The teaching service at Dartmouth Hitchcock Medical Center is under the close supervision of 13 board-certified otolaryngologists and oral maxillofacial surgeons.
The subspecialty areas represented include head and neck oncology, otology/neurotology, pediatric otolaryngology, facial plastic and reconstructive surgery, oral maxillofacial surgery, rhinology, as well as comprehensive otolaryngology.
Every patient seen in an outpatient or inpatient setting has an attending physician directly responsible for their care. 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.
Resident team
- Otolaryngology PGY-1 (Jan-June)
- General Surgery Intern
- Otolaryngology PGY-2, -3, -4
- PGY-5 (chief resident)
- Physician’s Associate (PA) resident(s)
For the last 6 months of the academic year, the PGY-1 is on the Otolaryngology service. For 2 months, the PGY-2 is off-service on the Allergy and Sleep Medicine rotation. For 4 months, the PGY-3 is off-service on a 2-month research block with elective time spent with Mohs Surgery and Plastic Surgery. For 2 months, the PGY-4 is off-service completing his/her research block. In the Chief's absence, the PGY-4 assumes leadership of the service.
Outpatient clinics
The Otolaryngology Clinic has 14 exam rooms and 5 Audiology booths. All exam rooms are fully equipped for otomicroscopy, flexible and rigid endoscopy including videostroboscopy, digital video and photo image capturing capabilities and minor procedures. The videostroboscopy unit 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 are conducted in the Physical Therapy section within the 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 2-3 clinic days per week and the physician associates each see patients 4 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 independent afternoon clinic weekly under the supervision of the appropriate staff.
Surgical services
The Otolaryngology service operates in 2 locations on the Dartmouth Hitchcock Medical Center campus: the main OR and the Outpatient Surgery Center (OSC). Additional OR days are often requested and usually made available for urgent, trauma and oncology cases. All operative cases are staffed by and under the direct supervision of an attending physician. When the residents are participating in didactic sessions, the Physician Associate staff will cover the OR as well as the consult pager. The Chief resident assigns resident coverage for OR cases. The residents also operate at the VA Medical Center in White River Junction with Dr. Ryan McCool and Dr. Louise Davies.
Inpatient and consultation services
Every inpatient and consult patient is under the care of an attending physician and the resident team. The resident team is led by the Chief Resident. In the Chief's absence, the PGY-4 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. Weekend rounds are conducted by the on-call resident and attending physician.
Inpatient consultations are seen at the bedside, or if possible, the patient is transported to our clinic. Each consult is seen by a resident with attending physician supervision.