I. Program Otorhinolaryngology / Bronchoesophagology

II.    Program Direction

Name of Department Chair: Glenn Isaacson, MD, FAAP, FACS

Name of Residency Program Director: Same

III. Length of Residency

Number of required years in specialty: 5 years (1 preliminary , 4 specialty)

Is prior graduate medical education required? No

If so, please give details

IV.    Training at Temple University Hospital

1. Inpatient

Number of service beds (including ICU): 514
Number used for teaching: 514

2. Ambulatory sites at Temple

Half day session / wk
Clinics, Private Practices
(ORL has no clinics or private practices – all patients are seen in coordination with attending physicians at our Kresge offices)
PGY1 surgery year N/A
PGY2 9 half day sessions / week
PGY3 9 half day sessions / week
PGY4 9 half day sessions / week
PGY5 9 half day sessions / week

3. Emergency Room at Temple University

Resident assignments are at what PG levels?
PGY 2-5 ORL residents provide emergency care

Are residents assigned a shift or are ER duties performed with other rotations or on-call?
Residents assigned to TUH provide coverage during business hours. The TUH resident on-call provides coverage at off-hours.

V.     Other Training Sites

Temple University Children’s Medical Center

Residents rotate at TUCMC in their first, second and third years of ORL training (PGY 2,3,4). Six months are spent at TUCMC in the first year and 3 months in the second and third years. The residents spend their time with three attending physicians (Drs. Isaacson, Szeremeta and Callanan) and occasionally assist at surgery with non-faculty otolaryngologists. Time is divided equally between supervised office hours and operating room experience. The residents on rotation perform all in-house consultations. Night call is provided by the TUH resident on-call. This rotation provides the complete pediatric otolaryngology experience required by ACGME for otolaryngology training.

Hahnemann Hospitals

Residents rotate at Hahnemann in each of their ORL training years (PGY 2-5). Two residents of unequal seniority rotate at each time. ORL residents spend 3 month at Hahnemann in PGY years 2,3 and 4 and 6 months in the chief year. Their experience includes time in the OR and in-patient care with a resident-run clinic operating twice a week. One Temple resident takes calls from home each night. The Hahnemann rotation provides a strong exposure to general ENT and experience in the management of advanced head and neck cancer ablation and microvascular reconstruction.

VI.    Recruitment

The Department of Otolaryngology Head and Neck Surgery recruits two residents per year through the Otolaryngology Match Program. Approximately 250 standardized applications are reviewed per year, and forty prospective candidates are invited for interviews. Candidates are selected based on academic excellence, standardized test scores, letters of recommendation and evidence of motivation during the interview process.

VII.    Current Residents

VIII.    Evaluation

1. Residents are evaluated in writing at the end of each 6-week rotation. Evaluations are based on the personal observation by faculty on that rotation. In addition, semi-annual resident evaluations are conducted within the Department. Each resident has the opportunity to meet with the faculty and exchange ideas to improve resident performance and the structure of the residency. Notes of these interviews are included in the resident’s personal file. Minimum standards for satisfactory performance include: satisfactory performance on clinical rotations, scores above the 25^th percentile on the annual otolaryngology examination and the completion on at least one scientific paper suitable for presentation at a national meeting by the time of graduation.

2. Do residents evaluate the program? Yes, during their semiannual interviews. These verbal critiques are immediately discussed by the faculty and used in our program of continuous quality improvement. Anonymous written reviews are submitted after each rotation.

IX.    Curriculum

The curriculum is designed to provide exposure to the complete field of Otolaryngology – Head and Neck Surgery during the four-year experience. Clinical rotations are divided into 3 month blocks. In the early years, residents are always under the close supervision of senior residents and faculty, usually on a one-to-one basis. There are no unsupervised resident clinics and all patients are seen by supervising faculty during in-house consultation. Senior residents are given greater autonomy in their actions and greater responsibility for supervising and teaching junior residents and medical students.

The education program is listed below. Formal teaching consists of 1-2 hours of lecture by residents, staff and visiting professors on Wednesday mornings and 2 hours of lecture on Friday morning. Attendance is mandatory for all residents and staff regardless of rotation. In addition to the two year cycle of formalized lectures, periodic courses and lecture series are added on an annual basis. Residents attend regional and national scientific meetings and are expected to attend city-wide otolaryngology meetings at the Philadelphia College of Physicians (approximate 6 per year).

