Aims This presentation summarises the outputs of a Masters of Philosophy project. Otoscopy remains central to otological diagnosis, yet accuracy varies with experience. Tympanostomy tube (TT, grommet) checks are often performed by junior clinicians, but their reliability in identifying TT status and complications is poorly characterised, risking delayed or unnecessary repeat reviews. This study examines discrepancies between non-expert and otolaryngologist otoscopy assessments of OME and TT status. Methodology A systematic review was conducted in accordance with PRISMA guidelines (PROSPERO: 1080108) evaluating diagnostic accuracy of non-expert otoscopy vs ENT surgeons. Studies from 2000 onward were included. In addition, an experimental study was undertaken to assess grommet evaluation accuracy: 10 junior doctors and 10 otolaryngologists independently completed an online quiz of 50 anonymised otoscopic images depicting TT outcomes (in situ-patent, in situ-blocked, extruded). Accuracy, sensitivity, and inter-rater agreement were compared. Both groups repeated the quiz with corresponding tympanometry data to assess improvement with additional information. Results Nine studies met inclusion criteria. Non-experts showed lower diagnostic accuracy (39-92%) than otolaryngologists (61-90%). Meta-analysis revealed no statistically significant difference, though sensitivity was lower for non-experts (95% CI 0.51-0.81) than experts (0.72-0.88). Inter-rater reliability among experts was moderate (κ≈0.5), indicating subjectivity in otoscopy. In the experimental study, otolaryngologists achieved mean accuracy of X% (SD Z%) vs Y% (SD T%) for juniors. Sensitivity for detecting TT complications was Z% vs W%. Accuracy improved with tympanometry data. Conclusion Non-experts demonstrate reduced accuracy in otoscopic diagnosis, particularly for TT assessment. Structured otoscopy training and image-based learning may improve diagnostic reliability and patient safety in postoperative ear care.