Residency Program

Otolaryngology FacultyMCW Otolaryngology Residency Program:

  • Positions Available Per Year:  3
  • Years of Training:  5
  • Locations:  Froedtert Hospital, Children's Hospital, and the Zablocki VA Medical Center
  • Program Director: David Poetker, MD
  • Associate Program Director: Thomas Robey, MD
  • Residency Coordinator: Diann Fiscus (414) 805-5609 (dfiscus@mcw.edu)

Our faculty consists of 23 full-time otolaryngologists-head and neck surgeons and four research scientists. Most faculty members have completed fellowships including pediatric otolaryngology (9), otology (2), head and neck oncology (3), laryngology (2), rhinology (2), and facial plastic surgery (2). The department has developed special expertise in various clinical areas. Our graduates have entered private practice, academic medicine, or have pursued fellowship training. We are committed to support a training experience that will allow our graduates to choose their own career path. Our program is fully accredited by the Otolaryngology Residency Review Committee of the ACGME.

 

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  General Program Outline

Five Year Training Program

View rotation schedule (PDF)

PGY-1 Resident
The PGY-1 year is managed by the Department of Otolaryngology and Communication Sciences as mandated by the ACGME. Rotations include Trauma Surgery, Plastic Surgery, SICU, Pediatric Surgery, Anesthesia and General Surgery in addition to six months on the otolaryngology service. All rotations are completed in Medical College of Wisconsin affiliated hospitals.

The PGY-1 year is designed to allow the resident to accumulate background information leading to more specialized training. Trainees emerge from this year with excellent patient care skills.

PGY-2 Resident
The PGY-2 year consists of 12 months of otolaryngology with rotations at Froedtert Hospital, Children's Hospital, and VA Medical Center. The PGY-2 resident is exposed to a variety of clinical dilemmas and diseases and is guided by faculty and more senior level residents.

The resident perfects examination techniques in this year and learns to evaluate patients in the outpatient and inpatient settings.

The PGY-2 resident begins to display learning through participation in conferences and case presentations. Examples of early surgical experience include: myringotomy, tonsillectomy, adenoidectomy, tracheotomy, endoscopy, and skin and oral cavity excisions. The PGY-2 resident assists in more complex procedures. Direct supervision is required for all surgical procedures at all of the institutions.

PGY-3 Resident
The PGY-3 year includes 3 months of dedicated research along with 2 months of research and clinic duty. A research proposal must be developed and presented, under the mentorship of a faculty member, before beginning the PGY-3 year.

One month of electives (divided weekly with the VA clinic) are dedicated specifically for resident exposure to allergy, audiology, speech pathology and head and neck radiology.

Four months of the PGY-3 year are spent on rotations at Froedtert Hospital, rotating specifically on the rhinology service, plastics service, otology and general otolaryngology service. And, one month is spent at Children's Hospital of Wisconsin.

The PGY-3 resident will continue to learn to diagnose a broad spectrum of adult and pediatric patients presenting to the clinic, emergency room, and as inpatient consultations.

Residents and Fellow at Children's Hospital of Wisconsin

PGY-4 Resident
The PGY-4 year consists of rotations at Froedtert Hospital (8 months) and Children's Hospital (4 months). While at Children's, the resident first tests his/her administrative skills, serving as Chief Resident.

The PGY-4 resident is expected to be able to discuss all but the most complex patients.  Surgical experience includes a variety of more complex procedures, including major head and neck, sinus, and pediatric, although the resident continues to assist on the most complex cases.

PGY-5 Resident
The PGY-5 year consists of four months at the VA Medical Center and eight months at Froedtert Hospital; the PGY-5 serves as Chief Resident at both institutions.

The PGY-5 resident routinely performs complex head and neck, otology, sinus, general, and reconstructive procedures under faculty supervision.

They may also be involved in multi-disciplinary surgical procedures with plastic surgery, oculoplastic surgery, oral and maxillofacial surgery, and neurosurgery.

The PGY-5 resident is expected to be capable of discussing the most complicated patients, confidently handling emergencies, recognizing and handling complications, seeking help at appropriate decision points, and expertly teaching more junior level trainees and medical students.

In addition, increased administrative and teaching duties further prepare each PGY-5 resident to become an independent otolaryngologist-head and neck surgeon.

