General Objectives
The Department of Otolaryngology/ Head and Neck Surgery at the University of Texas/Southwestern Medical Center at Dallas has designed its residency program to train qualified physicians to become educated and proficient in the diagnosis, medical and surgical management of disorders of the ears, nose, throat, head and neck. Through the resources at the medical school and the affiliated institutions, residents learn through didactic instruction and graduated clinical experience in the care of otolaryngology patients.
Principal Institution: Parkland Memorial Hospital
Affiliated Institutions: Zale Lipshy University Hospital, St. Paul University Hospital, Children's Medical Center Dallas, Dallas Veteran's Administration Hospital, and John Peter Smith Hospital
Zale Lipshy and St. Paul University Hospitals
R4
Surgical objectives are to perform complex cases under direct faculty instruction, such as skull base surgery, microvascular anastomosis, free flap elevation, head and neck cancer resection, airway reconstruction and sinus surgery, thyroid surgery, and facial cosmetic and reconstructive surgery, and to improve operative efficiency on less technically demanding cases. Both routine and complex post-operative management are emphasized under direct faculty guidance. Clinical objectives are to participate in faculty clinics when opportunity permits and to evaluate primarily new patients and devise a comprehensive treatment plan. Scholarly objectives are to remain current with readings of the major journals of the specialty for participation and leadership in the monthly journal club conference.
R2
Surgical objectives are to perform introductory level surgery with direct faculty instruction, such as parotidectomy, neck dissection, regional flap reconstruction, middle ear surgery, endoscopic sinus surgery, early stage tumor resection, skin graft, surgery for snoring and sleep apnea, and general otolaryngology. Routine and complex post-operative management is performed under direct faculty guidance. Clinical objectives are to participate in faculty clinics when opportunity permits and to see and evaluate the full range of otolaryngology disorders, both operative and non-operative. Scholarly objectives consist of remaining current with readings of the major journals of the specialty as well as studying and preparing for the operative cases of the next day through more formal textbook reading.
Wednesday
Wednesday at 7:00 am is weekly tumor board in the conference room, with full service attendance. It is occasionally cancelled if there are not enough new cases to present. On the second Wednesday of each month, there will be neurotology radiology conference at 7:30 am in the Meadows conference room instead of tumor board.
Parkland Memorial Hospital
R4
Surgical objectives are to perform complex cases under direct faculty instruction, such as skull base surgery, microvascular anastomosis, free flap elevation, head and neck cancer resection, airway reconstruction and sinus surgery, and facial cosmetic and reconstructive surgery, and to improve operative efficiency on less technically demanding cases. Additionally, the chief guides the junior resident (R3 and R2) through the performance of most routine cases, under faculty supervision, such as facial fracture reduction and repair, functional septorhinoplasty, ablative cancer surgery not requiring flap reconstruction, benign tumor surgery of salivary glands, neck abscess, tympanoplasty, limited sinus surgery, and laryngology. Clinical objectives are to oversee the evaluation of all patients in Parkland clinic when not in the operating room, ascertain that all in-patient consults are seen timely and addressed appropriately, and communicate all non-routine patient care issues (both operative and non-operative management) to the appropriate attending physician for staffing. Scholarly objectives are to remain current with readings of the major journals of the specialty for participation and leadership in the monthly journal club conference.
R3
Surgical objectives are intermediate to those of the R4 and the R2. Complex cases with which the R4 is already familiar, and cases above the level of the R2's, are the domain of the R3. In instances where two rooms are running simultaneously, the R3 acts as the teaching chief for the second room. The R3 also guides the R2's through cases in a teaching manner similar to the R4, again with faculty supervision. Clinical objectives are similar to those of the R4, and the two share the evaluation and/or supervision of all outpatient visits and inpatient consults. Scholarly objectives are to remain current with readings of the major journals of the specialty for participation and leadership in the monthly journal club conference. The other scholarly objective is to finish, plan, or further work on the research project that is accomplished primarily in the R3 year.
