Residency Overview
News
UC Irvine Resident Team
wins the Academic Bowl at the American Academy of
Otolaryngology-Head and Neck Surgery meeting in Boston
in September 2010. The UC Irvine team, consisting of
Drs. Davin Chark, Joe Brunworth, and Michael German beat
teams from University of Iowa, Thomas Jefferson
University, and New York Eye and Ear in the finals.
Structure
The Department of Otolaryngology-Head and Neck Surgery,
University of California, Irvine College of Medicine
sponsors a residency program in Otolaryngology-Head and Neck
Surgery which is five years in duration. The
PGY-1 year is developed around the new American Board of
Otolaryngology requirements that include rotations in
anesthesia, emergency medicine, neurosurgery and a diverse
mix of rotations in the surgical specialties. The
PGY-2-5 years concentrate on Otolaryngology-Head and Neck
Surgery. During the the PGY-2-4 years,
residents acquire skills in head and neck history and
physical examination techniques, and progressive acquisition
of skills in surgical procedures in the specialty.
During these years, training is received at UCIMC,
Kaiser Permanente (Anaheim), Children's hospital of
Orange County (CHOC), and Long beach Veterans Affairs
Medical Center (LBVAMC). In the PGY-3 year four
months is devoted to research. The final year
(PGY-5) of the residency program is spent primarily at UCIMC
and the focus is on leading the team of residents and
focused operative experience. Surgical skills are fine
tuned and administrative and leadership skills are developed
as chief resident on the service.
The didactic curriculum for the residency program is designed to
be comprehensive, academic, and well organized. A 24
month cycle is utilized, and is patterned after the
quartile system of the American Board of Otolaryngology (ABO). Our
curriculum follows the quartiles outlined by the ABO as follows:
1. General otolaryngology (including pediatric
otolaryngology)
2. Head and neck surgery
3. Otology and neurotology
4. Facial plastic and reconstructive surgery
A working knowledge of related specialties such as
neurosurgery, oral and maxillofacial surgery, plastic
surgery, general surgery, neurology, and pulmonary medicine
are also among the academic goals of the department. Much of
this information is learned at joint conferences
and via specific clinical experiences.
Faculty Supervision
Dr. Armstrong and the department faculty actively supervise and
administer the educational activities described above
(quartiles of the didactic curriculum, surgical caseload,
etc.). Formal resident evaluations occur twice each year,
with the program director meeting each resident to review
evaluations, surgical case numbers, and research progress.
The chairman and the faculty are dedicated and committed
to the education of the residents. Each resident receives
lectures and one on one teaching every week. Thorough preoperative evaluation and
sound medical/surgical judgment are stressed in
addition to excellence in postoperative care. All surgical
operations are attended by full-time faculty. In the
faculty private practices, many
patients are evaluated by the resident rotating with the
attending and presented to the attending physician.
The resident has the benefit of independent assessment with
mentored feedback at the time of the patient visit. In
addition there is a resident clinic
staffed by full time and volunteer faculty.
In these clinics, all patients are initially seen by the resident,
then presented to a senior resident. Attending
oversight is provided and the patients are also seen by an
attending physician. Residents participate in the
faculty surgeries, and all operative procedures performed at
UCI Medical Center and Long Beach VAMC are performed in
with resident participation. At the affiliated
hospitals (Kaiser, Children's Hospital Orange County)
the number of cases and faculty members exceeds resident
availability. At these sites, residents participate in
many but not all of the available surgeries.
Facilities and Equipment
Libraries
The main Resident library is located in our departmental
office. It contains the major journals of the
specialty. The major Otolaryngology textbooks
and other otolaryngology educational aids are also in this
library for resident use. In addition, a complete
collection of the Otolaryngology Self-Instructional Packets
(SIPacs) and the home study course monographs are provided for resident
use. Adjacent to the library is a resident computer,
DVD player (and CDs/DVD's on Temporal Bone anatomy,
Histopathology, anatomy, and surgical techniques). A
number of instructional videotapes are also
available. A
second resident library and workspace is located in the
clinic. The UCI Grunigen Medical
Library is located on the hospital campus,
situated between the faculty offices and the outpatient
clinic. The medical library has an extensive journal
and textbook collection, and a computer center available for residents.
