Residency Program

Introduction

The Accreditation Council of Graduate Medical Education "ACGME" accredits the Boston University Training Program in Otolaryngology-Head and Neck Surgery for training three(3) new residents per year. It is a five year program. The Program offers a large and diverse clinical and surgical experience, close supervision by over twenty-five, full-time faculty, a strong didactic program and opportunity for research in one of the world’s most exciting centers of learning, the city of Boston.

Purpose

The fundamental purpose of the Boston University Training Program in Otolaryngology is to educate and train physicians to function independently as specialists in the field of otolaryngology – head and neck surgery.

This specialty provides comprehensive medical and surgical care of patients with diseases and disorders of the head and neck that affect the ears, the face and its skeleton, the respiratory and upper alimentary systems and structures. Specialists in this discipline have knowledge, skills and understanding of the basic medical sciences relevant to the head and neck, the respiratory and upper alimentary systems, the communication sciences including audiology and speech – language pathology, the chemical senses of smell and taste, as well as allergy, cosmetics, endocrinology, and neurology as they relate to the head and neck. Included are the diagnosis and the medical and surgical therapy, reconstruction or prevention of diseases, neoplasms, deformities, disorders and injuries of the head and neck.

The three elements essential to quality medicine – patient care, teaching, and research – are well presented in our training program, but the major emphasis is on patient care. Duration of training is five (5) years of progressive training in the specialty of Otolaryngology – Head and Neck Surgery at Boston Medical Center and four affiliated institutions. Didactic training in otolaryngology is presented in planned formats throughout the five years.

Organization

The Program Director organizes and supervises the conduct of the training program, which includes establishing over-all policies, procedures and educational objectives of the Program and development and maintenance of an organized program of graduate medical education in Otolaryngology; selection, assignment, supervision, evaluation, counseling and discipline of the residents in the Program; approval and evaluation of the Program teaching staff; assignment of staff responsibilities related to resident teaching and research, and facilitation of faculty appointments; maintenance of necessary records and preparation of reports; establishment of resident training agreements with affiliated institutions and coordination of the Programs activities at such affiliates. The Program Director is responsible to the President of Boston Medical Center.

A Program Advisory Committee, comprised of one or more members of the Resident group and the full time Otolaryngology Faculty, meets at least every quarter to advise the Program Director concerning all aspects of the training program; these include, but are not limited to: didactic activities, including courses, meetings and conferences; policies regarding training, on call schedule, vacation, evaluation, discipline, and other matters relevant to the overall residency training program; performance and progress of the residents; personal needs and problems of each resident; disciplining, when required; awards and recognition; support of the committee recommendations; and selection of resident candidates.

Our history and tradition

Our residency program has a distinguished history of educating leaders and innovators in otolaryngology-head and neck surgery. The otolaryngology residency program began in 1959, when Dr. M. Stuart Strong, Chairman of the Department of Otolaryngology at the Boston University School of Medicine, accepted as his first resident, Dr. Charles Vaughan. Upon completion of his residency, Dr. Vaughan joined Dr. Strong on the faculty and these two men worked together to develop a carbon dioxide laser that could be used for laryngeal surgery. They were the first surgeons in the world to accomplish this feat and, consequently, the BUMC otolaryngology residency program became known for innovation.

Although it may be hard to believe, Drs. Strong and Vaughan are still active in different ways with our residency program. Dr. Vaughan comes each week to our didactic sessions and our teaching conferences, he continues to take on various special projects involving the development of teaching aids, and Dr. Strong still comes to many of our conferences and special events. We are extraordinarily proud of our entire current faculty who strive to perpetuate the traditions that we cherish. Hopefully, you will realize during your visit here that the individuals who comprise our faculty collectively have the same earnest dedication and unwavering commitment to teaching that we know have characterized our residency program since its inception more than fifty years ago. Furthermore, we are fully committed to making the years of residency training educational and collegial. We are well aware, as academic otolaryngologists, of our dual roles of providing care for our patients and having the responsibility to educate the residents in our program.

