Otolaryngology - Head and Neck Surgery Residency Program: Overview
Baylor College of Medicine understands that residency serves as the launching pad for young physicians' careers; therefore, our faculty are committed to providing the optimal training environment for physician scientists pursuing otolaryngology - head and neck surgery.
For more than three decades, the Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery at Baylor was led by Bobby R. Alford, M.D., a nationally recognized leader in the field. In September of 2010, Donald T. Donovan, M.D., was named as interim chair. Under his direction, 21 full-time clinical faculty, four full-time research faculty, and 43 voluntary clinical faculty provide residents with comprehensive training in otolaryngology - head and neck surgery
The five-year training program consists of a one-year internship under the direction and supervision of the department that is spent on general surgery rotations as well as otolaryngology and other surgical subspecialties. The following four years are spent in otolaryngology - head and neck surgery residency training, which includes three months devoted to basic or clinical research. Baylor's residency program, which is fully accredited by the Accreditation Council for Graduate Medical Education, is nationally recognized, academically oriented, and clinically comprehensive.
Clinical otolaryngology - head and neck surgery residency training is conducted in six of Baylor's outstanding affiliated hospitals: Houston Methodist Hospital, the Michael E. DeBakey Veterans Affairs Medical Center, Harris Health System Ben Taub Hospital, Texas Children's Hospital, The University of Texas MD Anderson Cancer Center, and St. Luke's Episcopal Hospital. Training in these specialized environments provides residents with extraordinary exposure to a broad spectrum of patients and procedures. In addition, the international reputation of our faculty results in an abundance of worldwide referrals. Subspecialty interests among the clinical faculty include otology/neurotology, head and neck surgery, pediatric otolaryngology, facial plastic and reconstructive surgery, endoscopic skull base surgery and allergy and immunology.
All residents receive additional training in research in order to introduce them to the fundamentals of research and to provide scientific insight into the practice of medicine. Many advances have resulted from the innovative research studies conducted in our laboratories, and more exciting developments are expected from our current researchers who are pursuing interests in the fields of cochlear biophysics, cochlear and vestibular hair cell transduction, vestibular compensation, cochlear development, and genetics of hearing loss. Opportunities exist to conduct basic science research in other Baylor College of Medicine laboratories, as well as the MD Anderson Cancer Center and Rice University.
Further education and development result from participation in didactic conferences, continuing education programs, scientific presentations, publications, and committee service. Each resident is eligible for the certification examination by the American Board of Otolaryngology upon the satisfactory completion of the Residency Program.
Every year, five outstanding medical school graduates from around the county are selected through a highly competitive process to join Baylor's Otolaryngology - Head and Neck Surgery Residency Training Program.
All residents complete one year of surgery internship at Baylor College of Medicine. The internship year is integrated into the Otolaryngology - Head and Neck residency program and is under the supervision of the department.
The surgical experience includes one-month rotations plastic surgery, neurosurgery, anesthesiology, emergency medicine and critical care. Other rotations during the year include general surgery, and pediatric surgery. The rotations in the Department of Surgery are spent at the Ben Taub Hospital, the Michael E. DeBakey Veterans Affairs Medical Center, and Texas Children's Hospital. Currently, two months are spent on the Otolaryngology service at Texas Children's Hospital.
The formal otolaryngology - head and neck surgery training consists of four additional years of dedicated clinical experiences. During the four years of training, residents rotate through Houston Methodist Hospital, the Michael E. DeBakey Veterans Affairs Medical Center, Harris Health System Ben Taub Hospital, Texas Children's Hospital, St. Luke's Episcopal Hospital and The University of Texas MD Anderson Cancer Center. Each hospital has comprehensive Otolaryngology - Head and Neck services with outpatient clinics, inpatient services, dedicated operating room time, emergency services, and diagnostic testing.
Having completed the PGY-1 internship, the four clinical residents begin the Otolaryngology - Head and Neck Surgery rotations as year PGY-2.
During the PGY-2 year, residents rotate through four Baylor affiliated Hospitals: Ben Taub Hospital, Houston Methodist Hospital, the Michael E. DeBakey Veterans Affairs Medical Center and Texas Children's Hospital. PGY-2 residents, during the first two months, also participate in a six-week basic science course that provides the necessary scientific background and clinical fundamentals for the physician entering this phase of training. Subjects include acoustics and audiology, head and neck anatomy and embryology, temporal bone anatomy, audiovestibular physiology, allergy, head and neck radiology, and otolaryngic-head and neck surgery emergencies.
During the PGY-3 year, residents assume greater responsibilities in patient care and surgery. The typical year includes a dedicated research block and rotations at Houston Methodist Hospital, Texas Children's Hospital, St. Luke's Episcopal Hospital and M.D. Anderson. The Texas Children's Hospital rotation includes special exposure to pediatric patients with airway anomalies, head and neck masses, hearing loss, neonatal and pediatric intensive care needs, chronic sinusitis, and congenital disorders.