  Duty Hours/Call

Duty Hours

Policy on Resident Duty Hours
Department of Otolaryngology and Communication Sciences
Medical College of Wisconsin

The Department’s policies are consistent with the policies set by the Medical College of Wisconsin (MCW) and the Medical College of Wisconsin Affiliated Hospitals, Inc. (MCWAH), under guidelines established by the Accreditation Council for Graduate Medical Education (ACGME) and the Otolaryngology Residency Review Committee (RRC).

The otolaryngology program schedules resident assignments to be in compliance with all applicable ACGME requirements. Faculty members know, honor and assist in implementing the applicable duty hour limitations. Residents must comply with limitations, accurately report duty hours and cooperate with duty hour monitoring procedures. All involved are expected to identify and report potential duty hour violations and collaborate to devise appropriate corrective action.

Duty hours are defined as all clinical and academic activities related to and required by the otolaryngology residency program. This includes patient care, administrative duties relative to patient care, provision of transfer of patient care, on-call time spent in-house and scheduled activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

  • Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.
     
  • Residents must have a minimum of one day (24-hour period) free of duty every week, when averaged over four weeks. At-home call cannot be assigned on these free days.
     
  • Duty periods of PGY-1 residents must not exceed 16 hours in duration.
     
  • PGY-1 residents scheduled as “in-house night float” while rotating on other services must not be scheduled for more than six consecutive nights.
     
  • Duty periods for PGY-2 residents and above may be limited to a maximum of 24 hours of continuous duty in the hospital. Strategic napping, especially after 16 hours of continuous duty, is strongly suggested. Residents may remain on-site up to four (4) additional hours for transition of patient care or to attend an educational conference, but they must not perform additional clinical responsibility after 24 hours of continuous in-house duty.
     
  • In unusual circumstances, residents, on their own initiative, may remain beyond their scheduled period of duty to continue to provide care to a single patient. Justifications for such extensions of duty are limited to reasons of required continuity for a severely ill or unstable patient, academic importance of the events transpiring or humanistic attention to the needs of a patient or family.
     
  • Under these circumstance the resident must:
  • Appropriately hand over the care of all other patients to the team responsible for the continuing care.
     
  • Document the reasons for remaining to care for the patient in question and submit that documentation in every circumstance to the program director, who will review each submission of additional service and track both individual resident and program-wide episodes of additional duty.
     
  • PGY-1 residents should have 10 hours, and must have eight hours, free of duty between scheduled duty periods.
     
  • PGY-2 and PGY-3 residents (considered intermediate level by the RRC for Otolaryngology) should have 10 hours free of duty and must have eight hours between duty periods.  They must have at least 14 hours free of duty after being in-house for 24-hours.
     
  • PGY-4 and PGY-5 residents (considered to be in the final years of education by the RRC for Otolaryngology) must be prepared to enter the unsupervised practice of medicine and care for patients over irregular or extended periods.
     
  • This must occur within the context of the 80-hour, maximum duty period length and one-day-off-in-seven standards. While it is desirable that PGY-4 and PGY-5 residents have eight hours free of duty between scheduled periods, there may be circumstances (described by the RRC of Otolaryngology as required continuity of care for a severely ill or unstable patient, or a complex patient with whom the resident has been involved; events of exceptional educational value; or, humanistic attention to the needs of a patient or family) where these residents must stay on duty to care for their patients or return to the hospital with fewer than eight hours free of duty.
     
  • The program director must be notified of and will monitor all circumstances of return-to-hospital by residents with fewer than eight hours free from duty.
     
  • PGY-2 residents and above must be scheduled for in-house call no more frequently than every-third-night (when averaged over a four-week period).
     
  • Any time spent in the hospital by residents on at-home call must count towards the 80-hour maximum weekly hour limit. At-home call must not be so frequent or taxing as to preclude rest or reasonable personal time, and the frequency of at-home call must satisfy the requirement for one-day-in-seven free of duty when averaged over four weeks.
     
  • Residents are permitted to return to the hospital while on at-home call to care for new or established patients. This time spent in the hospital must be included in the 80-hour weekly maximum.

Otolaryngology residents are not permitted to practice medicine and receive financial compensation (moonlight) outside of the residency training program.


Call

Call Responsibility

Call responsibility varies depending on PGY level. Primary call is covered by the PGY-1-4 residents. Second call is covered by the PGY-5 at Froedtert and the VA. Second call is covered by staff at the Children’s Hospital of Wisconsin.

Weekends call consists of Friday/Sunday or Saturday.

