OUTLINE FOR DESCRIPTION OF ROTATION

 

 

ROTATION:              ENT

 

PRECEPTOR(S):       Drs. Ron Darling, Ed Kass, Thomas Belson, William Darling, Mary Fox

 

DURATION:              2-4 Weeks

 

 

 1.        GOALS/OBJECTIVES:

            --- To master basic ENT exam skills including:

                        --- history

                        --- head, neck, ear, nose, and throat examination including indirect mirror nasal laryngoscopy.

            --- To become familiar with common ENT problems and to know when to refer them,

            --- To meet with the audiologist and review use of audiograms and hearing aids.

 

 2.        EXPECTATIONS OF THE RESIDENT:

                        --- See patients in an outpatient clinic with an ENT preceptor with exposure to a wide variety of disorders. Perform the ENT examination including indirect laryngoscopy on some patients.

            --- Discuss pathophysiology as it is encountered.

                        --- Observe/assist in surgery, for educational cases depending on preceptor and resident interest. Best  cases would be those FP's counsel patients on, i.e. T&A, tubes, etc.

 

 3.        SUGGESTED PREPARATION/REFERENCES:

            A copy of "Common Problems of the Head and Neck" - Dr. Roger Crumley, is distributed to our residents.

 

            Other suggested references:

            "ESSENTIALS OF OTOLARYNGOLOGY" by Lucente & Sobol.

 

            Saunders TEXTBOOK OF OTOLARYNGOLOGY is somewhat more extensive, but also an excellent basic reference.

           

 4.        TYPICAL DAY/WEEK:

            Monday through Friday, when not in FP clinic (8AM-12N, 1PM-5:30PM).

 

 5.        WORKUPS/WRITE-UPS:

            The resident will evaluate patients together with the preceptor in an office setting. Workups and write-ups are not generally required.

 

6.         PROCEDURES:

            This may vary some, depending on preceptor.  Residents should tell the preceptor they are interested in procedures. Possibilities include pneumatic otoscopy, indirect mirror laryngoscopy and nasal pharyngoscopy; examination of the ear under the oto microscope; myringotomy; tuning fork tests of auditory function. Surgical and basic procedures are basically not done by the residents, although the residents are invited to observe the procedures (eg. vent tube placements, etc.) here in the office and are also invited to observe otologic procedures in the operating room if they wish and their time permits.

 

 

 

7.         AVAILABLE EDUCATIONAL EXPERIENCES/CONFERENCES:

            WMH All Staff, MCW and program conferences are required. A suggested list of talking topics includes:

 

            -Otitis Media, When to Refer                                         -Oral and Pharyngal Infections

            -Disease of the Inner Ear                                               -Benign and Malignant Tumors

            -Conductive Hearing Loss                                              -Salivary Gland Disease

            -Foreign Bodies and Cerumen Impaction             -Allergic Rhinitis

            -Sinusitis                                                                       -Hoarseness

            -Cervical Masses                                                          -Indications for Tonsillectomy

            -Prophylactic Antibiotics for OM                                    -Vertigo

              vs. Tympanostomy Tubes

 

8.                IMPACT ON FP OFFICE SCHEDULE/NOON CONFERENCE SCHEDULE: 

           Little conflict is to be expected.

 

 9.        CALL:  NONE

 

10.       WEEKEND REQUIREMENTS:  NONE

 

11.       VACATION/TIME OFF:

            One week if the resident elects to do 4 weeks of ENT

 

12.       EVALUATION:

            The resident should be comfortable and competent performing an ENT history and physical exam, formulating a differential diagnosis, and generating treatment options. This should include indirect mirror exams.

 

13.       CRITERIA FOR SUCCESSFUL COMPLETION:

-- The resident will have an adequate ability to evaluate common disorders of the ears, nose and
     throat.

-- The resident must attend the ENT clinic or spend time with the otolaryngologist in the OR at least 8     half days per each two weeks of the rotation. One of these half days should be with the audiologist.

            -- The resident should demonstrate proper technique in basic ENT exam. 

.

14.       COMMENTS:

            The resident will probably find that experiences will vary somewhat depending on their preceptors. The residents have been encouraged to try to tailor the rotation somewhat to maximize their learning, by spending more time in the OR.

 

 

 

 

 

 

 

 

 

 

 

 

 

Revised:  6/1/05 – PHG:lmc