Rotations

Program Year 1: Surgery / Otolaryngology - Head and Neck Surgery

The first year of post-graduate training begins with orientation to the residency program and the participating institutions. Orientation includes Advanced Trauma Life Support (ATLS) and Advanced Cardiac Life Support (ACLS), simulation boot camp for minor procedures and surgical boot camp. The first year of post-graduate training consists of approximately month-long rotations in Surgery (six months) at Hartford Hospital, Saint Francis Hospital, and Connecticut Children's Medical Center and Otolaryngology at UConn John Dempsey Hospital (three months) and Connecticut Children's Medical Center (three months).

Surgical rotations include one month each of plastic surgery, pediatric surgery, surgical ICU, and neurosurgery and two, one-month general surgery rotations.

PGY1 residents participate in the educational activities of the service on which they are rotating, including didactic conferences. First year residents gain substantial experience in management of both outpatient and hospitalized patients, including postoperative management. PGY1 resident will never be unsupervised which permits laying down a solid foundation for eventual competence in various areas in a low-stress atmosphere that prioritizes patient safety. While on the otolaryngology service (the second half of the academic year), PGY1 residents are excused from first call responsibilities. They are permitted to take “buddy-home call” every fourth night that will allow supervised exposure and gradual accumulation of experience in evaluation and management of otolaryngologic emergencies.

Program Year 2: Otolaryngology - Head and Neck Surgery

The second year of otolaryngology training consists of three, two-month rotations at both UConn John Dempsey Hospital and the university-affiliated Connecticut Children's Medical Center.

During their six months at UConn John Dempsey Hospital, the resident works under the supervision of the chief resident and the on-site faculty. They will work in the clinic/office setting approximately three and a half days per week and will spend the remaining one and a half days in the operating room. While rotating at UConn John Dempsey Hospital, the resident gains valuable experience in the outpatient assessment of patients with a variety of otolaryngology/head and neck problems, and the preoperative and postoperative management of surgical patients. Continuity of care is a major objective of this rotation. Operative experience is gained under the supervision of the full-time faculty, not only in the simpler cases, but also as an assistant in more complex cases.

The remaining six months of the first year is spent at the Connecticut Children's Medical Center. Here the resident can expect to be in the clinic three half days per week, and in the operating room five to seven half days per week. The operative schedule is very busy, and typically includes the majority of pediatric "bread and butter" cases. The resident works primarily with six full-time fellowship-trained pediatric otolaryngologists and will gain experience in the medical and surgical management of pediatric patients, highlighted by management of the pediatric airway and infectious diseases of the head and neck. Call is taken from home and will be every third to fourth night.

Program Year 3: Otolaryngology - Head and Neck Surgery

The third year of otolaryngology training consists of 2, three-month rotations at Hartford Hospital craniofacial trauma service, and research at John Dempsey Hospital and a six-month rotation at the University-affiliated Hartford Hospital. While on the facial trauma service, the resident is an integral member of the craniofacial trauma team at Hartford Hospital, a Level 1 trauma center. The resident completing the trauma rotation should feel comfortable in the evaluation, diagnosis, and treatment of the most complex craniofacial traumas. Extensive experience in the care of soft tissue injuries is also a benefit of this rotation, and the trauma team faculty are always "on the cutting edge" of facial trauma management.

During the six-month rotation at Hartford Hospital, the resident can expect in-depth exposure to the operative management of head and neck disorders, including head and neck oncology, diseases of the paranasal sinuses, ears, and salivary glands. Of immeasurable benefit is the ability to work with nine otolaryngologists in this large community hospital, and to work with fellowship-trained otolaryngology facial plastic surgeons, neurotology surgeon and head and neck oncology/reconstructive surgeons. In order to facilitate continuity of care, the clinical faculty welcome residents into their offices for patient follow up.

The first three-month research block is included in this year of training. During this block the resident is expected to pursue a research project under faculty supervision. Call is taken from home and will be approximately every third to fourth night.

