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Residency Programs

The Resident Training Program in Johns Hopkins Department of Otolaryngology–Head and Neck Surgery is structured to develop a mature Academic Otolaryngologist-Head and Neck surgeon with extensive clinical and research experience.

This program provides the resident with the opportunity to be involved in the diagnosis and treatment of a wide variety of common and rare clinical problems. The Johns Hopkins Hospital (JHH) admits 1,300 otolaryngology-head and neck surgery patients annually and provides surgical services to approximately 1,200 more through the Same Day Care Center. There are approximately 26,000 patient visits to the departmental outpatient consultation clinics and over 2,000 surgeries a year. In addition, a well structured, six-month research exposure is required of all residents. Greater immersion in research (two years) is available. At present, one half of each resident class (two individuals) is selected complete the two year research experience.

By design, our program encourages thinking by our residents. The inquiring attitude molded by this experience will benefit our residents for the rest of their lives, leading them to ask questions and seek answers for the prominent problems within our specialty. It is hoped that this characteristic will place the graduates of our residency program among those who change the way we think about practice and specialty of Otolaryngology–Head and Neck Surgery.

We are looking for residents who have a love for learning, a selflessness which reinforce collegial interaction with others in the Institution, enthusiasm for living life fully, and a desire to serve others. We are proud of our program and of our Institution. We are hopeful that we can convey to you the reasons for our pride.

David W. Eisele, M.D., F.A.C.S.
Director, Otolaryngology-Head and Neck Surgery
Andelot Professor of Laryngology and Otology


I. GENERAL SUMMARY

Members of the Resident Staff assume responsibilities under faculty supervision for the care of patients on the inpatient service as well as in the outpatient clinic at levels consistent with their training and experience. Members of the Resident Staff also participate in the medical education program of the Hospital and the Johns Hopkins University School of Medicine.

II DETAILED DESCRIPTION

INTERN YEAR (PGY1)
The intern year consists of 5 months of General Surgery rotations, a 1 month Surgical Intensive Care Unit rotation, Emergency Medicine rotation, Neurosurgery rotation, Anesthesiology rotation and a 3 month rotation on the Head and Neck Oncology service. During the Head and Neck rotation, an introduction to the organization of the service is given. In addition, basic skills for outpatient assessment, care of head and neck inpatients, and airway management are taught.

SECOND YEAR (PGY2)
Second year residents rotate through 3 services at JHH and one at Johns Hopkins Bayview Medical Center. On all rotations, residents spend two days per week in outpatient clinic and three in the operating room. Inpatient ward responsibilities, night call, and emergency ward coverage are interspersed on a rotating schedule. In the outpatient clinic, residents work under the supervision of full-time faculty, fellows, and senior residents. They perform history and physical examinations on new patients, formulate a working differential diagnosis, and then present the patient to the supervisor. The faculty member then repeats the H&P, discusses the case with the resident, and a plan for further work-up or treatment is formulated jointly. The resident then assists in the execution of the plan. Follow-up patients are evaluated and managed in the same way. Simple office procedures such as biopsy under local anesthesia and flexible fiberoptic laryngoscopy are performed under the direct supervision of the faculty.

In the operating room, PGY 2 residents participate in routine surgical procedures such as tonsillectomy and myringotomy tubes with graduated proficiency and degree, always under the direct supervision of the faculty member who is present in the operating room. The PGY 2 resident also assists in more complex cases such as neck dissection and mastoidectomy. The resident is responsible for postoperative care in the recovery room or intensive care unit.

On the inpatient ward, the PGY 2 resident shares every fourth night call and participates in daily ward rounds for postoperative and non-operative inpatient care. All activities are performed under the supervision of the chief resident and faculty, but routine procedures such as intravenous access and blood drawing, and routine management decisions may be made with appropriate levels of independence. The resident is responsible for writing an admission history and physical note and discharge summary for each patient. The fundamentals of routine and complex postoperative care are mastered.

  1. Pediatric Otolaryngology: Congenital, infectious, neoplastic, and traumatic diseases of the upper aerodigestive tract, special sense organs, and head and neck are emphasized. The resident is expected to master pediatric endoscopy and tonsillectomy.
  2. Head and Neck Oncology: Diagnosis and management of benign and malignant neoplasms of the upper aerodigestive tract, and head and neck are the focus. The resident is expected to master simple soft tissue procedures such as submandibular gland excision and begin to learn the more complex surgical anatomy of the neck, larynx and skull base.
  3. Otology: The diagnosis and management of disorders of the ear and temporal bone including hearing loss and imbalance, as well as neoplasms of the lateral skull base, are emphasized. The PGY 2 resident is expected to master simple audiometric and vestibular testing methodology, cortical mastoidectomy, and tympanoplasty approach.
  4. General Otolaryngology at Bayview: The PGY 2 resident works with one senior resident under the oversight of the full-time faculty to manage this inpatient and outpatient service. Night call from home is divided between the two residents. Graduated independence in formulating a differential diagnosis, and executing a treatment plan under faculty supervision is afforded.

