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February 2016Taking Back Otolaryngology Teaching
Changing the focus of the PGY-1 otolaryngology curriculum also puts surgical residency education directly in the hands of otolaryngologists. “The RRC initiated the request for the change, and it was done so we could bring the control of the surgical training under otolaryngology training,” said Dr. Choi. “They weren’t always learning the surgical skills they needed and now, instead of placing that responsibility on our colleagues, we get to teach them the basic surgical skills rather than general surgical skills.”
Others agreed. “The feedback we got from residents was that the first year of training did not provide an adequate operative experience,” said Dr. Weber. “They were doing more work on the floor. Not that those skills aren’t good, but they were missing the technical training and the education necessary to become a surgeon.”
As an example, Dr. Weber said that as years have gone by, “we have seen that otolaryngology head and neck fellows may be less prepared to do a complex open surgery, because they have not had as much surgical experience due to the reasons discussed. Fortunately, by the end of their fellowships, they are all doing well and are better prepared to take on the challenging cases we face today.”
The residency curriculum changes seek to fix that. Once implemented, “we have the most vested in these residents, and, hopefully, we can provide them with the skills they need as otolaryngologists,” said Dr. Choi. As a result, “I’m hoping that some residents will get a chance to do some electives in their fifth years. It is unclear if that will happen, but that’s the intent.”
The RRC started discussing the changes about two years ago, Dr. Choi said, in response to residents’ and program directors’ feedback regarding the residents’ first year of training. The RRC presented a proposal to otolaryngology program directors in December 2014. The proposal was revised and then released for a 45-day public comment period. After the public comments were addressed, the proposal was sent to the ACGME Board of Directors and approved in September 2015. The Board approved the change on September 27, 2015, and it will take effect on July 1, 2016.