Curriculum Overview/Rotations All residents have assignments at the two hospitals during their four years of Otolaryngology training. During each rotation the residents have the opportunity to participate in the medical and surgical care of all surgery for all staff and private cases. The attending surgeons are always available for operating room and clinic coverage on a daily basis and the same applies for consultative and emergency services throughout the day and night. Direct supervision is always provided in this program. During each year, a rotation structure is created with residents at various levels of training. Each resident rotation is designed to help achieve the overall educational goal and therefore shares the common goal. In order to direct progress toward goal achievement, general and specific objectives are identified. General objectives are purposefully common to all rotations. Unique aspects of each rotation are outlined and specific objectives are listed under each rotation. In order to achieve our stated goal, we have purposefully mirrored the goals and objectives of the ACGME’s Outcome Project. Our assessment tools are designed to demonstrate progress towards these objectives by direct linking via a common format. General Objectives for All Rotations Competency Objectives Patient Care Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families Gather essential and accurate information about our patients Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment Develop and carry out patient management plans Counsel and educate patients and their families Use information technology to support patient care decisions and patient education Perform competently all medical and invasive procedures considered essential for the area of practice Provide health care services aimed at preventing health problems or maintaining health Work with health care professionals, including those from other disciplines, to provide patient-focused care Medical Knowledge Demonstrate an investigatory and analytic thinking approach to clinical situations Know and apply the basic and clinically supportive sciences which are appropriate to otolaryngology Practice-Based Learning and Improvement Analyze practice experience and perform practice-based improvement activities using a systematic methodology Locate, appraise, and assimilate evidence from scientific studies related to patients’ health problems Obtain and use information about our own population of patients and the larger population from which our patients are drawn Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness Use information technology to manage information, access on-line medical information; and support our own education Facilitate the learning of students and other health care professionals Interpersonal and Communication Skills Create and sustain a therapeutic and ethically sound relationship with patients Use effective listening skills and elicit and provide information using effective nonverbal, explanatory, questioning, and writing skills Work effectively with others as a member or leader of a health care team or other professional group Professionalism Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society, and the profession; and a commitment to excellence and on-going professional development Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices Demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities Systems-Based Practice Understand how our patient care and other professional practices affect other health care professionals, the health care organization, and the larger society and how these elements of the system affect our own practice Know how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources 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 Know how to partner with health care managers and health care providers to assess, coordinate, and improve health care and know how these activities can affect system performance PGY Rotations General Resident Progression* 1 Surgical rotations in neurosurgery, plastic surgery, vascular and general surgery, anesthesia, ICU, otolaryngology and trauma—under the direction of the Department of Otolaryngology. Will receive a tailored surgical internship to gain exposure to many specialty areas. During this surgical internship, the resident will gain experience caring for a wide range of surgical patients in the perioperative setting. As part of the intern year the resident will spend two months on the Otolaryngology services, getting acquainted with the activities of the different services. 2 Includes 4 months on the Head & Neck rotation, 4 months of pediatrics and 4 months of subspecialty inclusive of exposure to audiology and vestibular training. Residents will develop proposed research projects with the Research Division. Will be closely supervised and will begin to perform less complex procedures such as upper airway endoscopy, tonsillectomy, adenoidectomy, and myringotomy with tube insertions. 3 Clinical rotations at Strong Memorial Hospital with outpatient responsibilities at the Clinton Woods facility, plus six months of a dedicated research block. With mastery of the more basic procedures, the resident advances in surgical techniques. Common surgeries for a typical PGY-3 resident would include nasal reconstruction, tympanoplasty, sinus surgery and other oral and oropharyngeal procedures. 4 Twelve months clinical otolaryngology inclusive of 1 month in facial cosmetics and 1 month in a Head & Neck elective. Surgeries would expand to include major head and neck cancer resections with neck dissection, parotidectomy, thyroidectomy, surgery for sleep apnea, and mastoidectomy. 5 Chief Resident year— twelve months as chief with six months as administrative chief resident. The Resident will gain further experience in major head and neck reconstructive procedures, complex ear surgery, pediatric airway surgery, and cosmetic procedures. The PGY-5 will be asked to assume more teaching and administrative responsibilities as they attain the competencies to complete the program and be able to function as independent practitioners. *Residents entering Otolaryngology-Head and Neck Surgery training will follow a stepwise progression to master general patient care, and otolaryngology specific care and all surgical procedures under close supervision. While on clinical rotation, the residents have the opportunity to see cases generated from approximately 40,000 outpatient private visits and 2,800 outpatient clinic visits per year. Surgery volume resulting from this approaches 4,200 surgical cases which the residents participate in throughout the year. A full spectrum of clinical cases is available for teaching, and residents finishing the program perform approximately 1,800 cases as operating surgeons. An important feature of this residency is that it offers an extensive general training in otolaryngology with exposure to fellowship trained faculty in all subspecialties available in otolaryngology. This has resulted in a high level of clinical case material and resulting training.