Mission

The mission of the Otolaryngology Residency Program at Naval Medical Center San Diego is to provide the highest educational experience through the delivery of exceptional healthcare services to our patients and by the advancement of military medicine through education, training, and research.

Vision

The goal of the Department and Program Director is to recruit the best candidates into our specialty, who are dedicated to Otolaryngology and Navy Medicine, and to create for them the most positive learning environment possible in order to maximize their individual potential. Via continuous process improvements and program review, we will incessantly strive to provide an exceptionally well-rounded curriculum with outstanding clinical experience in all Otolaryngology specialties as well as abundant opportunity for research and academics.

Aims

• Our residency will graduate highly competent Otolaryngologists to care for our operational forces around the world and provide every opportunity to pursue advanced fellowship training and careers in academic medicine.
• Graduating residents will be competent in the management of traumatic injuries of the head and neck.
• Graduating residents will understand the operational impact of diseases of the head and neck and their implications on military readiness.
• Our residency will graduate highly effective Naval Officers and physician leaders with the skills and abilities necessary to lead other officers and enlisted members in hospital and operational medical systems around the world.

Friday is an academic day with full faculty participation that consists of a mix of pre op conference, QI conference, lectures, a leadership and professionalism discussion, interactive seminars, tumor board, morbidity and mortality conference, anatomy/temporal bone dissection, journal club, and head and neck radiology case conference. There is also a monthly joint grand round session with both University of California-San Diego Otolaryngology Department and Rady Children’s Hospital Otolaryngology Department.

The Blue Team is a mix of primarily facial plastics and oncologic surgery while the Gold Team is mostly pediatric surgery, otology and laryngology. There are some rotations with participating sites during the rotations for children’s hospital, oncologic surgery, trauma and surgical intensive care.

Elective opportunities are available and can vary year to year. The schedule is built in the spring prior to the start of the new academic year. Incoming interns and residents are contacted prior to the schedule’s construction to gather information from them about their specific interests and preferences so those may be considered during schedule assembly.

There is flexibility with regard to electives. The majority of rotations are designed to align with the educational experience required by the American Board of Otolaryngology – Head and Neck Surgery. However, a resident may desire more time on a specific subspecialty service as it may be of significant interest to them, and they may be considering a fellowship application. Such matters can be discussed candidly with the resident’s mentor and/or program director. Approval is subject to availability and feasibility when considering variables such as call coverage, minimum surgical case requirements and the ability of the desired service to support the training.

A typical night on call includes a junior resident, senior resident and a faculty attending. All call is considered “at home call” unless one is required to return to the hospital. The program provides call coverage at the sponsoring site (NMCSD), but also assists several participating sites with coverage. The cooperation with participating sites builds a more robust and interesting call experience.

The program may afford an opportunity to participate on a military medical mission as a resident. One or more residents may be selected by the program’s Clinical Competency Committee based on an appraisal of academic standing and overall maturity. The rotation serves to provide exposure to the core facets of otolaryngology – head and neck surgery in a nontraditional training setting of a naval hospital ship. This rotation is subject to availability.

• All Otolaryngology Head and Neck Residents are required to maintain Basic Life Support (BLS) and Advanced Life Support (ALS) or Advanced Cardiac Life Support (ACLS) certification throughout the residency training period.
• Residents will be scheduled to complete either the Combat Casualty Care Course (C4) in San Antonio, TX or Advanced Trauma Life Support (ATLS) and Tactical Combat Care Course (TCCC) at NMCSD during their PGY-4 or PGY-5 year.

Simulated cochlear implant procedures are performed in the institution’s state-of-the-art simulation center as well as simulation of robotic assisted temporal bone drilling.

The program has integrated a leadership curriculum into its didactic plan. The curriculum includes pre-reading related to self-reflection, emotional intelligence and a variety of other pertinent topics which are then discussed during academics.

The program has a research curriculum designed to facilitate research activity. In addition, the institution’s Clinical Investigation Department support resident research endeavors with qualified research coordinators who are familiar with matters pertaining to animal or human subject research and the internal review board submission process. There is a designated Research Director within the program to help learners navigate various aspects of project design and means to achieve presentation and/or publication.

A weekly quality improvement conference is held during academics and is a forum to update ongoing projects and to discuss new ones. Quality and process improvement initiatives are tracked and linked to associated accreditation designated focus areas.

The program promotes participation in relevant committees and subcommittees throughout the institution that may enrich the overall professional development of all learners.

