Otolaryngology Residency Curriculum

Offering a balanced curriculum training residents to become leaders within their field of study.

After completing an American Board of OtolaryngologypHead and Neck Surgery-compliant PGY-1 year of training, otolaryngology residents at Wake Forest School of Medicine spend the following four years gaining comprehensive inpatient training, outpatient training and research experience.

Inpatient Clinical Training

The entire inpatient experience is gained at the main teaching hospital, Wake Forest Baptist Medical Center, an 885-bed Level I trauma center that serves as the primary academic referral hospital for the western half of North Carolina. We also routinely care for patients from Virginia, West Virginia, Tennessee and South Carolina. Brenner Children’s Hospital occupies an attached tower on the main medical campus, and the Comprehensive Cancer Center also resides on the main teaching campus.

Within these facilities, there are:

Separate adult and pediatric emergency departments
A large surgical suite with 40 operating rooms (including adult inpatient, adult outpatient and pediatric operating areas)
Multiple subspecialty intensive care units
Adult day hospital
Numerous inpatient units

Having all clinical experience on one campus has distinct advantages. Residents can easily participate in the departmental academic curriculum. They get to know each other very well, as they see each other every day, eat meals together and round together. In addition, since the number of faculty is roughly the same as the number of residents, there is ample time for one-on-one interaction between them.

Team-based Training

The inpatient clinical services in our department are divided into teams for grouping subspecialties. This forms the basis of collaboration between faculty and residents.

Team A

Pediatrics
Rhinology
General otolaryngology

Team B

Otology/neurotology
Laryngology
Facial plastic and reconstructive surgery

Team C

Head and neck cancer

Team D

Consults
Trauma

Each service has two to four residents, who round together in teams in the morning and then collaborate with their respective attending physicians.

Generally, residents interact primarily with the attending physicians on their team in the operating room, clinic and inpatient wards. Effort is made to make sure that all residents get a balanced exposure to all of these services during the course of their training.

View a block diagram of the current year’s rotation schedule (PDF).

Otolaryngology Surgical Experience

Surgical experience in our department is extensive and comprehensive. Residents begin to gain experience in the operating room from day one, gradually and consistently developing their skills in performing the full spectrum of surgical procedures in our field.

Total case numbers have traditionally been well above national norms. Graduates are well-equipped to handle the types of surgical problems that typically present to the general practitioner to manage. In addition, the volume of complicated surgical problems managed in our department utilizing the latest technologies including robotics, image guidance, endoscopic and microscopic surgical techniques prepares the trainee to manage complex problems of the head and neck. The well-deserved national reputation of our program makes our graduates attractive applicants to fellowship programs around the country.

Outpatient Clinical Training

The reality is that almost every practicing otolaryngologist spends the majority of time in the outpatient clinic caring for patients. There is a great paradox in current Otolaryngology training in this country that the large majority of time during residency is spent in the inpatient setting and in the operating room. It remains a challenge for all Otolaryngology training programs to prepare their trainees to be fully prepared and comfortable to function in an outpatient care environment. Graduates must possess the readiness to be accountable for the longitudinal care of patients throughout the continuum of clinical care. Graduates from our program are uniquely prepared in this regard.

Otolaryngology residents obtain experience in faculty outpatient clinics and in the resident continuity (aka “OPD”) clinic.

Faculty Outpatient Clinic

Otolaryngology residents spend two months in faculty clinic during the PGY1 year of training. During this time, the residents get one-on-one exposure to faculty with their continuity patients in each of the subspecialty areas of our department. During the PGY2 through PGY5 years of training, residents spend one-half day per week in faculty clinic that corresponds to the inpatient clinical rotation that they are on. During this time, the residents progress from a shadowing role to a more independent role in the evaluation of patients under close supervision of the attending physician.

Resident Continuity (OPD) Clinic

Starting midway through the PGY-2 year of training, Otolaryngology residents begin their OPD clinic experience. Residents spend one-half day per week in OPD clinic regardless of which clinical or research rotation they are on. During a typical clinic session, the resident will see a manageable number of patients with an identified faculty member immediately available for support and consultation. The resident oversees and guides the entire clinical continuum of care for patients in OPD clinic. This includes:

Initial evaluation
Work-up
Medical or surgical intervention
All follow-up care

Patients stay with the same resident provider throughout this experience regardless of the duration of care. In this paradigm, a resident may care for a patient for more than three years during their training. Through this unique experience, the resident acquires a level of comfort being completely accountable for the longitudinal care of patients. This is an experience that has all be vanished in Otolaryngology training programs around the country and makes our graduates uniquely prepared for independent practice.

Resident Continuity (OPD) Clinic Overview Video

Research

An important part of our residents’ training is learning basic research concepts and contributing original research. Faculty and residents collaborate in both clinical and basic science research. Residents are supported to attend at least three national meetings (Academy meeting during PGY-3 and PGY-5 and COSM during PGY-4) and also the North Carolina/South Carolina Otolaryngology annual meeting during PGY-3 year of training. Residents are expected to submit an original research project to each of these meetings.

