Resident Attire: Residents are expected to project a professional image. Male residents should wear ties when not in scrub suits, and female residents should likewise dress appropriately. Coats should be worn over scrub suits when outside the operating room.
Chain of Command: When problems develop in any of the hospitals, the resident should follow protocol in dealing with them. Junior residents should consult with the senior resident, who in turn may consult with the faculty chief of the service involved. Problems not solved in this fashion will be taken to the Department chairman by the service chief.
Charts, X-rays, Records: CT scans, charts, and other patient material should be returned as quickly as practical, as these are often required for consultations or follow-up visits. Residents are responsible for returning X-rays and charts after surgery, conferences, etc. These arenever to be taken off campus, kept in the resident's car or home, etc. Continued violation of this rule may result in the offending resident being placed on probation. Residents are expected to remain current in their charting and dictating duties.
Reimbursement for Necessary Expenses: The Department is not allowed to purchase certain items or pay certain expenses for residents directly. However, we are allowed to reimburse your for certain expenses directly related to your otolaryngology training, with a maximum of $2,000 over your four years as allowed by the IRS. Reimburseable expenses include lab coats, camera equipment, and otolaryngology textbooks, and they must be purchased while you are officially an otolaryngology resident, not during your general surgery year. Items other than those listed above must be submitted in writing with a cost estimate to the Program Director for consideration prior to being purchased. As these items are purchased, please bring receipts to the Resident Secretary so that we may arrange for your reimbursement.
Lab Coats: Lab coats may be ordered through the Student Store. Residents may choose whatever style, type and color of embroidery, they wish. Funds are provided which should allow resident to purchase new laboratory coats twice during their residency.
Cameras and Photography: It is a departmental requirement that all residents in the Department of Otolaryngology have a 35 mm camera (with at least a 75 mm lens) for documentation of patient care as well as for teaching and educational purposes. Residents are expected to take pictures of all trauma cases (even minor facial lacerations), and no patient should be taken to the operating room for repair of facial injuries (either soft tissue or bony) without documentation of these injuries by appropriate photographs. Photographic documentation is also required for all reconstructive and cosmetic cases at Parkland, CMC, VAMC and JPS. Residents are encouraged to photograph as many facial plastics cases as possible (even if they were not involved in the case themselves), to provide better post-operative photographic documentation department-wide.
Residents are required to turn in exposed film and obtain new film from Dr. Truelson (in person). This will allow him to monitor quality, provide suggestions, keep the necessary department slides, provide copies (including follow-ups for those residents who have rotated off-service), and insure proper labeling. All photographs and slides become the property of the Department, although copies may be obtained by residents through the above channels. All slides and photographs must be identified with the patient's name, hospital, medical record number, and diagnosis. One means of accomplishing this is by photographing the addressograph stamp on the chart prior to taking the clinical photo. Secretaries are not to dispense film to residents or send film for developing for them.
Annual Otolaryngology-Head and Neck Surgery Exam: Otolaryngology residents must take this examination each year. The Department will pay the registration fee. This exam is optional for residents still assigned to General Surgery, but to encourage their taking the examination (for education and experience), the Department will pay their registration fee if they contact the Resident Secretary to arrange to take the test. Registration for the examination and coordination of the exam itself is through the office of the Program Director.
AAO-HNS Home Study Course: Otolaryngology residents are required to complete this course annually. The faculty feels strongly about the value of this course that it will be provided at no cost to each resident by the department. The Program Director receives from the Academy a list of all the residents who have completed the course along with their scores, allowing the Program Director to monitor course participation and provide help and the necessary encouragement where it may be needed. This course is optional for residents still assigned to General Surgery, who have not yet begun their Otolaryngology training.
Departmental Library: The Otolaryngology Conference Room and Library is located in room G7.234, and is open to the residents at any time. The combination to the lock may be obtained from the office of the Program Director. Books and bound periodicals may be checked out through the same office. Please replace items on the shelves when you have finished. Also, residents are requested to help keep the room clean and neat. This includes food and refreshment items brought into the room. The shelves and tables are not to be used to store reprints or projects.
If any problems are encountered with the AV equipment in this room, please report them immediately to the secretary of the Program Director so that they can be corrected.
Medical School Library: Residents assigned full-time to the Department may obtain a card to be used in copying material in the UTSMC library. The Department has allocated a total of $50 per month for all copying by all residents, and situations in which this privilege is abused may result in suspension of copying support for all residents. For preparing multiple copies, residents should use the copier in the Department Mail Room. The Department will submit a list of eligible residents at the beginning of each resident year, and your copy card may then be obtained from the Medical School Library.
Student Loan Deferments: Signatures required on student loan deferment forms are obtained through the office of the Program Director. The resident must fill in all blanks (including deferment period, address, etc.) prior to submitting the material, which will be signed and returned to the resident. It is the responsibility of the resident to send the completed form to the loan company.