The PGY-4 year of training provides intensive operating room exposure with rotations at the Ben Taub Hospital, the Michael E. DeBakey Veterans Affairs Medical Center, the UT MD Anderson Cancer Center, and as Chief Resident at Houston Methodist Hospital. This year offers comprehensive experiences with increasing levels of responsibility in otology, neurotology, skull base surgery, head and neck oncology, facial plastic surgery, reconstructive surgery, maxillofacial surgery, aerodigestive endoscopy, endocrine surgery of the head and neck, endoscopic sinus surgery, microlaryngeal surgery, head and neck pathology, and radiology of the head and neck.
The PGY-5 year of residency is the chief residency year with a three-month rotation at the Michael E. DeBakey Veterans Affairs Medical Center, six months at Ben Taub Hospital, and three months at UT MD Anderson, with fellow level responsibilities. During this year, the Chief resident is responsible for patients under his/her auspices at these three hospitals during outpatient clinics, inpatient hospitalizations, surgical procedures, and emergency consultations. The chiefs are directly responsible to the attending staff at each hospital. The Chiefs are responsible for overseeing and teaching junior residents in clinic, the operating room, and ER care. Medical students from Baylor College of Medicine rotate throughout the year, and the Chiefs are responsible for teaching the students the head and neck exam as well as basic principles of otolaryngology.
Resident responsibilities and educational goals are level-dependent as the resident progresses from junior to senior resident level. The experience at Ben Taub Hospital allows a comprehensive, hands-on experience with both adult and pediatric general otolaryngology patients as well as trauma patients. Rotations at the Michael E. DeBakey Veterans Affairs Medical Center provide unique opportunities in head and neck cancer management, otology, laryngology and facial reconstructive surgery. The Houston Methodist Hospital provides a high volume of specialty referral cases. The UT MD Anderson rotations provide a comprehensive exposure to head and neck cancer cases, with an opportunity to return as a senior level resident fulfilling fellow level responsibilities on a busy head and neck surgery service. Texas Children's Hospital provides experience in all facets of pediatric otolaryngology.
One highlight of Baylor's Residency Program is the research block in the PGY-3 year for otolaryngology - head and neck surgery residents. This experience is designed to introduce research design and the critical thought process used in laboratory science and in the pursuit of new knowledge, thereby providing the resident with strong scientific insight to apply to the practice of medicine.
Many residents choose to work with faculty within the department who are world leaders in the fields of cochlear biophysics, hair cell transduction, vestibular compensation, and cochlear development. Residents have also worked in other laboratories at Baylor or at other affiliated institutions, including Rice University and the UT MD Anderson Cancer Center, pursuing projects in tumorigenesis and molecular genetics. Our residents find this time to be extremely rewarding, and they are able to enhance their training through scientific presentations and publications.
Frequently, residents present their work at national meetings including the American Academy of Otolaryngology Head and Neck Surgery, the Association for Research in Otolaryngology, The Triological Society, the American Society of Pediatric Otolaryngology, the American Academy of Facial Plastic and Reconstructive Surgery, and the International Conference on Head and Neck Cancer. Baylor residents' projects have won research awards from the Academy of Otolaryngology Head and Neck Surgery, the Triologic Society, and the Texas Association of Otolaryngology - Head and Neck Surgery. The Department is also the home of the National Space Biomedical Research Institute, a consortium of biomedical research laboratories from the nation's leading universities, which have come together to better understand the effects of weightlessness and space radiation on the space flight crews and to develop countermeasures to mitigate the risks of long duration human space flight.
Didactic sessions are at the heart of the educational process for residents in training. Weekly Grand Rounds are a highlight of the educational program, and residents have the opportunity to select the case presentation and topic for discussion. The Department library has state-of-the-art audiovisual equipment to assist in the preparation of these presentations. Our library is linked to the HAM/TMC Library, the National Library of Medicine’s regional library for the five state region of Arkansas, Louisiana, New Mexico, Oklahoma and Texas. The hospitals are also equipped with computer access for electronic literature searches and other Internet resources.
In addition to Grand Rounds, regular subspecialty conferences are conducted in the areas of otology/neurotology, head and neck surgery, general otolaryngology, facial plastic and reconstructive surgery, allergy/immunology, and pediatric otolaryngology. Other lectures include neuroradiology, pathology, infectious diseases, speech pathology, radiotherapy, and pulmonary medicine. A current literature conference serves as a focus for new trends in the specialty. Tumor boards are held at UT MD Anderson, Ben Taub Hospital, the Michael E. DeBakey Veterans Affairs Medical Center, and The Methodist Hospital. These are multidisciplinary conferences that include otolaryngology - head and neck surgeons, oncologists, radiation therapists, oral surgeons, speech therapists, and pathologists, who meet with the residents to plan the therapy of patients with head and neck cancer.
To complement didactic conferences, hands-on learning experiences are provided periodically. These workshops include surgical dissection of the temporal bone, endoscopic sinus surgery, and training in the use of plating systems for facial fractures. The workshops are held in the Department, which has a newly renovated multidisciplinary teaching laboratory.
Our program is committed to academic excellence and professional development for our residents. One example of this commitment is our Visiting Professor Program, which brings distinguished faculty from other programs to Baylor, to share experiences and clinical or research knowledge with residents, graduate students, and faculty. These interactions occur in an informal atmosphere to promote one-on-one exchanges. An annual scientific forum is also part of the visiting Professor Program. The forum provides an excellent opportunity for residents to highlight their basic and clinical research projects.