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Otolaryngology. Our rich heritage is further complemented by our contemporary
change and growth. This growth has expanded our educational offerings to
students and residents, enhanced our clinical capability and increased both the
quality and quantity of research in our division.
Resident Education/Mentoring
Postgraduate medical education remains a primary focus of the Division of
Otolaryngology. In addition to housing an accredited residency program in
Otolaryngology-Head and Neck Surgery, the program also interfaces with
residents in General Surgery, Plastic and Reconstructive Surgery, Oral and
Maxillofacial Surgery, Pediatrics, and Internal Medicine. The following is a
brief description of postgraduate medical education activities in the Division
of Otolaryngology. The Otolaryngology Residency represents a structured 5 year
progressive program of study. The Post-graduate Year one (PGY-1) year begins
with a orientation to surgery, basic surgical skills course, general
competencies awareness training, and participation of Advanced Cardiac Life
Support (ACLS) and Advance Trauma Life Support (ATLS) courses. Following that
the PGY-1 resident rotates on surgical rotations that are prerequisite to
beginning Otolaryngology training including, Trauma/Critical Care Surgery,
Pediatric Surgery, Anesthesiology, Neurosurgery, and Emergency Medicine. The
PGY-2 year begins an intensive experience in Otolaryngology that includes 6
months of Pediatric Otolaryngology at the Kosair Children's Hospital, and 6
months of adult general Otolaryngology at the University of Louisville and/or
the Veterans Affairs Medical Center. This year includes participation and
acquisition in basic diagnostic skill including soft tissue trauma management,
upper airway evaluation with fiberoptic laryngoscopy and management of common
Otolaryngology emergencies such as epistaxis. The PGY-3 year allows the
resident further progression in decision making, increasing complexity of
operative experience, especially in head and neck oncology and facial plastic
and reconstructive surgery. The PGY-3 resident also participates in an
intensive 2 week Basic Science in Otolaryngology course at Indiana University
School of Medicine. The PGY-4 resident begins to have increased clinic
independence and responsibility in the management of adult otolaryngology
patients and with that increased operative surgery experience in the areas of
Rhinology, sinus surgery, complex head and neck oncology, complex maxillofacial
and neck trauma, and otology. The PGY-4 resident additionally attends a
temporal bone and skull base surgery course and laboratory as well he/she
complete the basic course in Otolaryngic Allergy. In the PGY-5 year (Chief
Resident), the residents take on increased administrative, clinical and
operative responsibility. The chief residents function as the administrators of
the resident call schedule. The Chief Residents work with the Program Director
to organize the didactic lectures and course schedule for the academic year.
The Chief Residents are also expected to participate in periodic
faculty/administrative quality improvement meeting that are important to the
continued improvement of the program. Residents in their PGY-5 year also attend
the Annual Meeting of the American Academy of Otolaryngology Head and Neck
Surgery Foundation. Our residents at every level have worked well in the
changing national milieu of graduate medical education and have been successful
in being compliant with resident work hours policy as well as possessing the
general competencies that are necessary for the contemporary physician in
training. Our residents are assessed with a number of internal and external
measures including but not limited to the following:
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Global evaluation utilizing ACGME Competencies
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Resident In-Service Examination
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Didactic Book Club Examination
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Mock Oral Examinations
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Standardized Patient Examinations
Residency education extends beyond the scope of Otolaryngology solely. We are
regular participants in educational programs for selected general surgery and
oral and maxillofacial surgery residents in their Otolaryngology clinical
rotation. This allows these residents to have a one month rotation exposing
them to the spectrum of our specialty and experience the interfaces between
their career path and Otolaryngology. Furthermore, we on a regular basis have
residents from Internal Medicine participate in our Ambulatory Otolaryngology
Clinic at the Veterans Administration Medical Center in order for them to
develop enhanced clinical skills in the history and physical examination as it
relates to disorders of the upper aerodigestive tract. The residents in
Pediatrics at the University of Louisville have an opportunity to shadow and
participate in the Otolaryngology Clinic of the Kosair Children's Hospital in
order to sharpen their skills in the examination of the ears, nose and throat
of infants and children. This also allows them to understand the contemporary
role of the Otolaryngologist in disorders such as Otitis media, tonsillitis,
and obstructive sleep apnea in children.
Institutes/Centers and Specialty Clinics
Multidisciplinary Head and Neck Oncology Clinic
In 2001, the Division of Otolaryngology began a serious collaborative effort
with Radiation Oncology and Medical Oncology in the establishment of a Head and
Neck Multidisciplinary Clinic located at the James Graham Brown Cancer Center.
This clinic allows one location access to all three medical specialties under
one roof at the same time. The clinic offers state of the art diagnostic and
treatment approaches for advance head and neck cancers. Patients seen in this
clinic are afforded the most contemporary options in the care of their head and
neck cancers such as:
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Image Modulated Radiation Therapy (IMRT)
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Concomitant Chemoirradiation for Organ Preservation
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Minimally Invasive Surgical Techniques and Protocols
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Intraoperative Radiation Therapy
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Comprehensive speech and swallowing rehabilitation therapy
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Advanced diagnostic imaging such as CT/PET fusion imaging
The clinic since its inception has also served as a portal of entry for
patients to participate in national protocols for advanced malignancy. We offer
patients an advanced array of protocols as participants in the national
Radiation Therapy Oncology Group (RTOG) and have been one of the highest
accruing centers in the United States for such protocols. We are also an
integral part of the James Graham Brown Cancer Center's progressive plan and
initiative to become a National Cancer Institute (NCI) designated cancer
center.
The Heuser Hearing Institute
The Heuser Hearing Institute represents a newly created cooperative effort
between the University of Louisville School of Medicine and The Louisville Deaf
Oral School. The purpose of the institute is to offer leading edge clinical
care, education, and research related to deafness, hearing loss, and balance
disorders. This facility is located on the Louisville Deaf Oral School Campus
which allows it to interface with the school and other services for hearing
impaired children. Dr. Fred Wightman joined our faculty in 2003 as the first
Heuser Hearing Professor. The goal is to achieve a center of excellence for
hearing and balance disorder that will represent the culmination of a joint
effort of the divisions of Otolaryngology, Otology, the Louisville Deaf Oral
School and the University of Louisville, Department of Psychology. Dr. Arun K.
Gadre, with special expertise in Otology, Neurotology and Skull Base Surgery,
has recently joined the faculty and is currently the medical director.
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