Goals and Objectives for Residency Training Department of Otolaryngology Head & Neck Surgery University of Toronto

Transcription

1 Gals and Objectives fr Residency Training Department f Otlarynglgy Head & Neck Surgery University f Trnt Index Page Overall Gals f the Prgram 2 Definitins f Resident Levels 4 CanMEDS 2005 Framewrk 5 Rtatin-Specific Educatinal Objectives 6 Otlarynglgy Elective Rtatins 6 Objectives f Training and Specialty Training 7 Requirements in Otlarynglgy (RCPSC) Rtatin Educatinal Objectives a) Neursurgery (PGY-1) 12 b) Adult Emergency Medicine (PGY-1) 15 c) Internal Medicine (PGY-1) 18 d) Anesthesia (PGY-1) 20 e) Diagnstic Imaging (PGY-1) 23 f) General Surgery (PGY-2) 25 g) Plastic Surgery (PGY-2) 28 h) Critical Care Medicine (PGY-2) 31 i) Otlarynglgy (PGY-1 and 2) 33 j) Otlarynglgy (PGY-3) 38 k) Otlarynglgy (PGY-4) 44 l) Otlarynglgy (PGY-5) 51

2 2 Overall Gals f the Prgram The missin f the residency-training prgram at the University f Trnt is t prduce graduates wh have all skills and cmpetencies necessary t functin as a cnsultant in General Otlarynglgy as well as the ability t transitin seamlessly int pst-graduate fellwship training. It is expected that graduates will acquire and demnstrate cmpetencies in all f the CanMEDS (Canadian Medical Educatin Directins fr Specialists) rles as utlined by the Ryal Cllege f Physicians and Surgens f Canada. These cmpetencies are rganized int dmains f Medical Expert, Cmmunicatr, Cllabratr, Manager, Health Care Advcate, Schlar, and Prfessinal (see page 5). These verall gals will be accmplished via a series f specifically designed rtatins and emplying a graded escalatin f respnsibility cmmensurate with the trainee s level f training and ability. The training prgram cnsists f specific rtatins at University f Trnt teaching and cmmunity hspitals. It is recgnized that these hspitals have different but verlapping areas f subspecialty expsure. The cre tlarynglgy teaching hspitals as f July 1, 2005 are as fllws: The University Health Netwrk (UHN) prvides trainees with in-depth expsure t Otlgy, Otneurlgy, Basic and Advanced Audilgy/Vestibular Testing, Head & Neck Onclgy, General and Majr Head and Neck Surgery, Micrvascular and Recnstructive Surgery and Skull Base Surgery. Munt Sinai Hspital (MSH) prvides trainees with in-depth expsure t General Otlarynglgy, Head & Neck Onclgy, Rhinlgy, Basic and Advanced Audilgy and Vestibular Testing, General Otlarynglgy Prcedures, Majr Head and Neck Surgery with emphasis n Endcrine Surgery, External and Endscpic Rhinlgic Prcedures. Expsure t Facial Csmetic Surgery is als prvided. The Hspital fr Sick Children (HSC) prvides in-depth expsure t all aspects f Paediatric Otlarynglgy. Saint Michael s Hspital (SMH) prvides trainees with in-depth expsure t General Otlarynglgy, Vice Disrders, Endcrine Head & Neck Disrders, Rhinlgy, Basic and Advanced Audilgy/Vestibular Testing, Nasal Airflw Testing, Head & Neck Trauma, General Otlarynglgy Prcedures, Endcrine Head and Neck Surgery, Basic and Advanced Laryngeal Prcedures, Endscpic and Rhinlgic Prcedures and Skull Base Surgery.