Anatomy Course - A course in Head and Neck Anatomy is provided by the Department of Anatomy under the supervision and direction of Dr. Carson Schneck. Dr. Schneck does a prosection about which he lectures and demonstrates pertinent anatomic details. These prosections include skull, orbit, head, neck and thorax. The residents perform their own dissections as well, which are presented to Dr. Schneck.

Chevalier Jackson Bronchoesophagology Course- this course in bronchoesophagology is an annual event at Temple University and has a history dating back to the 1920’s. Drs. Kelley and Soliman are co-directors, but all of the otolaryngology faculty as well as Temple anatomists and pulmonologists join in the instruction. Course material includes airway anatomy and physiology, techniques in airway management, and care of the full variety of airway pathology. A hands-on laboratory teaches technique and instrumentation using live animals. The first year residents are required to take the full course and more senior residents participate in the instruction and lab.

Tumor conference - A weekly tumor conference is held each Wednesday morning. It is attended by representatives of Pathology, Radiology, Radiation Oncology, Hematology-Oncology and supporting specialties. Patients are presented by junior or senior residents on their Temple rotation and examined by those in attendance. Relevant radiologic and pathologic material is reviewed and management of each individual planned. The residents are involved in both presentation of the patients and the interactive discussions.

Temporal Bone Dissection Course - There is a six-week temporal bone dissection course yearly under the direction of Dr. Hanson. Three-hour evening sessions consist of a didactic lecture by one of Temple's or Hahnemann's faculty, a discussion with dinner, and a drilling session under the supervision of one of the faculty. In addition, the residents are supplied with several temporal bones and the House dissection manual. At the completion of the course, each resident submits a dissected bone for consideration in the resident Temporal Bone Dissection contest. The bones are judged by the faculty and a prize awarded for the best specimen.

Audiology course - The first eight Friday morning didactic sessions are led by the audiology faculty. Basic topics in audiology, hearing science and electrophysiology are covered.

Friday Morning Conferences - From 6:30 - 8:30 AM each Friday the core course in Otolaryngology is conducted. Each morning is divided into two parts. A resident-led session (resident lectures, interesting case discussions, continuous quality improvement, journal club) and a didactic session are led by a Temple faculty member in Otolaryngology or from associated departments. The course material follows an annual rotation and is organized jointly by Drs. Szeremeta and Soliman and the chief residents. All major areas of otolaryngology and related fields are covered as outlined by the American Board of Otolaryngology. Attendance is mandatory for all residents and faculty.

Educational schedule

X.     Research

Residents have required research rotations in their second and third years of ORL training (PGY 3,4). They are encouraged and assisted in setting-up and completing either clinical or basic research projects. Completion of at least one research paper suitable for publication is a minimum requirement for completion of the residency.

List of publications

XI.    Resources

I. Residents have access to the personal libraries of the faculty (approximately 500 volumes) and to the Temple University School of Medicine Library, which is located in the same building as our offices. In addition, the Max Ronis, MD Resident Library was recently established in the resident’s area. Twenty-five new textbooks have been purchased exclusively for resident use. Residents receive the Home Study Course of the American Academy of Otolaryngology at Departmental expense, as well as the journals Otolaryngology Head & Neck Surgery, the ENT Journal and Archives of Otolaryngology – Head & Neck Surgery on a monthly basis without charge.

II. The Temple University School of Medicine Library carries all major Otolaryngology journals and is well stocked with general otolaryngology texts.

III. The residents have dedicated space in our Kresge offices, the Temple University Children’s Medical Center and Temple University Hospital, as well as a 400 square foot temporal bone dissection laboratory for their use. Computer equipment and Internet access area are available in the on-call room and in our research laboratory.

XII.    Dismissal

No resident has been dismissed in the past five years.

XIII.    Program Outcome

1. All residents have taken and passed the Otolaryngology Board Examination in the past 5 years (# 10).
2. Seven current and recent past residents have gone on to fellowship training. (Facial plastics 4, Pediatric Otolaryngology 1, Laryngology 1, Otology 1). Two residents in the past five years are in full-time academic practice, the remainder are in private practice.

Residents are responsible for teaching third year medical students in the course of their training. Teaching performance is not formally evaluated.