Otolaryngology Rotation

Upon completion of the Otolaryngology rotation, the neurosurgery resident shall be able to:

  1. Discuss hearing loss, dizziness, and tinnitus, including: history, physical examination, and initial investigations.
  2. Interpret audiometry tests, specifically the patterns seen with vestibular schwannoma, including: pure-tone thresholds, speech discrimination, caloric testing, and auditory brain stem responses.
  3. Describe the diagnosis and management of the patient with a vestibular schwannoma, including: history, physical examination, investigations, surgery, and radiation.
  4. Outline the options for facial reanimation following transection of the facial nerve, including: end-to-end anastomosis, and hypoglossal-facial nerve anastomosis, cross face transfers etc.
  5. Possess applied knowledge of sinonasal anatomy and by extension, endoscopic approaches to the skull base.
  6. Discuss embryology, clinical pictures and practical management of nasoencephalocoeles.
  7. Describe sinonasal skull base surgical entities, e.g. nasopharyngeal carcinomas, angiofibromas, sinonasal carcinomas, mucoceles, etc.

During the rotation, all residents should fulfill the Royal College’s CanMEDS Competencies.

COMMUNICATOR:

  1. Develop rapport, trust, and ethical therapeutic relationships with patients and families, be able to review/update day to day care with patients.
  2. Conduct, document and present pertinent surgical history and physical exam.
  3. With appropriate supervision discuss relevant information with patients and family, especially for conditions often managed with neurosurgery – acoustic neuroma, craniofacial resections, skull base fractures.
  4. Share and present pertinent information to other surgeons, specialists and other health care providers
  5. Accurately elicit and synthesize relevant information and perspectives of patients and families, colleagues, and other professionals

COLLABORATOR:

  1. Work/collaborate effectively in an interdisciplinary team, including pharmacy/physiotherapists/occupational therapists.
  2. Consult other services /specialists appropriately
  3. Be involved in all educational activities and teaching offered by the service.
  4. Be able to share workload and duties appropriately with other house staff.
  5. Describe the surgeon’s roles and responsibilities to other professionals; Describe the elements of a good consultation
  6. Recognize one’s own limitations and when help is needed from others
  7. Work with other health professionals effectively to prevent, negotiate, and resolve conflict

MANAGER:

  1. Effectively utilize and allocate finite resources, prioritize tests and OR emergency cases.
  2. While on a busy surgical service manage own time, education and personal life for a balanced lifestyle.
  3. Learn to work effectively and efficiently.
  4. Triage patients being able to identify urgent cases in emergency that require prompt and immediate management such as airway obstruction.
  5. Demonstrate an understanding of the influences that affect the workings of the health care system at various levels.
  6. Participate in discharge planning of a complex otolaryngology patient.
  7. To be able to lead the interdisciplinary team managing a otolaryngology patient

HEALTH ADVOCATE:

  1. Recognize and council patients on determinants of health in patients, especially with respect to surgical risks such as smoking, DM and bmi.
  2. Promote lifestyle which improves surgical risks, especially preoperatively in clinic setting.
  3. Contribute to overall patient well-being and outcome, though appropriate pre and post-operative care.
  4. Facilitate return of patient to community/alternate care and help put care/support in place to reduce return to hospital for surgical care.
  5. Ensure consults and tests are done in an appropriate timely manner.

SCHOLAR:

  1. To be involved in rounds and educational activities provide by the otolaryngology service.
  2. Identify and seek out personal learning needs, especially with respects to surgical problems also common to neurosurgical patients such as lower cranial nerve palsy, skull base fracture, csf leak management, endoscopic approaches to the skull base.
  3. Apply principles of critical appraisal to medical information, be involved in journal clubs
  4. Participate in patient, student and peer learning
  5. Contribute to development of new knowledge and be involved in appropriate research projects as available.

PROFESSIONAL:

  1. Demonstrate a commitment to their patients, profession, and society through ethical practice
  2. Exhibit appropriate professional behaviors in practice, including honesty, integrity, commitment, compassion, respect and altruism
  3. Maintain appropriate relations with patients and other health care providers.
  4. Show appropriate respect for opinions of other health care providers
  5. Be able to appraise and identify own limits with respect to knowledge and patient care, and when to ask for assistance and consult effectively