Residency Training

General Information
The Otolaryngology Training Program at
Vanderbilt Vanderbilt University School of
Medicine  accepts four residents per year. The
5-year training program in Otolaryngology
consists of 4 years of progressive training in
Otolaryngology-Head and Neck Surgery,
preceded by 1 year in general surgery. All
residents do their general surgery training at
Vanderbilt under the direction of the
Otolaryngology Program Director and in
collaboration with the Program Director for the
Department of General Surgery. The general
surgery training takes place at
Vanderbilt University Hospital and the Veterans
Administration Hospital, which is located on the Vanderbilt campus. During the first year on
general surgery (PGY-1), the residents are expected to gain sufficient experience in the
basic understanding of pre- and postoperative patient care, management of acute trauma of
the head, chest, and abdomen,  understanding of soft tissue surgical techniques, diagnosis
and treatment of pulmonary and cardiac diseases, understanding of the basic problems of
the surgical subspecialties, including anesthesia, neurosurgery, vascular surgery, thoracic
surgery, plastic surgery, general surgery, trauma surgery, oral surgery, and emergency
medicine. One month of the PGY-1 year is spent on the otolaryngology service.

PGY-2 Year

The years of Otolaryngology training are divided into 4

services at Vanderbilt. The Head and Neck Service, the
General Otolaryngology Service, the Pediatric Otolarygology
Service and the Otology/Neurotology Service. Each resident
rotates to all of these services (see addendum). In addition,
the PGY-5 and the PGY-2 residents rotate to the Veteran’s
Administration Otolaryngology service. The first year of
otolaryngology is directed toward developing clinical skills, in
taking a history and performing a physical examination of the
head and neck, as well as determining the diagnosis and
treatment of common pathologic conditions of the ears, nose,
throat, head and neck. Each resident spends 9 months at
Vanderbilt University Hospital on the Head and
Neck/Laryngology, Facial Plastics, Pediatric and General
services, and 3 months at the Veteran’s
Administration Hospital. All of the residents participate in the
outpatient clinical activities and gain significant experience in
examination techniques and develop diagnostic abilities in
Otolaryngology on both adult and pediatric patient
populations. Each resident also participates in specialty clinics,
such as laryngology, rhinology/allergy, adult and pediatric
otology, neurotology and head and neck clinics. Exposure and
experience with the following surgical procedures are required from the PGY-2
Otolaryngology residents: excision of neck masses, tonsillectomy and adenoidectomy,
SMR/septoplasty, myringotomy, myringoplasty, closed reduction of facial fractures, adult
diagnostic endoscopy, surgery of the maxillary sinus, tracheotomy, skin grafts, and nasal
polypectomy. The head and neck gross anatomy dissection course is provided by full-time
and part-time faculty of the Department of Otolaryngology and by other medical school
faculty. The basic sciences are supplemented by each resident’s participation in the Home
Study course sponsored by the American Academy of Otolaryngology-Head and Neck
Surgery Foundation, Inc. which is underwritten by the Department.

PGY-3 Year

In the second year of training (PGY-3), each resident will spend 6

months in the research laboratory working with one of the
Department’s full-time faculty or other approved Vanderbilt faculty
on a particular research project. While on the research rotation, the
resident spends one day a week in the clinic setting, working with
the allergy and immunology faculty at the multidisciplinary ASAP
clinic. The quality of allergy and immunology training at this
hospital is outstanding and the collaboration between members of
the Division of Allergy and Immunology and the Department of
Otolaryngology has been noteworthy. In fact, a joint Allergy, Sinus
and Asthma Program (ASAP) is operated at a separate off-site
facility. The other 6 months is divided between the General Service
and the Otology/Neurotology Service, the latter both at Vanderbilt
and St. Thomas hospitals. During this time, the PGY-3 resident will
gain continued experience and comfort in the management of
otolaryngology patients. Increasing responsibilities are reflected by
the resident’s involvement in inpatient consultation, teaching of
medical students and residents of other programs in the Vanderbilt
system, continuation of experience in managing patients seen in the
outpatient clinic, and refining diagnostic and treatment skills.
Knowledge of the workup and differential diagnosis is acquired for complex diseases related
to Otolaryngology-Head and Neck Surgery (acoustic neuroma, Ménière’s disease, allergy-
mediated diseases, unknown primary cancer of the head and neck, and diseases of the
thyroid gland). The second year Otolaryngology resident also acquires knowledge and
develops skills in the management of complex postoperative problems. Exposure to and
experience with the following surgical procedures are considered essential during this year
of training: open reduction of facial fractures, removal of foreign bodies from the upper
aerodigestive tract, pediatric endoscopy, endoscopic laser procedures, tympanoplasty,
mastoidectomy, excision of salivary glands, frontal and ethmoid sinus surgery, delay and
rotation of skin flaps , radical neck dissection, total laryngectomy, and portions of
blepharoplasty, rhinoplasty, otoplasty and face lift procedures. Continued participation in
the AAO-HNS Home Study Course is required. Attendance at a temporal bone course
sponsored by Vanderbilt University and directed by the Otology/Neurotology faculty occurs
during this year.

