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Residency Training

The Boston Medical Center Otolaryngology residency matches 3 residents each year. The residents rotate at Boston Medical Center, Lahey Hospital and Clinic, Boston Children’s Hospital, VA Medical Center – Boston, and a private facial plastic surgery practice during the course of their five years of Otolaryngology training.

PGY-1

The intern year of general surgery includes rotations at the Boston Medical Center, VA Medical Center, Boston Children’s Hospital, and Lahey Hospital and Clinic. PGY-1 residents spend 6 months on the otolaryngology service at our various affiliate locations, as well as the ACGME required rotations in anesthesia, general surgery, neurological surgery, neuroradiology, ophthalmology, oral-maxillofacial surgery, pediatric surgery, plastic surgery, and radiation oncology.

PGY-2

The PGY-2 year is the first full year of otolaryngology training and is focused on developing otolaryngology specific skills, including performing a complete head and neck exam. The year is divided up into eight (8) months of training at Boston Medical Center (Boston, MA) and four (4) months at Lahey Hospital and Clinic (Burlington, MA). The training at each rotation is focused on general otolaryngology, and head and neck surgical oncology. As a junior resident, responsibilities rotate between clinic, the operating room (OR) and consults. Each resident participates in all specialty clinics: otology, rhinology/allergy, laryngology, pediatric otolaryngology, head and neck oncology, and facial plastics, and develops proficiency in clinic based procedures including FNA, incisional biopsy, flexible laryngoscopy, among others.

At least 1/3rd of your time as a PGY-2 is spent in the operating room, which is divided between assisting in larger head and neck oncology cases as developing competency in less complex cases including sleep surgery, septoplasty, turbinate reduction, endoscopic sinus surgery, excision of neck masses, direct suspension mircolaryngoscopy, esophagoscopy, repair of facial fractures, repair of complex soft tissue defects, and many more.

All PGY-2 residents are expected to attend the annual American Academy of Otolaryngology meeting or Combined Otolaryngology Spring Meeting and is encouraged to present any academic work at additional meetings during the year.

Call as a PGY-2, on average, is every three (3) days and is considered “home-call.” This means that once all required responsibilities are completed at the hospital, the resident is able to go home after team sign-out and would not be required to return until the next morning’s rounds unless a consult is requested overnight or if an emergency requires their assessment.

PGY-3

The PGY-3 academic year is divided into three blocks. During this year, residents gain more focused experience in Pediatrics and Rhinology, as well as continued exposure to more complex surgical cases in Head and Neck Oncology, Otology, and Laryngology. They refine diagnostic and management skills in the outpatient setting by actively participating in a variety of subspecialty clinics, both pediatric and adult. In addition, during the PGY-3 year, each resident prepares the framework for research that they will carry out during the PGY-4 year research block.

Each resident will spend 4 months at Boston Medical Center where they will contribute to a busy service and advance skills in surgical technique and care of outpatients in clinic in all subspecialty areas. They will serve as a mentor to the incoming PGY-2 residents and begin to participate in the education of medical students. Training focuses on exposure to complex airway surgeries, facial plastic and reconstructive surgery including management of facial fractures, and beginning to serve as the primary surgeon in head and neck soft tissue surgery including thyroidectomy, neck dissection, and salivary gland surgery. Additionally, the PGY-3 at Boston Medical Center serves as the ‘Quality and Safety Resident’, attending conferences at an institutional level and coordinating the department’s monthly quality and safety conference (formerly the morbidity and mortality conference).

Residents will also spend 4 months at the Lahey Hospital and Clinic where they continue to enhance their skills in endoscopic sinus surgery and microlaryngeal surgery, and have the opportunity to serve as the primary surgeon for more complex cases including sialoendoscopy, thyroidectomy, parotidectomy, neck dissection, tympanoplasty/mastoidectomy, and trans-sphenoidal approaches to pituitary lesions, among others. Additionally, residents participate in a full range of subspecialty clinics with fellowship trained attendings. This large suburban hospital serves a different patient population then the Boston Medical Center while providing broad surgical and clinical experience.

Each resident will also spend 4 months at Boston Children’s Hospital during the PGY-3 year, where they work on a team with PGY-3 residents from other residency programs in the Boston area including the Massachusetts Eye and Ear Infirmary and Tufts University. There, the resident will refine skills in pediatric airway, sleep apnea management, otology including cochlear implants, and management of medically complex pediatric patients.

PGY-4

In their PGY-4 year, the resident transitions into the role of a senior resident, taking more responsibility for running the clinical team as well as gaining experience with more complex surgeries. The year is divided into three 4 month blocks; Boston Medical Center (BMC), the Veterans Affairs Boston Hospital, and the resident research rotation. The PGY-4 BMC block is the designated Otology rotation. The senior resident spends time in Otology clinic assessing patients, gains experience performing tympanomastoidectomy, ossicular chain reconstruction, stapedectomy as well as other complex Otologic surgeries in the operating room, and sees their patients post-operatively in clinic. While the majority of operative time is focused on Otologic surgery, the PGY-4 BMC resident is also a senior resident on the Head and Neck service, performing thyroidectomy, parotidectomy and complex oncologic resections with free tissue transfer reconstruction.

At the Veterans Affairs Hospital, the PGY-4 resident is the chief of the Otolaryngology service, responsible for running the inpatient service, leading the leading weekly Head and Neck Multidisciplinary Tumor Board, and independently evaluating and working up patients in the clinic. The operative experience is a mix of complex head and neck oncology and demonstrating proficiency in general otolaryngology procedures including sleep surgery, endoscopic sinus surgery, microlaryngeal surgery, and functional nasal septal reconstruction.

The final four month block is dedicated to research endeavors with one or more Department full-time faculty members. Monthly Department Resident Research and Scholarly Activities Committee meetings facilitate organizing and executing either clinical or basic research projects with a designated mentor within the BMC faculty.

PGY-5

In the final year of training (PGY-5), each resident will spend 4 months in each of three rotations. One four month block will be spent as the chief of service and head and neck chief at Boston Medical Center. In this capacity the resident will be responsible for the entire service at Boston Medical Center and reporting directly to the attendings. Increasing responsibilities are reflected by the resident’s involvement in supervising junior residents as well as teaching of medical students. The chief resident will acquire experience in the following surgical procedures: transoral robotic surgery, laryngectomy, composite head and neck resection, advanced frontal sinus surgery, skull base surgery, complicated reconstructive problems of the head and neck (including microvascular reconstructive surgery), and will be expected to be completely proficient in endocrine surgery, parotidectomy, and neck dissection, among others.

The second rotation is a facial plastics rotation working with two fellowship trained facial plastic surgeons within the department. In this role, the residents participates in both reconstructive and cosmetic facial plastic surgery, and repair of facial fractures, as well as spending time in an outpatient private facial plastics practice experiencing the clinic side of plastic surgery and gaining experience with injections and fillers. The surgical training is very hands on, and the residents enjoy an unparalleled cosmetic surgical experience.

The final rotation is as chief of service at the Lahey Hospital and Medical Center in Burlington. In this role the resident will mentor the junior residents, and work closely with a large department with eight attending surgeons, representing every sub specialty except pediatrics. The focus in on neurotology, head and neck oncologic surgery with reconstruction, and subspecialty clinic experience tailored to the chief resident’s post-graduation career plans.

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