R2
Surgical objectives are primarily to assist with and learn techniques of the more complex surgeries while mastering the techniques of the more basic procedures such as neck dissection, resection of early stage malignancy, salivary gland surgery, deep neck abscess drainage, benign vocal cord surgery, endoscopic evaluation of tumor extent, septoplasty, benign neck tumor surgery, pectoralis flap elevation, cervical rotation and deltopectoral flap elevation, and surgery for snoring and sleep apnea. Clinical objectives are to see the entire range of outpatient otolaryngology visits and develop independence with their evaluation and treatment. Scholarly objectives are to read and study disease processes of the head and neck at the textbook level as well as to develop more analytical skills when reading the current journals of the specialty.
R2
Same as listed above.
R1
Surgical objectives are to learn to perform the most basic procedures, including tonsillectomy, endoscopy with biopsy, tracheotomy, skin lesion excision and closure, and to assist with intermediate level procedures being performed by R2's and R3's. Clinical objectives are to learn outpatient evaluation and examination techniques, including fiberoptic endoscopy and office biopsy, under the supervision of more senior residents. Scholarly objectives are to read extensively about disease processes of the head and neck from textbooks primarily. The R1 will also read the journals of the specialty in order to become familiar with peer reviewed data presentation and organization and allow participation in monthly journal club conferences.
Specialty Clinics
Rhinology Clinic occurs every 1st, 3rd, and 5th Monday-Wednesday of the week from 1:00-5:00 pm. The purpose of this clinic is to focus on patients with special rhinologic pathology and discuss individual patients in a didactic method. Each patient is seen by all the participating residents on the service in addition to the attending staff at that clinic.Otology Clinic occurs on the 2nd and 4th Wednesday of each month from 1:00-5:00 pm. The purpose of this clinic is to focus on patients with difficult otologic problems and discuss them in a didactic method. Each patient will be seen by all the participating residents on the service as well as the attending staff of that clinic.Facial Plastics Clinic occurs on the 2nd Monday of the month from 1:00-5:00 pm. The purpose of this clinic is to focus on patients with unique facial plastic and reconstructive problems and discuss them in a didactic method. Each patient will be seen by all the participating residents on the service as well as the attending staff of that clinic.
Wednesday
Wednesday at 7:00 am is weekly tumor board in the conference room, with full service attendance. It is occasionally cancelled if there are not enough new cases to present. On the second Wednesday of each month, there will be neurotology radiology conference at 7:30 am in the Meadows conference room instead of tumor board.
Veterans Administration Hospital of Dallas
R4
Surgical objectives are to perform complex cases under direct faculty instruction, such as skull base surgery, microvascular anastomosis, free flap elevation, head and neck cancer resection, airway reconstruction and sinus surgery, and facial cosmetic and reconstructive surgery, and to improve operative efficiency on less technically demanding cases. Additionally, the chief guides the junior resident (R2's) through the performance of most routine cases, under faculty supervision, such as facial fracture reduction and repair, functional septorhinoplasty, ablative cancer surgery not requiring flap reconstruction, benign tumor surgery of salivary glands, neck abscess, tympanoplasty, limited sinus surgery, and laryngology. Clinical objectives are to oversee the evaluation of all patients in Parkland clinic when not in the operating room, ascertain that all in-patient consults are seen timely and addressed appropriately, and communicate all non-routine patient care issues (both operative and non-operative management) to the appropriate attending physician for staffing. Scholarly objectives are to remain current with readings of the major journals of the specialty for participation and leadership in the monthly journal club conference.
