General Skills
• Participate in the post-operative ward and office management of patients who have undergone major head and neck ablative and Reconstructive surgery
• Demonstrate a sophisticated approach to imaging studies including independent interpretation of findings
• Perform fine needle aspiration of neck lesions
• Biopsy nasal or oral cavity lesions
• Insert or change a tracheoesophageal puncture prosthesis
• Pack a pharyngocutaneous fistula and provide ongoing wound care/debridement
• Effectively manage pain associated with surgery and malignancy
• Demonstrate understanding of the indications for tracheotomy in a critical care setting
• Promptly and effectively assess patients with airway emergencies including airway obstruction and supervise junior colleagues in this situation
• Perform open and percutaneous tracheostomies
• Pre-operative assessment and preparation of patient for surgery
• Management of post-operative patient care issues (e.g., pain, labs, wounds)
• Participate in the post-operative ward and office management of ENT patients
• Interpret X-ray and cross-sectional imaging of temporal bones, paranasal sinuses, and soft tissues of the head and neck
Head and neck Oncologic Surgery
• Rapidly stage malignancies of the head and neck & develop approach to management
• Perform pan-endoscopy independently with accurate interpretation of findings
• Perform lymph node and neck mass biopsy
• Perform excision of branchial cleft cysts and thyroglossal duct cysts
• Perform parotidectomy with increasing degree of autonomy
• Perform neck dissections with increasing degree of autonomy
• Perform thyroidectomy, parathyroidectomy with limited consultant intervention
• Perform excision of oral cavity lesions
• Perform composite resections as well as pharyngolaryngectomies with increasing degree of autonomy
• Perform more extensive maxillectomies with consultant supervision
Facial Plastic and Reconstructive Surgery
• Demonstrate sophisticated understanding of the hierarchy of reconstructive options for defects in the head and neck
• Formulate plan for reconstruction of head and neck defects with attention to form and function
• Design and harvest flaps for major Reconstructive surgical procedures with direct consultant supervision
• Perform or assist at microvascular anastomosis for vessels and nerves in free tissue transfers
• Diagnosis and treatment of facial nerve disorders and reanimation strategies
• Assessment for septorhinoplasty including an appreciation of the nasal valve, open vs. closed approaches, as well as grafting techniques.
• Perform septorhinoplasty with direct consultant supervision.
• Management of patients suffering from facial trauma including the techniques of soft tissue repair and closed/open reduction of facial fractures.
Laryngology
• Develop a differential diagnosis and management plan for dysphonia
• Develop a differential diagnosis and management plan for dysphagia
• Management of vocal cord paralysis including investigation, medical therapy, and surgical therapy
• Perform rigid suspension laryngoscopy
• Perform microlaryngeal surgery with microlaryngeal instruments, CO2 Laser
• Understanding of intraoperative airway management during microlaryngeal surgery
• Perform, with supervision, endoscopic laser resections of early tumors of the larynx
• Assist at and begin to perform airway reconstruction (e.g. laryngotracheoplasty)
Neurotology / Otology
• Accurately assess patients suffering temporal bone trauma including ordering appropriate investigations
• Be able to interpret conventional audiometry and tympanometry in adults
• Understand the principles and application of auditory brainstem response (ABR) and otoacoustic emissions (OAEs)
• Understand the principles and application of electronystagmography including interpretation of findings
• Accurately diagnose benign positional vertigo and demonstrate a rational approach to its treatment
• Perform the particle repositioning maneuver
• Develop a rational approach to vestibular rehabilitation and participate in delivery of this care
• Participate in and demonstrate understanding of the indications for surgical treatment of vertigo (includes labyrinthectomy, vestibular nerve section, endolymphatic sac surgery, and posterior canal occlusion)
• Demonstrate an understanding of electro-diagnostic testing of the facial nerve
• Elevate a tympanomeatal flap with limited consultant intervention
• Perform tympanoplasty with limited consultant intervention
• Perform ossiculoplasty with consultant supervision
• Perform mastoidectomy with consultant supervision
• Demonstrate a rational, organized approach to management of disorders of the facial nerve
• Demonstrate a rational approach to selection of patients for cochlear implant surgery
• Assist at surgery for treatment of otosclerosis
• Assist at and demonstrate a logical approach to surgery for treatment of lateral skull base lesions including acoustic neuromas, other benign CPA lesions, and petrous apex lesions
Rhinology
• Perform effective rigid nasal and sinus endoscopy
• Biopsy nasal cavity lesions
• Participate actively in the post-operative office management of patients who have undergone sinus surgery including pharmacotherapy and debridement
• Demonstrate a sophisticated approach to selection of the surgical candidate for treatment of nasal obstruction and chronic rhinosinusitis
• Perform nasal septoplasty including choice of incision, method of septoplasty, and closure materials with decreasing degree of direct consultant supervision
• Perform inferior turbinate reduction
• Refine knowledge of paranasal sinus anatomy and perform surgical techniques of endoscopic polypectomy, uncinectomy, ethmoidectomy, and middle meatal antrostomy with decreasing degree of direct consultant supervision
• Acquire familiarity with indications for and performance of endoscopic sphenoidotomy and frontal sinusotomy
• Perform external approaches to the paranasal sinuses such as external ethmoidectomy, frontal sinus trephine, and frontal sinus osteoplasty
• Perform surgical treatments for epistaxis including endoscopic sphenopalatine artery ligation and anterior ethmoid artery ligation as well as internal maxillary artery ligation
• Acquire familiarity with techniques for the management of benign sinonasal neoplasms such as inverted papilloma (e.g. endoscopic medial maxillectomy)