ACLS Recertification: Each resident at the start of their Parkland rotation in their first Otolaryngology year, and again while assigned to Parkland in their third Otolaryngology year, must schedule and complete ACLS recertification. This can be scheduled by calling the ACLS Recertification Office at Parkland, 590-6757. Two half-day sessions are required (Thursday and Friday afternoon), and these are offered only once a quarter. The cost for those with a Parkland ID badge is $5 (the cost of the card). Residents should bring their completed card showing recertification to the secretary of the Program Director, so that a copy can be placed in their resident file.
Vacation-Conference Schedule: Each resident is allowed two weeks vacation and one week of conference leave per academic year (July through June). For this purpose, a "week" is Monday through Friday. Requests for the next year must be submitted in writing (on the form provided) two months prior to the requested dates to the Program Director. Requests received after June 1 for the academic year starting July 1 will be honored on a first come, first-served basis. Residents must observe the following guidelines: (1) No two residents on the same service off at the same time; (2) No scheduled vacation or conference leave during Christmas or New Year holiday, (3)) No vacation during the week preceding the Annual Otolaryngology ("In-Service") Exam. In addition, a limit is placed on the total amount of vacation time which may be taken by all residents on that service during each rotation at specific hospitals. Additional restrictions may be imposed by the chiefs of service at the various venues if necessary to assure adequate clinical coverage at their facility.
Vacations must be taken in blocks of seven days (including five weekdays).Conference time may be split into no more than two segments, totaling no more than five weekdays.Traditionally, the conference week during the R1 year has been used to attend the temporal bone dissection course offered by Dr. Fred Owens, and the week during the R3 year used to attend the Academy fall meeting.The faculty understand that attending conferences costs money, and often residents find it a hardship to attend a non-sponsored conference and would prefer to use the week for writing papers, reading independently, or for other academic pursuits. The department supports this activity, but it is imperative that the resident designs a plan for the week, specifically listing each day's planned activity and anticipated accomplishments, and submit this plan to the Program Director prior to taking the conference week break.
Requests for changes to the vacation/conference schedule must be submitted in writing to the office of the Program Director at least two months prior to the beginning of the service rotation.Vacation schedules are distributed to each of the affiliated institutions. However, it is the responsibility of the individual resident to notify his/her fellow residents, the chief of the service involved, and the clinic staff of scheduled vacation and conference periods in a timely manner, to avoid disruption in patient care.
Effective May 1, 2001, all resident absences from the campus for more than 24 hours during the normal Monday through Friday work week must be reported in writing to the office of the Program Director.
Departmental Support for Meetings Attendance: In order to encourage residents to participate in research and preparation of papers, the Department provides financial support to attend meetings under certain clearly defined circumstances. If a resident is the first author or presenter of a paper accepted, after refereed evaluation, for a recognized national or sectional professional meeting, the Department will reimburse approved expenses up to $1000 for that meeting. The specific meetings for which such support are available are: the American Academy of Otolaryngology-Head and Neck Surgery, The American Academy of Otolaryngic Allergy (annual meeting only), the American Academy of Facial Plastic and Reconstructive Surgery, the American Society for Head and Neck Surgery, the American Laryngological Society, the American Society of Pediatric Otolaryngology, the American Otologic Society, and the annual and sectional meetings of the Triological Society. Poster presentations do not receive Department financial support.
The Department will also reimburse approved meeting-related expenses up to $750 for attendance of residents in their third Otolaryngology year at the annual meeting of the AAO-HNS.
All Departmental support is contingent upon presentation to the resident's faculty mentor of an acceptable draft manuscript at least 30 days before the scheduled date of the meeting. All reimbursement for meeting attendance must be authorized by the Program Director and arranged beforehand with the Department Administrator, and failure to obtain pre approval of expenses may jeopardize reimbursement. A copy of the acceptance letter must accompany a travel request (see form, section 2 of Blue Book), and must be submitted no less than 30 days before the anticipated date of beginning travel (in order to obtain the most advantageous air fares, etc.). To comply with School and Department policies, reimbursement requests and supporting receipts must be turned in to the Department Administrator within 10 days of the end of the trip. Finally, approval of travel to attend and present at a meeting is predicated on the resident having sufficient leave time remaining during the resident year in question to allow his/her official absence for this purpose.
There will be a limit of $2000 total Department financial support for any resident during a single residency year. Departmental support for professional travel for residents remains contingent on the availability of sufficient fiscal resources to provide such funds. Residents should also be aware that Travel Grants are available to attend meetings and courses of many professional societies. Further information may be obtained from the office of the Program Director.
Resident Research and Elective: All residents are provided a three-month Elective period in the R3 year. Salary during this time is maintained through PMH.