THIRD YEAR (PGY3)

  1. Research: Six months of research time is provided for all residents. Some have an extended 24 month research opportunity with clinical training extended into PGY6 to complete RRC requirements. Prior to the rotation, residents must identify a mentor and a project and write a proposal which is reviewed and approved by the faculty. The resident works directly under the supervision of the mentor but is expected to demonstrate initiative in the direction of research, the execution of experiments and the analysis of results. A written summary of results in publishable form is required at the end of the rotation.
  2. General Otolaryngology at Greater Baltimore Medical Cente (GBMC)r: Under the supervision of full- and part-time faculty, responsibilities are similar to those of PGY4 residents at JHH, described below.

FOURTH YEAR (PGY4)
Residents in this year are given greater independence, typically working directly under the supervision of faculty members without the intermediate oversight of a chief resident. Responsibility and opportunity in the operating room is afforded commensurate with experience and demonstrated capability, allowing the resident exposure to more complex procedures. First call in-house night call responsibilities persist but with reduced frequency, permitting more time for participation in decision-making in the care of patients.

  1. Facial Plastics and Reconstructive Surgery: The diagnosis and management of deformities of functional and cosmetic significance due to trauma, congenital, postoperative, infectious, or neoplastic causes are emphasized. The resident works with full-time faculty at Johns Hopkins Hospital 3 days per week, and with part-time faculty at a free-standing surgicenter 2 days.
  2. Sinus and Laryngology: The resident works with full-time faculty of both the Sinus and Laryngology divisions during this rotation. The diagnosis and management of common sinonasal and anterior skull base pathology are emphasized by the Sinus division. The diagnosis and management of common laryngological disease, including voice, airway, and swallowing disorders, are the primary focus of the Laryngology service.
  3. General Otolaryngology at GBMC: The PGY 4 resident serves as a junior "chief" resident on the Head and Neck Oncology service working with several part-time faculty members on major head and neck oncologic procedures. The resident also supervises the junior house staff in the postoperative care of these patients together with the chief resident (PGY 5) and the faculty. The resident is introduced to the performance of major cases such as laryngectomy, neck dissection, and composite resection during this rotation.
  4. General Otolaryngology at Bayview: The PGY 4 resident assumes a chief resident role under the oversight of the full-time faculty to manage this inpatient and outpatient service. Night call from home is divided with the PGY 2 resident. As the chief resident on this service, the PGY 4 resident develops proficiency in teaching junior residents intraoperatively and in general patient care.

FIFTH YEAR (PGY5)
This is the chief resident year. On each rotation, the resident serves as the team leader, assigning daily duties to the junior house staff, and overseeing routine postoperative patient management, ward rounds, and night-time emergencies. In the operating room, all but the most complex cases (reserved for fellowship training such as microvascular free tissue transfer or cerebellopontine angle surgery) are to be mastered. In the outpatient clinic, the resident is expected to accurately recognize and diagnose all common and many unusual conditions, formulate an accurate differential diagnosis, a complete plan for work-up, and a treatment recommendation with discussion of all valid alternatives. Clinic evaluations and surgical procedures are supervised by full-time faculty who are present or immediately available at all times. Second call night coverage is the responsibility of the chief resident, supervising the first call resident, with the backup of the faculty on call.

All residents are required to participate in didactic sessions held on a weekly or annual schedule. They must take a home instruction course and the In-service Exam sponsored by the American Academy of Otolaryngology–Head and Neck Surgery

III. OUTLINE OF ROTATIONS

 Research TrackClinical Track
PGY-1 OHNS Intern5 months - General Surgery rotations
1 month - Surgical Intensive Care rotation
1 month - Neurosurgery rotation
1 month - Anesthesia rotation
1 month - Emergency Medicine rotation
3 months - Head & Neck Surgery rotation
5 months - General Surgery rotations
1 month - Surgical Intensive Care rotation
1 month - Neurosurgery rotation
1 month - Anesthesia rotation
1 month - Emergency Medicine rotation
3 months - Head & Neck Oncology rotation
PGY-2 OHNS Assistant Residents12 month clinical rotation, of which:

3 months - Pediatric OTO - JHH
3 months - Head & Neck Oncology - JHH
3 months - Otology - JHH
3 months - General OHNS - Bayview

12 month clinical rotation, of which:

3 months - Pediatric OTO - JHH
3 months - Head & Neck Oncology - JHH
3 months - Otology - JHH
3 months - General OHNS - Bayview

PGY-3 OHNS Assistant Residents24 month - research track
(6 months of 24 will be ACGME accredited)
6 months - General OHNS - GBMC
6 months - Research JHH
PGY-4 OHNS Assistant Residents12 month clinical rotation, of which:

3 months - Facial Plastic & Reconstructive Surgery - JHH
3 months - Sinus & Laryngology - JHH
3 months - General OHNS - GBMC
3 months - General OHNS - Bayview

12 month clinical rotation, of which:

3 months - Facial Plastic & Reconstructive Surgery - JHH
3 months - Sinus & Laryngology - JHH
6 months - General OHNS - GBMC
3 months - General OHNS - Bayview

