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OTOR 420A - Clinical Clerkship

James Lin, MD
Director of Undergraduate Medical Education

Deanna Loerwald
Clerkship Contact Person dstrah@lsuhsc.edu
(504) 568-4785

3rd Year Medical Students

   Duration: 3 weeks

   Availability: All blocks, all year

   Number of students: Open

4th Year Medical Students

Duration: 4 weeks

Availability: All blocks, all year

Number of students: Open

Background:

The Department of Otolaryngology-Head and Neck Surgery practices at 4 locations: Children’s Hospital in New Orleans, Our Lady of the Lake Regional Medical Center (OLOLRMC) in Baton Rouge, Earl K. Long (EKL) Hospital in Baton Rouge and University Medical Center (UMC) in Lafayette. The adult faculty practice has moved to OLOLRMC. The focus of practice at this institution includes laryngology, head and neck cancer, skull base surgery, advanced sinus disease and sleep disorders. The student will have the opportunity to work with speech and language pathologists and radiation oncologists, in addition to our faculty. EKL Hospital and UMC focus on general otolaryngology and head and neck cancer, while Children’s Hospital focuses on the diagnosis and treatment of children with a wide range of otolaryngologic problems. There is also an opportunity to become involved in research in otolaryngology.

At the beginning of the rotation, each medical student will be given a copy of the textbook entitled “Primary Care Otolaryngology”. The typical work week consists of clinical, surgical and didactic responsibilities. Students will have varying schedules depending on the rotation site to which they are assigned. The typical day starts at 6:30am and ends at 6:00pm, although this will vary depending on the responsibilities of a particular day. The student typically spends 3 days in clinic and 2 days in the operating room. Weekend responsibilities typically consist of rounding on in-house patients only. Weekend rounding is divided among the team members. Weekly conference (Otology and Tumor Board) is held on Wednesdays from 4:00pm-6:00pm and monthly Didactic Days are held on the first Tuesday of each month from 7:00am -4:00pm. Conference attendance is mandatory.

Overall Objectives:

After completion of this rotation, the student will be proficient in performing a complete head and neck exam and understand the diagnostic work-up, treatment and management of many diseases involving the head and neck. In addition, he/she will be proficient in formal patient presentations.

Specific Objectives:

3rd year Medical Students:

Improve skill in taking an ENT history
- Understand critical signs and symptoms
  - Unresponsive sinonasal disease
  - Unresponsive ear disease
  - Hoarseness/stridor/dysphagia/odynophagia
  - Airway emergencies
  - Head and neck masses/tumors
Increase competence in the examination of the head and neck
- Learn how to use the following tools:
  - Pneumatic otoscope
  - Headlamp/head mirror
  - Tongue depressor
  - Laryngeal mirror
  - Nasal speculum
  - Tuning forks
  - Bimanual palpation
  - Fiberoptic telescope
Acquisition of knowledge regarding otolaryngologic pathologies in order to formulate a differential diagnosis
Formulate treatment plan for common head and neck disorders
Be able to write a SOAP note for both in and out patients

4th Year Medical Students:

Become proficient in taking an ENT history
- Understand critical signs and symptoms
  - Unresponsive sinonasal disease
  - Unresponsive ear disease
  - Hoarseness/stridor/dysphagia/odynophagia
  - Airway emergencies
  - Head and neck masses/tumors
Become proficient in the examination of the head and neck
- Master the use of the following tools:
  - Pneumatic otoscope
  - Headlamp/head mirror
  - Tongue depressor
  - Laryngeal mirror
  - Nasal speculum
  - Tuning forks
  - Bimanual palpation
  - Fiberoptic telescope
Gain advanced knowledge regarding otolaryngologic pathologies in order to formulate a differential diagnosis
Understand and discuss the work-up needed to diagnose a particular problem
Formulate treatment plan for common and complicated head and neck disorders/diseases
Acquire advanced knowledge of head and neck anatomy
Be able to discuss the surgical plan for a particular patient
Assist with history and physicals and daily rounds
Demonstrate independent thinking

Means of Implementation:

The 3rd year medical students will be assigned a specific hospital in which to rotate by the residency coordinator of General Surgery. The student will become a part of the team assisting the residents with patient diagnosis, work-up and treatment. He/she is responsible for appropriate and timely documentation of patient care. The 4th year medical student will rotate at Children’s Hospital in New Orleans and OLOLRMC in Baton Rouge with the possibility of working at EKL and UMC. He/she will function as an intern and become an integral part of the team; he/she will participate in in-patient and out-patient care, will assist with surgical procedures and participate in junior medical student education. Self-study is encouraged and grand rounds presentation of cases is also required.

Method of Evaluation:

The student’s evaluation will be based upon the 6 core competencies set forth by the ACGME. This is a written evaluation which is completed at the end of the rotation. In addition, each student has the opportunity to evaluate each resident and faculty member with whom he or she has worked. There will be no written test following the rotation at this time. In the future we hope to reinstitute the otolaryngology OSCEE exam.