Thomas Jefferson UniversitySidney Kimmel Medical College

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Rotations

Otolaryngology Rotations

As a resident in our program you will experience a balanced approach to your clinical education.  Each year there are two on-service rotations where you work with a team of four other residents. The Head and Neck Service is dedicated to the in-patient care of patients requiring head and neck oncologic surgery, endocrine  surgery, and facial plastic and reconstructive surgery.  The “Jefferson Service” emphasizes in-patient care of rhinology, laryngology, cosmetic facial plastic surgery, sleep surgery, endocrine, and skull base surgery.  Each of these on-service rotations is approximately three months in length and is an intensive experience in the operative and inpatient management and care of OTO-HNS patients.  The remaining six months of each year is spilt into two, approximately three-month “off-service” rotations.  During the off-service blocks you are submersed in the experiences of ENT subspecialties as well as research which are described in detail below.

PGY-1

As of 2005, the intern year has been incorporated into the Otolaryngology training program. Interns will spend three consecutive months on the Head and Neck Service at Thomas Jefferson University Hospital.  They will also rotate one month each on Anesthesia, Emergency Medicine and Neurosurgery. The remaining six months will be spent in a traditional general surgery internship which is coordinated with the Department of General Surgery.

Call Schedule (ENT service)

There is no in-house or home call while on the ENT service.  However, the intern will assist in the hospital on Saturday mornings only.  Call responsibilities while on other services are handled at the discretion of those services.

PGY-2

In addition to the two on-service rotations of the Head and Neck Service and the Jefferson Service, three months will be dedicated to facial plastics.  During this time, the resident spends two days per week in the office engaged in facial analysis, injections, and local, minor procedures.  Two days are spent in the OR participating in cosmetic and reconstructive surgery.  A third component of the rotation involves a microvascular lab. Currently, a research and educational protocol allots ten rats per resident allowing for both training as well as research activity.  The final rotation is at A.I.DuPont Hospital for Children.  During this time, the resident begins his/her experience in pediatric OTO-HNS.  Time is split between the office and the operating room and all aspects of the care of pediatric OTO-HNS patients is covered.  While at A.I. DuPont, service responsibilities are shared with a PGY-4 resident and a pediatric OTO-HNS Fellow.

  • Head and Neck Service 3 months
  • Facial Plastics – 3 months
  • Jefferson Service – 3 Months
  • Pediatric OTO-HNSENT – 3 months (DuPont)

Call Schedule

Five in-house calls per month.  Two of these calls are a Friday and Sunday of one weekend.  The remaining three weekends are free of clinical responsibility.  Residents do not round on the weekends unless they are on call.

PGY-3

Again, as the trend is in our program, the resident will spend three months on Head and Neck Service and three months on the Jefferson Service.  During these on-service blocks, the 3rd year resident is responsible for all in-patient consults that come to the OTO-HNS service.  This is an opportunity to begin the process of clinical decision making and patient management while under the guidance of the senior and chief residents as well as the attending physicians.  The two additional rotations are dedicated neurotology and laryngology.  During the Neurotology rotation, two days are spent in the office and two days are spent in the operating room.  During this time, the residents also get an exposure to audiology.  The Laryngology rotation affords the resident an opportunity to see a variety of patients suffering from voice, swallowing, and sleep disorders, and to participate in office-based procedures such as transnasal esophagoscopy, video stoboscopy, and transcervical vocal fold injections.  Cases in the operating room range from micro direct laryngoscopy with vocal fold injections to laryngotracheal reconstructions to laser treatment of larygotracheal stenosis and multi-level sleep surgery.

  • Head and Neck Service 3 months
  • Neurotology – 3 months
  • Jefferson Service – 3 Months
  • Laryngology – 3 months

Call Schedule

Four in-house calls per month.  One of these calls is a Saturday.  The remaining weekends are free from clinical responsibility. Residents do not round on the weekends unless they are on call.    The PGY-3 is also responsible for the office home call, answering questions and directing patients that call the outpatient office after hours.

PGY-4

Six months are spent at Thomas Jefferson University Hospital during the fourth year (three months on each of the on service rotations). During this time, residents are starting to take a lead role in many of the operative procedures, including thyroidectomy, parathyroidectomy, rhinoplasty, and facial fracture repair.  Residents will return to A.I. DuPont Hospital for three additional months dedicated to pediatric otolaryngology with a heavy emphasis on otology and airway reconstruction. Finally, a three-month block is dedicated to basic science research.

  • Head and Neck Service – 3 months
  • Research – 3 months
  • Jefferson Service – 3 Months
  • 2nd Pediatric Rotation – 3 months (DuPont)

Call Schedule

Five home-calls per month.  As a senior resident you provide back up to the junior in-house resident.  Two of these home call days are absorbed by a Saturday/Sunday coverage.  The remaining three weekends are free from clinical responsibility.

PGY-5

During the final year, three months each are spent as chief of the respective services at Thomas Jefferson University Hospital.  During the resident’s time as the Head and Neck Chief, the resident spends two days in the office.  All aspects of patient care are coordinated by the resident under the guidance of the attending, from arranging for pre-operative imaging and testing, to scheduling surgery, to arranging for ancillary services when appropriate.  Two days are spent in the operating room.  Here the resident takes a lead role in the operative cases, ranging from neck dissections to parotidectomies to thyroidectomies to free flap reconstructions.  This is a longitudinal experience wherein the resident sees the patient from initial office visit to operating room to post-operative management.  In addition to the outpatient and operative experiences, the Head and Neck Chief Resident is responsible for all aspects of in-patient care of the Head and Neck Service patients, as well as managing the team of residents and mid-level practitioners (Nurse Practitioners and Physician Assistants) who are providing that care.  Three months are spent as the Chief of the Jefferson Service.  During this time, the resident manages the resident team responsible for patient care.  Also the Chief Resident spends 3-4 days per week in the operating room further gaining mastery of the surgical procedures in OTO-HNS. 

The final subspecialty rotation is the Chief level neurotology experience.  Here the resident splits time between the operating room and the office, often operating on the more complicated neurotologic patients.  Additionally, the Neurotology Chief manages the neurotology inpatient service.    Finally, a three-month period as Academic Chief Resident is dedicated to departmental administrative duties and medical student education.

  • Head and Neck Service – 3 months
  • Chief Neurotology – 3 months
  • Jefferson Service – 3 Months
  • Academic Chief – 3 months

Call Schedule

Four home-calls per month.  As a senior resident you provide back up to the junior in-house resident.  There are no weekend calls for the chief except for one Friday night per month.

William Keane, MD
William Keane, MD
Chairman
Edmund Pribitkin, MD
Edmund Pribitkin, MD
Program Director
Maurits Boon, MD
Maurits Boon, MD
Associate Program Director
Karen Keane, MD
Karen Keane
Program Coordinator

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