  • PGY1: Varies depending on rotation. PGY-1's have 3 months of otolaryngology. During the OTO months, they will take primary in-house call on 2 weekends of the month from 7:00 am-7:00 pm, backed up by an upper level resident.
  • PGY2: First 6 months of PGY-2 year are in house call, the remainder is home call, covering all 3 hospitals averaging 4 calls/month and 1-2 weekends per month.
  • PGY3: 12 months of home call covering all 3 hospitals averaging 4 calls/month and 1-2 weekends per month.
  • PGY4: 12 months of home call covering all 3 hospitals, lighter than the PGY-2 and -3 year, with 3-4 calls/month and 1-2 weekends per month.
  • PGY5: 12 months of “second call” for residents covering Froedtert and VA shared between all PGY-5's.

If you’re not on call for the weekend, then you don’t need to round. Typically each resident gets 2 (sometimes 3) weekends off a month.

A holiday schedule is set at the beginning of the year including the July 4th, Labor Day, Thanksgiving, Christmas, New Year’s and Memorial Day.

  Research

Derek Vanhille, MD presenting at COSM.A Resident Research Review Committee has the responsibility of preparing PGY-1 and PGY-2 residents’ for their research rotation. The committee is comprised of faculty members active in basic science and clinical research. The role of the committee is to establish guidelines for the submission and formulation of research proposals and to evaluate each proposal for merit.

Several factors determine the merit of a research proposal:

  • Educational value for training
    • Grant writing skills
    • Hypothesis formulation skills
    • Statistical analysis
  • Scientific or clinical value
  • Feasibility in the time allotted for the rotation
  • Candidate background and experience
  • Mentor experience and expertise in proposed project
  • Budget / Mentor Funding Availability

Formal presentations are scheduled throughout the year promoting a step-wise process through the development of a full research proposal. The schedule of presentations and deadlines is as follows:

  • Spring
    PGY-1 Residents select Research Mentors
  • Early August
    PGY-2 Resident research application due
  • Mid-August
    Resident Research Committee meets to discuss applications
  • Late August
    PGY-2 Residents receive Research Committee comments/concerns
  • Late September
    PGY-2 Residents present revised proposal to Resident Research Committee
  • Early November
    Resident present research to all faculty and residents         
  • Early December
    CORE grant budgets due for review
  • Mid-December
    AAO-HNS Grant Letter of Intent due
  • Mid-December
    CORE grant applications due to Chair for pre-submission review
  • Mid-January
    CORE grant applications due

Research rotations start in the PGY-3 year. This year consists of three months protected research time and two months of research time with clinical responsibilities. The resident will be expected to present his/her results following the rotation. It is encouraged that the results of the project be submitted for presentation at a national meeting along with submission of a manuscript to a peer-reviewed journal.

Otolaryngology Research
Drs. Hoekzema, Linn, Southwood and O'NielNikki Johnston, PhD and Tina Samuels

In the past year, our residents have traveled and presented their research at many different venues, including:

  • Combined Otolaryngology Spring Meetings (COSM), Chicago, IL, May 18-20, 2016. Nasal mucosa temperature in healthy individuals and its correlation to subjective nasal patency, poster presentation by Kevin Casey, MD. Creation of a novel immortalized laryngeal cell line from normal true vocal fold epithelium, oral presentation by Jessica Southwood, MD. Pepsin, A biomarker for extraesophageal reflux in children with laryngomalacia, oral presentation by Kendra Luebke, MD.
  • American Society of Pediatric Otolaryngology Summer Meeting, Vail, CO, August 7-10, 2016. Perioperative Management of Persistent Tracheobronchial Foreign Bodies, oral presentation by Jessica Southwood, MD.
  • Society for Ear, Nose and Throat Advances in Children (SENTAC), San Antonio, TX, December 3-7, 2015. Lipoblastoma presenting as an oral cavity mass in a newborn, poster by Jessica Southwood, MD. Nasopharyngeal Glioma: An unusual presentation of nasal obstruction and sleep apnea in an infant, poster by Kevin Casey, MD. Vocal fold immobility in preterm infants: estimate of prevalence and analysis of factors associated with its development, oral presentation by Jad Jabbour, MD.
  • Wisconsin Society of Otolaryngology-Head and Neck Surgery Annual Fall Meeting, Lake Geneva, WI, October 1-2, 2016. Intranasal airflow distribution and perception of nasal patency, oral presentation by Kevin Casey, MD. Pillarplasty with adenotonsillectomy: outcomes compared to a control population, oral presentation by Ryan Little, MD. Creation of a novel immortalized laryngeal cell line from normal true vocal fold epithelium, oral presentation by Jessica Southwood, MD. Laryngeal abscess formation in an immunocompromised patient, oral presentation by Derek Vanhille, MD.
  • American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting, San Diego, CA, September 18-21, 2016. Pepsin in pediatric chronic rhinosinusitis: A pilot study, poster by Jad Jabbour, MD. Intranasal airflow distribution and perception of nasal patency, oral presentation by Kevin Casey, MD.
  • The Triological Society – Combined Sections Meeting, Miami Beach, FL January 22-25, 2016. Self-directed learning in otolaryngology residents in preparation for surgical cases: a survey examining study habits and use of available resources, oral presentation by Jad Jabbour, MD.
  Conferences

