Comfort Level Managing Common Head and Neck Disease

Abstract

Objective: 1) Assess comfort levels in managing common, primary care head and neck disease during the 4 years of medical school and the 3 years of primary care residency. 2) Learn where participants would refer if comfort levels were low.

Method: Cross-sectional survey using Survey Monkey (www.surveymonkey.com) of George Washington University medical students (n = 256), George Washington University medicine residents (n = 15), and Children’s National Medical Center residents (n = 50). Common head and neck diagnoses were surveyed (n = 24) using a Likert scale. Data were analyzed with Microsoft Excel.

Results: Throughout all years, respondents were most comfortable with the management of rhinitis/seasonal allergies, otitis media/externa, sinusitis, and epistaxis. Respondents were least comfortable in the management of tracheotomy care, persistent salivary gland swelling, and sudden hearing loss. Among all years, the majority of respondents would refer all conditions to an otolaryngologist with the exception of sleep apnea (pulmonology), vertigo (neurology), cleft lip (plastic surgery), facial nerve palsy (neurology), and thyroid nodules (general surgery).

Conclusion: Although there is a correlation between training year and comfort, there remains a number of conditions that respondents do not feel comfortable managing. In addition, although there is much debate as to which specialty is best to handle management, there tends to be a consensus across all training levels.