ENT clinic was definitely one of the high points of intern year and a unique opportunity afforded to us as anesthesia interns at Baylor. The primary goal of the rotation is for us to get comfortable with upper airways, specifically the nasopharyngeal airway. The clinic gets many, many consults for swallowing difficult and hoarseness, which means lots of practice with flexible fiberoptic nasopharyngolaryngoscopy to evaluate the larynx and the cords. There are also numerous post-laryngectomy patients, so you’ll definitely get comfortable with trach monitoring and management, and maybe even perform a few in clinic trach exchanges.
The day starts around 8 a.m. when the team arrives to the clinic. Patients will start getting roomed and its off the races. Being a surgical subspecialty clinic, things tend to move very quickly, which I personally enjoyed. The morning continues as you pick up patients, take a quick H/P or post-op assessment, scope them if indicated, staff with either the attending or one of the ENT chiefs, and move on to the next patient. Notes are also quick and succinct. That continues to about 12:30 p.m. when there’s a break for lunch and then starts again for afternoon clinic around 1 pm. I would say on most days, clinic was done around 2-3 p.m. The ENT residents will usually head to the ORs after clinic to finish up some cases. They were more than happy to have us join them in the OR if it was something we thought would be helpful. I personally wanted to scrub on a tracheostomy placement to see what was happening on the other side of the curtain. A good anesthesiologist should always know some of the basic steps for the case on the table in order to stay prepared – especially when that case involves the airway!
The rest of the afternoon after clinic finished is yours to use as you see fit. It’s a great rotation to start studying for Step 3 if needed. Also, no call!
I really enjoyed my time in the ENT clinic – fast paced, procedural, pertinent to future practice, great experience for future nasofiberoptic intubations. Truly such great opportunity we have at Baylor Anesthesia.