Medical School Curriculum

First Year

OTOLARYNGOLOGY CLINICAL SKILLS
Instructor: Jason Rich, MD, 362-0365

Introductory lecture and group sessions pertaining to the complete head and neck examination. After the one-hour lecture, students will be divided into small groups to learn the otoscopic, nasal, oral cavity and neck examination to be proctored by physicians from the ENT department.


Second Year

M55 660B CLINICAL TOPICS IN OTOLARYNGOLOGY
Instructor: Brian Nussenbaum, MD, 362-6599

This course consists of eight introductory lectures on common diseases of the head and neck, including head and neck carcinoma, hearing loss, vertigo, neck masses, pediatric otolaryngology, salivary gland disorders, sinusitis, otolaryngologic emergencies and facial fractures. Each lecture is highlighted by case presentations and treatment options in addition to pathophysiology. This course follows the physical examination practicum given earlier in the academic year.


Third Year

M95 790 INTEGRATED SURGICAL DISCIPLINES CLERKSHIP
Duration: 12 Weeks, (3) 4-Week Rotations
Coursemaster: John Kirby, MD, Department of Surgery, Box 8109 (314)-362-5237
Clerkship Coordinator: Douglas Brown, PhD, Department of Surgery, Box 8109 (314)-362-5237 brownd@wudosis.wustl.edu

The 12-week third- year surgery clerkship is divid ed into three 4-week rotations. Students are assigned to one general surgery rotation, one sub specialty rotation, and one MSK or MSK alternative rotation. Approximately six weeks prior to the start of the clerkship, information concerning the clerkship and rotation selection process are distributed to the students via e-mail. Students rank their rotation preferences in each of the three categories. Students are assigned to rotations based on the ranked preferences they submit and the space available on each rotation. Certain combinations of rotations are disallowed to ensure a balanced experience among specialty and general surgery rotations. General Surgery Rotations can be taken at Barnes Hospital, VA, and ConnectCare and are specialized to some degree. Subspecialty rotation choices are : Anesthesiology, Cardio-Thoracic Surgery, Neurosurgery, Ophpthalmology, Otolaryngology, Pediatric Surgery, Plastic Surgery, Urolog ic Surgery, and Vascular Surgery. MSK rotations are split into two 2-week rotations on various services within the Department of Orthopedic Surgery (with the exceptions of Rheumatology and Sports Medicine rotations). Students must have access to transportation to participate on many of the MSK rotations; otherwise, they can choose an MSK alternative rotation in Neurosurgery or Plastic Surgery.

During the surgery clerkship, there is ample opportunity for students to spend time in the operating rooms; however, the primary focus is on outpatient clinics and the daily care and management of surgically treated patients. In addition, students attend the teaching conferences and rounds for their assigned services and will have some structured night call shifts during their general surgery rotation.

Throughout the 12-week surgery clerkship, students attend a core lecture/workshop series two afternoons during most weeks. This series covers a wide range of topics in general surgery as well as skills workshops in suturing technique, laparoscopic camera navigation, airway management, resuscitation techniques, and trauma. Several of the skills workshops utilize the Howard and Joyce Wood Simulation Center.

In addition to the lecture/workshop series, students attend small group tutorial sessions (approximately eight hours total) with an assigned general surgery faculty member for the duration of the clerkship. These tutorial sessions are arranged at mutually convenient times between the faculty member and the student group. These sessions provide students an opportunity to present and discuss clinical case scenarios (including the review of radiologic studies.
Students are welcome and encouraged to call Dr. Brown in the Surgical Education Office with any questions concerning the surgery clerkship (362-5237).

INTEGRATED SURGICAL DISCIPLINES CLERKSHIP (M95 790) MEETING PLACE:
Location: 9th floor of Wohl Hospital – Butcher Conference Room
Time: 7:30 AM , the 1st weekday of the clerkship rotation


Fourth Year Electives

M55 801 OTOLARYNGOLOGY
Instructor(s): Joel Goebel, M.D., 747-0553
Location: 9916 McMillan Hospital Building
Elective Contact: Maria Harrington, 747-0553
Other Information: Students considering a career in otolaryngology should speak to Dr. Goebel prior to scheduling this elective. Prior to first day of elective, student should contact Dr. Goebel to discuss options of elective and to ascertain starting time and location.
Enrollment limit per period: Limit 3/period for Weeks: 1, 5; Limit 2/period for Weeks: 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Four-week rotation includes evaluation of ENT problems presented to specialist for diagnosis and treatment. The student participates in the clinic, hospital and operating room. This also includes time on the Pediatric ENT Service, Audiology, Voice Laboratory and Vestibular Evaluation Laboratory. Option of rotation on the ENT Service at VAMC is available.

Student time distribution: Inpatient 40%, Outpatient 40%, Conferences/Lectures 20%; Primary Care 20%, Subspecialty Care 80%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: 50
On call/weekend responsibility: Every fourth day

M55 802 GENERAL OTOLARYNGOLOGY
Instructor(s): Joel Goebel, M.D., 747-0553
Location: 9916 McMillan Hospital Building
Elective Contact: Maria Harrington, 747-0553
Other Information: Students considering a career in otolaryngology should speak to Dr. Goebel prior to scheduling this elective. Prior to first day of elective, student should contact Dr. Goebel to discuss options of elective and to ascertain starting time and location.
Enrollment limit per period: 1
Valid start weeks for 2-week blocks are: Weeks 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, and 43.