Educational Conferences

Otolaryngology Research Conference

Otolaryngology Grand Rounds (monthly)
Grand Rounds topics are presented by faculty and residents in a lecture format with discussion to follow. Guest speakers/visiting professors may also present during this accredited hour. All otolaryngology faculty and residents are required to attend. Attendance is taken and written evaluations are completed in accordance with CME accreditation requirements.

Morbidity and Mortality Conference (monthly)
This is a case presentation/discussion format held jointly by the services at Froedtert Hospital, Children'sMorbidity and Mortality conference Hospital, and the VA Medical Center. Chief residents present cases which are reviewed, discussed and critiqued by faculty and residents.

Core Curriculum Lecture Series (weekly)
This series spans a two-year period to include basic science and clinical information within each subspecialty. The content and format of the curriculum (e.g. lectures, case presentations, journal club, etc.) will be at the discretion of the faculty member(s) assigned to each curriculum. Subsections include otology/skull base, general/basic science/radiology, head and neck oncology/pathology, laryngology/voice, sinus/rhinology/allergy, facial plastics/reconstructive surgery/facial trauma, and pediatric otolaryngology.

Otolaryngology Residents and Dr. Robey

Research Conference (monthly)
This conference is designed to instill core knowledge of basic research methodology and skills, provide a forum for presentation of research and feedback, and provide mentorship for developing researchers. Lectures are given by faculty members and residents present research proposals and summaries.

Head and Neck Tumor Board (weekly)
This is actually two multi-disciplinary conferences, one held at the VA Medical Center and one held at Froedtert Hospital. Tumor Boards are held in conjunction with radiation oncology, hematology/oncology, speech pathology, nursing, and hospital dentistry. Each new cancer patient is presented. Radiologic studies are reviewed. Work-up and management for each patient are discussed and decisions regarding care are made.

Facial Trauma Conference (bi-monthly Sept-May)
This conference is held jointly with plastic and reconstructive surgery, oculoplastic surgery, and oral surgery. It is a lecture style conference with presentation by one of the residents, fellows or faculty from a rotating schedule between the departments.

Journal club is held quarterly in association with the subspecialty being presented in the Core Curriculum.

Wednesday and Friday Morning Faculty Clinical Conferences (weekly)
A faculty member leads a discussion of a clinically relevant topic, based on articles or cases. Regular conferences cover topics in pediatric otolaryngology, laryngology, facial plastic surgery, otology, sinus and rhinology and head and neck. The residents might be asked to review material before the conference. All attendees are expected to participate in discussion.

Roger H. Lehman, MD Lecture (yearly)
This event brings in recognized experts and leaders in otolaryngology-head and neck surgery to the Department

Previous Lehman lecturers include: H. Bryan Neel III, MD; Helmuth Goepfert, MD; Shiro Fujita, MD; Derald E. Brackmann, MD; Lauren D. Holinger, MD; Hugh F. Biller, MD; M. Eugene Tardy, Jr., MD; Richard A. Buckingham, MD; Robert H. Ossoff, DMD, MD; Arnold G. Schuring, MD; James Y. Suen, MD; Patrick E. Brookhouser, MD; Harold C. Pillsbury III, MD; Charles W. Cummings, MD; Richard A. Chole, MD, PhD; David W. Kennedy, MD; Michael D. Maves, MD, MBA; Heinz Stammberger, MD; Robert H. Miller, MD, MBA; Gordan Hughes, MD; Mark A. Richardson, MD, MScB, MBA; Joseph B. Nadol, Jr., MD; Neal D. Futran, MD, DMD; Jesus Medina, MD; Robin T. Cotton, MD; Dean M. Toriumi, MD.

