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This year is very similar to the traditional general surgery internship, though first year residents are also exposed to emergency medicine, critical care, anesthesia, and neurosurgery. Other surgical rotations provide the basic education and experience necessary for the eventual care of head and neck surgery patients. Two months of this year are spent rotating on the Otolaryngology service.
During the first full year of Otolaryngology training, we emphasize the development of a high level of diagnostic skills and early exposure to operative techniques. During the first three months of the second year, the new residents participate in a series of one to two hour conferences per day which are entitled "The Basic Introduction to Otolaryngology." These sessions provide an overview of the specialty and serve as a springboard for in-depth training. At the present time, the second year resident is a part of a larger team on a specific service for four months. These services provide care for private and non-private patients at John Sealy Hospital. During this time, the second year resident works under the direct supervision of a senior resident. Emphasis is placed on out-patient diagnostic and therapeutic skills, preoperative evaluation, assistance with more complex otolaryngologic surgical procedures, audiology and speech pathology, and mastering minor surgical procedures. The second year resident also begins to develop a research plan to be executed during the third year.
During this year, there are required rotations.
There is a 4-month research rotation during which the resident participates in an independent scientific project under the direction of faculty. This rotation is fully supported financially and logistically by the department's research resources.
This year is spent working with an eight person otolaryngology group practice in Houston. This rotation is affiliated with Memorial Hospital System of Houston and provides an excellent opportunity for the resident to view and participate in the private practice of our specialty on a very high level. (This group consists of individuals who have special areas of expertise and interests that include neuro-otology, otolaryngic allergy, head and neck cancer surgery, and facial plastic and reconstructive surgery.) The general office practice of otolaryngology is emphasized during this rotation. At the same institution, there is interaction with residents in a Family Practice training program, and residents provide consultation for the patients on that service. This rotation is supervised by G. Walter McReynolds, MD.
The fourth year of the residency program begins the phase of training which is comparable to the senior resident year in most otolaryngology programs. This is the year with the heaviest concentration of surgical activities. There are also major responsibilities for the care of in-patients as well as the out-patient clinic. It is our goal that by the time the resident completes this year of training, he or she should be thoroughly grounded in all aspects of otolaryngology and capable of functioning independently as a general otolaryngologist. One important feature of this year is a 2 month rotation at the Alaska Native Medical Center (ANMC), in Anchorage. The ANMC rotation was developed to give PGY 4 residents extensive exposure to the diagnosis and surgical treatment of middle ear disease. It is expected that during this rotation the resident will gain significant experience with tympanoplasty, ossicular chain reconstruction, and mastoid surgery. In addition, the resident will be exposed to general otolaryngology conditions and maxillofacial trauma.
This year completes the final portion of the senior resident experience and is designed to permit the resident some flexibility to pursue areas of special interest. We feel that this year often eliminates the need for a post-residency fellowship and permits the graduating resident to enter either an academic environment or a private practice situation with the necessary preparation to function at a high level of expertise. Residents rotate on 3 different services and function as the chief, with responsibilities for patient care and teaching. The residents in this year will share the responsibility for the coordination of teaching conferences and the selection of some topics to be discussed.
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