Residency Applications ♦ Our Vision ♦ Mission Statement ♦ Program Description ♦ Resident Responsibilities ♦ Surgical Experience ♦ Research ♦ Conferences ♦ Mini-Courses ♦ Medical Student Elective ♦ Salaries, Benefits, Sample Contract ♦ Current Residents ♦ Recent Graduates

Residency Applications

All appointments must be processed through the Electronic Residency Application Service (ERAS) at www.aamc.org/students/eras/start.htm. Our deadline for receiving applications is November 1st.

If you have any questions regarding our residency program, please email our residency program coordinator, Mary Noel-Olivio, at mnoeloli@tulane.edu.

Vision Statement

Our vision is to be a model for a highly successful organization, committed to superior patient care, resident/student education, and innovation in research. We seek to be the premier local and regional provider of otolaryngologic and audiologic services; to set standards of excellence in clinic outcomes, education and research; and to exceed the expectations of our patients and customers, residents and students, institutional faculty and staff.

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Program Description

The Tulane Affiliated Residency Program in Otolaryngology Head and Neck Surgery is currently a fully accredited five-year program consisting of one year of structured general surgery and four years of otolaryngology - head and neck surgery. The program is based at Tulane University Hospital and Clinic (TUH&C) and includes rotations at Touro Infirmary (TI), Ochsner Clinic Foundation (OCF), and the Veterans Administration Hospital in Biloxi, Mississippi (VAB).

All otolaryngology programs (effective July 1, 2005) will take responsibility for the PGY I year of training. Various new rotational requirements will be expected for all residents entering training in 2005. However, in an attempt to fully implement these requirements we began this structured year of general surgery last year (July 2004). There were initially some "bumps in the road," but by year's end all trainees received the newly required rotations.

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Resident Responsibilities

• OTO IIs - rotate for eight months at OCF, and four months at the VAB.
• OTO IIIs - rotate for four months at OCF, four months at TI, and four months at TUHC.
• OTO IVs - rotate for four months at the VAB, four months at OCF, and four months of research.
• OTO Vs - rotate for six months at TUH&C and six months at OCF.

Residents participate in the outpatient clinics at these facilities where a total of 35,000 patients are examined and treated annually. More than 4,000 inpatients are cared for annually by the Tulane Otolaryngology - Head and Neck Surgery Service providing an outstanding opportunity for clinical training. Each resident is given graduated responsibility in the overall management of patients depending on his/her level and ability, culminating in the last year in which as a chief resident, he/she has the responsibility (under the supervision of the staff) for running the services at one of the affiliated hospitals.

In summary, residents currently spend 51 months on full-time clinical otolaryngology-head and neck surgery rotations. In addition, they are required to spend three months on a dedicated full-time research rotation. The new 80 hour resident workweek is monitored and enforced on a on-going basis throughout the year. Educational, evaluation, and promotion criteria center around acquiring proficiency in the six core competencies: patient care, medical knowledge, practice-base learning/improvement, interpersonal/communication skills, professionalism, and systems-based practice.

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Surgical Experience

OTO I Residents are expected to perform the following procedures:

• Oral Biopsy
• STSG/FTSG
• Basic soft tissue skills including closure of simple lacerations
• Rhinoscopy(rigid and flexible)
• Nasal packing

OTO II Residents are expected to perform the following procedures:

• Myringotomy/Tube
• Perform and interpret audiogram
• Tonsillectomy and adenoidectomy
• Bronchoscopy
• Tracheostomy > age 4 years
• I&D deep neck space abscess
• Lymph node biopsy
• Closed reduction nasal fracture
• Inferior turbinate reduction
• Nasal polypectomy

OTO III Residents are expected to perform:

• Tympanoplasty
• Direct larynosocpy with manipulation (e.g., biopsy, foreign body removal, dilatation)
• Branchial cleft excision
• Thyroglossal duct ecision
• Basic microlaryngeal procedures, including laser
• Administer and interpret allergy skin test
• Submandibular gland excision
• Excision facial skin tumors
• Repair complex laceration
• Septoplasty
• Endoscopic ethmoidectomy
• Endoscopic maxillary antrostomy

OTO IV Residents are expected to perform:

• Mastoidectomy (CWU/CWD)
• Esophagoscopy (w/wo foreign body removal)
• Tracheostomy < age 4 years
• Uvulectomy/Palatopharyngoplasty
• Neck dissection (selective, radical)
• Partial glossectomy
• Regional flap reconstruction
• Flap reconstruction facial defects advancement, bilobe, rhomboid, etc.
• Scar revision
• Repair midface fracture
• Endoscopic sphenoid sinusotomy

OTO V Residents are expected to perform:

• Ossicular Chair Reconstruction
• Removal upper airway foreign body
• Laryngoplasty
• Laryngectomy
• Parotidectomy
• Thyroidectomy
• Basic rhinoplasty
• Endoscopic frontal sinusotomy

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Resident Research

One block of time (three months) is reserved for full-time research during the PGY-IV year of residency in the Otolaryngology Department. The residents are expected to carry out an independent research project as part of their training. This may consist of clinical research or collaborative basic research, either in this department or in other departments (e.g., the Plastic Surgery Section of the Department of Surgery).

Useful information for resident research.

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Conferences

The Tulane University Department of Otolaryngology prides itself on a rich didactic experience. The faculty are dedicated to teaching residents in a formal learning environment. A multi-disciplinary approach is emphasized, with input from Radiology, Plastic Surgery and Pathology staff. All conferences are held on Thursday afternoon between 4 and 7 pm. Attendance is mandatory for all in-town residents. Live video teleconferencing is currently available to offer these educational opportunities to our residents and faculty at the VA in Biloxi, MS. A sampling of these conferences include:

• Audiology and Temporal Bone Conferences- Lectures about the anatomy and physiology of the ear as well as the evaluation of otologic function. The residents also receive hands-on experience in performing complete audiograms.

• Case Conference - A presentation of unusual or educationally valuable cases with discussion by the faculty and residents. Faculty from the departments of pathology and radiology participate in the conference. Also included in the conference is a death and complication analysis.

• Current Literature Conference - A faculty directed discussion of selected articles from otolaryngology and other medical journals with special quarterly emphasis on the Home Study Course.

• Grand Rounds - A case presentation followed by an in depth lecture about the patient's disease process. Discussion by the residents and faculty make this one of our more interesting conferences.

• Patient Safety Conference - A review of the elective surgical cases planned at each institution, including detailed analysis of the preoperative indications, alternatives to surgery, and possible problems to be anticipated at the time of surgery. Complications and/or deaths at each institution are next discussed with critical review of events leading to these consequences and possible methods of prevention. A Healthcare Matrix is utilized to teach the ACGME mandated core competancies.

• Research Conference - The faculty and residents present ongoing departmental research projects.

• Speech and Language - The speech pathologists present lectures and representative case material familiarizing residents with both diagnostic and rehabilitative methods for patients with speech and swallowing pathologies.

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Conference Schedule (July - December 2007)

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Mini-Courses

• A Basic Science and Clinical Science Course is held in the fall with lectures on topics as they relate to otolaryngology. These lectures are given by members of the medical school faculty.

• A Head and Neck Anatomy Course is held in the spring where clinically oriented cadaver dissections are performed.

• A one week comprehensive Temporal Bone Drilling Course is held in the fall as well, for each resident level. Tulane has its own temporal bone lab which is available to all residents 24 hours a day.

• Special courses in Basic Audiology, ENG, ABR and Hearing Aid Fittings are held at various times throughout the year.

• Tulane residents partake in the Home Study Course provided by the Academy. The Home Study Course is a two year program of selected readings with self-assessment examinations, designed especially for the practitioner and resident in otolaryngology-head and neck surgery. The course consists of eight sections, four of which are covered each year. This course is provided free of charge to all residents.

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Senior Medical Student Elective

Fourth year medical students rotate two weeks at the Ochsner Clinic
Foundation, and two weeks at Tulane University Hospital and Clinic. This elective is offered early in the fourth year and is designed for students interested in a career in the specialty. Although it is not required, applicants who are considering Tulane for a residency spot are encouraged to rotate with us. Another senior elective is given from January to June each year and is designed for individuals persuing a career in primary care. For more information, please contact the Office of Student Affairs at (504) 988-5331.

We suggest all senior students rotating on our service complete AAO-HNS's Clinical Otolaryngology OnLine (COOL) modules. COOL modules are interactive case studies in which the learner is presented with a medical scenario and guided through the evaluation and treatment options based on established medical practice.

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