Interlibrary loan and electronic document requests are
available, as well as professional library assistance for
literature searches.
Hospitals
UCI Medical Center (UCIMC) is an approximately 500 bed
tertiary medical center. We have just completed a brand
new state-of-the-art university hospital. The new
medical center has doubled the number of operating rooms,
and has advanced intraoperative monitoring and
digital HD technology. The brand new ICU and stepdown
units provide a first rate patient experience and optimize
workflow for clinicians. The medical center is the
only level I trauma center in Orange County, and the Medical
Center is situated at the junction of several major
freeways. The medical center has primary care and
specialty clinics on site, which provide primary, secondary,
and tertiary care services for the region. Four to
five residents rotate at UCIMC.
Children's Hospital of Orange County (CHOC) is a
renowned children's hospital serving Orange County. It
is located 2.2 miles from UCIMC, and is a 5-minute drive
from the medical center. Currently, three pediatric
otolaryngologists teach residents at CHOC, lead by Gurpreet
Ahuja, M.D. One resident rotates at CHOC full time,
participating in a large number of general pediatric
otolaryngology surgeries, difficult airway cases, and
pediatric head and neck surgical cases. There is a
weekly pediatric Otolaryngology clinic at CHOC staffed in
rotation by the pediatric otolaryngologists and the
pediatric otolaryngology resident.
Kaiser Lakeview and Sand Canyon Medical Centers are the hub for the
Kaiser rotation. Two residents rotate at Kaiser, which
provides exposure to an integrated HMO setting.
Residents rotate at Kaiser during the PGY-3, 4, and 5 years.
This rotation provides a high volume of sinus surgery,
otologic cases, and thyroid surgery. There is also
exposure to head and neck cancer and skull base surgery at
this site. The Kaiser rotation is evolving. A
new facility at Sand Canyon was completed in 2008, and a
replacement hospital and medical office building in Anaheim
are under construction.
The Veterans Affairs Medical Center, Long Beach (LBVAMC) is
a large VA medical Center located approximately 14 miles
from UCIMC. LBVAMC has an active Otolaryngology clinic
with general Otolaryngology, otology, and a strong exposure
to facial plastic and reconstructive surgery. It is
also a major referral center for cochlear implants in the VA
system.
Equipment
A fully equipped voice and speech laboratory with
videostroboscopic capabilities, airway analysis, etc. is
available in the clinic area. This was purchased with an NIH
grant. Since that time other
equipment has been upgraded in this facility. Audiological
equipment is updated on a regular basis and is
considered state-of-the-art. As mentioned above, computers,
etc. are available to the residents and are considered
up-to-date. A full complement of endoscopes is available in
the operating room and the outpatient clinic area.
Outpatient Clinics
Each clinical site has outpatient clinics containing fully
equipped rooms set up for a complete head and neck examination.
At UCIMC, LBVAMC, and Kaiser, videostroboscopy equipment is
on site in the clinic. Full service audiology is
present at all clinical teaching sites as well. Each
site has either a dedicated microscope room, and at several
sites, there are wall mounted microscopes for detailed
otologic examinations and procedures.
At UCIMC there is an operating room situated in the
outpatient clinic. Minor procedures and facial
plastic/reconstructive procedures with conscious
sedation are performed in this room. Plans are underway to upgrade
this suite for general anesthesia capability.
Research
This residency training program features several
educational goals for each and every resident who completes
training here. The faculty expect that each finishing
resident will attain a knowledge level, surgical skill
level, and resident research capability equivalent to at
least the 75th percentile of other graduating residents
across the United States. One major goal of the training
program is to train future academic surgeons in the
specialty of otolaryngology-head and neck surgery.
Accordingly, research, both basic and clinical, is an
important and stressed aspect of the training program. Each
resident is expected to complete a basic science type of
research project and a clinical project (such as a
retrospective review, etc.) during the training period. It
is expected that each of these will result in a scientific
manuscript which is presented at a meeting and published
paper. The department feels that through such academic goals
and pursuits, each resident will easily attain clinical expertise, scientific adequacy,
and passage of the American Board of Otolaryngology
certifying examination.
