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Otolaryngology Head and Neck Surgery Residency 

Residency Overview

Structure

The Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine College of Medicine sponsors a five year residency program in Otolaryngology-Head and Neck Surgery.  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 with the focus on leading the team of residents and a 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

The Chairman, 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.  A new facility at Sand Canyon was completed in 2008, and a new replacement hospital and medical office building was completed in September of 2012 in Anaheim. 

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.