The PGY-1 year consists of six months of Otolaryngology training, including two months of pediatric otolaryngology, three months of head & neck surgery/consultation service, and one month spent between neuroradiology, speech pathology and audiology. The remainder of the year is spent rotating on oromaxillofacial surgery, plastic surgery, neurosurgery, general surgery and the intensive care unit. 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. Surgical experience is graduated and dependent on the skill level of the resident, but generally includes myringotomy, tonsillectomy, office-based endoscopy and microscopy, and acquisition of soft tissue handling skills. During the first year, the residents will establish a plan and topic for the research project, and identify a faculty mentor.
PGY-2s spend three months on pediatrics, four months at the VA, four months on head and neck. The resident is responsible for assisting with most major surgery done on their service. All tonsillectomies, myringotomies, and minor nasal and otologic surgical procedures are done by the PGY-2 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. Additionally, PGY-2s have a one-month preparatory research rotation, to allow time to devise their research program and write a grant proposal with the guidance and support of their faculty mentor, with oversight provided by the resident research committee. 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.
The PGY-3 residents have a protected 5-month research rotation. 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. Clinically, the PGY-3s spend two months on otology, and one month each of endocrine surgery, laryngology, sinus and facial plastics. Emphasis is on introduction to increasingly complex endoscopic procedures, facial plastic procedures including septorhinoplasty and facial trauma, and tympanoplasty and mastoidectomy on Otology.
In the PGY-4 year, four months each are spent at Kaiser and acting as the chief at the VA, and one month is spent on facial trauma at Legacy Emmanuel. The remaining three months are customized to resident interest, and typically consist of rotation on head and neck, sinus, facial plastics and pediatrics. Increasing involvement in complex surgical cases is anticipated, moving toward independence.
The PGY-5s typically divide their year between chief experiences on the head and neck, facial plastics/sinus and otology services. Beginning in 2019, the PGY-5swill experience a customized year designed to address any deficiencies in knowledge or surgical exposure, and allow an elective, individualized experience tailored to the resident's specific career goals.
Program Facilities and Direction
The Department of Otolaryngology-Head and Neck Surgery's outpatient clinic facility is located in the Physician's Pavilion building, adjacent to the main OHSU Hospital. The department has a total of 18 examining rooms, 10 treatment rooms, four audiometric testing booths, three voice rooms, and a vestibular laboratory. The department has its own conference/class room located in Sam Jackson Hall. The department's administrative offices and secretarial staff are located adjacent to the clinic. We have additional administrative staff located nearby in Sam Jackson Hall. Our facial plastic and reconstructive surgery and sinus clinics are located at the Center for Health & Healing in Portland's South Waterfront District. All of our locations are easily accessible via public transportation, including the Portland tram, and bikes and car-shares are encouraged to limit traffic and ease patient access to our buildings.
The Department of Otolaryngology-Head and Neck Surgery admits patients to OHSU Hospital, Doernbecher Children's Hospital, Providence St. Vincents, and the Portland Veteran's Administration Medical Center (VAMC). The health care system includes nearly 1,000 beds -- OHSU Hospital is licensed for 509 beds and the VA Medical Center is licensed for 490 beds.
Doernbecher Children's Hospital includes an extensive outpatient facility as well as 120 inpatient beds. The Department of Otolaryngology is closely associated with this hospital, utilizing clinic space and operating rooms. The audiology division, and Cochlear Implant Program, is integrated into the children's hospital for speech pathology, implant care, and audiologic care.
The Audiology division consists of licensed audiologists and provides basic and advanced evaluations, including ABR, ECOG, otoacoustic emissions, intraoperative monitoring, cochlear implant evaluations and rehabilitation, vestibular assessments, and hearing aid dispensing.
Within the department, there is a temporal bone lab, complete with eight fully equipped positions. Formal temporal bone courses are offered during the second year of training. The lab is regularly accessible to residents for research, study, and patient care.
The Northwest Center for Voice and Swallowing, our voice disorders program, under the direction of Joshua Schindler, M.D. and Donna Graville, Ph.D., CCC-SP has locations in the Physician's Pavilion and the Center for Health & Healing. This clinic is involved in the management of difficult voice and speech problems, including management of the professional voice. The department offers laryngeal physiology (for research and treatment), as well as newer treatments of voice disorders including Botox injection and implants. Speech pathologists and voice teachers are involved in the service.
The Oregon Hearing Research Center is a division of the Department of Otolaryngology-Head and Neck Surgery and participates closely with the residency training program. The lab occupies 17,000 square feet of the Mark Hatfield Research Center adjacent to the hospital, as well as 4,000 square feet in the Medical Research Building. The OHRC faculty work closely with our residents to develop and carry out research, and there are summer opportunities for medical students to participate in research projects underway. Alfred L. Nuttall, Ph.D. is the director of the center, which includes nine Ph.D's and two M.D.'s. The lab is dedicated to hearing research, including vascular diseases of the ear, treatment outcomes, and hair cell regeneration.
The department's other affiliations include the Westside Primary Care, which offers pediatric and audiology patient care, and NW Kaiser Permanente. The National Center for Rehabilitative Audiology Research (NCRAR) is located at the PVAMC, and is a source of collaboration and research resources. In addition, the department is affiliated with Tucker-Maxon Oral School, which is an oral training school for the profoundly hard of hearing in Portland. Many of the cochlear implant patients are enrolled in this school.