Resident Schedule

Residents during surgery

UT Health San Antonio Otolaryngology has resident rotations that are all discipline-based rotations involving two teams. Residents typically stay on a team for one- or two-month blocks. All residents round at University Hospital and OR/clinic assignments are based on the current Team’s cases.

Team A – Head & Neck Surgery/Facial Plastic and Reconstructive Surgery
Team B – Otology/Rhinology/Facial Plastic Surgery/Pediatric Otolaryngology*

*Pediatric Otolaryngology rotation is designed as an apprenticeship model

During the intern year, our residents are exposed to six months of Otolaryngology (ENT), with direct involvement in the care patients on our inpatient service, with early emphasis in perioperative care in the subspecialities of general ENT, head and neck, facial plastics and reconstruction. Per Accreditation Council for Graduate Medical Education mandates, the ENT intern will spend six months off service to include Trauma Surgery, Surgical ICU, Oral Maxillofacial Surgery, Anesthesia (all at main UH hospital), and two months of General Surgery at the Audie L. Murphy Memorial Veterans’ Hospital (VA) (connected to main hospital).

Operative experience as an intern is graduated. Typically, interns serve as an assistant surgeon in head and neck cases to upper-level residents and faculty, in addition to getting early involvement in flap reconstruction cases and basic pediatric cases. ENT clinic exposure is steadily integrated into the intern experience as well, with one day per week dedicated to clinic, with your remaining time is spent caring for inpatients on the ENT floor, seeing consults with upper-level residents, and scrubbing into the operating room (OR).

 

During the first full year of Otolaryngology training, we emphasized the development of diagnostic skills and early exposure to operative techniques as a both assistant and primary surgeon.

This year tends to be Pediatric and Laryngology focused year, serving as primary surgeon in the “bread and butter” Pediatric ENT cases and gradually progressing to more advanced procedures as the year progresses and skills are honed. Laryngology experience starts early in the clinic with awake endoscopic procedures and diagnostic evaluations before progressing to advanced cases in the OR.

The goal of this year is master the minor procedures of ENT, develop clinical efficiency, and see consults and make treatment plans independently (with guidance). The PGY 2 resident also begins taking junior level call, every four nights as home call. Built into PGY2 year is a month-long dedicated research block to establish the foundation of research in residency, establish a mentor, and begin a formalized project.

 

As a “senior” junior resident, clinical acumen and surgical skills continue to progress, with a 2-month advanced Pediatric rotation with the expectation to perform most pediatric cases as an independent surgeon.

In third year, a focused training of Rhinology and Otology are emphasized, in addition to continuing to be primary surgeon in laryngology, head and neck, and general ENT cases.

In this year, PGY3 residents supervise and assist lower-level residents in minor procedures, seeing and working up consult patients, and progressing to develop their own personal interests in the different ENT specialties and tailoring the clinical and operative experience to each resident’s preference. The PGY3 resident leads the weekly multidiscipline tumor board conference and continues to take junior level call. An annual facial trauma/orbital dissection course is available in PGY3 in conjunction with the Brooke Army Medical Center ENT residents.

 

The fourth year of the residency program you serve as a senior resident, now graduating from junior call and taking back up call, one week total per month.

The surgical experience in fourth years is tailored to personal interest, with “Flex” rotations or opportunities for elective months to ensure a well-rounded experience and prepare our residents for future training and career goals. Rhinology, Otology, advanced Pediatric cases, and primary surgeon in head and neck (i.e. neck dissections, flap inset, thyroidectomies) are performed during this year with demonstrated competency.

Built into this year is a 2-month dedicated research block early in the year. Fellowship applications are typically completed during this year and opportunities to network via Academy and various nationwide subspecialty courses and meetings are highly encouraged.

 

The final year of residency serves as the leader of the resident cohort, with enhanced leadership development, administrative responsibilities (assigning residents to cases), and team management skills, including teaching of lower-level residents and medical students. You serve as primary and supervising resident in all operations, often performing with full independence typically operating 4 to 5 days per week.

During this year, surgical skills are sharpened in the most advanced and complicated cases. Fellowship interviews are often conducted during this year, and Chief Residents attend the annual AAO conference, interview for private practice positions, and have the opportunity to attend various courses nationwide.

The Chief Residents divide their time equally between Team A and Team B where they are solely responsible for the clinical activity and administration of the service and communications directly to faculty.