources. To correctly diagnose this illness; without basing a diagnosis on subjective description of symptoms, sufferers must attend an Audiologist to directly assess the damage to the inner ear through a range of balance and caloric tests. To recover from this illness individuals need to attend Vestibular Rehabilitation Therapy with a trained Physiotherapist.

Unfortunately for thousands or sufferers in Ireland; and millions worldwide, this information is not taught to GP’s’, therefore they have no knowledge of the chronic nature of Labyrinthitis. People are suffering unnecessarily for prolonged periods of time, sometimes years or decades, for absolutely no reason. The professional help is available but because GP’s are usually the first port of call in western countries, and they are not equipped with the knowledge of where they need to direct sufferers, this illness is left untreated or incorrectly treated.

I am requesting that you review how inner ear illness is taught to General Practitioners as a matter of urgency.

I appreciate you taking the time to read my letter and I look forward to hearing from you soon.

Kind Regards,

Marian Groome (BSC Psych (Hons), PTA)

Karena’s Response:

Hello Marian,

As National Director of GP Training, your email today has been passed to me. I will be the line manager of the curriculum fellow we are in the process of recruiting. May I assure you you are preaching to the converted. I took an interest in vestibular disorders early in my career. I completed a research thesis on vertigo in 2000 and have been the main contributor to current medical textbook knowledge of the causes of vertigo when it occurs in the community.

I completely agree that vertigo is poorly addressed by the medical community. I believe that it is just as poorly understood in hospitals as in General Practice.

I do not agree that it is necessary to attend an audiologist to ascertain the diagnosis, I believe hugely in good history taking.

I completely agree we need more access to vestibular rehabilitation.

I have worked ceaselessly for almost 20 years now, writing articles, providing a special interest service, giving workshops, to improve the understanding of vestibular disorders.

I can assure you it is already an item on the core curriculum for General Practice. Unfortunately it competes with about 800 other items which a GP has to know.

However I will keep an eye on the evolution of the core curriculum to ensure vestibular disorders retain a prominent place.

I am also happy to work with you in other ways, as appropriate, apart from my National Post to raise awareness of this distressing condition and means to alleviate the symptoms.

 With Regards

Karena Hanley

Dr. Karena Hanley

National Director of GP Training,

Irish College of General Practitioners.

4/5 Lincoln Place,

Dublin 2


Tel   00353 1 6763705