Medical Student Rotations

Medical students who are exploring their interest in the Otolaryngology - Head and Neck Surgery Residency through an elective rotation in the fourth year of medical school are often intimidated by the volume of material that they need to survey and/or digest. Rightfully, there is much trepidation about getting ‘pimped’. When the OR schedule is known, students tend to be more comfortable having read about the procedures they are about to observe and have some understanding of the indications, risks and benefits and outcomes. But when they see consults in the Emergency Department, on the wards or in the office, the uncertainties that go along with the encounters tend to induce some anxiety.

To help our medical students, cope with the stresses of an elective we have created a syllabus (supplemental figures) of high-yield content. This is not intended to be a comprehensive review of otolaryngology - head and neck surgery material, but address topics that a clerkship director might consider core knowledge that a medical student should walk away with at the end of a rotation. Effort was directed at content that should be of long-term benefit to the medical student, even if they elect not to pursue otolaryngology as a career.

We are making this syllabus (supplemental figures) available, online, because the COVID-19 pandemic disrupted plans for ‘away’ or ‘audition’ rotations for our visiting students. Virtual rotations are in vogue, but for the most part, they are open-house opportunities and have limited educational value. It is our hope that by sharing this syllabus (supplemental figures), we can meet some of the educational needs of the interested students.

I am grateful to two medical students who worked to generate this content: Kelly McKenna created an outline which Christian Caceres expanded and organized it into the syllabus (supplemental figures). It is going to take some time to mature this document and complete all the sections. A third student, Carly Malesky, created a document pertaining to Endoscopic Sinus Surgery FESS Elective, that students may find helpful while preparing to observe sinus surgery in the operating room. Please feel free to reach out to me with suggestions.

The goal of the Otolaryngology rotation is to increase the appreciation of the senior medical student of the principles and approaches to otolaryngologic pathology. This rotation will help the student improve knowledge, clinical and technical skills, while working as a junior, but valued team member of the otolaryngology service. Students will rotate through four sites with exposure to diverse patient populations, ranging from neonatal/pediatrics to geriatrics, economic, cultural, and racial backgrounds and a wide range of pathologies. Students will work closely with the residents and direct supervision of faculty with subspecialty training in pediatrics, geriatrics, laryngology, head and neck surgical oncology, endocrine surgery, facial plastics and reconstructive, facial trauma, rhinology/skull base and otology/neurotology. Students will interact with both academic and private-practice faculty to appreciate different setting in which otolaryngologists practice their art.

Objectives will include the following:

Knowledge

    1. Develop an understanding of otolaryngologic anatomy and its relation to encountered pathology.
    2. Understand basic indications and interpretation of diagnostic (e.g., audiograms, serologic) and radiological tests (including head and sinus CT scan and MRI).
    3. Begin to develop knowledge of common surgical procedures including integration of technological innovations (nerve monitoring, image guidance, robotics, etc.).

Clinical Skills

    1. Refine data gathering abilities to empower differential diagnosis generation.
    2. Gain specialty-level, general head and neck physical examination skills as well as, specialty exam skills driven by specific patient presentations.
    3. Recommend diagnostic studies and treatment options.
    4. Gain familiarity with handling of surgical instruments, including endoscopes.
    5. Hone suturing technique.

Communication and Professional Skills

    1. The student will serve as a valued member of the otolaryngology service and work in collaboration with the otolaryngology residents under direct supervision of the chief resident and members of the Otolaryngology faculty.
    2. The student will have the opportunity to work with the otolaryngology service in the operating room and evaluate patients as a consultant in both inpatient and outpatient settings, as well as, the emergency room.

Participate in the following operative procedures

    1. Operative laryngoscopy and bronchoscopy
    2. Adenotonsillectomy
    3. Myringotomy and tube insertion
    4. Congenital neck mass excision
    5. Endoscopic sinus surgery
    6. Thyroidectomy/parathyroidectomy
    7. Neck dissection
    8. Ablative upper airway surgery
    9. Flap reconstruction post ablative procedures
    10. Septoplasty/rhinoplasty
    11. Tympanoplasty/mastoidectomy
    12. Cochlear implantation

Evaluation

    1. Students are evaluated based on the professionalism and teamwork, core knowledge (see syllabus (supplemental figures)) and the quality of an assigned, brief presentation.