Residency Program
OBJECTIVE OF RESIDENCY PROGRAM
RESIDENCY APPLICATION
COMPOSITION OVERVIEW AND GENERAL STRUCTURE
RESIDENT TEACHING REQUIREMENT/EXPERIENCE
RESIDENT PERFORMANCE REVIEWS
RESIDENT RESEARCH TRAINING
RESIDENT CLINICAL TRAINING PROGRAM
FACULTY
FACILITIES
OBJECTIVE OF RESIDENCY PROGRAM
The most salient educational mission of the department is to train academic otolaryngologists. In addition to providing residents with state of the art training in all subspecialties of otolaryngology, ample opportunities are provided for resident involvement in teaching, research, and administration in order to prepare the graduates for entry into academic medicine.
Starting with the 2005 match cycle affecting individuals completing medical school and entering residency on July 2006, the new residency curriculum at the Departmen of Otolaryngology at Wayne State University will consist of five years of training. The preliminary year of general surgery will be incorporated into the new five-year Otolaryngology curriculum. The first year curriculum will still focus on general surgical training with exposure to different surgical subspecialties. The second to fifth year curriculum will consist of three months rotations at different hospitals focusing on different subspecialities of Otolarngology-Head and Neck Surgery. Residents participate in inpatient and outpatient clinical care, educational conferences and research during their training period.
Also, starting with the 2005 match cycle, the Department will participate in the National Residency Matching Program (NRMP) and Electronic Residency Application Service (ERAS). To participate in the match, applicants must register with the NRMP at www.nrmp.org and fill out an application using ERAS at http://www.aamc.org/audienceeras.htm. Adhering to guidelines of the NRMP and a timely application is important. Registration starts on August 15 and ends on December 1. Interviews will be conducted in December and January. Since the otolaryngology program is fully accredited by the ACGME as a categorical five year residency program, applicants will not need to submit a separate application to the General Surgery Department for the preliminary general surgery position..
Each year, the Department of Otolaryngology at Wayne State University receives approximately 150 applications from highly qualified individuals. The Resident Recruitment Committee reviews and invites approximately 36 - 40 candidates for interview. The interview will be conducted during the months of December and January. After the interview, the Committee makes its final recommendations and 4 applicants are matched into the residency program. Admission into the residency program has traditionally been a highly competitive process.
Any graduate of a Medical School may apply for a residency position. Appointments are made for a period of one year, beginning July 1st. Annual reappointment is available to those who demonstrate proper initiative, industry and ability. All persons appointed to the residency program must qualify for licensure by the Michigan State Board of Medicine, Lansing, Michigan.
COMPOSITION OVERVIEW AND GENERAL STRUCTURE
The residency in Otolaryngology is an accredited integrated university program with a certificate issued by Wayne State University School of Medicine after successful completion of the training period. The residency includes clinical, research, and academic training conducted at a variety of facilities throughout the Detroit Metropolitan area. The Department of Otolaryngology has 20 residents per year and additional openings for fellows in Neurotology and Head and Neck Surgical Oncology. The residency program is governed in large measure by the rules detailed in the Resident Handbook, which is distributed to all residents. When modifications of such policies and procedures are made the Handbook is corrected to reflect the changes, and residents must sign off indicating their knowledge and understanding of the adjustments.
Numerous teaching conferences are offered during the week usually on Wednesday a.m.. These include Grand Rounds, head and neck tumor conferences, professor rounds, basic science, journal clubs, and research seminars. In addition, several courses are offered by the department including a temporal bone course, head and neck anatomy course, laser course, and pathology course. Attendance in these courses and conferences is mandatory and clinical faculty are encouraged to release residents from the operating room or clinic so that to attend these events.
In addition to the regularly scheduled educational activities, all residents are asked to take the Continuing Education Course of the American Academy of Otolaryngology - Head and Neck Surgery. Limited funds are available for residents to attend the national meetings or selected special instruction courses at other institutions.
RESIDENT TEACHING REQUIREMENT/EXPERIENCE
A primary objective of the residency program is to train academically oriented clinical otolaryngologists. To meet this goal, all residents must develop teaching skills. Under the direction of faculty mentors, residents are expected to deliver numerous departmental lectures and local, regional, and national conference presentations. Financial support is usually provided by the department to defray travel costs to present research papers. In addition, residents are expected to hone their teaching skills by supervising junior residents and medical students in the operating rooms, wards, as well as the clinics. Departmental teaching performances are evaluated by audience participants, and results are discussed with each resident, both during the semi-annual reviews and periodically by those faculty mentors who have been involved in the work presented.
The Department conducts in-depth evaluations of all residents twice a year. The Resident Review Committee is comprised of selected full-time faculty members from both the clinical and research components of the department. The Committee is responsible for evaluating resident progress within the program. This Committee reviews all of evaluation forms obtained from the program directors and attending faculty, and discusses the finding with respective residents. Recommendations for improvement are written for the record, shared with the resident in question, and placed in the appropriate file for that individual. When deficiencies in level of clinical knowledge (based on observation and results of in-service exam scores), overall performance, or professional interactions are noted by the reviewers, special tutoring and mentorship is arranged to correct the problem areas. This timely identification and correction of deficiencies have contributed to the high percentage of retention and completion of the program by residents. The structure for the regular formal review of residents, although vigorous and taxing, is a strength of the training program.
