Otolaryngology Residency Overview

The SAUSHEC otolaryngology residency formed in 1995 when the two pre-existing Air Force and Army ENT residencies consolidated. It is now based primarily out of SAMMC, but sends residents to a variety of institutions to help create a comprehensive curriculum. Currently, SAUSHEC ENT is an exceptional quality residency easily ranked on par with the top 10 nationally. Our graduates are highly successful, with a 100% ABO board pass rate over the last 5 years, graduating with case numbers exceeding 90% nationally, and have a very strong diverse competency in all areas of general otolaryngology (unlike most civilian programs which overly concentrate on trauma and cancer).

The teaching faculty: We have some of the best teaching faculty in the world. There are currently 16 ENT staff assigned to the San Antonio Military Medical Center. Subspecialty representation is particularly strong: 4 fellowship trained staff in Head and Neck Oncology, 3 in Neuro-otology, 1 Pediatric, 2 Facial Plastic and Reconstructive Surgery, 2 sleep medicine, 2 Rhinology, 1 Laryngologist, and 1 Generalist. All the faculty surgeons practice general Otolaryngology in addition to their fields of specialty interest.

Academics: Friday is a dedicated academic day for residents. There is a weekly lecture, along with faculty attended pre-operative conference. Conferences in Radiology and Pathology as well as labs in gross anatomy and temporal bone anatomy are scheduled monthly. The schedule also includes three months of dedicated, staff mentored research time split between the PG 2,3 and 4 years of training.

First year residents in Otolaryngology (PGY2) function as members of a clinical team under the direction of a senior resident and the staff. They are expected to gain experience in pre-op, post-op and outpatient management through seeing clinic and performing hands-on patient care. During this year they are expected to develop specialty oriented surgical skills through lab exercises, independent study of surgical atlases and supervised participation in surgery. They should begin focusing their study through reading assigned periodicals, at least one major text, and the Home Study Course. An important part of this education includes the Audiology and Otolaryngology Basic Science courses early in the year. They are responsible for selecting a topic, performing a literature search and developing a realistic research protocol. PGY2s are also expected to maintain their physical fitness and pass the APFT as scheduled.

Second year residents also function as members of a clinical team under the direction of a senior resident and staff. They are expected to assume greater responsibility for pre-op, post-op and outpatient management decisions, to instruct junior residents and medical students, and to prepare and present assigned subjects at conferences. They are responsible for developing a realistic research protocol and for having the final version approved by the Department of Clinical Investigation. PGY3s are also expected to maintain their physical fitness and pass the APFT as scheduled.

Third year residents are expected to become increasingly involved in patient care decisions, both as a team member and independently. They act as a team leader during any absence of the chief resident and are expected to actively supervise students, interns and junior residents. Major clinical segments of this year include rotations concentrating on Head and Neck oncology, Otology, and in the clinic OR concentrating on nasal and facial plastic surgery. They are responsible for completing data collection for the resident research project initiated during the PGY-3 year.

Chief residents (PGY5) are clinical team leaders, responsible for the scheduling and clinical operation of a busy surgical service. In addition to these administrative tasks, they are responsible for all patient care decisions carried out by their team. They oversee the management of all outpatients and direct all aspects of the pre-op evaluation, surgical planning and post-operative care of surgical patients on the service. They are the primary surgeon in all major cases operated by their team and are responsible for supervising junior residents in surgical cases appropriate for their level of training. PGY5s are responsible for completing a resident research project, for continued independent study / preparation for specialty board exams, and for their personal military preparedness and physical fitness.