Meetings & Conferences
Grand Rounds
Grand Rounds conferences are held each week on Wednesday
afternoons. The Grand Rounds are divided into two separate
but interwoven sessions. The first is a Resident
sponsored didactic session and the second is the formal
Department grand rounds.
The Resident grand rounds are organized by and presented
by the residents and is intended to supplement the didactic
sessions provided by the Department elsewhere. These
meetings are intended to be more informal than the
Department's Grand Rounds, and each resident is expected to
present basic academic topics. The initial intention of
these meetings was to assist in preparation for the annual
Otolaryngology Training Examination, as well as the actual Academy
Boards. However, these sessions have grown in scope and
now are additionally intended to provide residents with an
opportunity to practice presenting before formal meetings
and to present interesting or special cases. The topics are
related to and chosen in conjunction with the topic of the
academic quartile. For example, the July 2009 - December
2009 quartile is devoted to Otology and related subjects,
and the Resident Grand Rounds during this period are also
dedicated to Otology subjects. These session last
approximately one hour and include multimedia presentations
and "round table" discussion groups.
Departmental Grand Rounds are held from 5 to 7 PM
every week (Wednesday afternoon). This period is an
opportunity for the residents, faculty and guest speakers to
deliver didactic lectures and to promote resident/faculty
education. These formal sessions include demonstrations,
multimedia presentations, and interactive discussions.
Morbidity and Mortality conference is held once a month
during the Grand Rounds time. From time-to-time,
interdisciplinary conferences are held with the Department
of Anesthesia or on occasion the Division of Plastic
Surgery. Residents can expect to receive a definitive
discourse on the topic presented and utilize this
information in clinical and academic settings.
Head & Neck Tumor Board
A weekly tumor board is held at UCIMC. The UCI tumor
board is comprised of a multidisciplinary team of
specialists including head & neck
surgeons, radiation oncologists, medical oncologists, head &
neck pathologists, and head & neck radiologists.
The clinic is attended by social workers, and when
appropriate, neurosurgery, endocrinology, and speech
pathology. One resident is assigned to present each new
case. The average volume is three new cases per week.
The board is structured with patients coming to the
outpatient clinic, where the board can meet the patients,
then the group retreats to a nearby conference room to
present diagnostic studies, review pathology, and discuss
treatment options. For more information, click
here.
Pediatric Otolaryngology Conference
A monthly pediatric Otolaryngology conference is held on
the
morning of the first Thursday of the month in the department
resident library. It is attended by all the residents and
the pediatric otolaryngologist on the faculty who are based
at the Children's Hospital of Orange County (CHOC).
Pathology Conference
Pathology conference occurs monthly at UCIMC. The
conference is held in the department of pathology at the
multi-headed microscope, where interesting and unusual head
and neck pathology cases are reviewed with a pathologist. The conference is held in a room in which every
resident observer has his own microscope viewer and can
point to pathology and describe it for the senior
pathology-observer-teacher.
Neuro-Radiology Conference
Head and Neck
Radiology conferences occur each month in a dedicated Grand
Rounds session designed to promote the residents' education
by presenting interesting patient cases and displaying
relevant radiographic studies. We are fortunate to have the
recognized authority in head and neck radiology, Dr.
Anton Hasso, Director of Neuroradiology of the Department of Radiological
Sciences at UCI, to lead these sessions.
Temporal Bone Dissection Laboratory
The main temporal bone laboratory for the training program
is a state-of-the-art, three station, video equipped
microvascular and temporal bone laboratory. Temporal bones
are procured for this laboratory from the Department of
Anatomy at UC Irvine. Residents perform temporal bone
dissections at the laboratories whenever they desire (the
labs are always open to residents) and in 4 yearly sessions
supervised by our neurotologist. A second, smaller
laboratory is located at the Long Beach VA Medical Center.
Facial Plastic and Reconstructive Surgery Conference
Each month, a three hour conference dedicated to
instruction in facial plastic & reconstructive surgery is
provided to the residents and community otolaryngologists. These sessions are both clinical and
didactic. Patients are presented to the conference when they
illustrate a particularly complex or difficult clinical
problem. In addition, lectures are delivered on subjects
related to facial plastic and reconstructive surgery. The
goal of this conference is to supplement the plastic surgery
education provided elsewhere in the resident experience.