3 3 Sunnybrk and Wmen s Cllege Health Sciences Centre (SWCHSC) prvides trainees with in-depth expsure t General Otlarynglgy, Otlgy, Otneurlgy, Basic and Advanced Audilgy/Vestibular Testing, Head & Neck Onclgy, General and Majr Head and Neck Surgery, Micrvascular and Recnstructive Surgery, and Skull Base Surgery. Trnt East General Hspital (TEGH) prvides trainees with in-depth expsure t General Otlarynglgy (including Paediatric Otlarynglgy), Otlgy, Rhinlgy, Head & Neck Onclgy, General and Paediatric Otlarynglgy Prcedures, Basic and Advanced Head & Neck Surgical Prcedures, Basic and Advanced Endscpic Rhinlgic Prcedures and Facial Plastic Surgery Saint Jseph s Health Centre (SJHC) prvides trainees with in-depth expsure t General Otlarynglgy (including Paediatric Otlarynglgy), Otlgy, Rhinlgy, General and Paediatric Otlarynglgy Prcedures, Head & Neck Surgical Prcedures, Basic and Advanced Endscpic Rhinlgic Prcedures and Facial Plastic Surgery It is expected that expsure t General Otlarynglgy will ccur at all sites in the Operating Rms, Outpatient Clinics, In-patient wards, and Emergency Departments. It is als acknwledged that, while specific subspecialty expertise may be cncentrated at ne site r anther, it is nt necessarily limited t these sites and that there will be verlap, particularly in areas f Paediatrics, Otlgy, and Rhinlgy. Achievement f the verall bjectives f the Prgram will als be accmplished thrugh ff-service rtatins in Emergency Medicine, Internal Medicine, Anesthesia, Head and Neck Radilgy, Neursurgery, General Surgery, Plastic Surgery, Critical Care Medicine, as well as Elective rtatins.

4 4 Definitins f Resident Levels: Chief Resident shall refer t the administrative chief resident respnsible fr call schedules and ther lgistical issues pertaining t the training prgram. The Chief Resident shall be elected by his/her peers. Senir Resident shall refer t residents in PGY-4 r PGY5. On rare ccasin, a PGY-3 resident may functin in this capacity when desirable fr training purpses. Off-Service Otlarynglgy Resident shall refer t a resident in the Otlarynglgy training prgram wh is in his/her year f Cre Surgery training in anther discipline. Off-Service Resident shall refer t a resident in anther training prgram ding an elective n an tlarynglgy service

5 5 CanMEDS 2005 Framewrk Essential Rles and Key Cmpetencies fr Specialist Physicians Medical Expert 1. Functin effectively as cnsultants, integrating all f the CanMEDS Rles t prvide ptimal, ethical and patient-centered medical care; 2. Establish and maintain clinical knwledge, skills and attitudes apprpriate t their practice; 3. Perfrm a cmplete and apprpriate assessment f a patient; 4. Use preventive and therapeutic interventins effectively; 5. Demnstrate prficient and apprpriate use f prcedural skills, bth diagnstic and therapeutic; 6. Seek apprpriate cnsultatin frm ther health prfessinals, recgnizing the limits f their expertise. Cmmunicatr 1. Develp rapprt, trust and ethical therapeutic relatinships with patients and families; 2. Accurately elicit and synthesize relevant infrmatin and perspectives f patients and families, clleagues and ther prfessinals; 3. Accurately cnvey relevant infrmatin and explanatins t patients and families, clleagues and ther prfessinals; 4. Develp a cmmn understanding n issues, prblems and plans with patients and families, clleagues and ther prfessinals t develp a shared plan f care; 5. Cnvey effective ral and written infrmatin abut a medical encunter. Cllabratr 1. Participate effectively and apprpriately in an interprfessinal healthcare team; 2. Effectively wrk with ther health prfessinals t prevent, negtiate, and reslve interprfessinal cnflict. Manager 1. Participate in activities that cntribute t the effectiveness f their healthcare rganizatins and systems; 2. Manage their practice and career effectively; 3. Allcate finite healthcare resurces apprpriately; 4. Serve in administratin and leadership rles, as apprpriate. Health Care Advcate 1. Respnd t individual patient health needs and issues as part f patient care; 2. Respnd t the health needs f the cmmunities that they serve; 3. Identify the determinants f health f the ppulatins that they serve; 4. Prmte the health f individual patients, cmmunities and ppulatins. Schlar 1. Maintain and enhance prfessinal activities thrugh nging learning; 2. Critically evaluate infrmatin and its surces, and apply this apprpriately t practice decisins; 3. Facilitate the learning f patients, families, students, residents, ther health prfessinals, the public, and thers, as apprpriate; 4. Cntribute t the creatin, disseminatin, applicatin, and translatin f new medical knwledge and practices. Prfessinal 1. Demnstrate a cmmitment t their patients, prfessin, and sciety thrugh ethical practice; 2. Demnstrate a cmmitment t their patients, prfessin, and sciety thrugh participatin in prfessin-led regulatin; 3. Demnstrate a cmmitment t physician health and sustainable practice

