Teaching Service
The subspecialty areas represented include head and neck surgery, otology/neurotology, pediatric otolaryngology, facial plastic and reconstructive surgery as well as general otolaryngology.
Every patient seen in an outpatient or inpatient setting has an attending physician directly responsible for their care. There is no "resident" or "indigent" service. The resident team, under the direction of the chief resident and attending staff, rounds on and cares for all inpatients and consults on the otolaryngology service.
The resident team
- Otolaryngology PGY1 (when on service)
- General surgery intern
- DHMC otolaryngology PGY2, 3, 4
- PGY5 (chief resident)
For three months of the year, the PGY1 is on service. For four months, the PGY4 is off service on the research block, for two months is off service on the allergy rotation, and for one month is off service on oral surgery. In the Chief's absence, the DHMC PGY4 assumes leadership of the service.
Outpatient clinics
The Otolaryngology Clinic at DHMC has 13 exam rooms and 5 audiology booths. All exam rooms are fully equipped for otomicroscopy, flexible and rigid endoscopy, digital video imaging capabilities and minor procedures. One room is equipped with a videostroscopy unit which is used by the physicians within the section as well as speech pathology. Infrared video electronystagmography services, hearing aid fitting and cochlear implant programming are provided by the Audiology section within the Otolaryngology Division. Computerized dynamic platform posturography testing and vestibular rehabilitation is conducted in the Physical Therapy section within Rehabilitative Medicine Division.
The clinic runs each day of the week from 8:00 am to 5:00 pm. Individual attending physicians are assigned to 3 clinic days per week and the physician assistant and nurse practitioner each see patients 5 days per week. Residents will be assigned to cover specific attending clinics by the chief resident and the program director according to educational needs. During this assigned time, the resident will see patients scheduled into a specific attending physician's clinic and will be under the direct supervision of the attending physician during the session. The chief resident will run his/her own private clinic each Monday afternoon under the supervision of the physician on call.
Surgical services
The otolaryngology service has ten blocked main OR rooms each week. Additional OR days are often requested and usually made available for urgent, trauma and oncology cases. Construction on an outpatient surgery center will be completed by December 2010. This will provide our service an additional room each day of the week. All operative cases are staffed by and under the direct supervision of an attending. Major cases are staffed by two residents and junior level cases are often staffed by a senior resident acting as a teaching resident with a junior resident. On these cases, attending supervision is immediately available and the attending physician is present for the key portions of the procedure. The chief resident assigns resident coverage for OR cases.
Inpatient and consultation services
Every inpatient and consult patient is under the care of an attending and the resident team. The resident team is led by the chief resident. In the chief's absence the DHMC PGY4 is responsible. The chief resident is responsible for leading and organizing morning and afternoon rounds and managing the care of every patient on the service under the direct supervision of an attending physician. Time is set aside in each attending physician's schedule to make morning rounds on their patients with the resident team. Weekend rounds are conducted by the chief and the PGY2 or 3, or the PGY4 alone, depending on the call schedule. The resident team will round with the on call attending physician.
Inpatient consultations are seen at the bedside, or if possible, the patient is transported to the ambulatory care center clinic. Each consult is seen by a resident with attending supervision.