Robert J. Toohill, MD Lecture (yearly)
This lectureship features a ‘physician-scientist who brings translational research to the bedside.’

Berrylin J. Ferguson, MD served as the first Robert J. Toohill Lecturer in 2013, and Timothy L. Smith, MD, MPH as the second in 2014.

Endoscopic Sinus Surgery and Rhinoplasty Course (yearly)
The course familiarizes and introduces techniques to expand and refine surgical skills, by combining didactic sessions, narrated dissections, and hands-on dissection of fresh cadavers.

Bronchoscopy Course (every other year)
The faculty runs an all-day course for the residents, which teaches principles of endoscopy in both adults and children. A laboratory session gives practical exposure in both canines and felines. University of Wisconsin-Madison faculty and residents are invited to attend.

Temporal Bone Dissection (yearly)
Faculty presents a series of lectures and directed dissections each year. All residents have 24-hour access to the temporal bone laboratory and human specimens for independent dissections.

Administrative Conferences

Education Working Group (every other month)
The Program Director invites faculty and residents to discuss various aspects of the residency. This informal conference has covered such topics as schedule implementation, technical standards, rotation effectiveness, call responsibilities, research experience, new conference development, the residency review process, programmatic suggestions, operative experience, and curriculum innovation.Research Conference

  Application Procedure

Our program is five years in length and we match three candidates per year. The application and match processes are administered by ERAS and the National Resident Matching Program (NRMP), per the Association of Academic Departments of Otolaryngology-Head and Neck Surgery.

All applicants must apply through ERAS. Your final application must include:

  1. ERAS Application
  2. At least 3 letters of recommendation from the faculty of your choice. (We recommend one letter from your OTO Department Chair and/or Program Director.)
  3. Dean's Letter
  4. Personal statement
  5. Medical School Transcript
  6. USMLE/COMLEX Scores
  7. Photo ID

*2017 applications must be submitted via ERAS by Saturday, October 15, 2017.

Interview dates are set for January 5 and 6, 2018.

International medical graduates must follow all ECFMG guidelines and apply through ERAS, in addition to supplying all of the documents listed above.

Thirty - Forty candidates are interviewed each year. An excellent way to learn about our program, and for us to get to know you, is to schedule an elective rotation with us. To find out more about away rotations at the Medical College of Wisconsin, visit the Medical College of Wisconsin Office of the Registrar or call (414) 955-8733.

Residency Contacts
Diann Fiscus
(414) 805-5609
dfiscus@mcw.edu

Alyssa Schwab
(414) 805-5671
alschwab@mcw.edu

Mailing Address
Otolaryngology
Froedtert Hospital
9200 W. Wisconsin Ave.
Milwaukee, WI 53226

  Benefits, Conditions & Terms of Employment

The Medical College of Wisconsin Affiliated Hospitals, Inc. (MCWAH) offers an excellent comprehensive benefits package. View MCWAH's Benefits,  Conditions & Terms of Employment.

David Poetker, MDDavid Poetker, MD
Residency Program Director and Professor
Division of Rhinology and Sinus Surgery
Department of Otolaryngology and Communication Sciences
Medical College of Wisconsin

Thomas Robey, MDThomas Robey, MD
Associate Residency Program Director and Associate Professor
Division of Pediatric Otolaryngology
Department of Otolaryngology and Communication Sciences
Medical College of Wisconsin

2016 Graduation Dinner

2016 Graduation Dinner

Locations

Our program is based at the Medical College of Wisconsin, a large private institution that serves Milwaukee, the state of Wisconsin, as well as surrounding states. Residents rotate through the college hospital service that is based at Froedtert Hospital, Children's Hospital of Wisconsin, and the Clement J. Zablocki VA Medical Center.

The experience at Children's Hospital of Wisconsin provides special expertise in the diagnosis, management, and treatment of infants and children with a broad range of pediatric otolaryngology.

The experience at Froedtert Hospital, and Zablocki provides unique opportunities to care for adult patients with a wide range of disorders. Specialty clinics in the evaluation of hearing and balance disorders, sleep disorders, sinus disease, head and neck cancer, and swallowing disorders are conducted with resident involvement.

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