The Western Reserve Hospital Residency Program in Otolaryngology/Facial Plastic Surgery has been developed to conform to the requirements of the American Osteopathic College of Ophthalmology and Otolaryngology – Head and Neck Surgery and the American Osteopathic Association Committee on Post-Doctoral Training. The program is designed to provide the basic requirements toward certification in ENT / facial plastic surgery. The WRH administration, Graduate Medical Education Department, and ENT/facial plastics faculty are committed to provide the necessary training and resources in the development of competent osteopathic specialists in general otolaryngology, head and neck surgery and orofacial plastic surgery.
The mission of the WRH ENT/FPS residency program is to develop a competent osteopathic physician, skilled in the practice of otolaryngology, head and neck surgery, and orofacial plastic surgery by meeting or exceeding educational goals and objectives through the use of competency based, compassionate, patient-centered learning strategies. Clinical exposure to all age groups, along with instruction in text, journal, and electronic resources is accomplished throughout the 5 years. The ultimate goal of our training program is excellence in patient care, recognized by colleagues and patients alike.
Through innovative design, faculty commitment, and utilizing the best Northeast Ohio resources, WRH ENT/FPS residents develop efficient, comprehensive, diagnostic and clinical reasoning skills in a progressive fashion during their 5 years of training. Beginning with a surgical skills boot camp in the first week of residency, our ENT/FPS residents are taught to develop an understanding and correlation of laboratory procedures, radiological tests, pathological specimens, and nuclear departments. The program teaches the understanding of deviations from normal physiology in all phases of bodily function and body chemistry, including the application of osteopathic manipulative therapy in the practice of otorhinolaryngology.
Through early intra-operative participation, the first years of the WRH ENT/FPS program emphasize the study of anatomy, pathology (both gross and microscopic), physiology and physiological functions, and basic surgical techniques. This is accomplished through text, electronic, bedside, and simulation training. Procedures and skills, such as central lines, intubation, arterial lines, and chest tubes, are evaluated through videotaped human patient simulator labs until competence is evident. Each resident is then given the privilege to perform these procedures in the clinical setting. A new temporal bone laboratory is provided for resident proficiency in these procedures.
In the later years, exposure is gained in the office and operative suite as each resident progresses individually. Beginning with a nationally renowned basic sciences course in the 3rd year, the ENT/FPS Residency Program offers the opportunity to work with national leaders in Neurotology/Otology, Head and Neck Oncology/Reconstruction Surgery, and Temporal Bone Courses. Subspecialty rotations in pediatrics, office ENT, and orofacial plastic surgery compliment a strong in-house surgical experience. Each resident is required to participate in the annual AAO-HNS In-Service Examination, as well as the Home Study Course. Instruction in the use of CO2 as well as KTP/Yag Lasers is done during the third year of training. As resident competency is demonstrated, increased exposure and responsibility is given in both the operating room and patient care, until the final year, where the ENT/FPS chief resident is expected to further hone and develop his/her skills for future private practice.
The following is a sample overview schedule for the WRH ENT/FPS residency program:
View this Chart in a PDF
The first year will comply with the OGME-1R training year as outlined in the AAO-HNS ACGME Basic Standards. The schedule is as follows
During his/her first year, the resident will receive most surgical education outside the operating room along with some operating room participation. The main emphasis is on pre-operative diagnosis and post-operative care to be correlated with intra-operative anatomy and surgical findings. The special services of General Medicine/Nuclear Medicine and Pathology/Radiology, Anesthesiology/Recovery Room/Pulmonary Medicine will be highlighted. During these services, there will be limited surgical responsibilities.
The second year begins with a 5 week intensive ENT basic science / temporal bone course at the University of Iowa which may also be completed during year 3. During the residents' second year, considerable time will be spent in the operating room to learn assisting, surgical principles, surgical techniques, and performing minor surgeries. Nine months will be spent with ENT physician faculty in both the office setting and operative suite, with one-two of these months spent with core faculty members in Sandusky. Three months of pediatric ENT is done during year 2 at Rainbow Babies Hospital/University Hospital Cleveland for proficiency in pediatric ENT surgeries, pediatric audiology, and other pediatric specific ENT disorders.
There are 6 months of general ENT office and surgical experience done during this year. Incremental responsibility is placed of each resident to develop his / her skills in these months. Three months are spent at the University of Pittsburgh Medical Center / Allegheny General Hospital for otology. Three months are spent at University Hospital Cleveland – Head and Neck surgery. These 6 months of out rotations are done with world-class physicians in the field of ENT/FPS and while they require some travel, are crucial for an excellent training experience.
The fourth year is spent performing major surgery under supervision. The resident will be assigned cases for total surgical care based on level of competency. A period of seven months is spent in ENT/FPS surgery, including potentially two months in Sandusky. Three months are again spent at University Hospital – Cleveland for advanced Head and Neck surgical experiences. Three more months are completed at University of Pittsburgh Medical Center / Allegheny General Hospital for otology. A one month surgical selective is offered during this year for those interested in other areas of Otolaryngology (i.e. Laryngology, Allergy, Rhinology) training.
During year 4, each resident will continue to expand his/her knowledge base in the same areas encountered during the first three years of residency. He/she will also assume additional responsibilities of surgical training of junior residents and medical students. This is also a year in which pursuit of Fellowship programs is undertaken. Time away from the training program for interviews are on a case-by-case basis.
During this year, each resident is taught advanced ENT/FPS surgical skills and assumes a majority of the care of patients, with appropriate attending physician supervision. The senior resident spends 10 months training at WRH and surrounding Hospitals, with preference given to his/her participation in selected operative interventions. Two months for electives or return to University Hospitals Cleveland – Head and Neck service can be completed during this year. These experiences are based on the needs of the resident, in areas where he/she feels that exposure will help prepare him/her for private practice or fellowship. A close working relationship is developed between attending physician and resident, with dependence on each for competent patient care and a quality educational experience.
Throughout each year, there are numerous didactic activities which are required. Each Friday there are 4 hours of attending physician led lecture and resident board review. Supplementary lectures will be provided by faculty on a quarterly basis and will be on major topics in ENT/Facial Plastic Surgery.
All ENT/FPS residents must participate in the annual AOCOO-HNS In-Service exam. In preparation there are weekly board review sessions, led by multiple ENT/FPS faculty. In addition, each resident must complete the AAO-HNS approved Home Study Course during years 2-4.
All WRH residents must attend both a monthly tumor board session and mortality review conference. These review any surgical oncologic cases as well as any pre-operative diagnostic challenges for current cases. There is attendance by the primary care physician, as well as all disciplines involved in the patient care plan including radiology, oncology, radiation oncology, pathology, and surgery.
There is also noon lecture, grand rounds, OMM, and morning report lectures each Tuesday through Thursday on a rotating basis.
Sample Otolaryngology Didactics Schedule September 2015
Phil Khalil, DO Program DirectorWestern Reserve Hospital, ENT/ FPS
Facial Plastic Surgery
Head & Neck Oncology/Reconstruction
Kellen Stromberg, DO PGY-V
Des Moines University of Osteopathic Medical Center
Matt Vajen, DOPGY-IV
Ohio University College of Osteopathic Medicine
Brittany Boger, DOPGY-II
Arizona College of Osteopathic Medicine of Midwestern University
Benjamin Lehmkuhl, DOPGY-I