San Jose O’Connor FAMILY MEDICINE RESIDENCY PROGRAM ENT CURRICULUM
I. GOALS A. To develop a working knowledge of anatomy, physiology and pathology of the ears, nose and throat B. To understand the diagnosis and management of common ENT problems that present in primary care by using the physical examination, otoscope, tympanogram, audiogram and nasopharyngoscope C. To understand when referral is appropriate for both chronic and acute ENT conditions D. To understand how to assist patients and family members with chronic ENT disorders such as hearing impairment, dysphagia, dysphasia, cancer, tracheostomies, etc.
II. OBJECTIVES A. PATIENT CARE Understand the diagnosis and management of common ENT conditions including but not limited to: Ear Otalgia Hearing loss and hearing aids External ear disorders and use of a wick for external otitis Otitis media and its complications Vertigo and vestibular disorders Tinnitus Ear injuries Indications for ear surgery Nose and sinuses Rhinitis and sinusitis Epistaxis and nasal packing Fractures of the nose Mouth and throat Oral lesions Esophageal disorders Facial nerve paralysis Temporomandibular joint disease Obstructive sleep apnea Neck Thyroid and parathyroid disorders 1
Salivary gland disorders Hoarseness, laryngitis and tracheitis Neck masses Dysphagia Pediatric ENT Acute otitis media and otitis media with effusion and tympanostomy Pharyngitis, tonsils and adenoids and indications for surgery Allergic disorders General ENT Antimicrobial therapy and pharmacology in ENT Foreign bodies Head and neck tumors and biopsy techniques Trauma i. Able to perform a focused history and physical exam for the above problems ii. Be able to perform a complete oral cavity examination and examination for head and neck cancer iii. Gain experience in common diagnostic procedures such as: use of the otoscope including insufflation, tuning fork including the Rinné and Weber tests, audiometry and tympanometry, larngoscopy (indirect and direct), nasal illuminator, nasal speculum and if possible the nasopharyngoscope, Hall-Pike maneuver to assess vestibular disorders and the treatment for benign positional vertigo iv. Gain experience in common therapeutic procedures such as: anterior and posterior nasal packing for epistaxis, use of a wick for external otitis, cerumen removal, foreign body retrieval from the nose and ear, basic airway protection and management v. Understand how to evaluate a patient with hearing loss B. MEDICAL KNOWLEDGE i. Know the normal anatomy, physiology and the pathology of the ear, nose, sinuses, mouth, pharynx, larynx, neck and salivary glands ii. Know the effects of drugs and toxins on otorhinolaryngologic function and disease iii. Understand the importance of regular assessment of hearing in elderly patients and the impact of hearing loss on functional capacity iv. Know the indications for hearing assist devices (hearing aids) v. Know the indications for imaging studies including plain films, CT and MRI and the interpretations of these studies
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C. PRACTICE-BASED LEARNING AND IMPROVEMENT i. Use information technology to manage and retrieve information and support their own education ii. Know where to look for practice guidelines and the most recent information on ENT diagnosis and treatment iii. Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information D. INTERPERSONAL AND COMMUNICATION SKILLS i. Understand the role of the ENT consultant and work effectively and collaboratively together ii. Demonstrate a supportive and compassionate approach to the care of the patient with ENT disease iii. Give patient education and counseling competently and work to assure compliance iv. Be able to retrieve and discuss patient education handouts v. Recognize the effects of hearing loss on communication E. PROFESSIONALISM i. Demonstrate respect, compassion, integrity and a commitment to excellence in all professional activities ii. Demonstrate a sensitivity and responsiveness to each patient’s culture, age and disability F. SYSTEMS-BASED PRACTICE i. Understand indications for referrals and how referrals to an otorhinolaryngologist are made ii. Demonstrate a commitment to patient confidentiality and informed consent
III. METHODS OF IMPLEMENTATION A. Resident’s see patients during Surgical Subspecialty block rotation in the 3rd year of residency in an otorhinolaryngologist’s office. They see patient’s independently and present cases to the attending physician. B. Residents participate in consultations and may participate in surgery depending on the site C. Residents continue their regular Family Health Center responsibilities during this rotation and follow patients in a longitudinal fashion D. Exposure to patients with ENT problems in the Family Health Center and the emergency department E. Periodic ENT lectures and conferences F. A reading list is supplied and regular study is expected
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IV. EVALUATION A. Daily feedback by the attending B. End of rotation written evaluation by the attending ENT physician based on the above goals, objectives and the ACGME competencies C. Attendance at all conferences
Rev. 4/07
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