This two-week elective is an extremely flexible program consisting of several options:

General Ear, Nose and Throat Service: Student functions as a junior resident at either Barnes-Jewish Hospital or St. Louis VA Medical Center — John Cochran Division. At Barnes-Jewish Hospital, participation in clinic, hospital inpatient and operating room settings would expose student to a broad spectrum of patients. At the VA Hospital the emphasis would be on head and neck tumors.

Head and Neck Service — Barnes-Jewish Hospital: Student functions as junior resident on ENT hospital floor with great deal of exposure to head and neck surgery.

Pediatric Otolaryngology — St. Louis Children’s Hospital: Student participates as a junior resident, involved in pre- and postoperative surgical care as well as outpatient medical care.

Preceptorships: Student is assigned to a private practitioner’s office, functioning in his/her office as well as hospital service.

Other options can be entertained and formulated according to the student’s particular needs. Students participating in this elective will be required to spend an afternoon or morning in the Audiology/Vestibular Laboratory learning fundamentals of audiological and vestibular evaluation. Attendance at Monday afternoon conferences as well as Grand Rounds on Wednesday mornings is expected.

Student time distribution: Inpatient 20%, Outpatient 70%, Conferences/Lectures 10%; Primary Care 40%, Subspecialty Care 60%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: 60
On call/weekend responsibility: None

M55 803 PEDIATRIC OTOLARYNGOLOGY
Instructor(s): David W. Molter, M.D., 454-2136
Location: 3S35 St. Louis Children's Hospital
Elective Contact: Patty Tampow, 454-2136
Other Information: Students should report to 3S35, St. Louis Children's Hospital, 8:30 a.m. first day of elective.
Enrollment limit per period: 2
This course is offered as either a 2 or 4 week duration.
Valid start weeks for 2-week or 4-week blocks are: Weeks 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41 and 43.

The student will actively participate in the clinical office, inpatient consultations and surgery with the attending staff at St. Louis Children's Hospital. Care would be taken to provide experience in the common problems one would see in primary care pediatrics or family practice. Participation in subspecialty/multidisciplinary clinics such as the Cleft and Craniofacial clinic is encouraged. Opportunity will be provided to learn the fundamentals of audiological evaluation. Students participating in this elective will attend academic conferences in both the pediatric and adult divisions.

Student time distribution: Inpatient 50%, Outpatient 40%, Conferences/Lectures 10%; Primary Care 30%, Subspecialty care 70%
Major teaching responsibility: Attending physician and residents
Patients seen/weekly: 100
On call/weekend responsibility: At student's discretion

M55 820 PRACTICUM IN ADULT CLINICAL AUDIOLOGY
Instructor(s): Michael Valente, Ph.D., 362-7489
Location: 11th Floor, Center for Advanced Medicine (CAM)
Elective Contact: Michael Valente, Ph.D., 362-7489
Other Information: Students should contact Dr. Valente to schedule this elective.
Enrollment limit per period: 8
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Guidance provided in the administration and interpretation of audiometric tests. Emphasis on defining the severity of auditory dysfunction in addition to identifying sites of pathological processes. Theoretical bases of acoustics, anatomy and physiology, and electronics reviewed as they relate to auditory assessment. Modification of conventional test paradigms and hearing aid procedures covered according to each student’s interests and needs.

Student time distribution: Inpatient 10%, Outpatient 80%, Conferences/Lectures 10%; Primary Care 50%, Subspecialty Care 50%
Major teaching responsibility: Audiology staff
Patients seen/weekly: 120
On call/weekend responsibility: None

M55 831 NEUROTOLOGY
Instructor(s): Joel Goebel, M.D., 747-0553
Location: 9th Floor McMillan Hospital Building
Elective Contact: Maria Harrington, 747-0553
Other Information: Students should contact Dr. Goebel if interested in this elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Active student participation in the physical exam, advanced testing, and management of patients with balance dysfunction. Attend patient clinic two days a week and test patients on ENG, rotary chair and computerized platform three days a week. Research participation welcome with prior arrangements.

Student time distribution: Outpatient 80%, Conferences/Lectures 20%; Primary Care 10%, Subspecialty Care 90%
Major teaching responsibility: Attending
Patients seen/weekly: 40
On call/weekend responsibility: None

M55 833 AMBULATORY OTOLARYNGOLOGY FOR THE PRIMARY CARE PHYSICIAN
Instructor(s): Joel Goebel, M.D., 747-0553
Location: Barnes-Jewish Hospital and St. Louis Children’s Hospital clinics
Elective Contact: Maria Harrington, 747-0553
Other Information: Students should contact Maria Harrington, 9906 McMillan Hospital Building, 747-0553, prior to the start of this elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This course offers a four-week exposure to ambulatory care of patients with diseases of the head and neck. Eight half-day sessions per week will be offered in attending clinics for general otolaryngology, head and neck cancer, otology and pediatric otolaryngology. Two half-day sessions are reserved for audiology, vestibular lab and voice lab experience. Surgical exposure is available for selected cases as identified by the student and attending physician, but the main goal of this rotation is outpatient diagnosis and management.

Student time distribution: Outpatient 100%; Primary Care 50%, Subspecialty Care 50%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: >100
On call/weekend responsibility: None


Research Opportunities

Students interested in acquiring research experience are welcome to review the lab web sites of our faculty and to approach them as potential mentors. See individual faculty bios for links to their lab pages or visit the Research Center for Auditory and Vestibular Studies. Additional information on local research opportunities for WashU undergraduate and medical students can be found in the 2012-2013 Guide to Student Research Opportunities.