Some Notable Graduates

If you sense during your visit to our residency program that the faculty here have a desire to help train those individuals who will strive to make significant contributions to the world of medicine and to society in general, then you will have perceived something that is important to us. Graduates of our residency program who have entered private practice tend to become leaders within their communities. For example, Dr. Jerry Schreibstein is a past chair of the Board of Governors of the American Academy of Otolaryngology-Head and Neck Surgery. As chair, he oversaw all grassroots activities and initiatives that are of interest to practicing otolaryngologists throughout the country and presided over the Board of Governors, which is made up of representatives from all of the state otolaryngology societies as well as all specialty societies. Former graduates of the BUMC Otolaryngology Residency Program who have become distinguished academic otolaryngologists include the following:

Ivan El-Sayed, MD, Associate Professor, University of California San Francisco
Gerald Healy, MD, Emeritus Professor, Harvard University School of Medicine
Wayne Koch, MD, Professor, Johns Hopkins University School of Medicine
Jamie Koufman, MD, Professor of Clinical Otolaryngology New York Medical College, Director of the Voice Institute of New York
Stephan Park, MD, Professor, University of Virginia School of Medicine
Brent Senior, MD, Professor, University of North Carolina School of Medicine
Stanley Shapshay, MD, Professor, Albany Medical College
Peak Woo, MD, Professor, Mount Sinai School of Medicine
Steven Zeitels, MD, Professor, Harvard University School of Medicine

Audiology

The Audiology Divisions at Boston Medical Center, Children’s Hospital, and Lahey Clinic provide state-of-the-art diagnostic testing for those who present with problems of hearing or with imbalance, vertigo, dysequilibirium. Also, we are able to provide patients with hearing aids including the most advanced kinds of digital hearing aids. We see patients of all ages, including newborns, infants, and the elderly. We have at the Boston Medical Center one of the country’s first universal newborn hearing screening programs. Research is a key component of the audiology activities at Boston Medical Center, as well as at Children’s Hospital and the Lahey Clinic. The audiology staff engages in clinical research projects and has given numerous presentations at national audiology and otolaryngology meetings. Our audiologists currently are participating in an NIH funded research project.

Speech Pathology at Boston Medical Center

Boston Medical Center’s Speech Pathology Division offers state-of-the-art evaluation and treatment options for patients with a variety of voice and swallowing disorders due to head and neck cancer, neurologic disease, use of the professional voice, and vocal polyps and cysts to mention just a few. Under the direction of world renowned speech pathologist Dr. Susan Langmore, training and clinical application of FEES (fiberoptic endoscopic evaluation of swallowing) and modified barium swallow protocols have transformed diagnosis and treatment of swallowing disorders. The speech pathology program is an exemplary trifecta of academic teaching, groundbreaking research, and clinical application. Nine research projects are currently active in the recently established Center for Voice and Swallowing, including a Boston Medical Center directed $2.7 million NIH/NCI (National Institute of Health/National Cancer Institute) clinical trial. In addition, both Children’s Hospital and the Lahey Clinic have outstanding speech pathology divisions. This past year, beginning in July, all speech pathologist working at the Boston Medical Center began reporting administratively to Dr. Susan Langmore at the Department of Otolaryngology. Previously all speech pathologist had reported to the Department of Physical Medicine and Rehabilitation.

Resident Research and Scholarly Activities Committee (RRSAC)

The RRSAC was formed in 2003 to help organize, facilitate, monitor, and support all endeavors pertaining to research and scholarly activities pursued by our otolaryngology residents. The Committee faculty members represent a balance of basic, clinical, and technological research experience. A senior otolaryngology resident also serves on the Committee. The Department of Otolaryngology residents continue to be active in research, both during and outside of their required research blocks. They have presented at conferences for the Eastern Section of The Triological Society, the Combined Otolaryngology Spring Meeting (COSM), and the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) Annual Meeting. Resident publications have appeared in various peer reviewed journals including Laryngoscope, Annals of Otology, Rhinology & Laryngology, Otolaryngology - Head and Neck Surgery, and Archives of Otolaryngology - Head & Neck Surgery. The new chair of the RRSAC is Dr. Jeffrey Spiegel.

Affiliate Institutions

Affiliation with prominent teaching hospitals throughout the greater Boston area has always been an important strength of the BUMC Otolaryngology residency program. The enduring affiliations are based on solid relationships which have created a common sense of purpose with excellent communication among all of the affiliated teaching hospitals. Otolaryngologists based at all of the affiliated hospitals work full time within their hospitals and none of the otolaryngologists with whom residents work are in community based private practices. Many of the otolaryngologists at the affiliated hospitals hold faculty appointments at the Boston University School of Medicine. Each year the local residency program directors from each of the affiliated hospitals meet with the Chairman, Residency Program Director, and Administrative Chief Resident at the annual meeting of the Residency Program Steering Committee. The purpose of the meeting is to critically review the entire educational program of the previous year based on evaluations and feedback from residents and faculty and to plan changes and improvements in the educational program for the upcoming year.

