As of July 1, 1993, as a Quebec university program, upon graduating from fourth-year medicine candidates can enter directly into speciality training "streams" such as otolaryngology. Internships have been eliminated. As of July 1, 1990, candidates will enter general surgery (PGY1-otolaryngology) and then commence their formal otolaryngology training for four years (PGY2-5).
General objectives:
The otolaryngologist must possess a sound knowledge of the general principles of medicine and surgery as they apply to the practice of otolaryngology. This will require adequate training and experience in clinical problems related to the ear, nose, paranasal sinuses, buccal cavity and its appendages, pharynx, larynx, neck, bronchi, chest, and oesophagus, including related neurological areas for both pediatric and adult populations.
There should be training in and understanding of the applied anatomy of the above areas, including the maxillo-facial structures. Applied microbiology, biochemistry, embryology, histology, pathology, pharmacology, and physiology must be studied to acquire a knowledge of the basic sciences necessary to the understanding and practice of otolaryngology. The otolaryngologist must have a special knowledge of the basic principles and clinical techniques of audiology and a familiarity with those of speech pathology, including a knowledge of the physics of sound. He/She must also have a knowledge of the principles and techniques of vestibular function testing.
In addition to the above objectives, the 7 CanMEDS key competencies have been solidly integrated into the program. These include the role of the otolaryngologist as medical expert, communicator, collaborator, manager, health advocate, scholar, and professional. The specifics and learning and evaluating of these competencies are described in some detail under the objectives for the R2, R3, R4, and R5 levels, respectively.
Specialty training requirements at ÎÛÎÛ²ÝÝ®ÊÓƵ University:
The residency training program in otolaryngology includes one year of CORE surgery and four years of otolaryngology as described below:
Please refer to Core Surgery, R2, R3, R4, and R5 objectives.
Educational program
Academic half day
The academic half day was introduced in January 2004 and represents three hours of protected teaching time every Thursday from 3:45 pm to 5:15 pm. Residents from the R1 to the R5 levels are excused from their clinic duties to attend this half day. This day is structured with heavy resident input and includes didactic and interactive teaching sessions covering all of the major areas of general otolaryngology and the representative subspecialties of the field. In addition, special emphasis is placed on areas of perceived weakness such as otology and neuro-otology. It is also a forum for teaching the 7 CanMEDS competencies, ethics, medical legal issues, and subjects in fields related to otolaryngology. Three to four times per year, question and answer "fun" competitions are held for the residents and are structured in a game format. Attendance on these days is compulsory, and the information presented during this protected teaching time forms the basis for 70% of the material covered in in-training exams.
Mini-seminars (Academic full days)
Over the past academic year, full day mini seminars were introduced in subspecialty areas of otolaryngology based on resident feedback. A full day mini-seminar was held in otology/neuro-otology, vestibular physiology and pathophysiology, rhinology, and facial plastic surgery. Based on positive resident feedback, these mini-seminars will likely be repeated on a yearly basis.
University grand rounds
Grand rounds are held once a week on Thursday afternoons from 5:15 pm to 6:15 pm. Most presentations are made by attending staff and residents in the teaching program; however, occasionally presentations are made by visiting professors from around the world with international reputations or invited clinicians from the ÎÛÎÛ²ÝÝ®ÊÓƵ milieu. The rounds allow the residents to critically review the literature pertaining to a case or small series of cases and present that literature to their peers and staff in otolaryngology.
- INVITED PROFESSORS
- UNIVERSITY GRAND ROUNDS
- LECTURES SERIES IN ORL
Every year, two residents (jr. and sr.) presentations are chosen for an award.
Hospital rounds
Each hospital site has in-hospital rounds once weekly, which include M&M, radiology, journal clubs (journal clubs are held four times a year on a Thursday evening in place of rounds). At the Montreal Children's Hospital, this occurs every Monday morning. At the Jewish General Hospital, rounds are held on Thursday mornings and include head and neck oncology and radiology rounds. The ÎÛÎÛ²ÝÝ®ÊÓƵ University Health Centre rounds for the Royal Victoria Hospital and Montreal General Hospital are held Monday mornings and cover, in a rotating fashion, the topics of pathology, radiology, rhinology, otology, laryngnology, and morbidity and mortality rounds. The rounds are designed with heavy resident input as to the content and format.