Vascular Malformations Conference
A monthly vascular malformations conference is held at the
Beckman Laser Institute under the direction of Dr. Brian
Wong and Stuart Nelson, M.D.
Journal Club
Journal Club is a resident-led session, meeting
approximately 3-4 times per academic year. Classic or
otherwise timely and interesting articles are presented and
discussed by the residents with faculty facilitation of
discussion. The meetings are held in informal
settings, often over dinner in a local venue. These
meetings serve to broaden the educational experience of the
residents, as well as increase camaraderie among the
residents and faculty.
Weekly Journal Club meetings are held at the laboratory of
Dr. Fan-Gang Zeng. Residents on the otology research
rotation attend.
Academic Meetings
Residents are strongly encouraged to attend and present
papers at national and regional academic meetings. The
department provides financial assistance to support resident
travel to major regional and national meetings where the
resident is presenting a paper or poster, and presentation
at these meetings by the residents is an expected an
required activity.
Residency
Curriculum
The program has a very strong background and history of
outstanding performance on the American Board of
Otolaryngology examination, and coverage of the entire scope
of the discipline of otolaryngology-head and neck surgery.
In addition, interdisciplinary interaction with such specialties
as neurosurgery, pathology, radiology, pediatrics, plastic
surgery, general surgery, and oral and maxillofacial surgery
are an integral part of the content and planning of the
training program. The following areas are included in the
educational experience of each resident:
Bronchoesophagology, Facial plastic and reconstructive
surgery, Head and neck surgery, Laryngology, Rhinology,
Otology, Otolaryngic allergy, Immunology, Endocrinology,
Neurology, Speech pathology, Swallowing and speech
physiology, and pathophysiology, and therapy Prosthetic
management of head and neck deformities, Basic dentistry,
Laser medicine and surgery.
The training program results as a graduated one with
development of increasing levels of responsibility through
the five years of training as follows:
 |
Basic surgical skills, sterile
technique, handling of tissue, fluid and electrolyte
physiology and disorders, anesthesia, emergency
medicine, basic wound care, basic
patient management. Three months rotation on
Otolaryngology service. |
 |
During the PGY-2
year, the resident learns the complete head and neck
history and physical examination, use of the head mirror
and diagnostic mirrors, use of endoscopes, and
binocular microscopy.
Surgical procedures learned include myringotomy with
tube placement, tonsillectomy, adenoidectomy,
tracheotomy, laryngoscopy, esophagoscopy,
bronchoscopy, and septoplasty. The
majority of the year is spent at UCIMC, and one or
two months is spent at CHOC and/or LBVAMC.
Preparatory work for the research project in the
PGY-3 year is undertaken this year. the
resident develops a research project which is
presented to and passed by the departmental research
committee. |
 |
The surgical experience expands in the PGY-3
year. Basic endoscopic sinus surgery is undertaken as well as
preliminary otologic surgical experiences including
the decortication portion of mastoidectomy, extended
septoplasty, uvulopalatopharyngoplasty, neck
dissection, microlaryngoscopy,
and laser laryngoscopy. Four months of the PGY-3
year are devoted to research. Clinical
rotations include UCIMC, Kaiser, CHOC, and LBVAMC. |
 |
In the PGY-4 year, a significant portion of this
year is spent at UCIMC and the Kaiser rotation. More
advanced head and neck cancer and otologic
procedures are emphasized at UCIMC as well as more
advanced sinus procedures. At Kaiser there is
a strong focus on thyroid surgery, endoscopic sinus
surgery, otology, and general otolaryngology
procedures. The resident research project(s)
that was executed in the PGY-3 year is written up
and presented generally during the PGY-4 year.
Clinical research project(s) are also either completed or
extensively worked during this time period. |
 |
Senior resident year. During this year, the
resident extends his/her expertise to the entire
surgical spectrum of the specialty performing major
skull base and other head and neck cancer
extirpations, all aspects of otologic surgery, all
aspects of sleep apnea surgery, full endoscopic and
non-endoscopic sinus surgery, as well as facial
plastic and reconstructive surgery including
aesthetic facial surgery. |
Resident Living
Call Schedule
Call schedules differ for junior, senior,
and chief residents, and also vary according to the rotation
a resident is assigned to at any particular time.
