Balancing pediatric otolaryngology training for fellows and residents at a children's hospital.

Abstract

To determine the feasibility of providing surgical, endoscopic, and patient contact experience of high educational value at a children's hospital sufficient for adequately training contemporaneously both residents in otolaryngology-head and neck surgery and fellows in pediatric otolaryngology. Retrospective review of operating room case logs and assignment of cases based on arbitrary perception of inherent case complexity and skill and experience that are required to manage the case. Tertiary care children's hospital located in a major metropolitan area. (1) Volume of surgical and endoscopic cases assigned retrospectively to junior resident, senior resident, or fellow. (2) Score on newly developed self-assessment skill list in pediatric otolaryngology. During 1 year, there were 3224 surgical and endoscopic procedures performed in the operating room. Of the total number of procedures, only 44 (1.4%) were designated as being exclusively assigned for hands-on experience to a fellow, but 380 (11.8%) were appropriate for both a senior resident and a fellow and therefore were apportioned in an alternating fashion. A self-assessment instrument has been developed to assess competency and comfort in the management of otolaryngic disorders, both surgical and nonsurgical, in children. The volume and assortment of surgical and endoscopy cases at a tertiary care children's hospital can provide the basis for a rich, practical hands-on experience for residents and fellows. Since few surgical or endoscopic cases require pediatric fellowship training for mastery, becoming a pediatric otolaryngologist depends on acquiring skills and competence that exceed the technical skills acquired in the operating room.