6 6 Rtatin-Specific Educatinal Objectives Otlarynglgy These rtatin-specific educatinal bjectives relate t knwledge, skills, and attitudes that are t be acquired and demnstrated n the specific rtatin identified. It is acknwledged that the experience f the residents n any rtatin will be influenced by external factrs and that the expsure is nt necessarily limited t the stated bjectives. It is expected that the resident will read and becme familiar with the rtatin specific bjectives upn cmmencing a given rtatin. It is als expected that the cnsultants supervising residents will be intimately aware f the rtatin specific bjectives. Elective Rtatins: It is expected that the trainee will develp specific educatinal bjectives fr all elective rtatins. This plicy is f necessity due t the varying nature f electives between different trainees and will als prvide the trainees an pprtunity t demnstrate cmpetency in the CanMEDS dmains f schlar, cmmunicatr, cllabratr, and prfessinal. The trainee will have the respnsibility t indicate the intended elective site and cntent as well as the supervisr t the Prgram Directr. The trainee must develp bjectives and submit the prpsed infrmatin, in writing, t the Prgram Directr. The Prgram Directr will be available t meet with the trainee t review r prvide guidance in develping these bjectives. Once the abve criteria have been satisfied, the Prgram Directr will grant apprval fr the elective. The trainee is als welcme t use the rtatin-specific bjectives that fllw as a guideline; the elective bjectives need nt be as detailed r lengthy as the required rtatins but must be specific, measurable, apprpriate, and realistic. In rder fr the elective t be apprved all requested infrmatin must be submitted t the Prgram Directr at least 2 (tw) mnths prir t cmmencement f the elective. The fllwing pages give the Objectives f Training and Specialty Training Requirements in Otlarynglgy as defined by the Ryal Cllege f Physicians and Surgens f Canada. Fllwing that are Rtatin Specific Objectives fr the varius rtatins assciated with yur training.

7 7 Ryal Cllege f Physicians and Surgens f Canada Objectives f Training and Specialty Training Requirements in Otlarynglgy Apprved by Educatin Cmmittee, 2000 Objectives f Training DEFINITION Otlarynglgy is that branch f medicine cncerned with the screening, diagnsis and management f medical and surgical disrders f the ear, the upper respiratry and upper alimentary systems and related structures and the head and neck. GENERAL OBJECTIVES Otlarynglgists must pssess a sund knwledge in the general principles f medicine and surgery. During the curse f training, the resident will acquire satisfactry knwledge f the principles cmmn t all surgical practice. Otlarynglgy embraces sme cmpnents f neurlgy, neursurgery, plastic surgery, dermatlgy, respirlgy, pathlgy, ral surgery and ther specialties. Residents must have knwledge in these fields as relates t the specialty. Residents must develp clinical cmpetence and detailed knwledge f the scientific ratinale fr the medical and surgical management f tlarynglgic disrders in patients f all ages. This includes knwledge f the techniques f cranifacial surgery, neurtlgic surgery, facial csmetic surgery and recnstructive surgery f the head and neck. Residents must demnstrate the knwledge, skills and attitudes relating t gender, culture and ethnicity pertinent t tlarynglgy. In additin, they must demnstrate an ability t incrprate gender, culture and ethnic perspectives in research methdlgy, data presentatin and analysis. On cmpletin f the educatinal prgram, graduating physicians will be cmpetent t functin as a cnsultant tlarynglgist. SPECIFIC OBJECTIVES (Revised int CanMEDS frmat May 2000) At the cmpletin f training, the resident will have acquired the fllwing cmpetencies and will functin effectively as:

8 8 Medical Expert/Clinical Decisin-Maker General Requirements Demnstrate diagnstic and therapeutic skills fr ethical and effective patient care. Access and apply relevant infrmatin t clinical practice. Demnstrate effective cnsultatin services with respect t patient care, educatin and legal pinins. Specific Requirements Specific knwledge in the fllwing areas: Embrylgy, anatmy, histlgy, physilgy, pharmaclgy, pathlgy, pathphysilgy, micrbilgy, bichemistry, genetics and immunlgy f the ear, nse, paranasal sinuses and upper aerdigestive tract and adnexa and related neurlgical and cervicfacial structures. Physics f sund and neurphysilgy f hearing and vestibular functins including the principles underlying audilgical and vestibular testing, electrphysilgic techniques and ther related labratry prcedures. Principles f nclgy as they apply t the head and neck. Principles f trauma management as it relates t head and neck. Principles f therapeutic and diagnstic radilgy and their applicatin within the specialty including the interpretatin f imaging techniques relevant t the head and neck. Principles f laser therapy, crytherapy, and electr surgery and their applicatins. Principles and techniques used in evaluatin and treatment f speech, hearing, vice and swallwing disrders. All diagnstic and surgical prcedures cmmnly perfrmed in tlarynglgy. This specifically includes cmpetence in the areas f general tlarynglgy, tlgy, sinnasal surgery, endscpy, head and neck surgery and recnstructin, cervicfacial trauma, cervicfacial csmetic surgery and the use f reginal anesthesia. In prvisin f pre- and pst-perative care by demnstrating apprpriate clinical judgement in selectin f therapy. Cmmunicatr General Requirements Establish therapeutic relatinships with patients and their families. Obtain and synthesize relevant histry frm patients/families/cmmunities. Discuss apprpriate infrmatin with patients,/families and members f

