Resident Objectives Overview

This document serves as a guide to the goals and objectives for our residency program in otolaryngology. It is not intended as a detailed listing of the knowledge base required in each area. Instead it serves as an overview for the expectations of the otolaryngology residents as they progress through their training program. Certain aspects of the program may need to be individualized for a given resident, but a certain base of knowledge and proficiency in procedures is expected for each year of the program. Evaluation of residents are partly based on these guidelines. Some basic capabilities are expected of our residents upon entry to the program. Certainly these skills should grow throughout the residency, but it is expected that all residents, regardless of year, should exhibit basic competency in the following areas:

• Obtaining a case history Patient counseling An appreciation of the family dynamics involved in patient care
• The ability to communicate clearly and positively with individuals from diverse backgrounds
• The ability to maintain good professional relationships with colleagues and coworkers.
• The ability to write and dictate notes to charts and operation reports Certain personal attributes are also expected of our residents. It is essential that individuals placed in a position of trust be honest, dependable, exercise sound judgment, and maintain personal integrity. The resident's manner and appearance should be consistent with these attributes.

Teaching is an ongoing responsibility of the residents. Teaching not only shares the knowledge base and attitudes of the residents with others but solidifies the residents own information base and comprehension of the material. A list of teaching activities is in Appendix A. Residents' research responsibilities are twofold: Each resident should be able to critically evaluate research presentations and journal articles. This skill will be essential not only for the residents' research, but should allow the resident to better incorporate new research findings into his/her future practice. Each resident should participate in various aspects of research throughout her/his residency. These activities should include at least one project that is the primary responsibility of the resident in conjunction with a mentor. The purpose of these activities is to prepare the resident for an academic career if s/he chooses. Further information regarding the research section of the residency program is contained in Appendix B. The body of this document describes, by year, the abilities the resident should be expected to acquire during each year of the program. For each type of disorder included, the resident should be expected to know the appropriate tests to order, which consultants to include, the criteria for referral, the appropriate therapy or therapies, how to assess the treatment, and how to provide appropriate follow-up.

APPENDIX A TEACHING GOALS AND OBJECTIVES FOR RESIDENTS IN OTOLARYNGOLOGY

The goal of the teaching objectives is to allow residents to develop teaching skills that are sufficient for an academic career.

OBJECTIVES:

The resident should teach medical students on a one-on-one basis in the operating room. The resident should participate in walk rounds in general surgery with medical students. The resident should teach a medical student assigned to him/her for a period of one week, primarily discussing patient care of surgical cases. The resident should teach at the level of the listener. The resident should communicate the subject matter based on terminology and concepts familiar to the listener. Any terms or concepts that the listener is unfamiliar with should be defined and explained. The resident should serve as a role model for medical students and other residents. The resident should develop handouts and teaching materials for medical students and residents. The resident should advise the faculty of the needs of the residents in general and as needed specifically for a given resident. The resident should assist in selecting lectures for the didactic series. The resident should provide feedback to other residents regarding the efficacy of their teaching and provide constructive criticism. The resident should stimulate interest in Otolaryngology among medical students, prospective medical students, Otolaryngology residents, and professionals working in other specialties. The resident should promote and encourage medical students and fellow residents. The resident should maintain a positive communicative environment that will foster an exchange of information and attitudes among medical students, residents, nurses, physicians and professionals in other specialties. The resident should maintain a compendium of knowledge to serve as adequate source of information that is respected by his/her colleagues. The resident should provide in-service lectures for nurses. The resident should provide Otolaryngology lectures for individuals in other specialty areas.

APPENDIX B RESEARCH OBJECTIVES FOR OTOLARYNGOLOGY RESIDENTS

The goal of the resident's research activities are twofold: To prepare the resident to critically evaluate published research and to incorporate new research into his/her clinical practice over the years. To prepare the resident to generate quality research, as part of an academic career in the future.

Postgraduate Year #1:

General Surgery During the first year of General Surgery, the resident will rotate through the research laboratories in order to establish a future mentor and plan future research projects. The resident should begin to do some reading in the area of interest with a mentor. During postgraduate year one the resident should be provided with a two week elective period to accomplish the following two objectives:

OBJECTIVES

The resident should gain an overview of research activities in the Division of Otolaryngology - Head and Neck Surgery at SIU School of Medicine. The resident should be able to describe the general areas of research activity in each laboratory and be able to describe the types of research activities that could be carried out in each laboratory even if that particular type of research is not currently in progress. The resident should select a mentor and begin reading in an area of interest for future research activity.

Postgraduate Year #2:

During postgraduate year #2 the resident should in detail plan future research activities, write protocols and submit proposals to the faculty research committee and to animal and human subjects committees.

OBJECTIVES

• The resident should complete a review of the literature in the research area of his/her interest.
• The resident should design a testable hypothesis and design a study to test that hypothesis.
• The resident should obtain approval from his/her research project from the Human Subjects or Animal Subjects committee as required.
• The resident should employ good scientific writing style in critiquing other literature, writing the review of the literature, and in the protocol describing his/her research project.
• The resident should collect the data for his/her research project. Objectives 2,3,4,5,6, and 7 must be met before obtaining research time for data collection.
• The resident should analyze data from an existent data set or one that s/he has collected.
• The resident should outline and describe the appropriate statistical analysis that will be used for the study's data set.
• The resident should be encouraged to work in conjunction with a statistician for both study design and analysis.
• Twelve weeks will be provided for these activities.

