OHSU

Residency Curriculum

FIRST-YEAR OTOLARYNGOLOGY CURRICULUM

During the first year of residency, students are working in surgery, and are essentially surgery residents. During the first year of Otolaryngology training (PGY-2), four months are spent at the Portland Veterans Administration Medical Center (PVAMC). The other rotations for the PGY-2 year include four months that are spent on head and neck and four months that are with the pediatric otolaryngology service. The rotation at the Portland VA Hospital includes outpatient and surgical experience in all areas of the specialty, including otology, facial plastic surgery, head and neck, and sinus surgery. The pediatric otolaryngology rotation includes outpatient clinic exposure and surgical experience in tonsillectomies, myringotomies, tubes, and endoscopic procedures. The head and neck service, under the supervision of the chief resident and staff, includes surgical and medical experience in head and neck procedures.

The first-year resident admits, examines and writes orders under the supervision of the senior resident and staff when treating hospitalized patients. The outpatient experience is under the supervision of the senior resident and the full-time clinical faculty.

The resident is responsible for assisting with most major surgery done on his or her service. All tonsillectomies, myringotomies, and minor nasal and otologic surgical procedures are done by the first-year resident with staff supervision. In addition, soft tissue surgery experience in both facial plastic and head and neck cancer is gained under the direction of staff and senior residents.

The first-year residents are assigned a series of didactic lectures presented to medical students, as well as supervising assigned elective students. Residents will work with Dr. Mark Wax on the schedule of the lectures to the students.

During the first year in Otolaryngology, the residents will establish a plan and topic for the research project, and will attend local and regional specialty meetings. During the first year, residents attend an advanced soft-tissue workshop, learn soft-tissue and craniofacial techniques, and are given an introduction to alloplastic filler. First-year residents also attend and teach, as a demonstrator, the First Year Anatomy Course. This four-week course encompasses cadaver dissection, as well as lectures.

 

SECOND-YEAR OTOLARYNGOLOGY CURRICULUM

During this year (PGY-3), six months are spent on a research rotation where investigative techniques are encouraged. Each resident conducts a research project and is directed by an individual advisor. A publishable article is required by the end of the research project. The resident is encouraged to devise his/her research program with the guidance and support of the resident research committee of the department and with the help of a faculty mentor. Basic research projects can be undertaken with the supervision of the staff at the Oregon Hearing Research Center, the Center for Epithelial Malignancy, or under the auspices of the clinical faculty.

During this period, anatomic and temporal bone dissection are required. Of the remaining six months, residents will experience a mix of head & neck surgery, pediatric otolaryngology, otology, facial plastic & reconstructive surgery, and sinus. During these rotations, emphasis is on introduction to endoscopic sinus surgery, and facial plastic procedures including septoplastics, rhinoplastics and facial trauma.

During the PGY3 year, the resident attends an intensive temporal bone course. Local courses in rhinoplasty or sinus surgery are available. The resident presents regularly at grand rounds, journal club and presents a review paper.

Attendance at local and regional meetings is expected, and the resident is encouraged to present research paper(s) at national meetings.

During this year, the resident has further exposure to audiology, pathology and radiation oncology.

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THIRD- AND FOURTH-YEAR OTOLARYNGOLOGY CURRICULUM

The curriculum for the third and fourth year is set up to allow for increasing responsibility. The third- and fourth-year residents act as the chief of service on their assigned rotation. Additional responsibility for education, guidance, and service is expected of residents in the PGY4 and PGY5 years (years 3 and 4 in the Otolaryngology Department). The rotations allow the residents to perform procedures commensurate with the level of his or her experience and training.

Rotations during the third year include four months at the Portland VA Medical Center, three months in Sinus, one month in Head & Neck, and four months at the Kaiser Medical Center. The Kaiser Medical Center rotation includes additional head & neck surgery experience, plus service in the very active Cleft clinic at that site. During the fourth year, residents gain experience in facial plastic and reconstructive surgery, otology, sinus, and head & neck surgery.

The rotation at the VA Medical Center as PGY4 resident is under the supervision of James Cohen, M.D., Ph.D. and includes experience in the full range of the specialty. Significant experience in nasal and tumor surgery is gained on this service.

The head and neck service is under the direction of Peter E. Andersen, M.D. and Mark K. Wax, M.D. Residents on the service are responsible for all inpatients and their follow-up care. Additionally, the residents during this rotation are incorporated into the head and neck clinic for evaluation of new patients and surgical follow-up. The months spent during the last two years at OHSU Hospital on the otology and neurotology services are under the supervision of Frank M. Warren, M.D. The residents will receive increasing experience in otologic and neurotologic procedures. As with the head and neck service, residents are incorporated into the outpatient clinic for patient follow-up care and new patient evaluation. The facial plastic rotation is under the direction of Tom D. Wang, M.D. During this rotation, the resident receives increasing experience in complicated facial flaps, facial reconstruction, exposure to cleft lips and palates, as well as other extensive facial plastic reconstructive procedures. During the sinus/pediatric service, the resident will receive extensive exposure to complicated endoscopic sinus surgical procedures, as well as more complicated pediatric airway obstructions and surgical treatment. Sinus surgery is under the direction of Timothy Smith, M.D. Pediatric otolaryngology under the direction of Henry A. Milczuk, M.D. Overall, the third and fourth years at chief resident level provide the resident with opportunity to perform surgery and treat patients with faculty at an advanced level and to gain significant experience in all areas of the specialty.

The third- and fourth-year curriculum presents the resident with a unique opportunity to relate closely with individual faculty members and become involved in the individual practices and teaching responsibilities.

During the third and fourth year, the resident is expected to complete a research project and submit it to a national meeting. Presentation and attendance at the Combined Otolaryngology Spring Meeting, annual fall meeting of the American Academy of Otolaryngology-Head and Neck Surgery, Western Section of the Triologic Society and the Oregon Academy of Otolaryngology is strongly encouraged and supported.

 

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