鈥⑻� 听Adult hospital rotations of total of 9 months rotation (JGH, MGH, RVH)
鈥⑻� 听Duration: During the Second Half of PGY4 (Jan 1- June 30), two rotations of 3 months
听 In addition to one rotation of 3 months during the enrichment year as PGY4
鈥⑻� 听The PGY4 residents will be expected to use their knowledge of the basic sciences to gradually expand their clinical repertoire and clinical problem solving skills.
鈥⑻� 听Their technical training is designed to meet the requirements as outlined in the rotational objectives of the 麻豆AV Department of Otolaryngology 鈥� Head & Neck Surgery Residency Handbook
鈥⑻� 听All of the general otolaryngology clinics, sub-specialty clinics and surgeries are supervised by attending staff.
鈥⑻� 听All pre and post operative care management are fortified
鈥⑻� 听Regular informal quizzing as well as structured written and oral examinations serves as part of the evaluation process, using the One45 framework.
鈥⑻� 听All residents must undergo a STASER or STACER evaluation by attending staff person every six months. They are also evaluated by 360 degree inter-professional evaluation (feedback from allied health care personnel, nurses, secretaries)
Medical Expert
1. Operative objectives
a)听 In addition to acquiring greater proficiency in the procedures encountered during the first year, development will be acquired in the following skills:
鈥⑻� 听Septal surgery (septoplasty, nasal polypectomy)
鈥⑻� 听Sinus surgery
鈥⑻� 听Cervical node biopsy
鈥⑻� 听Assistance at major head and neck surgery
鈥⑻� 听Microlaryngeal surgery
b) Some experience of the following procedures with adequate supervision should be obtained near the end of the second year:
鈥⑻� 听Rhinologic surgery
听听听听 o听听 听rhinoplasty
听听听听 o听听 听ethmoidectomy, functional endoscopic sinus surgery
鈥⑻� 听Otologic surgery
听听听听 o听听 听myringoplasty
听听听听 o听听 听tympanoplasty
听听听听 o听听 听mastoidectomy
鈥⑻� 听Neurotologic surgery
听听听听 o听听 听intratympanic injections
鈥⑻� 听Head and neck surgery
听听听听 o听听 听salivary gland surgery e.g. submandibular gland excision
听听听听 o听听 听Neck dissection different types
鈥⑻� 听Facial plastics and Reconstructive surgery
听听听听 o听听 听 Flaps local and locoregional
听听听听 o听听 听split and full thickness skin graft
鈥⑻� 听Laryngnologic procedures
听听听听 o听听 听vocal fold injection
听听听听 o听听 听laser laryngeal procedures
听听听听 o听听 听 medialization
鈥⑻� 听General Otolaryngology
听听听听 o听听 听rigid upper endoscopy with foreign body extraction
听听听听 o听听 听management of obstructive sleep apnea and surgical options
听听听听 o听听 听management of head and neck manifestations of systemic disease
听听听听 o听听 听cricothyroidotomy
听听听听 o听听 听tracheostomy
c) Exposure to the following procedures:
鈥⑻� 听Otology
听听听听 o听听 听Stapedectomy
听听听听 o听听 听facial nerve surgery
听听听听 o听听 听labyrinthine surgery
听听听听 o听听 听neurotologic procedures
鈥⑻� 听Head and Neck
听听听听 o听听 听Parotidectomy
听听听听 o听听 听composite resection maxillectomy
听听听听 o听听 听thyroid and parathyroid surgery
听听听听 o听听 听Zenker鈥檚 diverticulum surgery
听听听听 o听听 听laryngectomy
鈥⑻� 听Facial Plastic and reconstructive
听听听听 o听听 听Otoplasty
听听听听 o听听 听face lift
听听听听 o听听 听blepharoplasty
2.听 Didactic objectives
Active resident participation in academic half and full day seminars, lectures, hospital rounds and journal clubs will increase. Where possible, the residents will be increasing involvement in teaching junior medical staff to include medical students, clinical clerks and junior residents.听 The resident will be introduced to the methods of clinical research and ethics in clinical trials.