Generally, the schedule conforms to the following
guidelines:
|
Location |
Year |
Call Responsibilities |
| UCIMC/CHOC/LBVA |
Junior (PGY-2, 3) |
Q 4-5 days (home call)
2 weekends/month (home call) |
| |
Senior (PGY-4, 5) |
Backup call
|
| Kaiser |
(PGY-3, 4, 5) |
QOD until 7PM
Every other weekend (home call) |
Trauma coverage at UCIMC is shared with
Plastic Surgery Service (UCIMC ) on a weekly rotation.
The call schedule is determined by the residents and
approved by the Program Director.
Proximity to UCI: Because the majority of the call
is from home, the residents are required to reside within a
15 minute proximity to UCIMC. This includes many of
the surrounding communities including Irvine, Tustin, and
Anaheim.
At all times, a Chief resident is on call and available
by pager at all times to the on call resident. A designated
faculty member is also available at all times.
The Area
The residents at UCIMC enjoy certain benefits from
participating in one of Southern California's residency
programs!
UCIMC is located in the city of
Orange, in Orange County, California. Some of the
outlying communities include Anaheim, Anaheim Hills, Irvine,
Tustin, Newport Beach, Laguna Beach, and other desirable
living areas. The LBVAMC is located in
Long
Beach, California. Nearby cities include Sunset Beach,
Seal Beach, Huntington Beach, Palos Verdes Peninsula, and
other cities. San Diego and Los Angeles are
within a reasonable driving distance and can provide a
welcome opportunity to explore different aspects of Southern
California living.
The weather is usually fairly temperate. To check out the
weather in Anaheim right now, click
here.
Most residents choose to live in Long Beach, Irvine, Newport
Beach or Anaheim. Each of these areas provides specific
benefits, from easy access to surf, to shopping/recreation
centers. Check out the surf at Huntington Beach right
now by clicking
here.
The lifestyle of a typical Californian varies from person
to person, but generally, an active, healthy lifestyle is
the rule rather than the exception. Most people find the outdoors
a resplendent getaway from the hustle and bustle of
everyday life... Orange County can be a starting point for a
trip to
the beach or to the mountains for skiing,
snowboarding, mountain biking or hiking. It has often been said that living in Orange County permits its residents to
surf in the morning, go skiing during the day, and return
for a dinner on the beach all in the same day!
UCIMC is located in close proximity to the Anaheim
Angel's Big A Stadium, the Anaheim Ducks' Pond, Disneyland,
and Knotts' Berry Farm. The list of things to do is simply
too exhaustive to list here, but check out some of these
sites for further information (or surf the web on your own):
Newport Beach
Seal Beach
Orange County
Disneyland
A Day in the Life of...
Typically, the ENT resident's day start
between 6:15 AM and 7:00 AM. Rounds are undertaken on all in-house patients and patients on which the service is
consulting. The rounds are generally led by the service's
chief resident, with all residents and medical students
actively participating. During the weekdays, faculty members
generally round with the service team on patients. The days
are filled with either clinic or surgery, with all residents
expected to get a fair mix of each. Operations at UCI are
performed in our main OR center or in our outpatient
surgical center and at the OR Ward at the LBVAMC. Evening
rounds conclude the days' activities and again are performed
by the entire team. These rounds occur usually between 5:30
PM - 7:30PM. The residents attend any meetings or lectures
scheduled for that specific day.
Our aim is to promote healthy lifestyles for the
residents, and while academic pursuits are encouraged,
expected, and mandatory, we also recognize that outside
activities contribute to a resident's general sense of well
being. Currently, our residents participate actively in
The Pacific Chorale Choir Group, surfing, martial arts, and other
activities. Often, residents meet socially outside of the
hospital, as time permits.
Residency Match
Resident matching is completed each fall. We customarily
interview 30-40 candidates in order to generate our
residency matching list. The total number of residents for
the training program is 10 (3-2-3-2).
Interested
medical students who would like to contact individual
residents in our program are encouraged to do so via e-mail,
available on this web site through the UCI directory.
Questions about away rotations here at UCI should be
directed towards Mary Ann Evans:
maevans@uci.edu (714)-456-5753
