Faculty Chair:
Contacts:
Required Experiences:
Memorial Medical Center
Optional Experience:
Weekly Schedule PGY2:
| Sunday | Monday | Tuesday | Wed | Thursday | Friday | Saturday |
| ENT | ENT | Clinic | ENT | Clinic | ||
| ENT | ENT | Didactics | ENT | Clinic |
Requirements:
AOA
Surgery
The program must provide at least twenty weeks of training in surgical disciplines, including at least four weeks of general surgery training during the OGME-1 year.
At a minimum this shall include:
- Preoperative and post-operative care.
- Training in the following sub-specialties, which may be ambulatory or inpatient.
- Ophthalmology.
- Orthopedics.
- Urology.
- ENT.
ACGME
Residents must have at least 100 hours (or one month) dedicated to the care of surgical patients, including hospitalized surgical patients. (Core)
This experience must include operating room experience
There must be specific subspecialty curricula to address the breadth of patients seen in family medicine. (Core)
The program must ensure that every resident has exposure to a variety of medical and surgical subspecialties throughout the educational program. (Detail)
Description of Rotation or Educational Experience:
During the ENT Rotation the resident will obtain the skills necessary to diagnose, treat, and refer disorders that are common in the family physicians office. It is expected that the resident spend time in the clinic setting, and the OR. Hands-on education must be provided.
Expectations:
Residents
Residents are expected to arrive to the Otorhinolaryngology rotation on time and to dress and act in a professional manner. They are expected to contact the preceptor’s office prior to their first day on the rotation in order arrange the initial meeting time and location on day one of the rotation. It is expected that while at the preceptor’s office the residents will be respectful of the office space and personnel. The resident is responsible for maintaining a procedure log as well as completing assigned readings.
Faculty
Family medicine faculty will provide precepting of ENT cases and procedures as seen in resident continuity clinics. Dr. Gorav, and possibly other physicians in his area of practice, will provide precepting during the focused otorhinolaryngology rotation. The faculty and preceptors are expected to allow the resident to participate in active patient care as well as procedures when appropriate. The preceptors should also provide time and allowance for explanation and teaching of ENT conditions and their treatments.
Call
There is no specific call responsibility for this rotation.
Patient Care
Goal
Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of the surgical patient. Residents are expected to:
Competencies
Be able to perform a surgical assessment and develop an appropriate treatment plan. (Medical Knowledge, Patient Care)
Coordinate ambulatory, in-patient and institutional care across health care providers, institutions and agencies. (Systems-based Practice, Patient Care)
Objectives
- Perform a basic head and neck exam with equipment available to a primary care practitioner (flashlight, tongue blade, otoscope).
- Preform a mirror exam. Observe, but need not perform, a fiberoptic exam of the larynx
- Perform an ear exam including tympanometry and have an opportunity to compare an exam performed with the otoscope and an exam using binocular microscope.
- Obtain and report appropriate history
- Generate an appropriate differential diagnosis
- Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
- Counsel and educate patients and their families in a clear, respectful and culturally conscious manner
- In the appropriate setting, the resident should demonstrate the ability to independently perform or appropriately refer:
- Audiometry, screening
- Cerumen removal
- Indirect laryngoscopy
- Nasal cautery
- Nasal packing
- Tuning fork tests
- Tympanometry
- I&D peri-tonsilar abscess
- Intra-operative skills
- Basic principles of asepsis and sterile technique
- Antibiotic prophylaxis
- Preparation & draping
- Basic use of surgical instruments
- Incision/dissection
- Exposure/retraction
- Hemostasis
- Wound closure
- Drains
- Dressings
- Assist on major procedures
- Perform minor procedures
- Simple excision
- I&D
- Aspiration
- Foreign Body removal
- Wound debridement
- Post-operative care
- Suture removal
- Drain removal
- Dressing change
- Wound care
- Pain management
Medical Knowledge
Goal
Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to:
Competencies
Be able to demonstrate surgical knowledge and assessment and develop an appropriate treatment plan. (Medical Knowledge, Patient Care)
Objectives
In the appropriate setting, the resident should demonstrate the ability to apply knowledge of:
- Basic surgical anatomy
- Invasive versus noninvasive diagnostic tests
- Common ENT surgical diagnoses
- Acute otitis media
- Serous otitis media
- External otitis
- Ruptured eardrum (acute)
- Cerumen impaction
- Presbyacusis
- Tinnitus
- Vertigo
- Epitaxis
- Deviated nasal septum
- Tonsillitis
- Allergic Rhinitis
- Sinusitis
- Epiglottis
- GE reflux
- TMJ arthritis
- Neck masses
Practice Based Learning and Improvement
Goal
Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life long learning. Residents are expected to develop skills and habits to be able to:
Competencies
- Identify strengths, deficiencies and limits in one’s knowledge and expertise
- Locate, appraise and assimilate evidence from scientific studies related to their patients’ health problems
- Participate in the education of patients, families, students, residents and other health professionals, as documented by evaluations of a resident’s teaching abilities by faculty and/or learners
Objectives
- Ask questions as an engaged, critical learner
- Use information technology to manage information, access on-line medical information, and support their own education.
System Based Practice
Goal
Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:
Competencies
- Incorporate considerations of cost awareness and risk-benefit analysis in patient care
- Work in interprofessional teams to enhance patient safety and improve patient care quality
Objectives
- Practice cost-effective health care and resource allocation that does not compromise quality of care
- Advocate for quality patient care and assist patients in dealing with system complexities to minimize discomfort or confusion
Professionalism
Goal
Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:
Competencies
- Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation
Objectives
- Accept responsibility for patient care
- Consistently performs in a punctual, reliable and collegial manner
Interpersonal and Communication Skills
Goal
Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:
Competencies
- Communicate effectively with patients and families across a broad range of socioeconomic and cultural backgrounds
- Communicate effectively with physicians, other health professionals, and health related agencies
- Work effectively as a member of leader of a health care team or other professional group
Objectives
- Make organized and effective oral presentations
- Communicate with the patient, family and members of the healthcare team in a timely, developmentally and culturally appropriate manner
- Obtain informed consent in an appropriate manner
- Document patient care in appropriate record system and maintain essential components of the patient’s record of care
Teaching Methods
Residents will provide medical care to patients under the direct supervision of the attending physician. They will be supervised on all procedures performed in the hospital. The will participate in weekly conferences at the FMC. Residents will be assigned specific reading topics to be completed by the end of their month on the service.
Assessment Method (residents)
Direct observation with a final global assessment based on a competency scale. All procedures will be recorded on New Innovations.
Assessment Method (Program Evaluation)
Residents will be provided with an evaluation of their experiences and given the opportunity to provide feedback of the rotation during their quarterly IEP assessments.
Level of Supervision
The resident is directly supervised by the attending physician during all procedures performed in the hospital. The attending will see all patients on the service each day and will document their involvement in the patient’s care. An Attending will be available the entire time the resident is on service.
Educational Resources
Readings
Videos
American Academy of Otolaryngology – Clinical Otolaryngology OnLine (COOL)
SNMFMRP Curriculum 