3. Temporal bone dissection
The resident will complete his program of temporal bone dissection in preparation for the development of his clinical otological skills.听 A temporal bone course is given in the fall of every year.
听
PGY4 at the JGH- The Expert Role specific objectives
PGY4 at the MGH - The Expert Role specific objectives
PGY4 at the RVH - The Expert Role specific objectives
听
Communicator Role
As a communicator the otolaryngology resident should effectively facilitates the doctor-patient relationship and the dynamic exchanges that occur before, during, and after the medical encounter. The resident is thought and evaluated on these issues:
鈥⑻� 听Demonstrate effective establishment of therapeutic relationships with patients and their families
鈥⑻� 听Recognize unique issues related to head and neck patients, particularly relevant to patients with cancer of the head and neck including end-of-life discussions
鈥⑻� 听Recognize unique biopsychosocial issues related to deafness and the deaf community and recognize their unique communication requirements
鈥⑻� 听Demonstrate the capacity to recognize the psychological, occupational and social consequences of speech and voice disorders, particularly relevant to vocational demands
鈥⑻� 听Obtain and synthesize relevant history from patients, their families, and communities
鈥⑻� 听Prepare clear, accurate, concise, appropriately detailed clinical notes, consultation notes, discharge summaries, and operative reports
鈥⑻� 听Present histories, physical findings, and management plan to consultants in an organized, efficient, and confident manner
鈥⑻� 听Respect diversity and difference, including gender, religion and cultural beliefs on decision-making
鈥⑻� 听Discuss common procedures with patients and their families in a clear and understandable form including risks/benefits, informed consent, and post-operative care
鈥⑻� 听Address challenging communication issues effectively, such as obtaining informed consent, delivering bad news, and addressing anger, confusion and misunderstanding
鈥⑻� 听Participate, and present effectively in organized rounds and seminars
The communicator role is evaluated especially on:
鈥⑻� 听Demonstrate effective establishment of therapeutic relationships with patients and their families
鈥⑻� 听Present histories, physical findings, and management plan to consultants in an organized, efficient, and confident manner
鈥⑻� 听Obtain and synthesize relevant history from patients, their families, and communities
鈥⑻� 听Prepare clear, accurate, concise, appropriately detailed clinical notes, consultation notes, discharge summaries, and operative reports
鈥⑻� 听Discuss more complex procedures (e.g. tympanoplasty, thyroidectomy) with patients and their families in a clear and understandable form including risks/benefits, informed consent, and post-operative care
鈥⑻� 听Prepare, participate, and present effectively in organized rounds and seminars
鈥⑻� 听Demonstrate the capacity to recognize the psychological, occupational and social consequences of speech and voice disorders, particularly relevant to vocational demands
鈥⑻� 听Recognize unique issues related to head and neck patients particularly relevant to patients with cancer of the head and neck including end-of-life discussions
鈥⑻� 听Respect diversity and difference, including gender, religion and cultural beliefs on decision-making
鈥⑻� 听challenging communication issues effectively, such as obtaining informed consent, delivering bad news, and addressing anger, confusion and misunderstanding
听
Collaborator Role
As collaborators the otolaryngology residents effectively work within a health care team to achieve optimal patient care. The resident is thought and evaluated on these issues:
鈥⑻� 听Demonstrate an understanding of the team structure of an in-patient service ('the resident team') and fulfill his/her role in this structure
鈥⑻� 听Demonstrate recognition and respect for the opinions & roles of other team members
鈥⑻� 听Identify the situations and instances where consultation of other physicians or health care professional is useful or appropriate
鈥⑻� 听Demonstrate collegial and professional relationships with other physicians, office and clinic support staff, operating room personnel, and emergency room staff