Every resident will participate in research activity. In choosing a research project, whether basic science or clinical, the resident should initially consult the research director. He will be able to give guidance and counsel, and often can allow the resident to contribute to or continue research, which is already ongoing. In the case of clinical projects, the resident will be put in touch with the appropriate faculty member who will serve as preceptor on the project. The research director will meet with each resident 5 months prior to the projected start of their elective rotation to discuss projects and give guidance. The resident must complete and turn in to the research direactor a Grant Application (available from his office) covering the project no later than 3 months prior to the beginning of the Elective/Research rotation. The resident is expected to make a 15-minute presentation covering the project at the June conference, which ends his/her senior resident year. The final research manuscript is due in the chairman's office by January 31 of the resident's final year.
In addition to the research project, part of the research rotation may be used to take an off-campus mini-fellowship. To do this requires that the individual submit the details of the proposed fellowship to the Program Director three months prior to the beginning of the elective rotation and appear at the subsequent faculty meeting to defend the choice. Such mini-fellowships are supported by Department funds for salary expenses and require that a paper based on the experience gained during the training be submitted by the resident within one month of returning.
In addition to research and the possibility of an away mini-fellowship, training in allergy and communicative/vestibular disorders will be scheduled during this three month block. The specific schedule is determined by Angela Shoup, PhD. Residents must meet with her before the beginning of the rotation to schedule the two week experience and make it as productive as possible.
Monthly Conferences: The first Friday of each month is devoted to our Departmental Conference, and resident clinical activities are suspended except for coverage of emergencies.
All residents, except those in their initial General Surgery training, are required to prepare and deliver 2 30-minute lectures during conference time on specified topics. These topics are scheduled by the Program Director, and a lecture outline will be provided in the form of a series of questions that must be answered in the talk. This format will ensure coverage of the most important aspects of each topic as well as make sure that all topics are covered on a three-year cycle. A written hand out should accompany the lecture for distribution to the other residents to allow these to be used for preparation for the OTE and written boards. There will be a limited opportunity to switch topics with fellow residents of the same year, depending on the conference schedule that day.
Visiting Professors are scheduled several times each year. Case presentations to the Visiting Professors are the responsibility of the senior resident on the applicable service (usually University Hospital or Children's Medical Center), but should be coordinated with the faculty member responsible for the conference.
A regular part of the conferences is a Radiology session with Dr. Dianne Mendelsohn. It is the responsibility of the residents assigned to University Hospital to pull interesting radiographs and deliver them to Dr. Mendelsohn at least two weeks before conferences where she is scheduled to lecture, to allow her time to prepare.
Journal Club: The Journal Club is scheduled as part of the monthly conference, with an additional journal club on the following Tuesday at 5:00 pm. Journals reviewed are the preceding month's issues of Archives of Otolaryngology, Annals of Otolaryngology, Laryngoscope and Otolaryngology-Head and Neck Surgery. Each Otolaryngology resident is expected to attend and to have prepared. Additional articles from other journals may be distributed prior to Journal Club for discussion.
Temporal Bone Laboratory: The Department has a state of the art, 17-station temporal bone laboratory. This is the site of four Temporal Bone Laboratory sessions per resident year. These are held on Saturday, from 8:00 AM to 1:00 PM. Temporal bone privileges for surgery are obtained by satisfactorily completing and demonstrating to a faculty proctor the resident's ability to drill temporal bones, point out landmarks, etc.
Head and Neck Anatomy Course: A course and laboratory dissections covering anatomy of the head and neck is held on alternate years. These occur on Saturday, from 8:00 AM to 1:00 PM, in the UTSMC Anatomy Lab, under the direction of Dr. Truelson.
Basic Science Core Lecture: Three half-day lecture sessions per year are devoted to basic science topics. These are held in the Department Conference Room from 8:30 AM to 12:30 PM. Various faculty members participate, and the program is under the direction of the Program Director. These sessions are presented to provide a basic science background for the clinical knowledge acquired during residency and in preparation for Inservice and Board exams. Attendance is mandatory for all residents in their R1 through R4 year of Otolaryngology.
Department Courses: Various courses may be presented by the Department throughout the year. In the past these have included an Endoscopic Sinus Surgery Course, a course in Otolaryngic Allergy, and a seminar in Pediatric Otolaryngology. Arrangements are generally made for residents to attend and participate in these courses.
Medical Records: As emphasis in medical records shifts heavily to documentation for both practical and medicolegal purposes, the JCAH has defined standards of documentation that include, most importantly, legibility of records. Their definition of a legible chart note is one that can be read completely by two independent, randomly chosen people. If a note is discovered to be illegible, the hospital is cited with the infraction.
An illegible note on a chart serves absolutely no useful purpose to anybody. Don't presume that a quickly written, illegible note saves you any significant time. It only costs you additional time on the phone having to confirm what someone else cannot read.