The residency leverages relationships with other medical treatment facilities and organizations to augment and in some cases, supplement the overall training experience. Rotations with participating sites are typically during the second, third, and fourth year of training but may also occur in the first and fifth. At this time, most of the sites are regional however, there is one three-month rotation, for primarily neurotology experience, located in Sacramento, California.

Generally, rotations are four weeks. A typical week is divided into two days in the operating room, two days in clinic, and one academic day. Clinic includes learning to take a thorough head and neck history and perform a physical exam, to include nasopharyngoscopy and otologic microscopy. In clinic, rotators will assist the duty resident with acute referrals, handling a myriad of clinical scenarios such as management and drainage of peritonsillar abscesses, closed reduction of nasal fractures, epistaxis control, deep neck abscesses and upper aerodigestive tract foreign bodies. In the operating room, rotators will have the opportunity to assist in the vast array of procedures performed by the various sub-specialists (rhytidectomy, septorhinoplasty, direct laryngoscopy, endoscopic sinus surgery, neck dissection, thyroidectomy, etc.). Each Friday is dedicated to academics. Regular conferences include pre-operative review, post-operative review, grand rounds, tumor board, head and neck radiology conference, resident/staff lectures, M & M, and journal club. Applicant rotators will be asked to give a fifteen-minute to half hour lecture on a topic of their choice preferably during their last Friday on the service.

Please visit our Medical Student Rotation informational page to see a listing of available medical student rotations offered at NMCSD.

Interviews are typically conducted by a resident and the program director, separately, during either the third or fourth week of the rotation. In some instances, an applicant may not be able to spend up to four weeks with the program. Under these circumstances, the interview will be conducted in the second week and the rotator will be expected to give a presentation. If an applicant is unable to rotate with the program, interviews by phone are available. Applicants will be contacted by a program representative during the rotation with an interview schedule.

For the interview, the program only requires a CV, a Personal Statement and any available board scores for the interview. The Personal Statement should be no longer than one page – structurally it should have a beginning (where one came from or how one came to know the specialty), a middle (where one is now in their life’s journey/how one’s learning experience is going) and an end (why embarking on a career in the specialty is what one truly desires). The CV should include pertinent information such as education and employment but may also include volunteerism and/or community service along with a few hobbies or favorite activities. Exam scores can be sent by email or even included on the CV; they will be verified once available in the application system (MODS).

To request an interview with the program, please email the Otolaryngology Head & Neck Surgery Program at:  dha.san-diego.San-Diego-NMC.list.nmcsd-oto@health.mil.

Program graduates take the American Board of Otolaryngology – Head and Neck Surgery certifying examination. Board applicants are eligible to take the board certification exam following graduation. Applicants must complete all pre-requisites required by the American Board of Otolaryngology – Head and Neck Surgery. The written (computer based) exam is typically taken in September following residency graduation. After successfully passing this exam and all fellowship training candidates who are actively practicing will collect 40 consecutive operative cases and 40 non-operatively managed patients that will be submitted to the board. The board will select 10 cases that will be reviewed in an oral board examination.  For additional information, please visit the American Board of Otolaryngology - Head and Neck Surgery website located at:  Homepage | American Board of Otolaryngology - Head and Neck Surgery

Teaching is an important component of residency as it facilitates the reinforcement and retention of medical knowledge as well as clinical and procedural skills. As residents advance in the program, they will find themselves paired with junior residents whom they may teach and mentor under the supervision and guidance of more senior residents and faculty.

The program receives PGY-1 trainees from other specialties with a head and neck component and also receives both third and fourth-year medical students. Our residents have ample opportunity to teach and mentor these groups. Additionally, Otolaryngology residents have the opportunity to provide professional lectures to students and other-service PGY-1 trainees during academic days.

In addition to board certified comprehensive otolaryngologists, the program has subspecialty trained faculty in:

• Facial Plastic Surgery 
• Laryngology
• Pediatric otolaryngology
• Oncologic Surgery
• Otology

Residents have the opportunity to select faculty mentors with whom they have periodic meetings designed to check their progress, encourage their continued learning and growth, and provide an outlet for questions and concerns. Mentors may also be designated by the learner to present issues of importance to them to the Program Director should they feel uncomfortable doing so themselves. Mentors may be selected based on a particular subspecialty interest, should that interest change, learners are able to work with a different mentor should they desire to do so.

The residency employs a well-being program designed to foster a healthy and safe learning environment. This includes a designated well-being representative responsible for monitoring and advocating the program’s wellbeing initiatives. There are activities planned around well-being initiatives and may include games and friendly competitions, off-site meetings or gatherings and meditation. Of note, the program has special events every fifth Friday during the academic year to support well-being and encourage comradery.