鈥⑻� 听Recognize the expertise and role of allied health professionals such as speech language pathologists, audiologists, technicians, nurses, and clerical staff
鈥⑻� 听Recognize the advantages for optimal patient care provided by an multidisciplinary Head and Neck oncology team
The collaborator role is evaluated especially on:
鈥⑻� 听Identify the situations and instances where consultation of other physicians or health care professional is useful or appropriate
鈥⑻� 听Demonstrate collegial and professional relationships with other physicians, office and clinic support staff, operating room personnel, and emergency room staff
鈥⑻� 听Recognize the expertise and role of allied health professionals
鈥⑻� 听Recognize the advantages for optimal patient care provided by a multidisciplinary head and neck oncology program
听
Manager Role
As managers the otolaryngology residents are integral participants in health care organizations, making decisions about allocating resources, and contributing to the effectiveness of the health care system. The resident is thought and evaluated on these issues:
鈥⑻� 听Utilize resources effectively to balance patient care duties, learning needs, educational / teaching responsibilities & outside activities and personal life
鈥⑻� 听Allocate finite health care resources in a wise, equitable, and ethical fashion
鈥⑻� 听Utilize information technology to optimize patient care and life-long learning including facile use of hospital IT resources (e.g. filmless radiology, electronic charting)
鈥⑻� 听Actively participate in preparation, presentation, analysis, and reporting of morbidity and mortality rounds
鈥⑻� 听Accurately identify criteria for patient admission to hospital in the urgent/emergent situation as well as the implications of such decisions
鈥⑻� 听Use patient information tools effectively
鈥⑻� 听Demonstrate an appreciation of the importance of quality assurance/improvement, such as patient safety initiatives
鈥⑻� 听Take care of charts and use head and neck patient database
鈥⑻� 听Demonstrate ability to lead a health care team
鈥⑻� 听Serve in administrative and leadership roles, such as participate effectively in committees and meetings
The manger role is evaluated especially on:
鈥⑻� 听Demonstrate ability to lead a health care team
鈥⑻� 听Utilize resources effectively to balance patient care duties, learning needs, Educational/teaching responsibilities and outside activities
鈥⑻� 听Allocate finite health care resources in a wise, equitable, and ethical fashion
鈥⑻� 听Utilize information technology to optimize patient care and life-long learning including facile use of hospital IT resources (e.g. filmless radiology, electronic charting)
鈥⑻� 听Demonstrate an appreciation of the importance of quality assurance/improvement
鈥⑻� 听Actively participate in preparation, presentation, analysis, and reporting of morbidity and mortality rounds
鈥⑻� 听Accurately identify criteria for patient admission to hospital in the urgent/emergent situation as well as the implications of such decisions
鈥⑻� 听Serve in administrative and leadership roles, such as participate effectively in committees and meetings
Health Advocate Role
As Health Advocate the otolaryngology residents responsibly use their expertise and influence to advance the health and well-being of individual patients, communities, and populations. The resident is thought and evaluated on these issues:
鈥⑻� 听Recognize and respond to opportunities for advocacy within Otolaryngology, both for your patients as well as for the community in which we practice and populations at large
鈥⑻� 听Encourage behaviors that promote hearing protection and conservation at work and at home
鈥⑻� 听Facilitate patients' access to local and national resources available for the hearing impaired
鈥⑻� 听Encourage behaviors that reduce/eliminate risk factors for the development of head & neck cancer (e.g., tobacco, alcohol, UVA/UVB sun exposure)
The health advocate role is evaluated especially on:
鈥⑻� 听Recognize and respond to opportunities for advocacy within Otolaryngology, both for your patients as well as for the community in which we practice
鈥⑻� 听Demonstrate familiarity with important determinants of health relevant to Otology such as environmental noise exposure
鈥⑻� 听Encourage behaviors that promote hearing protection and conservation at work and at home
