Training programs in otolaryngology-head and neck surgery in the United States are evaluated by the Residency Review Committee for Otolaryngology (RRC), which consists of representatives from the American Medical Association (AMA), the American College of Surgeons (ACS) and the ABOto, and are accredited by the Accreditation Council for Graduate Medical Education (ACGME). Information concerning approved educational programs can be found in the Graduate Medical Education Directory published by the American Medical Association.
Individuals who enter otolaryngology-head and neck surgery training on or after July 1, 2005 must satisfactorily complete a minimum of five years of training, as specified below, in an ACGME-approved program(s):
Residency programs must be of five years duration, with at least twelve months of basic surgical, emergency medicine, critical care, and anesthesia training within the first year; including at least 48 months of progressive education in the specialty. This training must include a final year of senior experience. This final year must be spent within the accredited program in which the previous year of training was spent, unless prior approval is obtained from the ABOto.
The first year of otolaryngology-head and neck surgery training should include six months of non-otolaryngology rotations with a minimum of four weeks but not exceeding 2 months per rotation. Rotations must include intensive care and the rest must be selected from the following areas: general surgery, neurological surgery, neuroradiology, ophthalmology, oral-maxillofacial surgery, pediatric surgery, plastic surgery, and radiation oncology. In addition, six months of otolaryngology rotations designed to develop basic surgical skills, general care of otolaryngology patients both in the inpatient setting and in the outpatient clinics, emergency medicine, and cultivation of an otolaryngology knowledge base. PGY 2-5 must include 48 months of progressive education in otolaryngology. Each resident must spend 12 months as chief resident on the otolaryngology clinical service at the primary clinical site or one of the participating sites of the sponsoring institution during the last 24 months of the program.
A resident wishing to transfer from one residency program to another must notify the ABOto in writing at least six weeks prior to the date of transfer, and must explain the circumstances of the proposed transfer.
Letters from the current and prospective directors of training must also be submitted:
- The letter from the current Program Director must verify the exact amount of training successfully completed in the program and explain the reason for the transfer. A PGY-1 Rotations List must also be submitted.
- The letter from the prospective Program Director must verify that sufficient residency positions, accredited by the Residency Review Committee for Otolaryngology of the Accreditation Council for Graduate Medical Education (ACGME), exist in the program to provide the transferring resident with the training necessary to meet the requirements of the ABOto for certification.
Failure to comply with the transfer requirements may result in loss of eligibility to participate in the ABOto certification process.
Leave of Absence
Leaves of absence and vacation may be granted to residents at the discretion of the Program Director in accordance with local rules. The total of such leaves and vacation may not exceed six weeks in any one year. If a circumstance occurs in which a resident’s absence exceeds the allotted time outlined by the ABOto, the program director must submit a plan to the ABOto for approval on how the necessary training will be achieved, which may require an extension of the residency.
Core Surgical Procedures
The ABOto and the RRC for Otolaryngology have identified certain procedures that represent basic skills all otolaryngologists should learn during residency. Although not a comprehensive list of procedures performed by otolaryngologists, the skills needed to perform the core procedures can be used to perform other procedures. Residents are evaluated by their faculty and when a resident reaches a level of proficiency with the procedure, the Program Director will indicate this achievement on the resident’s evaluation form on the ABOto website.
All otolaryngology residents must maintain an operative log available on the ACGME website. It is critical that the resident enter all cases performed and complete the necessary information. Residents who assist at surgery should be sure to include those cases, as they are important because they indicate a logical progression in the surgical educational process. In general, a resident should first assist on a case before being listed as primary surgeon, signifying an increased level of responsibility based on experience.
The cases are coded using the CPT code, which is widely used for billing and other purposes. It will benefit the resident greatly to learn how to use the CPT system so that he/she will be familiar with it when entering practice.