PGY-1 (Otolarynlology Internship)
During Internship, residents will rotate with general surgery, plastic surgery, pediatric surgery, neurosurgery, surgical intensive care, and anesthesia for the first six months. During this time, the PGY-1 resident will assess, plan and initiate treatment of adult and pediatric patients with surgical and/or medical problems. They will care for patients of all ages with surgical and medical emergencies, multiple organ system trauma, soft tissue wounds, nervous system injuries and diseases, and peripheral vascular and thoracic injuries. They will care for critically-ill surgical and medical patients in the ICU and emergency room setting. They will participate in the pre-, intra-, and post-operative care of surgical patients. They will participate in surgical anesthesia in hospital, including evaluation of anesthetic risks and management of intra-operative anesthetic complications. Activities will foster proficiency in the peri-operative care of surgical patients, inter-disciplinary care coordination, and airway management skills. The latter six months of internship will be spent on otolaryngology-head & neck surgery under the supervision of the Otolaryngology Faculty. It is expected that they will develop basic surgical skills, as well as skills in the inpatient and outpatient management of surgical patients pre-, intra-, and post-operatively. Residents will also be expected to differentiate between emergent and non-emergent situations. They will learn to manage otolaryngology patients in the emergency department. They will cultivate their otolaryngology knowledge base.
The OTO-2 house officer will become a full-time member of the otolaryngology service. The otolaryngology service is divided into 4 separate subspecialty teams:
- Team 1: Head & Neck Surgery & Microvascular Head/Neck Reconstruction
- Team 2: Otology & General Otolaryngology
- Team 3: Pediatric Otolaryngology & General Otolaryngology The OTO-2 house officer will spend 6 months on Team 2 and 6 months on Team 3. The weekly schedule will consist of 2-3 days of OR and 2-3 days of outpatient clinic. In addition, the resident will provide care on the wards and ICU for the inpatients on the UMC otolaryngology service. The resident will also attend all of the scheduled conferences during the week. The OTO-2 residents will rotate with OTO-4 and OTO-3 residents for junior level call duty at UMC Medical Center. All calls will be taken from home.
Following a year of Otolaryngology experience, the OTO-3 resident will now be able to incorporate and supplement those clinical experiences with 6 months of selective/elective rotations. Two of the required selectives are Plastic surgery for a duration of 2 months and Allergy/Immunology for one month. The remaining months will be spent on Neuro-radiology, Head & Neck Pathology, and Oral-Maxillofacial Surgery. The OTO-3 resident will also spend the remainder of the 5 months as the junior resident on the head/neck surgery service (Team 1). He/she will have extensive experience assisting in complicated head and neck surgery such as neck dissection, laryngectomy, maxillectomy, thyroidectomy, and craniofacial resections. The resident will also gain experience as primary surgeon in the common otolaryngology surgeries, such as tracheostomy, septoplasty, various aerodigestive endoscopic evaluations and sinus surgery. During the OTO-3 year, the resident will assume home-call for otolaryngology coverage of the UMC Emergency Department and in-hospital consults ranging from 2-5 days a week. While on the plastic surgery service, the resident will share on-call duties with other surgical residents for facial trauma (2 months) and is exempt from Otolaryngology home-call duties. The final month is spent on research whereby the OTO-3 resident will submit a research proposal, identify a faculty mentor, submit IRB approval, obtain necessary grant funding and perform the preliminary steps in preparation for the OTO-4 continuous 3 month research block.
Three months of dedicated research is mandatory for the OTO-4 year. The OTO-4 resident will undertake a project worthy of presentation at a major meeting and publication. The project may be basic science, translational, or clinical in nature, and may draw upon the expertise and resources of members of the Otolaryngology faculty and/or those of allied disciplines (allergy and immunology, oncology, radiation oncology, pediatrics, neurobiology, anatomy, surgical pathology, audiology, speech pathology, etc.). For the remainder of the six months, OTO-4 residents will serve as the more senior resident on Teams 2 and 3. Three months will be spent on Team 2 (Advanced Otology/General Otolaryngology) and three months will be spent on Team 3 (Advanced Pediatric Otolaryngology/General Otolaryngology). He/she will perform advanced level surgeries under the guidance of attending physicians and will be given the responsibility of in-patient care with attending guidance. Teaching of junior residents, interns, and medical students is also expected. The remaining three months will be spent on Outpatient ENT Surgery under the supervision of Dr. Paul Johnson. The OTO-4 resident will participate in outpatient surgeries with Dr. Paul Johnson, Dr. Walter Schroder (community otolaryngologist) and the Otolaryngology Staff at Nellis Air Force Base/ Michael O’Callaghan Federal Hospital. A major component of an otolaryngology practice is outpatient surgery. The OTO-4 resident will gain exposure in working in the outpatient surgery environment. They will be responsible for the preoperative evaluation and postoperative care of these patients. He/she will participate in endoscopic sinus surgery, septoplasty, facial plastic surgery, tonsillectomy, adenoidectomy, and laryngoscopies/bronchoscopies.
The OTO-5 resident will be the administrative chief for the entire otolaryngology service for this year. He/she will be in charge of making the call schedule, making accommodations for resident vacation requests, and schedule staffing for the UMC outpatient clinics. In addition to being the service chief, the OTO-5 house officer will spend 6 months on the Advanced Head & Neck Surgery Service (Team 1). The service treats a wide variety of patients and performs a high volume of surgeries and reconstructions. With a special emphasis on head and oncology, the OTO-5 resident will be performing some of the most technically challenging cases in otolaryngology while on that service. For the other 6 months, the resident will be the Chief Resident at UMC. He/she will lead a team consisting of the otolaryngology intern and junior residents, the general surgery resident, and the emergency room resident who are on the otolaryngology rotation. At the end of this rotation, the graduating resident develops sound clinical judgment and possesses the ability to formulate and carry out appropriate management plans for patients with Otolaryngology disorders. They attend all the conferences that are held at UMC, teach junior residents and medical students, organize conferences with the faculty, and gives grand rounds. This is a culmination of residency training in preparation for a career in private practice, managed care, or academic Otolaryngology. The educational didactic core lecture program is described in this document and includes weekly core curriculum and basic science lectures, grand rounds, journal club, tumor board, neuroradiology conference, speech and language pathology, morbidity and mortality/quality improvement conferences.