鈥⑻� 听Facilitate patients' access to local and national resources available for the hearing impaired
鈥⑻� 听Encourage behaviors that reduce/eliminate risk factors for the development of head and neck cancer (e.g.: tobacco, alcohol, UVA/UVB sun exposure)
Scholar Role
As Scholars the otolaryngology residents demonstrate a lifelong commitment to reflective learning, as well as the creation, dissemination, application and translation of medical knowledge. The resident is thought and evaluated on these issues:
鈥⑻� 听Actively participate in the teaching of medical students (didactic, in clinics, and on Wards / in OR
鈥⑻� 听Facilitate learning in patients and other health professionals
鈥⑻� 听Actively participate in preparation and presentation of weekly hospital and grand rounds
鈥⑻� 听Demonstrate a critical appraisal of research methodology, biostatistics, and the medical literature as part of monthly Journal Clubs
鈥⑻� 听Develop, implement, and monitor a personal educational strategy and seek guidance for this educational strategy as appropriate
鈥⑻� 听Contribute to the development of new knowledge through participation in clinical or basic research studies
鈥⑻� 听Demonstrate commitment to evidence based standards for care of common problems in Otolaryngology
鈥⑻� 听Demonstrate the evolving commitment to, and the ability to practice, life-long learning
The scholar role is evaluated especially on:
鈥⑻� 听Actively participate in the teaching of medical students (didactic, in clinics, and on wards/in OR)
鈥⑻� 听Facilitate learning in patients and other health professionals
鈥⑻� 听Actively participate in preparation and presentation of weekly hospital and Grand Rounds
鈥⑻� 听Demonstrate a critical appraisal of research methodology, biostatistics, and the medical literature as part of monthly Journal Clubs
鈥⑻� 听Practice the skill of self-assessment
鈥⑻� 听Develop, implement, and monitor a personal Educational strategy and seek guidance for this Educational strategy as appropriate
鈥⑻� 听Demonstrate the evolving commitment to, and the ability to practice, life-long learning
鈥⑻� 听Contribute to the development of new knowledge through participation in clinical or basic research studies
鈥⑻� 听Demonstrate commitment to evidence based standards for care of common problems in Otolaryngology
鈥⑻� 听Actively participate in weekly academic rounds series including advance preparation for the topic(s)
听
Professional Role
鈥⑻� 听As professionals the otolaryngology residents are committed to the health and well-being of individual s and society through ethical practice, profession-led regulation, and high personal standards of behavior. The resident is thought and evaluated on these issues:
鈥⑻� 听Deliver highest quality care with integrity, honesty, and compassion
鈥⑻� 听Exhibit appropriate professional and interpersonal behaviors
鈥⑻� 听Practice medicine and Otolaryngology in an ethically responsible manner
鈥⑻� 听Recognize limitations and seek assistance as necessary
鈥⑻� 听Seek out and reflect on constructive criticism of performance
鈥⑻� 听Endeavour to develop an appropriate balance between personal and professional life to promote personal physical and mental health/well-being as an essential to effective, life-long practice
鈥⑻� 听Demonstrate a commitment to their patients, profession and society through participation in profession-led regulation, e.g. recognize and respond to others unprofessional behavior in practice, understand the legal and ethical codes of practice
The Professional role is evaluated especially on:
鈥⑻� 听Deliver highest quality care with integrity, honesty, and compassion
鈥⑻� 听Exhibit appropriate professional and interpersonal behaviors
鈥⑻� 听Practice medicine and Otolaryngology in an ethically responsible manner
鈥⑻� 听Recognize limitations and seek assistance as necessary
鈥⑻� 听Seek out and reflect on constructive criticism of performance
鈥⑻� 听Endeavor to develop an appropriate balance between personal and professional life to promote personal physical and mental health/well-being as an essential to effective, life-long practice
鈥⑻� 听Demonstrate a commitment to their patients, profession and society through participation in profession-led regulation (e.g.: recognize and respond to other unprofessional behavior in practice, understand the legal and ethical codes of practice
听
听
听
听