New paradigm for faculty and resident clinical care roles
Continuing resident involvement in clinical activities is considered a critical aspect of ongoing resident education. This priority has been previously described by the head and neck surgery department in Lombardy, Italy 5. The traditional hierarchy of junior residents performing primary assessment of patients guided by a senior resident is disrupted for two reasons. First the cohort system requires more manpower for daily assignments. Second, in order to reduce the number of at risk exposures, involvement of an experienced clinician is critical at the earliest phase of clinical interactions. In the new paradigm, detailed management of urgent otolaryngologic issues could be discussed as they arose through one-on-one discussion, in small groups, and in group video conferences, with special attention paid to the unique impact of the ongoing pandemic on clinical decision-making. Certain activities once considered routine for a head and neck surgeon, such as bedside endoscopy or tracheotomy change, now pose potential risk to the surgeon and trainee. Consideration is given to which patients require such procedures and who should be present. There were also opportunities to discuss evolving appropriate use and re-use guidelines as well as proper donning and doffing of personal protective equipment.