Lahey Clinic

Robert Dolan, M.D., FACS Chief of Otolaryngology and Local Program Director
Lahey Clinic, located in Burlington, Massachusetts, is a physician-led, nonprofit hospital with nearly 450 physicians and more than 4,000 nurses, therapists and other support staff who work together to provide compassionate care and superior patient outcomes. The Clinic's multidisciplinary approach affords patients access to preeminent physicians from virtually every medical specialty who cooperate to develop personalized treatment plans for each patient. From advanced technology to research and medical education, Lahey Clinic combines the renowned specialty resources of its medical centers with top-quality primary care services at community-based practices throughout northeastern Massachusetts. The primary goal of this rotation is to provide residents with faculty supervised, advanced operative experience in all aspects of otolaryngologic surgery including general otolaryngology, head and neck surgery, facial plastic and re-constructive surgery, laryngology and professional voice, otology, and rhinology, and in the evaluation and management of patients with all types of otolaryngologic disorders.

Veteran's Administration Medical Center (VAMC)

John Gooey, M.D., Chief of Otolaryngology and Local Program Director
The Veterans Administration Medical Center in Boston serves as a referral center for complex otolaryngologic problems from other Veterans Hospitals throughout the New England region. Rotations at the VAMC in the first, fourth and fifth years of residency training provide a rich experience in head and neck oncologic surgery, sinus surgery, and general otolaryngology and give residents an opportunity to learn in an environment that traditionally has provided significant latitude for making autonomous decisions under an amount of supervision that assures patient safety and aims to achieve optimum outcomes for patients. Thus, residents learn graduated responsibility for patient care and surgical intervention within a system where residents have a major role in patient care

Children's Hospital

Michael Cunningham, MD Chief of Otolaryngology
Mark Volk, M.D., Local Residency Program Director
The Children's Hospital – Boston has been ranked by US News and World Report as the best hospital for children in the United States. There are 14 full-time pediatric otolaryngologists, 3 fellows, 27 audiologists, and 22 speech pathologists in the Department of Otolaryngology at the Children's Hospital. Dr. Gerald Healy, the recently retired Chairman of the Department of Otolaryngology at the Children's Hospital served as president of many of the most prestigious otolaryngology societies including the American Society of Pediatric Otolaryngology (ASPO), the American Laryngological Association, The Triological Society, and he is a past president of the American College of Surgeons. Residents on rotation at the Children's Hospital not only learn how to manage otolaryngic conditions that occur commonly in children but they also have the opportunity to learn how to manage rare and complex disorders that occur in the head and neck.

Our Current Faculty

All of our faculty at BMC hold full-time appointments in the Department of Otolaryngology at the Boston University School of Medicine. All faculty at our satellite rotations hold academic appointments as well, either at BUSM or at other schools of medicine in the greater Boston area. Hence, all of our faculty have demonstrated a serious commitment to education. Because a significant portion of your time as a resident in our program will be spent at our affiliated hospitals, we like to have residency applicants meet faculty from the affiliated hospitals.

About the Boston University Campuses

Our interviews take place in the FGH Building, originally constructed in 1864 and one of only two remaining structures from the original Boston City Hospital. This building, designed by Gridley F. Bryant, has been designated as an historic landmark and the entire interior of the building was reconstructed before we moved into our new academic offices in December 2007. We are located on the medical campus of the Boston University School of Medicine, the Goldman School of Dentistry, the Boston University School of Public Health, and many other buildings that house research facilities. The Charles River campus of Boston University is located about three miles from the medical campus and is connected with the medical campus via a shuttle bus. The Department of Otolaryngology has ties to several schools and departments on the Charles River Campus including the Boston University School of Biomedical Engineering and the Sargent College of Health and Rehabilitation Sciences. We encourage collaboration of all kinds with the Hearing Research Center (HRC).