The department has exceptional research facilities at the Vera Prentis Lande Medical Research Building and Karmanos Cancer Institute-Prentis Research Building. There are active on-going basic research programs in molecular biology and biochemistry of the ear, vestibular and cochlear pathophysiology, and head and neck tumor immunology and gene therapy. Additional research opportunities in the department include sinus immunology, sleep apnea, and speech and swallowing. Opportunities for research are also available with investigators from other departments.
One major goal of the training program is to train future academic surgeons in the specialty of otolaryngology-head and neck surgery. Accordingly, research, both basic and clinical, is an important and stressed aspect of the training program. All residents must complete a basic science research project prior to graduation from residency program. Typically, a resident chooses an area of interest, identifies research mentors, and develops protocol during the second year of residency of this five year program. By the end of the second year, a research proposal is finalized and reviewed by a research committee. After acceptance by the committee, the resident is given the opportunity to carry on the research during the 3 months research block time during the third year of residency. The resident is subsequently required to write a thesis (paper) in a format that would be acceptable for publication. The research project is presented in various steps of completion to the remainder of the faculty and at the annual research meeting usually held in May. In addition, the residents are expected to be involved in several other clinical or research projects during their five years of residency. The department holds an annual Otolaryngology Scientific Forum. This full day event provides an opportunity to evaluate basic science and clinical research productivity. Resident presentations at this forum are a departmental requirement.
RESIDENT CLINICAL TRAINING PROGRAM
The residency training program consists of didactic teaching and education programs, conferences, research and clinical duties at the affiliated hospitals. The curriculum includes instruction in all phases of modern Otolaryngology including Otology, Neuro-Otology, Skull Base Surgery, Oncologic Head and Neck Surgery, Rhinology and Allergy, Laryngology, Pediatric Otolaryngology, Plastic and Reconstructive Surgery, and Bronchoesophagology.
At the beginning of this program, residents will immediately experience the integration of patient care, research and education. The first year curriculum will focus on general surgical training with exposure to different surgical subspecialties, such as emergency room, trauma surgery, plastic surgery, neurosurgery, head and neck surgery, surgical intensive care, pediatric surgery, anesthesia, as well as general surgery. The rotations during this year will be jointly determined by the Department of Otolaryngology and Department of Surgery. The second to fifth year curriculum will consist of three months rotations at different hospitals focusing on different subspecialties of Otolaryngology-Head and Neck Surgery.
Currently, the second year rotations include the adult services at Harper and Receiving Hospitals and Children's Hospital. The training at this stage emphasizes examination of patients and specialized history taking, evaluation of the various laboratory tests and the resulting data, and diagnosis of otolaryngologic pathology and disease. The preoperative evaluation and decision making are stressed in addition to excellence in postoperative care. The resident performs less complicated surgical procedures and assists in major procedures. The emphasis this year is on the development of basic otolaryngologic surgical techniques and learning head and neck surgical anatomy. Third year rotations include research and adult services at Harper and Receiving Hospitals. Fourth year rotations include Harper and Receiving Hospitals, the Veteran's Affairs Hospital, and the Beaumont Hospital. These rotations offer residents the opportunity to continue to develop clinical skills and they are given greater responsibilities for patient care and surgical activities. They begin to take on leadership roles and assume greater responsibilities assisting the senior residents and faculty. Finally, the fifth year rotations include the VA, Providence Hospital (Michigan Ear Institute) and Harper/Receiving Hospitals. This year as the chief resident is the time to perfect clinical, surgical, supervisory, and administrative skills, and develop competency to take charge. At this stage, the resident is expected to have developed the expertise to plan and to carry out all of the major and minor otolaryngologic surgical procedures.
The ambulatory rotation will take place at Bloomfield Hills, Southfield and the Harper Professional Offices. The second and third year residents will be offered mentorships in otology, facial plastics surgery, head and neck, rhinology and pediatric otolaryngology.
During the residency program, residents will be provided the guidance and information to become comfortable in clinical practice and have the tools to continue their professional growth as effective teachers and competent investigators in any clinical environment.
The Department of Otolaryngology adheres strictly to the ACGME implemented 80-hour weekly limit on resident work hours. Further, in order to adhere to the work hour limit on continuous duty, residents are relieved from clinical duties in the morning following an overnight in-house call. In-house call coverage is required only at Harper University Hospital and Detroit Receiving Hospital. The call schedule is determined by the chief resident. Currently, the call schedule is 1 in 4 for PGY2, twice a month for PGY3, once a month for PGY4, and back-up calls for PGY5.