Postgraduate Year #3

The resident should be provided with a period of two months research time to accomplish the following objectives. It is anticipated that throughout the postgraduate year #3 that the resident should be working towards these research objectives.

OBJECTIVES

The resident should assist in data collection on an ongoing study. The resident should learn the techniques necessary to do research in his/her chosen area. The resident should objectively analyze other studies in the literature through journal group experience and the review of the literature for his/her own research project. This analysis should include a critique of the scientific hypothesis, the rationale for developing the hypothesis, the methods employed to test the hypothesis including: the selection of subjects, measures made, techniques employed to obtain these measures, and methods of analysis. Additionally the resident should be able to critically analyze the researchers' interpretation of their findings in light of their original hypothesis and potential applicability and implications of the study. Six to seven weeks will be available for these activities.

Postgraduate Year #4

The resident should be provided with a two month period of time during this postgraduate year to accomplish the following research objectives:

OBJECTIVES

The resident should prepare a paper and/or presentation from the data collected in postgraduate year #3. The resident should finish the self-designed study that was initiated in postgraduate year #3 and prepare it in publication format under the advice of the faculty mentor.

Postgraduate Year #5

OBJECTIVES

The resident should prepare a paper of a self-designed data base study in the format of a peer reviewed journal. The paper must be submitted. Additionally the resident should be encouraged to publish or present a case study. The resident should present his/her research at a national or international meeting. To develop public speaking skills, the resident should be encouraged to present his/her research in a lecture format. In lieu of this format, the resident may substitute a poster presentation and present his/her research in a lecture style format for the residents and faculty of Otolaryngology. The resident should write a grant application in either postgraduate year #4 or #5. Six weeks will be available for this study.

RESIDENT OBJECTIVES -YEAR 1

General Otolaryngology

• During the first year the resident needs to become competent taking a history and performing a physical examination including the use of the pneumatic otoscope, operating microscope, laryngeal mirror, rigid and flexible laryngoscopes and sinus scopes.
• The painless cleaning of the ears and nose are also required objectives.
• The resident should develop an understanding of common disease processes such as serous otitis media, otitis media and externa, airway obstruction, obstructive sleep apnea, pharyngitis, neck mass, tonsillitis and peritonsillar abscess. He/she should know the evaluation options for treatment and indications for surgery.
• Learn to evaluate the symptoms of hoarseness, dysphagia, tinnitus, hearing loss, vertigo and initiate evaluation and treatment in an emergency and office setting. Allergy and Immunology
• To understand where the array of allergic disease (including all body systems) fits into the field of medicine.
• To thoroughly understand the scope of allergic disease in otolaryngology.
• To understand the applications of allergic etiologies in otolaryngic problems that seemingly are nonallergic in nature; such as the pathogenesis of hyperfunctional dysphonia and vocal nodules, inner ear disease. To be competent in basic immunology. For example this includes an understanding of the general concepts of immunogenic reactions, the evolution of immunogenic cell lines, the classification of hypersensitivity reactions, the physiology of inflammation, the arachidonic acid pathways, cyclic AMP, cytokines and leukotrines to name a few.
• To understand early and late phase reactions.
• To be able to compare the similarities between nasal and lung allergic pathophysiology.
• To gain proficiency in recognizing the clinical signs of otolaryngic allergy. Competency should be measured to the point of being able to predict the type of allergy based on physical findings. For example, differentiating allergic rhinitis due to pollenosis versus allergic rhinitis due to house dust sensitivity on the basis of physical exam.
• Have a feeling for the historical evolution of allergy in the field of medicine and surgery.
• To have a thorough understanding of the pharmacologic categories of drugs used in the treatment of allergic disease to include, in addition, the rationale for using antihistamines, decongestants, mucolytic agents, systemic and topical steroids.
• Special problem areas should be well understood, for example such as the use of drugs in pregnancy, the admonitions on Claritin and Hismanal, the rationale of topicals versus systemics. To be able to recognize which drugs have immunogenicity provoking capabilities or may interfere with the treatment of allergic disease, such as beta blockers, tricyclic antidepressants, MAO inhibitors, ACE inhibitors, non steroidal anti-inflammatory drugs, and aspirin.
• To understand, recognize and treat anaphylaxis. To have a basic understanding of the biology of aeroallergens. This should include perennial and seasonal concepts, identification of classes, and cross reactivity along with the concept of total allergic load.

Contact Information:

Please feel free to contact our offices at the School of Medicine with any questions you may have concerning the Otolaryngology Residency Program: Southern Illinois University School of Medicine Division of Otolaryngology - Head and Neck Surgery
Attn: Sally Godbey, Residency Coordinator
Springfield, IL 62794-9662
Phone: 217-545-4777
E-mail: sgodbey@siumed.edu