Otolaryngology Resident Education: Beyond Procedural Case Logs, a 10-Year Single Institutional Review

Introduction: Residency training in otolaryngology—head & neck surgery (OHNS) involves both medical and surgical care. While the Accreditation Council for Graduate Medical Education (ACGME) has set minimum numbers for key indicator procedures, no equivalent benchmark exists to gauge resident experience with ambulatory management of otolaryngologic diseases, despite this accounting for up to 70% of most physicians’ practices. This study provides a 10-year review of OHNS resident clinic encounters at our program.

Methods: The electronic health record within an integrated healthcare system was queried for OHNS clinic encounters from 2013 through 2022 during which residents were the visit provider or assistant to an attending physician. The query included encounter date, resident class and year, primary visit diagnosis, and associated ICD code. Diagnoses were broadly sorted into categories as adapted from the ACGME OHNS Milestones. The most common diagnoses and categories for each postgraduate year were identified.

Results: From 2013-2022, 30 OHNS residents participated in 45,257 unique clinic encounters, of which 22,312 (50.7%) had the resident as the visit provider. Among the ten residents (5 classes) whose entire training was captured within this period, residents performed an average of 1,856 encounters prior to graduation. Aside from immediate postoperative visits, the five most common primary diagnoses were benign masses (6.3%), ear infections (5.6%), cutaneous malignancies (4.7%), cerumen impaction (4.6%), and hearing loss (4.4%).

Conclusions: To our knowledge, this is the first study to evaluate resident OHNS clinics, showcasing prominent representation of otologic pathologies and head & neck masses while highlighting opportunities to improve exposure to other common otolaryngologic conditions. Similar metrics from other programs are needed to ensure the breadth of diagnoses encountered during training reflect current practice. These data may lead to the establishment of a benchmarking program to further enhance otolaryngology resident education and prepare trainees for independent practice.