New Application: Pediatric Otolaryngology Review Committee for Otolaryngology acgme



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New Application: Pediatric Otolaryngology

Review Committee for Otolaryngology

ACGME


Program Personnel and Resources
Program Director
Is there a supervision policy that specifies lines of responsibility for fellows and faculty members, as well as for residents and other learners? [PR II.A.3.e)] ☐ YES ☐ NO
Faculty
Indicate whether appropriately-qualified faculty members from the disciplines listed below will participate in the program. [PR II.B.7.a)-m)]


  1. Anesthesiology ☐ YES ☐ NO

  2. Audiology and speech pathology ☐ YES ☐ NO

  3. Child and adolescent psychiatry ☐ YES ☐ NO

  4. Gastroenterology ☐ YES ☐ NO

  5. Medical genetics ☐ YES ☐ NO

  6. Neonatology ☐ YES ☐ NO

  7. Neurology ☐ YES ☐ NO

  8. Pathology ☐ YES ☐ NO

  9. Plastic surgery ☐ YES ☐ NO

  10. Prenatal and fetal medicine ☐ YES ☐ NO

  11. Pulmonology ☐ YES ☐ NO

  12. Radiology ☐ YES ☐ NO

  13. Sleep medicine ☐ YES ☐ NO


Resources


  1. Briefly describe the inpatient and outpatient facilities available to the program [PR II.D.1.a)]




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  1. Indicate whether the following are available at the participating sites. [PR II.D.1.b)-e)]







Site #1

Site #2

Site #3

Site #4

Site #5

Site #6

An emergency department













Neonatal intensive care unit













Pediatric intensive care unit













Facilities for the diagnostic assessment of infants and children with otolaryngologic disorders, including:













Audiologic assessment













Voice assessment













Speech assessment













Language assessment













Developmental assessment













Facilities to support clinical research
















  1. Describe how fellows will be provided with prompt reliable systems for communication and interaction with supervising physicians. [PR II.D.2.]




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Fellow Appointments - Other Learners
Briefly describe how the program director will ensure the presence of other learners, including otolaryngology residents, residents from other specialties, unaccredited pediatric otolaryngology fellows, other subspecialty fellows, PhD students, and nurse practitioners, will not interfere with the appointed fellows’ education. [PR III.C.]


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Educational Program
Patient Care


  1. Indicate the settings and activities in which fellows will demonstrate competence in each of the following areas of patient care. Also indicate the method(s) used to assess competence.




Competency Area

Settings/Activities

Assessment Method(s)

Evaluating neonates, infants, children, and adolescents 18 years and younger with congenital abnormalities, infectious and inflammatory disorders, and inherited and acquired conditions of the head and neck, including hearing loss and other communication impairments

[PR IV.A.2.a).(2).(a)]



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Diagnosing and managing the medical and surgical treatment of the aerodigestive tract, ear, nose, sinus, throat, voice and speech, and head and neck, and disorders of neonates, infants, children, and adolescents 18 years and younger

[PR IV.A.2.a).(2).(b)]



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Performing procedures, with an emphasis on neonates, infants, children younger than three years of age, and children and adolescents with significant co-morbidities as defined by American Society of Anesthesiology (ASA) status, in the following surgical domains: [PR IV.A.2.a).(2).(c).(i)-(ix)]

Closed and open airways

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Congenital anomalies

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Endoscopic airways

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Facial plastics

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Facial trauma

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Head and neck surgery

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Otology

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Rhinology

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Complex and uncommon pediatric procedures infrequently encountered in the general practice of otolaryngology

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  1. For each participating site, include all operations performed on the pediatric otolaryngology service during the most recently-completed academic year. [PR IV.A.2.a).(3)]




PROCEDURE(S)

CPT Code(s)

