Philadelphia University + Thomas Jefferson University

Rotations

Otolaryngology Rotations

As a resident in our program you will experience a balanced approach to your clinical education.  Each year, residents spend time on two to three of the inpatient teams (Head and Neck, Subspecialty, and Consult services).  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 Subspecialty service emphasizes in-patient care of rhinology, laryngology, cosmetic facial plastic surgery, sleep surgery, endocrine, and skull base surgery.  Lastly, the Consult service manages consultations from both the emergency department and other inpatient teams within TJUH.  The remainder of the rotations for each year are primarily structured by subspecialty (with the exception of the 20-week research block during PGY4) and are designed in such a way that time is split evenly between the clinic and operating rooms.  During these “off-service” rotations, residents do not have any inpatient responsibilities outside of the operating room.  Time is also reserved each week during the subspecialty rotations for research and studying.

PGY-1

Interns spend six months in our department.  Half of their time will be spent on the Head and Neck Service where they will round on the head and neck oncology patients and operate four days a week.  They will also spend two months on the consult service where they have an opportunity to see common consults on their own with senior resident support and formulate treatment plans.  Finally, they will spend a month at A.I. DuPont Hospital for Children as well as a month with Drs. Fisher and McGettigan, two recent graduates of the program who practice general otolaryngology.  They will also rotate one month each on Anesthesia  and Neurosurgery. The remaining four months will be spent in a general surgery internship that is coordinated with the Department of General Surgery that includes trauma/acute care surgery, ICU/critical care, plastic and endocrine surgery.  

Call Schedule (ENT service)

There is no in-house or home call while on the ENT service.  However, the service does require support of one intern on inpatient rounds on Saturday/Sunday mornings - to be alternated between the two on-service interns.  Call responsibilities while on other services are handled at the discretion of those services.

PGY-2

The Head and Neck rotation PGY2 is separated into two distinct blocks- one during which the resident works exclusively with two different Head & Neck attendings in the clinic and OR.  These rotations introduce residents to the breadth of head & neck oncologic surgery early in training and provide excellent continuity of care.  Ten additional weeks are spent on-service with the Consult Team.  While on this rotation, PGY2’s enjoy a diverse case mix in the OR, work up new consultations, formulate treatment plans with the assistance of senior residents, and become adept at handling common ORL problems such as epistaxis and peritonsillar abscesses.  During the Facial Plastics block, the resident spends three days per week in the clinic engaged in facial analysis, injections, and in-office procedures.  Two days are also spent in the OR participating in cosmetic and reconstructive surgery.  A third component of the rotation involves a microvascular lab.  The final rotation is at A.I. DuPont Hospital for Children.  During this time, the resident begins his or 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 are 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- 20 weeks
  • Facial Plastics – 10 weeks
  • Consult Service – 10 weeks
  • Pediatric OTO-HNS – 10 weeks

Call Schedule

Five to seven in-house calls per 10-week block.  Two to three weekend calls which include Friday and Sunday per 10-week block.  The remaining weekends are free of clinical responsibility.  Residents do not round on the weekends unless they are on call.

PGY-3

The PGY-3 on-service rotations include 10 more weeks with the Consult team, as well as 10 weeks with the Subspecialty service.  The Consult rotation again offers a diverse, high volume operative experience.  Outside of the OR, there is a level-appropriate escalation of responsibility, as the PGY3 runs the Consult team and presents plans directly to attendings during one-on-one rounds.  During the Subspecialty block, the residents are immersed in the peri- and post-op care of patients undergoing Endocrine, Laryngologic and Sinus and Skullbase surgery.  The remaining 30 weeks of the year are spent off-service.  During the Neurotology rotation, typically one day a week is spent  in the office and three to four days are spent in the operating room, where there is a focus on tympanoplasty, mastoidectomy and chochlear implantation.  During this time, the residents are also exposed 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 stroboscopy, and transcervical vocal fold injections.  Cases in the operating room range from microdirect laryngoscopy with vocal fold injections to the laser treatment of subglottic stenosis and formal laryngotracheal reconstructions.  During the Laryngology rotation, the residents get extensive exposure to sleep medicine and surgery through their time with Drs. Boon and Huntley.  This includes drug-induced sleep endoscopy, UPPP, and upper airway stimulation with the hypoglossal nerve stimulator.  Lastly, the Rhinology block provides a vast operative experience with both functional endoscopic sinus surgery and complex cranial base surgery.  While in clinic, the Rhinology resident is also introduced to allergy testing and immunotherapy.