Tumor Board Rounds
Formal tumor board rounds are held weekly at the Jewish General Hospital and every other week at the Royal Victoria Hospital. These are formal rounds with the presence of a pathologist, radiation oncologist, and at least two surgeons. Radiologists, medical oncologists, dieticians, social workers, and speech pathologists may all be present as appropriate for particular bases. These are teaching rounds in which the residents may be asked questions and their opinions are considered in a formal treatment plan of individual cases.
Journals clubs
Journal clubs are held 4 times per year on a Tuesday evening. Journals are selected in advance and include two scientific papers and two ethics papers. The papers are presented in PowerPoint format with the presenting resident highlighting key points. The paper is then critically reviewed by the resident and an attending staff. Ethics papers are chosen and presented to stimulate active discussion around key ethical issues.
Guest speakers
Guest speakers are scheduled on a regular basis throughout the academic year. Speakers are usually asked to give a pre-selected lecture on a Thursday evening from 5:15 pm to 6:15 pm and to give another lecture to the residents on the following morning from 9:00 am to 10:00 am, to be followed by case presentations from 10:00 am to 12:00 pm. The guests are invited well in advance, and the entire department is notified electronically through email and through ENT bulletin boards at each respective hospital. Verbal announcements are also made at university rounds concerning guest speakers.
Annual events include:
- Resident Research Day/James D. Baxter Lectureship
- Raymer Lectureship (JGH)
- McNally Memorial Lectureship (RVH)
- Herbert S. Birkett Memorial Lecturer (held by Med-Chi Society – otolaryngology section)
- Melvin D. Schloss Pediatric Lectureship
Publications
Residents are expected to author or co-author papers presented locally, nationally, or internationally. The annual Resident Research Day is held, and at this time, all residents are expected to present a ten-minute paper. There is a progression in the sophistication of these papers from the R2 to the R4 and R5 levels.
There are two awards presented for best presentation (Jr. and Sr.).
Resident attendance at meetings
Any resident shall have the right to attend, without loss of salary, one or more meetings or courses, up to a total of ten days per year. Residents are encouraged to attend meetings that are subject to approval or that are approved by the Program Director or Chairman. Senior residents (R5) are entitled to attend one meeting during the final year and will be financially compensated to a maximum of $750 for said meeting. Residents presenting papers (not posters) will also be reimbursed to a maximum of $500 for their expenses.
Exams
There are two in-house training exams held per year. These exams are written in a Royal College format and are made up of 70% of material covered in the academic half day, with 30% of general otolaryngology material. In addition, there is a yearly Canadian otolaryngology in-training examination written by all residents across the country. The exam allows residents to position themselves with respect to their peers across the country in terms of their knowledge base. There are two oral exams held yearly in December and June for R3 to R5 residents. There are multiple mock orals held specifically for graduating residents prior to the Royal College exams.
Vacations
Residents are entitled to four weeks of vacation per year, not more than two (2) weeks of which shall be taken in any one rotation. Exceptions will be made for trips planned abroad and only with the approval of the Program Director. R2s must be available in July and August to attend the introductory lectures and are not permitted to take their vacation during the Annual CSO--H&NS meeting. A VACATION REQUEST FORM IS AVAILABLE FROM THE DEPARTMENTAL SECRETARY AT EACH HOSPITAL.
Vacation requests should be made six months in advance and may be modified with the agreement of both the chief resident and the Program Director up to three months in advance. Following that date, modifications will only be made in extenuating circumstances. Residents must fill in the enclosed vacation request form which is available at each hospital, and return it to the ÎÛÎÛ²ÝÝ®ÊÓƵ administrative office. A resident must obtain prior approval from the Site Director where the resident will be doing his/her rotation as well as from the Program Director and the chief resident who is responsible for the on call schedule and the appropriate hospital coverage.
Prizes and presentations
Prizes and presentations are held throughout the year and include the following:
- Resident Research Day/James D. Baxter Lecture — ÎÛÎÛ²ÝÝ®ÊÓƵ
- Triological Society — sectional awards for residents
- American Academy of Otolaryngology — H&NS — awards for resident presentations and research
- Melvin D. Mendelsohn Temporal Bone Drilling Prize — sponsored by BristolMyersSquibb
A Jr. and a Sr. residents receive and award for:
- Best grand rounds presentation during the academic year
- Best Canmeds resident (W. H. Novick Award)
Courses
Attendance at courses outside Montreal is not encouraged; however, if a course attended it is at the resident's expense.
Study leave
Study leave is granted for ten days per year in accordance with current resident agreement.