Site #1

Site #2

Site #3

Site #4

Site #5

Site #6

Total

Congenital Anomalies Domain

Branchial cleft anomaly excision

42810; 42815

#

#

#

#

#

#

#

Thyroglossal duct cyst excision

60280; 60281

#

#

#

#

#

#

#

Dermoid cyst/ Glioma/ Encephalocele excision

30117; 30118; 30124; 30125

#

#

#

#

#

#

#

Hemangioma, lymphatic or vascular malformation excision

11440; 11441; 11442; 11443; 11444; 11446; 38550; 38555

#

#

#

#

#

#

#

Ranula excision

42408; 42409; 42450

#

#

#

#

#

#

#

Head and Neck Surgery Domain

Drainage deep neck abscess (age < 3 years or ASA > II)

21501; 41015; 41016; 41017; 41018; 42300; 42305; 42320

#

#

#

#

#

#

#

Retropharyngeal space (RP) abscess

Parapharyngeal space (PPS) abscess

– internal approach


42720

#

#

#

#

#

#

#

Retropharyngeal space (RP) abscess

Parapharyngeal space (PPS) abscess



– external approach

42725

#

#

#

#

#

#

#

Excision angiofibroma or other nasopharyngeal tumor

30118; 31040

#

#

#

#

#

#

#

Parotidectomy

42410; 42415; 42420; 42425; 42426

#

#

#

#

#

#

#

Submandibular gland excision

42440

#

#

#

#

#

#

#

Thyroidectomy

60210; 60212; 60220; 60225; 60240; 60252; 60254; 60260; 60270; 60271

#

#

#

#

#

#

#

Otology Domain

Mastoidectomy

61530; 61596; 69501; 69502; 69505; 69511; 69530; 69601; 69602; 69603; 69604; 69605; 69635; 69636; 69637; 69641; 69642; 69643; 69644; 69645; 69646; 69670; 69955

#

#

#

#

#

#

#

Ossicular reconstruction

69632; 69633; 69636; 69637; 69642; 69644; 69646

#

#

#

#

#

#

#

Cochlear implant

69930

#

#

#

#

#

#

#

Osseo-integrated implant

69710; 69714

#

#

#

#

#

#

#

Closed Airway Procedure Domain

Tracheostomy (age < 3 years)

31601

#

#

#

#

#

#

#

Open Airway Procedure Domain

Thyrotomy (Laryngofissure)

31300; 31320

#

#

#

#

#

#

#

Laryngoplasty / Laryngotracheoplasty

31580; 31582; 31584; 31587; 31588

#

#

#

#

#

#

#

Cricotracheal / Tracheal resection and repair

31780

#

#

#

#

#

#

#

Endoscopy with Intervention Domain

Laryngoscopy and intervention

31400; 31527; 31528; 31529; 31530; 31531; 31535; 31536; 31540; 31541; 31545; 31546; 31560; 31561; 31570; 31571; 31599

#

#

#

#

#

#

#

Bronchoscopy and intervention

31623; 31624; 31625; 31630; 31631; 31635; 31636; 31638; 31640; 31641; 31656

#

#

#

#

#

#

#

Esophagoscopy and intervention

43201; 43202; 43204; 43215; 43216; 43217; 43219; 43220; 43226; 43228

#

#

#

#

#

#

#

Rhinology Domain

Sinonasal endoscopic (age < 13 years or ASA > II)

31237; 31240; 31254; 31255; 31256; 31267; 31276; 31287; 31288

#

#

#

#

#

#

#

Endoscopic sinonasal, extended

31290; 31291; 31292; 31293; 31294

#

#

#

#

#

#

#

Repair choanal atresia

30540; 30545

#

#

#

#

#

#

#

Facial Plastics Domain

Otoplasty

69300

#

#

#

#

#

#

#

Cleft repair – lip

40700; 40701; 40702; 40720; 40761

#

#

#

#

#

#

#

Cleft repair – palate

42200; 42205; 42210; 42215; 42220; 42225; 42226; 42227; 42235

#

#

#

#

#

#

#

Pharyngoplasty / Pharyngeal flap

42225; 42950

#

#

#

#

#

#

#

Mandibular osteotomy

21195

#

#

#

#

#

#

#

Placement mandibular craniofacial distraction device

21110

#

#

#

#

#

#

#

Reconstruction microtic ear, any stage

21230; 14061

#

#

#

#

#

#

#

Repair complex lacerations (all sites, including intraoral)

13120; 13121; 13122; 13131; 13132; 13133; 13150; 13151; 13152; 13153

#

#

#

#

#

#

#


Medical Knowledge
Indicate the activities (lectures, conferences, journal clubs, clinical teaching rounds, etc.) in which fellows will demonstrate proficiency in their knowledge of the following area. Also indicate the method(s) that will be used to assess fellow proficiency.