  • Consult Service - 10 weeks
  • Rhinology- 10 weeks
  • Neurotology – 10 weeks
  • Subspecialty Service – 10 weeks
  • Laryngology – 10 weeks

Call Schedule

Three to four in-house calls per 10-week block and two to three weekend calls per 10-week block which includes Saturday only.  The remaining weekends are free from clinical responsibility. Residents do not round on the weekends unless they are on call.    The PGY-3 class is also responsible for the office home call, answering questions and directing patients that call the outpatient office after hours. 

PGY-4

PGY4 residents rotate through the Consult service one final time and return to the Head & Neck team as well. During both of these rotations, residents start to take a lead role in many of the operative procedures, including thyroidectomy, parathyroidectomy, rhinoplasty, facial fracture repair, and neck dissection.  The PGY4 on the Consult team provides oversight and takes on a teaching role.  While on the Head & Neck service, the PGY4 runs the weekly Tumor Board conference.  Residents also return to A.I. DuPont Hospital in the PGY-4 year for ten additional weeks dedicated to pediatric otolaryngology with a heavy emphasis on endoscopic ear surgery  and airway reconstruction. Finally, a 20-week block is reserved for research.  Aside from one operative day per week and call, research time is completely protected from inpatient obligations.

  • Head & Neck Service – 10 weeks
  • Research – 20 weeks
  • Consult Service – 10 weeks
  • 2nd Pediatric Rotation – 10 weeks

Call Schedule

Five to seven weekday calls per 10-week block.  Weekday calls are second call as a back-up to the junior in-house resident.  Senior residents on call come into the hospital to assist with emergencies and operate after hours.  The PGY4 class also takes two to three weekend calls per 10-week block during which they are required to be in the hospital to lead inpatient rounds and discuss patient management with attending surgeons.  The remainder of the weekend call is home call.  

PGY-5

During the final year, 10 weeks each are spent as chief of the Head & Neck and Subspecialty services at Thomas Jefferson University Hospital.  During the resident’s time as the Head & Neck chief, he or she spends two days in the office with the department chair, Dr. Keane.  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 and 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 the initial office visit to the operating room and finally during 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 advance practice providers (Nurse Practitioners and Physician Assistants) who are providing that care.

While chief of the Subspecialty team, the resident spends 4-5 days per week in the operating room further gaining mastery of the surgical procedures in OTO-HNS. 

Ten weeks are spent as Operative Chief.  During this block, chief residents participate in the procedures of their choice allowing them to focus on their chosen subspecialty.  This is strictly an oeprative block with no inpatient clinical responsibility outside of call.

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.  Finally, a 10-week period as Academic Chief Resident is dedicated to departmental administrative duties and medical student education.  During this rotation, the resident will operate approximately 2-3 days per week.

  • Head and Neck Service – 10 weeks
  • Neurotology – 10 weeks
  • Subspecialty Service – 10 weeks
  • Academic Chief – 10 weeks
  • Operative Chief - 10 weeks

Call Schedule

Four weekday calls per 10-week block (no weekdays while on the head and neck oncology service).  Weekday calls are second call as a back-up to the junior in-house resident.  Senior residents on call come into the hospital to assist with emergencies and operate after hours.  One to three weekend calls per 10-week block which includes only Friday night.  Chief residents do not take Saturday/Sunday call.  

William Keane, MD
William Keane, MD
Chairman

Maurits Boon, MD
Maurits Boon, MD
Program Director

Colin Huntley, MD
Colin Huntley, MD
Associate Program Director

Colin Huntley, MD
Stanley Pelosi, MD
Associate Program Director

Karen Keane, MD
Karen Keane
Program Coordinator

News & Events

2nd Annual Sialendoscopy Course
November 16, 2018

Designed for licensed healthcare professionals who perform, or wish to perform, sialendoscopy in their practices.  

Course Location:

Jefferson Alumni Hall
1020 Locust Street
Philadelphia, PA 19107


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