Program Year 4: Otolaryngology - Head and Neck Surgery

The fourth year of otolaryngology training consists of four rotations: Two, three-month blocks at the university-affiliated Saint Francis Hospital, and the second three-month research rotation at UConn John Dempsey Hospital and one, three-month block at Hartford Hospital.

A major feature of the Saint Francis Hospital rotation is that the "solo" resident assumes primary responsibility for the care of clinic and hospitalized patients. The resident is expected to independently evaluate a patient and formulate a treatment plan. While faculty supervision remains in place, the senior resident develops as a colleague whose input is central to patient care. The residents run a half-day clinic a week, and can expect to operate five to seven half-days a week. The consult service sees one to five new consults a day. The resident will work with eight otolaryngologists and will gain experience in complex otologic surgery under the guidance of a fellowship trained otologist. Two fellowship-trained skull-base surgeons at the Saint Francis provide the resident with an unparalleled experience in surgery of this anatomic region. The resident continues to build on their head and neck oncology exposure and the large volume of general otolaryngology cases makes these "solo" rotations an extremely rewarding experience.

During the three-month rotation at Hartford Hospital, the resident can expect to build on the experience gained in PGY3 and improve his/her surgical skills in operative management of head and neck disorders, including head and neck oncology, diseases of the paranasal sinuses, ears, and salivary glands. Through strengthening the relationship with nine otolaryngologists in this large community hospital including fellowship-trained otolaryngology facial plastic surgeons, neurotology surgeon, and head and neck oncology/reconstructive surgeons, the residents gain progressively increased independence. In order to facilitate continuity of care, the clinical faculty welcome residents into their offices for patient follow up.

A second, three-month research block is included during this year of training that affords the resident the opportunity to complete their project and prepare the results for publication. As a senior resident, call is taken as backup to the junior resident, from home, every fourth night.

Program Year 5 - Otolaryngology - Head and Neck Surgery

The final year of otolaryngology training consists of four, three-month rotations at two sites: UConn John Dempsey Hospital (six months) and Hartford Hospital (six months).

The chief resident at UConn John Dempsey Hospital gains a substantial portion of their otology experience and a substantial oncology operative experience during this rotation. As a resident surgeon under the supervision of a fellowship trained neurotologist, the resident builds on the foundations established as a fourth-year otolaryngology resident at Saint Francis Hospital and Hartford Hospital. Under the supervision of a fellowship trained head and neck oncologic surgeon, the chief resident gains their most complete experience in head and neck surgery. In addition, exposure to head and neck reconstruction after major oncologic surgery is gained under the supervision of a fellowship-trained reconstructive surgeon at Hartford Hospital through team approach to head and neck cancer patients that integrates UConn John Dempsey Hospital surgical oncologist. The resident is expected to participate in the multidisciplinary head and neck cancer clinic, and has the opportunity to see the cancer patient preoperatively, help perform the operation, and then follow the patient postoperatively. The chief resident at UConn John Dempsey Hospital effectively serves as "Junior Attending," and as such has one clinic per week for which they are responsible, with direct faculty supervision. The resident should expect to operate three to four days per week, and when not in the operating room, will participate in either a very busy general clinic, or one of several specialty clinics, including multidisciplinary taste and smell, voice, otology, vertigo, thyroid/parathyroid clinics or the above mentioned cancer clinics.

During the six months at Hartford Hospital, residents will have the opportunity to work closely with the subspecialty trained faculty (neurotology, facial plastic surgery) and expand their surgical experience. In addition, they will gain significant expertise in thyroid surgery. The chief resident will coordinate care between UConn John Dempsey Hospital's head and neck oncology surgeon and Hartford Hospital's reconstructive surgeon toward successful management of complex cancer patients. Besides this team approach to very complex patients, the chief resident will work closely with Hartford Hospital head and neck surgical oncologist in the operating room and wards. While at Hartford Hospital, the final-year resident oversees and assigns responsibilities to the residents at the Hartford Hospital and Connecticut Children's Medical Center campuses. There is also opportunity for the resident to spend time in the faculty's offices, which is an invaluable resource in the resident's education of "real world" practice management. As a senior resident, call is taken as backup to the junior resident, from home, every fourth night.