PGY-4 Year

In the third year of training (PGY-4), the resident continues to

participate in the Home Study Course offered by the AAO-
HNS. This year the resident spends 12 months at Vanderbilt
University Hospitall. During these 12 months, the resident will spend time divided between
the Head and Neck Service, the General Service, Facial Plastics and Otology/Neurotology
Service. During this year, the resident has tremendous responsibility in the management of
his patients. This is the year that the resident develops knowledge and experience in the
management of various medical and surgical complications, as well as becoming aware of
the various rehabilitation techniques and procedures currently being performed in
Otolaryngology-Head and Neck Surgery. Surgical skills learned during this year include:
superficial and total parotidectomy, modified neck dissection, composite resection,
sphenoethmoidectomy, mastoidectomy, stapedectomy, endolymphatic shunt, maxillectomy,
rhinoplasty, face lift, blepharoplasty, otoplasty, correction of congenital deformities, facial
nerve decompression, and removal of nasopharyngeal tumors. All elective and emergency
in-house consultations are performed by the PGY-4 resident. Each resident is expected to
prepare and present a scientific paper at either a regional (Southern Section of the
Triologic) or national (AAO-HNS or COSM) meeting.

PGY-5 Year
The fourth year of Otolaryngology training (chief
resident/PGY-5) is one of total responsibility involving
administrative duties pertaining to scheduling, residency
training, teaching assignments including medical students,
and completion of ongoing research projects. Total exposure
to the surgical experience of the full-time and part-time staff
is the highlight of this year. This surgical experience should
provide each chief resident with adequate training for
certification in the specialty of Otolaryngology-Head and Neck
Surgery. Each fourth year (PGY-5) resident serves as a chief
resident of the Vanderbilt Head and Neck Service, the General
Otolaryngology Service, the Veteran’s Administration Hospital
Service, and also the Otology/Neurotology Service. The chief
resident is administratively responsible for all aspects of
patient care and for all categories of diseases in the head and
neck including cancer, allergy, neurotology, hearing and
equilibrium, plastic and reconstructive surgery, laryngology,
adult and pediatric endoscopy, and diseases of the paranasal
sinuses, including endoscopic sinus techniques. The chief
resident will develop an understanding of chemotherapy and
radiation therapy in the management of head and neck cancer and will acquire experience
in the following surgical procedures: partial laryngectomy, tracheal resection and
reconstruction, laryngotracheoplasty, thyroidectomy (subtotal and total),
parathyroidectomy, temporal bone resection including skull base surgery, complicated
reconstructive problems of the head and neck (including microvascular reconstructive
surgery), neurotology (including middle cranial fossa surgery), and major pediatric
otolaryngological surgery. The chief resident develops a great fund of knowledge and
experience in the management of difficult medical and surgical complications and their
treatment. All cases of morbidity and mortality will be discussed by this resident at the
monthly Morbidity and Mortality conference. The chief resident participates actively in
teaching medical students, paramedical personnel, junior Otolaryngology residents and
residents from other services at Vanderbilt. All in-house consultations performed by the
junior residents are reviewed by the chief resident. The Home Study Course is taken by the
chief resident, making a total of four years that each resident is exposed to this excellent
teaching vehicle of the American Academy of Otolaryngology-Head and Neck Surgery Foundation,
Inc.

Resident Rotations