9 9 the health care team. Listen effectively. Specific Requirements Demnstrate the capacity t recgnize the psychlgical, ccupatinal and scial cnsequences f disrders f the head and neck and the ability t prvide effective cunselling t patients and their families. In particular residents will recgnize the unique issues related t deafness and the deaf cmmunity, balance disrders, sleep apnea, malignancies f the head and neck and ther pertinent disrders related t the tlarynglgy patient. Demnstrate the ability t explre patient's beliefs, cncerns, and expectatins abut the rigin, nature and management f his/her illness. Otlarynglgists need t be able t assess the impact f such factrs as age, gender, ethn-culture backgrund, scial supprt, and emtinal influences n a patient's illness. Maintain clear, accurate and apprpriate recrds. Cllabratr General Requirements Cnsult effectively with ther physicians and health care prfessinals. Recgnize when ptimal care is best prvided by an interdisciplinary team and cntribute effectively t team activities. Specific Requirements Demnstrate the ability t recgnize team members' area f expertise. Respect the pinins and rles f individual team members. Cntribute t healthy team develpment and cnflict reslutin, and cntribute their wn expertise t the team's task. Manager Utilize resurces effectively t balance patient care, learning needs, and utside activities. Allcate finite health care resurces wisely. Wrk effectively and efficiently in a health care rganizatin. Utilize infrmatin technlgy t ptimize patient care, life-lng learning and ther activities.

10 10 Health Advcate General Requirements Identify the imprtant determinants f health affecting patients. Cntribute effectively t imprved health f patients and cmmunities. Recgnize and respnd t thse issues where advcacy is apprpriate. Specific Requirements Encurage behaviurs that prmte hearing prtectin and cnservatin at wrk and at hme and the encuragement f behaviurs that reduce patient's risks f malignancy f the head and neck thrugh avidance. This can be applied at the individual patient level, t a practice ppulatin, r at the general scietal level. Prmte plicies that encurage early identificatin f patients presenting with disrders f the head and neck thrugh screening prgrams fr hearing impairment and malignancy. Facilitate patient's access t lcal and natinal resurces available fr the hearing impaired. Actively educate ther health care prviders and the public regarding cmmn head and neck prblems that benefit frm early interventin. Schlar General Requirements Develp, implement and mnitr a persnal cntinuing educatin strategy. Critically appraise surces f medical infrmatin. Facilitate learning in patients, huse staff, students and ther health prfessinals. Cntribute t develpment f new knwledge. Specific Requirements Demnstrate the ability t select an apprpriate questin, efficiently search fr and assess the quality f evidence in literature and keep up t date with evidence-based standards f care fr the mst cmmn tlarynglgy prblems. Demnstrate understanding f the imprtant rle f basic and clinical research, and f the critical analysis f scientific develpments, in relatin t the practice f cntemprary tlarynglgy, i.e., epidemilgy and bistatistics and research techniques. While nt all tlarynglgists will engage in active research, they must have the

11 11 Prfessinal skills t participate in cllabrative research prjects, quality assurance, r guidelines develpment relative t the practice f tlarynglgy. Deliver highest quality care with integrity, hnesty and cmpassin. Exhibit apprpriate persnal and interpersnal prfessinal behaviurs. Practice medicine ethically, cnsistent with the bligatins f a physician. Specialty Training Requirements (These specialty training requirements apply t thse wh began training n r after 1 June 1994.) Five years f apprved training in tlarynglgy. This perid must include: 1. Tw years f cre training in surgery, in which up t 12 mnths must be spent in tlarynglgy r related designated specialties. This perid is under the directin f the Otlarynglgy Prgram Directr in cnjunctin with the Cre Surgery Prgram crdinatr. This initial perid f pstgraduate training allws the acquisitin f knwledge, skills and attitudes underlying the basics t the practice f surgery in general and preparatry t further training in Otlarynglgy. 2. Three years f apprved resident training in tlarynglgy. This perid is under the directin f the Otlarynglgy Prgram Directr. This may include six mnths in clinical r basic research in a department apprved by the Cllege.