High-Density Otologic Camps in Regions of Sparse Expertise

Aims/Purpose: When 2 models of otologic surgery instruction in Ethiopia are compared, high-density otologic surgery campaigns are more effective for accelerated skills transfer in areas of sparse expertise than the standard outpatient clinic/OR model.

A continuously operating otolaryngology/head and neck surgery department in a large public hospital is compared with a nonprofit specialty hospital where outpatients are selected for weeklong surgical campaigns. The number and variety of otologic visits and operations in each setting, presence of expert supervision, and resident-trainees' surgical progress were tallied.

The public hospital saw 84 otologic operations in 1 full year. Meanwhile, the ear specialty surgical campaign site saw 185 otologic operations in 6 surgical campaign weeks. All operations at both sites were performed primarily by trainees. Experienced otologists supervised 40% of operations at the public hospital and 100% at the surgical campaign site. At the end of the year, none of the 10 resident-trainees in the public hospital were able to perform a simple underlay tympanoplasty, compared to 6 of 12 resident-trainees in the campaign setting.

Where otologic expertise is sparse, otologic surgical campaigns allow the most effective use of resources-patient pathology, medical facilities, trainee attendance, and imported instructors.