About our Education Program
The significant growth of our Department over the past decade and increase in resident compliment from 2 residents a year to 3 residents a year has allowed us to return to our ideal educational structure with a mentorship system. We are now the largest Head & Neck oncology service in the state of Maryland and UMMC is an NCI accredited Comprehensive Cancer Center. With subspecialists in every Otolaryngology discipline in a single medical center (not including our attached VA hospital) our residents benefit from a high clinical volume and a broad surgical experience. Our rotation schedule provides an immersive and progressive education in each subspecialty, tailored to resident growth. The addition of physician extenders ensures that resident time is devoted to educational tasks, with less educationally beneficial tasks performed by the extenders under the guidance of the physicians.
Our PGY-1 residents are completely integrated into the Otolaryngology department and spend six months rotating through general otolaryngology, pediatric otolaryngology and head and neck surgery. In addition to this, PGY-1s rotate through plastic surgery, radiation oncology, neuroradiology, neuro intensive care, anesthesiology and general surgery.
The PGY-2 resident will have dedicated rotations in pediatric otolaryngology, laryngology, otology and neurotology and head and neck surgery.
During the pediatric otolaryngology rotation the resident will experience a blend of supervised outpatient, inpatient and surgical experience across the breadth of the discipline.
During the laryngology rotation, there is a balance of outpatient evaluation and treatment, and surgical care, including performing stroboscopic examinations and assisting on outpatient laryngeal interventions. The resident sees outpatients with our Speech-Language Pathologist, learning the fundamentals of their evaluation process, including performing Flexible Endoscopic Evaluation of Swallowing. Specialty-focused team teaching includes “stroboscopy rounds” with the attending to review clinical videos.
While on the otology and neurotology rotation the PGY-2 resident spends time learning the outpatient evaluation and management of otologic problems as well as gets early exposure to ear and skull base surgery. All surgical cases are discussed at the semi-weekly interdisciplinary Otology-Audiology conference. The addition of endoscopic middle ear surgery technology broadens the resident’s surgical training, and allows them to master principles of this innovative technique. One morning each week is spent in the temporal bone lab.
The PGY-2 resident spends 4 months where they devote their time to the comprehensive care of patients with head & neck and skull base cancer on 2 separate Head & Neck services. The PGY-2 will spend time both in the inpatient and outpatient setting learning the management of complex cancer patients. They will participate as junior surgeon in operative cases. They will also be exposed elements of non-oncologic Head & Neck disease, including care of patients with chronic rhinosinusitis and image guided endoscopic surgery.
All PGY-3 residents will have a dedicated research block of six months. This research block is fully dedicated time without clinical responsibilities during the day. Our Department now has 5 independently funded labs specializing in auditory genetics and genomics, tumor immunology and stem-cell research. Residents prepare an approved research protocol before beginning their rotation. Presentation of the results at national meetings and publication of manuscripts is supported by the department.
At the VA Medical Center, PGY-3 residents care for veterans with a wide range of otolaryngologic problems both in the outpatient clinic and the operating room. Many of the university faculty also practice at the VA Progressively more responsibility is given to the PGY-3 resident as competence is demonstrated.
The PGY-4 and PGY-5 residents are considered chief residents and the leader of their particular service. They take back up call to the junior residents. The PGY-4 and 5 years consist of 6 clinical blocks meant to give the resident advanced experience in all aspects of otolaryngology.
There are 4 months each year devoted to comprehensive care of patients with Head & Neck and skull base cancer on 2 separate Head & Neck services (A&B). The resident will learn principles and techniques of robotic surgery on the DaVinci system. The Head & Neck A rotation also includes anterior open and endoscopic skull base surgery, including endoscopic transphenoidal pituitary surgery, repair of CSF leaks, anterolateral approaches to the skull base and anterior approaches to the cervical spine. The Head & Neck B rotation includes elements of non-oncologic Head & Neck disease, including care of patients with chronic rhinosinusitis and image guided endoscopic surgery.
During the trauma/facial plastics rotation the senior residents are responsible for caring for patients with facial trauma at the R Adams Cowley Shock Trauma Center, as well as patients undergoing cosmetic and reconstructive procedures. They have broad exposure to the full range of facial plastic surgery from office based cosmetic procedures (including botox, fillers, lasers) to free flaps for head and neck cancer reconstruction.
The PGY4-5 resident has two 2-month blocks as the Airway resident. An increase in complement supports addition of this unique educational module. The resident is immersed in care of pediatric and adult patients with airway disease, responsible for evaluation and surgical care of all inpatient consultations with emergent and urgent airway issues. The Airway resident participates in all complex airway cases in adults and children, performs outpatient laryngeal procedures, and is the teaching surgeon for all consult tracheostomies. The resident also participates in care of patients with endocrine diseases with John Olson, MD PhD.
At the Baltimore Veterans Administration Hospital, the PGY-4&5 resident carries out all major otolaryngologic surgery under the direction of the attending staff. Cases include laryngectomy and radical neck dissection, endoscopic sinus surgery, and tympanomastoidectomy. Every other Monday at the VA hospital is dedicated to facial plastic and reconstructive procedures.
On the Otology-Neurotology rotation chief residents are completely immersed in the care of patients with otologic disease and tumors of the lateral skull base. Residents are actively engaged in the pre, intra and post-operative care of patients in addition to their long-term follow up in the outpatient clinic. Residents also evaluate and treat patients with medical Otologic and Neurotologic disorders in the outpatient offices. In addition to classic general surgical Otology, with a large volume of chronic ear disease, ossicular chain reconstruction and otosclerosis surgery, the Department has a very busy hearing restoration program with a large volume of cochlear and bone conduction implants, and a busy skull base service. There are no fellows in the Department, and residents participate in all of these procedures as the senior surgeon in training