INTRODUCTION TO ENT ROTATION

Here are a few details on your upcoming ENT rotation.This is a two-week outpatient experience in a community ENT physician office, with a couple of choices for preceptors as discussed below.As a brief rotation, what you get out of the experience depends on efficiently using the reading and clinical time to accomplish the goals and objectives.

The ENT curriculum consists of the following:

1. ENT Office — depending on schedule and availability, your experience is in one or both of the following offices - Call the preceptor offices Now to confirm preceptor availability, then let Kary Trumble know what your schedule will be.

A. Charles Souliere, M. D. experienced and enthusiastic about teaching. He allows residents to see patients ahead of them, and does allow involvement in some procedures.

Address: 915 Sixth Avenue, Suite 1, Tacoma, WA.Telephone 627-6731/ 627-6734

B. Donald Shrewsbury, M. D. - Long time preceptor for this rotation, has a busy practice, is interested in teaching, this tends to be a somewhat more observational experience and answers questions usually towards the end of the day.

C. Nicholas Hamill, M.D. — Younger partner, very enthusiastic teacher, allows some hands on opportunities, gives our main lecture series.

Address: B2010 Allenmore Medical Center, 1901 South Union, Tacoma, WA. Telephone 627-4502.

Available Times in Office

Mornings 9 am - noon

Afternoons 1 - 5 PM

Mondays

Souliere or Hamill

Shrewsbury

Tuesdays

Hamill

Shrewsbury

Wednesdays

Shrewsbury

Hamill

Thursdays

Souliere

Souliere

Fridays

Shrewsbury

Hamill

For additional experience: C. Madigan ENT Residency Clinic - For those especially interested in getting extra opportunities to do flexible nasopharyngoscopy, I would suggest spending one or two half days at Madigan as an added experience, but not as the whole rotation.

Positives - More opportunities for hands-on procedures i.e. NP Scope. Has pediatric referral clinic Monday afternoon and Tumor clinic Tuesday morning.

Negatives - Lower volume, less bread and butter adult cases than community ENT offices.

Schedule: Clinic is available every day of the week except Wednesday afternoon. As above, Monday afternoons are Peds Referral clinic, Tuesday mornings are the Tumor clinic.

To arrange, call the chief resident at 968-2749 (Department Office)

1. ENT Self Test — You should answer all questions by the end of the 2 weeks What should you really get out of ENT? Enough to answer the questions posed in these case scenarios because these are the patients I guarantee you will see many times in your career as a family physician. Prepare now or learn later on on-the-job!

2. Fiberoptic Nasopharyngoscopy Module

Everyone should complete the NP procedure module, regardless of whether you plan to perform this procedure later in practice; working through the requirements of the module helps understand the anatomy of the nose and throat, and what your patients will experience at your consultant’s office.

This is a self-guided module found on the TFM curriculum web site:

http://faculty.washington.edu/dacosta/Procedures/np.html

1. Reading

Required: The following monographs will be loaned to you during the rotation - you can check them out from Kary Trumble. Please return them at the end of your rotation to avoid being charged for their replacement.

a. AAFP Monograph 242—Common Ear, Nose and Throat Problems: review this as a preparation for what the AAFP board exams are likely to ask you in the area of ENT.

b. Common Problems of the Head and Neck Region - another good text for more in depth explanations of common ENT problems.

c. Nasolaryngoscopy — A self-study program for the Family Physician.