Boston University School of Medicine

Now, more than ever before, the medical research at the Boston University School of Medicine (BUSM) targets essentially every aspect of modern medicine from nanotechnology and the molecular and cellular aspects of diseases to the development of innovative medical devices. The research initiatives also link these clinical care innovations in the laboratory to practicing clinicians and clinician-scientists. This further crystallizes with the involvement of a network of neighborhood health centers and community hospitals linked to the BUMC system.

Boston University School of Medicine sits at the hub of a modern urban academic health center that includes BUMC, two VA hospitals, the Boston University Goldman School of Dental Medicine, the Boston University School of Public Health, and BioSquare – the site of a growing number of biotechnology firms.

About Boston Medical Center

Boston Medical Center (BMC) is a private, not-for-profit, 581-bed licensed academic medical center located in Boston’s historic South End. The hospital is the primary teaching affiliate for Boston University School of Medicine. BMC’s mission is to provide exceptional care without exception and to assure consistently accessible health services to all. It is the largest safety net hospital in New England. Established in July 1996, BMC represents the country’s first full asset merger of two public hospitals with a private academic medical center. BMC has nearly 5,000 employees, 1,400 physicians, and an annual operating budget of $800 million. BMC provides a full spectrum of pediatric and adult care services from primary to family medicine and advanced specialty care. Boston Medical Center also has the largest 24-hour Level 1 trauma center in New England. Residents receive extensive training in virtually all aspects of otolaryngology while on rotation at BMC including management of complex patients, maxillofacial trauma, facial plastic and reconstructive surgery, head and neck surgery including minimally invasive robotic assisted surgery, thyroid and parathyroid surgery, anterior and posterior skull base surgery, otolaryngic allergy, laryngology, voice and swallowing, pediatric otolaryngology, rhinology, and otology. Residents also have an opportunity to work closely with the audiology and speech language pathology teams that are based in the Department.

Accreditation

The Accreditation Council for Graduate Medical Education (ACGME) accredits postgraduate medical educational programs throughout the United States. Within the ACGME, there are 27 Residency Review Committees (RRC) each having responsibility for overseeing the postgraduate residency programs in certain areas of medicine and surgery. The RRC for Otolaryngology last evaluated the Boston University Medical Center (BUMC) Residency Program with a site visit on September 13, 2006. Subsequent to that thorough evaluation, our residency program received a full five-year accreditation. Our department also received a written commendation for the way we assist residents in preparing for surgical cases. In addition, at the time of our 2006 site visit, we requested and were granted permission to expand our residency program from two to three residents per year.

BU Otolaryngology Alumni Association

A top priority of our Alumni Association is to support those residents currently in training. Many of our prior graduates hold prominent positions around the country and have the potential to provide the contacts essential for success beyond residency. In addition, Alumni Association members contribute annually to the Resident Education Fund. This fund provides monetary support for our residents to travel to important national meetings, as well as providing a yearly stipend for books and other educational materials. The Alumni Association also sponsors the annual Alumni Day Scientific Program that provides an opportunity for residents and alumni to meet and participate in Alumni Day events.

The 80-hour work week/ home call

Beginning July 1, 2003, the Accreditation Council on Graduate Medical Education (ACGME) required that all residency programs in the United States limit the work hours of residents to no more than 80 hours per week. The BUMC Otolaryngology Residency Program has been in full compliance with this major change in resident work hours since it was mandated by the ACGME. Beginning in July 2004, residents in our program have taken call from home at all hospital rotations except for Children's Hospital. This has helped with keeping work hours in compliance with ACGME requirements.

The Service versus Education Committee

The BUMC Otolaryngology program is one of the first academic departments of Otolaryngology in the United States to concentrate specifically on the conflicts between educational goals and service obligations in a day-to-day residency. We realize that the residents’ responsibilities to provide service to patients may impact the maximum use of all educational opportunities. While managing these duties is part of training effective physicians, these responsibilities should not undermine one another. Six years ago, we established the Service versus Education Committee (SVEC). This committee is comprised of four individuals: Residency Program Director, Administrative Chief Resident, Residency Representative to the Resident’s Union, and Department Chairman. The SVEC meets quarterly and the agenda for each meeting is controlled entirely by the two residents who serve on the committee. Agenda items focus specifically on the matter of existing or potential conflicts between resident education and service obligations. Minutes of the meeting are taken by the Administrative Chief Resident and kept on file. In the days and weeks after each SVEC meeting, efforts are made to resolve all troublesome issues.