Proficiency Area

Settings/Activities

Assessment Method(s)

Medical and surgical management of neonatal, infant, childhood, and adolescent diseases of the head and neck to a level appropriate for unsupervised practice as defined by the didactic curriculum.

[PR IV.A.2.b).(1)]



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Practice-based Learning and Improvement


  1. Briefly describe one planned quality improvement activity or project that will allow the fellow to demonstrate an ability to analyze, improve, and change practice or patient care. Describe planning, implementation, evaluation, and provisions of faculty member support and supervision that will guide this process. [PR IV.A.2.c).(1)] (Limit response to 400 words)




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  1. Briefly describe one example of a learning activity in which fellows engage to develop the skills needed to use information technology to locate, appraise, and assimilate evidence from scientific studies and apply it to their patients' health problems. [PR IV.A.2.c).(2)] (Limit response to 400 words)

The description should include:



  • Locating information

  • Appraising information

  • Assimilating evidence information (from scientific studies)

  • Applying information to patient care




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Interpersonal and Communication Skills
Briefly describe one learning activity in which fellows demonstrate competence in interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. [PR IV.A.2.d)] (Limit response to 400 words)


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Professionalism


  1. Briefly describe the learning activity(ies), other than lecture, by which fellows demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. [PR IV.A.2.e)] (Limit response to 400 words)




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2. Briefly describe one learning activity in which fellows demonstrate competence in advocating for quality patient care when facilitating patient management in the home, school, or institutional setting. [PR IV.A.2.e).(1)] (Limit response to 400 words)




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Systems-based Practice
Describe the learning activity(ies) through which fellows demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. [PR IV.A.2.f)] (Limit response to 400 words)


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Fellow_Experiences'>Curriculum Organization and Fellow Experiences


  1. List the conferences for all participating sites in the program. Include the date/time, leader, and topic. Add rows as necessary. [PR IV.A.3.a)]




Conference

Site #

Date/Time

Leader

Topic





































































































































































































































  1. Describe how fellows will participate in the above conferences. What kind of responsibility will fellows have for preparation and presentation? How will attendance be documented? [PR IV.A.3.a).(3)-(5)]




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  1. Describe how fellows will participate in a multidisciplinary, interdisciplinary team to manage and treat conditions for at least three of the following: cochlear implant, craniofacial disorders, tumors, or vascular anomalies. [PR IV.A.3.b).(1)]




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Evaluation
Formative Evaluation
How will the program director ensure the balanced progress of each fellow towards achieving experience with a variety and complexity of surgical procedures? [PR V.A.2.d)]


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Program Evaluation and Improvement


  1. Describe how the program will review program goals and objectives and program effectiveness in achieving them. [PR V.C.4.]




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  1. Will at least one fellow participate in these reviews? [PR V.C.4.] ☐ YES ☐ NO

If “NO,” explain.



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Fellow Duty Hours in the Learning and Working Environment
Clinical Responsibilities
Describe the composition of the surgical team and how work will be assigned to the caregiver team members based on each individual’s level of education, experience, and competence. [PR VI.E.2.-3.]


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Teamwork


  1. Describe how fellows will collaborate with surgical residents, and with faculty members, other physicians outside of their specialty, and non-traditional health care providers, to best formulate treatment plans for an increasingly diverse patient population. [PR VI.F.2.]




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  1. Describe how the program director will ensure that fellows assume personal responsibility to complete all tasks to which they are assigned (or which they voluntarily assume) in a timely fashion. [PR VI.F.3.]




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  1. Describe how lines of authority will be defined by the program, and how all fellows will have a working knowledge of expected reporting relationships to maximize quality care and patient safety. [PR VI.F.4.]




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Pediatric Otolaryngology Updated 8/2015

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