Residents have four months of dedicated research time:

One month during PGY-2 is spent organizing at least one research activity, presenting a research prospectus to the otolaryngology department and beginning the process of writing an internal review board application
Two months during PGY-3 are spent doing the majority of the data acquisition and assimilation and moving projects to completion
An additional month during PGY-4 is spent bringing open research projects to a close

Conferences and Didactics

To lay the groundwork for clinical and research exposure, the department maintains a comprehensive lecture and conference curriculum for the ongoing education of residents and faculty, which includes:

Faculty Lectures

All otolaryngology faculty participate in giving lectures to the residents. There are generally one to two faculty lectures per week. The lectures include a variety of interactive formats such as subject matter lectures, case-based discussions, and mock oral board scenarios. In general, a two-year lecture curriculum is maintained so each resident gets exposure to material more than once during the course of training.

Wednesday Morning Conference

Wednesday morning conference occurs weekly, begins at 7:30 am and is attended by all faculty, residents and any other learners on rotation. A variety of conference formats exist and occur on a rotating basis.

A traditional ‘grand rounds’ conference consists of two residents delivering presentations (20-minute duration each) on a topic of their choosing in PowerPoint format. Each resident gives two or three grand rounds presentation per year.
Neuroradiology conference occurs on a quarterly basis. We are fortunate to have one of the best neuroradiology training programs in the country. During this conference, a neuroradiologist goes over imaging with clinical context. This is a great interactive and entertaining conference that is attended by all neuroradiology faculty and fellows.
Audiology conference occurs on a quarterly basis. During this conference, we thoroughly review a small number of interesting and challenging audiology and vestibular cases. The cases are presented by a resident with input by audiology and otolaryngology staff.
Quality Care Continuum Review (QCCR) conference occurs on a quarterly basis. This has traditionally been referred to ‘morbidity and mortality’ conference. During this conference, a resident presents a small number of patients who experienced complications or unintended occurrences during their care. This conference provides abundant learning opportunities for attendees that can lead to process improvement or patient safety initiatives for the department.
COCLIA conference follows the 7:30 am conference on a weekly basis. During COCLIA, each resident is responsible for researching and preparing a concise response to a COCLIA topic and presenting it to the resident group. The responses are archived on a server that is accessible to all residents for future study.

Temporal Bone Lab Video Overview

The temporal bone drilling lab offers the capability for 12 drilling stations. On a monthly basis, the residents and teaching faculty convene for a lecture followed by a related temporal bone dissection. There is an organized curriculum that is tailored for the resident that is appropriate for their level of experience. The temporal bone curriculum generally repeats on an annual basis.

Audiology, Speech and Pathology Lectures

Twice per month, our residents receive a lecture on a rotating basis from members of our audiology and speech pathology teams. There is a two-year rotating curriculum covering a broad range of basic science and clinical topics including basic and advanced audiologic assessment, vestibular testing and speech/voice/swallowing evaluation and treatment. We are also lucky to have interested pathologists come and give presentations on microscopic diagnosis of a wide variety of otolaryngic tumors and conditions.

Journal Club

On a monthly basis, residents participate in subspecialty journal club with corresponding faculty. A selection of peer-reviewed journal articles are chosen for review. This conference is usually held in a relaxed setting of a dinner and liquid refreshments. This is an essential conference that teaches the skills necessary to critically analyze the medical literature.

Clinical Conferences

Head and neck tumor conference occurs every Wednesday at noon. During this conference, a team of clinicians convene to review new and ongoing surgical oncology cases. Participants include:

Otolaryngology
Medical oncology
Radiation oncology
Pathology
Radiology

During this conference, residents gain an appreciation for the benefit of high-level interaction of specialized care providers as it pertains to the clinical outcomes of this specific patient population.

National and Regional Meetings

The Otolaryngology department supports the attendance of residents to attend the Annual Meeting of the Academy of Otolaryngology-Head and Neck Surgery foundation during the PGY-3 and PGY-5 years. Also, the PGY-4 residents attend the annual Combined Otolaryngology Spring Meetings (COSM). Residents submit research projects to each of these meetings and present their findings in a poster or podium format. The PGY-3 residents also attend the annual meeting of the NC/SC Otolaryngology state societies and make a scientific presentation there.

The department also supports residents traveling to other regional educational conferences pending availability. These include:

Carolinas Pediatric Airway Course (PGY-3)
Duke Otolaryngology Boot Camp (PGY-2)
Head and Neck dissection course
Temporal bone dissection course
AO maxillofacial plating course
Sinus dissection course

Technology Transfer and Commercialization

Research Focus Areas

Translation to Care

More Resources