The chairman and the faculty are dedicated and committed to the education of the residents. The Otolaryngology department consists of 9 full time clinical Otolaryngologists, 6 full time PhD researchers and 4 PhD clinical faculty. In addition there are over 30 affiliated clinical faculty that participate in the training program.
The Detroit Medical Center
Most of the facilities utilized by the Department of Otolaryngology are located in the Detroit Medical Center - a conglomerate of hospitals, clinics, laboratories, libraries, and classrooms. The Medical Center consists of the Wayne State University School of Medicine, the Shiffman Medical Library, Prentiss Medical Research Building, Harper University Hospital, Children's Hospital of Michigan, Hutzel Hospital, the Rehabilitation Institute, Detroit Receiving Hospital and the University Health Center.
Detroit Receiving Hospital
This 350 bed hospital is the primary trauma facility for the Detroit Medical Center with approximately 65,000 emergency cases per year. The hospital provides excellent experience and training in trauma and emergency Otolaryngology. Facial trauma calls are shared with Plastic Surgery and Oral Maxillofacial Surgery.
Harper University Hospital
This is a completely renovated, voluntary, non-profit general hospital with 600 beds. Approximately 24,000 patients per year are admitted, of which 3,000 are admitted to the Otolaryngology services. The hospital provides a large volume and variety of all types of Otolaryngology pathology.
Karmanos Cancer Institute and Hospital
The Karmanos Cancer Institute and Hospital is designated by the National Cancer Institute as among the very best cancer centers in the United States. The Meyer L. Prentis Comprehensive Cancer Center of Metropolitan Detroit, operated by the Institute and Hospital, is one of 38 National Cancer Institute-designated comprehensive cancer centers in the United States. Caring for more than 6,000 new patients annually on a budget of $200 million, conducting more than 400 cancer-specific scientific investigation programs and clinical trials, the Institute and Hospital is among the nation's best cancer centers. The Institute and Hospital strives to prevent, detect and eradicate cancer through 1,200 staff including 300 faculty members supported by hundreds of volunteers and thousands of financial donors.
Children's Hospital of Michigan
This is a modern 310-bed hospital providing rotating residents with excellent experience in the disease of children. The entire spectrum of childhood diseases is treated at the hospital under the direction of the Otolaryngology staff.
Beaumont Hospital
This 1000 bed hospital located in Oakland County provides for a rotation in which residents learn pediatric otolaryngology, facial plastic surgery and otology in a community setting. Outpatient care is conducted in offices staffed by fulltime and voluntary faculty.
Veteran's Administration Hospital
The Detroit Veteran's Administration Hospital is a 432-bed inpatient and outpatient facility located in downtown Detroit adjacent to the Detroit Medical Center. The VA Hospital participates in training Wayne State University residents in a number of medical and surgical specialties including otolaryngology. The hospital contains a full range of medical, surgical and psychiatric services, both inpatient and outpatient. Complete audiological and vestibular test facilities are available as well as state of the art equipment in the operating room. Residents rotating at the VA Hospital would be expected to participate in care of patients with a wide range of otolaryngological disease.
Harper Professional Building
The Harper Professional Building office is one of the major out-patient facility for the Detroit Medical Center. Speech Pathology forms a cooperative unit with Otolaryngology to compliment clinical services and integrate research projects. Approximately 5,000 out-patients are cared for per year by the Otolaryngology Services. Medical student and residency programs are developed around this clinic experience.
Other Hospitals and Offices
Other hospitals that residents will be involved in patient care include St. Joseph Mercy Oakland, and Pontiac Osteopathic Hospital. Residents will also see patients with faculty at the Bloomfield Hills and Southfield Offices.
Helen Vera Prentis Lande-Medical Research Building
The Medical Research Building houses the molecular biology and neurophysiology laboratories of the Department. Facilities for biochemical, anatomical, and electrophysiological analysis of the ear and related systems are provided for the laboratory. Animal storage facilities, operating rooms, temporal bone laboratories, audiologic sound, and approximately 25,000 square feet of various research projects.
Head and Neck Cancer Lab
The Department of Otolaryngology maintains two head and neck laboratories focusing on basic cancer research. One of these laboratories is located on the 4th floor of the Prentis Building of the Karmanos Cancer Institute and includes 1,000 square feet with all needed equipment and core facilities to perform cutting-edge cancer research. The other laboratory, with approximately 800 square feet of space, is located on the 4th floor of the Detroit VA Medical Center.
Voice, Speech, and Swallowing Lab
This laboratory is located in the Harper University Hospital Professional Office Building, Suites 510/512. Space is shared with the University Otolaryngology P.C.out-patient clinic. Both clinical and research activities focus on patients with voice, speech and swallowing disorders. State-of-the art videolaryngostroboscopy, videoendoscopy, speech aerodynamic, acoustic, and tongue, lip, and jaw force physiologic instrumentation are routinely used for patient evaluations and treatments. A multidisciplinary approach to patient care is employed within the laboratory to facilitate the associated clinical speech pathology program operating out of the same suite of offices.
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