R2
Surgical objectives are primarily to assist with and learn techniques of the more complex surgeries while mastering the techniques of the more basic procedures such as neck dissection, resection of early stage malignancy, salivary gland surgery, deep neck abscess drainage, benign vocal cord surgery, endoscopic evaluation of tumor extent, septoplasty, benign neck tumor surgery, pectoralis flap elevation, cervical rotation and deltopectoral flap elevation, and surgery for snoring and sleep apnea. Clinical objectives are to see the entire range of outpatient otolaryngology visits and develop independence with their evaluation and treatment. Scholarly objectives are to read and study disease processes of the head and neck at the textbook level as well as to develop more analytical skills when reading the current journals of the specialty.
R2
Same as listed above.
Tumor Board
Tumor board is held Thursdays 1, 3, 4 and 5 at 7:00 am in the 5th floor conference room, where patients are presented with their films and are then examined by those in attendance. The full service is in attendance, along with representatives from radiation oncology, medical oncology, pathology, oral surgery, plastic surgery, speech pathology and others.
Children's Medical Center Dallas
R4
Surgical objectives are to perform complex pediatric cases, such as tympanomastoid surgery, endoscopic and open airway reconstruction, complicated endoscopic sinus surgery, and head and neck tumor surgery, under direct faculty instruction. In certain circumstances, the R4 may guide a junior resident through a case of moderate complexity with faculty supervision. Clinical objectives are to evaluate and treat the entire spectrum of pediatric otolaryngology problems under faculty supervision and to supervise the junior residents in their outpatient activities. Scholarly objectives are to remain current with readings of the major journals of the specialty for participation and leadership in the monthly journal club conference.
R1
Surgical objectives are to gain extensive experience with introductory level pediatric otolaryngology procedures such as tonsillectomy, adenoidectomy, tympanostomy tube insertion, preauricular cyst excision, turbinate reduction surgery, excision of skin lesions, frenulectomy, and endoscopy. Procedures are performed under direct faculty or senior resident instruction. Clinical objectives are to examine, evaluate and treat patients with the full spectrum of pediatric otolaryngology outpatient disorders under senior resident and/or faculty supervision. Scholarly objectives are to read extensively about disease processes of the head and neck from textbooks primarily. The R1 will also read the journals of the specialty in order to become familiar with peer reviewed data presentation and organization and allow participation in monthly journal club conferences. Attendance at the pediatric otolaryngology lecture series is mandatory.
R1
Same as listed above.
John Peter Smith Hospital
R3
Surgical objectives are to perform the complete spectrum of otolaryngology procedures under the direct instruction of the John Peter Smith Hospital faculty. In cases where the resident is experienced with the procedure being performed, he or she may guide the R1 through the case under the supervision of the faculty. These include all aspects of oncology, facial plastic and reconstruction, facial fracture repair including mandible fractures, thyroidectomy, sinonasal surgery, airway reconstruction, and otology. Clinical objectives are to participate in the evaluation of all patients in clinic when not in the operating room, ascertain that all in-patient consults are seen timely and addressed appropriately, and communicate all non-routine patient care issues (both operative and non-operative management) to the appropriate attending physician for staffing. Scholarly objectives are to remain current with readings of the major journals of the specialty for participation and leadership in the monthly journal club conference.
R1
Surgical objectives are to participate in the full spectrum of otolaryngologic surgery with direct supervision through the R3 and/or faculty as appropriate for the complexity of the case. Clinical objectives are to see the entire range of outpatient otolaryngology visits and to begin to develop independence with their evaluation and treatment. Scholarly objectives are to read extensively about disease processes of the head and neck from textbooks primarily. The R1 will also read the journals of the specialty in order to become familiar with peer reviewed data presentation and organization and allow participation in monthly journal club conferences.
Research/Elective
R3
The sole objective of this rotation is to accomplish the majority of the research work that has previously been planned during the formulation stage of the research project. Assistance writing the presentation of the project is also obtained from the appropriate faculty member. If the resident has special interest in pursuing training outside the institution, either to gain experience with a particular surgeon or to increase operative exposure in a specific area of interest, this can be accomplished as delineated in the resident training book.