PGY-5 OHNS Chief Residents12 month clinical rotation, of which:

3 months - Head & Neck Oncology- JHH
3 months - Otology - JHH
3 months - General OHNS - GBMC
3 months - Head & Neck Oncology - GBMC

12 month clinical rotation, of which:

3 months - Head & Neck Oncology- JHH
3 months - Otology - JHH
3 months - General OHNS - GBMC
3 months - Head & Neck Oncology - GBMC

PGY-5+ OHNS Chief Residents6 months - Senior subspeciality rotation - JHH
6 months - optional fellowship
 

Application Process

Dear Applicant:

Thank you for your interest in our program. All students wishing to apply to this program must apply through the Electronic Residency Application Service (ERAS) sponsored by the Association of Academic Departments of Otolaryngology—Head and Neck Surgery.

To complete application, go to the following link http://www.aamc.org/eras. Once at ERAS website, click on "Residency & Osteopathic Internship Applicants" for a complete description of the application process.

Each year, the Johns Hopkins Otolaryngology Residency Training Program receives approximately 400 applications from which about 40 applicants are chosen to interview to fill the 4 positions. All applications are reviewed and interviews for prospective candidates are arranged on the basis of their medical school record, research experience, extracurricular activities and letters of recommendation. There is no minimum score requirement, however, competition is exceptionally high, with many more outstanding applicants than openings each year. Applicants are ranked on the basis of high moral, ethical and professional qualifications by the Resident Selection Committee for final selection in the Otolaryngology Matching Program.

Deadline for applications: In order for an application to be considered it must be submitted to ERAS in time to be received in the Otolaryngology Department at Hopkins by October 1, 2014.

Interviews are scheduled during the months of December 2014 and January 2015, and you will be notified by mail if you are invited to interview.
For additional information, please contact:

Christine Stansbury
at cstansb1@jhmi.edu
or by phone at (410) 955-1932.

Sincerely,
Douglas Reh, MD
Program Director, Residency Program

Residency in Neurotology
 

The Department of Otolaryngology-Head and Neck Surgery is pleased to offer a two year Residency in Neurotology. The primary goal of our training program is to produce a clinician-investigator with sufficient technical and experimental design skills to independently initiate a program of clinical service and research as an academician in Neurotology. This is a high expectation for a short period of time. We expect, however, that training within the Division of Otology-Neurotology will accomplish this goal for the following reasons: 1) we will recruit from a select group of candidates who will enter the program having demonstrated a commitment to research and specific knowledge in relevant areas in Otolaryngology, 2) we expect that our Neurotology resident will enter with a sufficient fund of clinical skills to allow for rapid acquisition of technical skills, and 3) will provide a vigorous training sequence.

The first 6 months will be devoted to defining a specific research project and acquiring the skills needed to accomplish this project and future investigations in the field. In the ensuing 18 months we expect the Neurotology Resident to master the technical skills required to perform contemporary procedures of the internal auditory canal, cochlea, and skull base, as well as receive training in audiological and vestibular testing, neuroradiology and radiosurgery.

The specific curriculum to be followed for the Neurotologic trainee will vary depending on their of research interest. Each trainee, however, will

  1. Complete a core training program defined by the basic sciences department involved and will include full participation in the Auditory Structure and Function Course.
  2. Complete a research project that will be suitable for publication in a high quality journal and introduce new directions for further research.
  3. Complete a short course in experimental design/statistics and ethics as offered by the Bloomberg School of Public Health.
  4. Participate in weekly Grand Rounds in the department of Otolaryngology–Head and Neck Surgery, as well as seminar series at the Center for Hearing Sciences.
  5. Participate in the weekly Neurotology Conference. The trainee will be responsible for presenting to the Neurotology group on a monthly basis on topics ranging from basic auditory and vestibular science to clinical management and surgical treatment of Neurotologic disorders.

For certification, the trainee must demonstrate a mastery of the concepts underlying the design and conduct of their basic science project. In the clinical phase of training, the resident must demonstrate sound clinical and surgical judgment and show competency in neurotologic surgical skills as judged by the staff of the Division of Otology, Neurotology. A solid performance as demonstrated in presentation of research and clinical data in our department and national conferences will be required.

The Resident trainee in Neurotology will be available for operative for management of major neurotologic procedure over an 18 month interval. The trainee will assist residents in general otologic procedures to enhance their operative and teaching skills. The resident will also participate in Neurotologic clinics to be closely supervised by staff. The resident will have full privileges to perform general otologics procedures in their second year and will be supervised for major neurologic procedures.

Further information about our division is available at
http://www.hopkinsmedicine.org/otolaryngology/otology/index.html

Please address all inquiries regarding application to the Residency in Neurotology to:

Drs. John Carey (Program Director) and Yuri Agrawal (Associate Program Director)
The Johns Hopkins Residency in Neurotology
c/o Christine Stansbury
cstansb1@jhmi.edu
(410) 955-1932
6214 JHOC
601 N. Caroline Street
Baltimore, MD 21287

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