Discussion

We designed and implemented two initiatives to foster interest in otolaryngology – head and neck surgery among first- and second-year medical students. Previous work on medical education strategies, specifically regarding otolaryngology – head and neck surgery skills workshops, has focused primarily on fourth-year medical students who had already decided to pursue otolaryngology – head and neck surgery.^{Reference Dermody, Masciello and Malekzadeh5,Reference Keilin, Farlow, Malloy and Bohm6} Our flexible laryngoscopy workshop and centralised research platform have facilitated early-career medical students’ exposure to and interest in the field, increased comfort with procedures, and improved access to mentorship and research resources.

Flexible laryngoscopy is a skill that residents are expected to master early in training. It takes six attempts, on average, for a novice medical student to become competent in performing flexible laryngoscopy.^{Reference Laeeq, Pandian, Skinner, Masood, Stewart and Weatherly7} Simulation training and repeated practice have been shown to decrease both time to visualisation and the number of mucosal contacts.^{Reference Deutschmann, Yunker, Cho, Andreassen, Beveridge and Bosch8} Given the ubiquity and importance of competency with laryngoscopy, it was chosen as the cornerstone of our workshop.

Eleven of 15 students who attended the workshop completed the survey (73.3 per cent response rate); students were in their first (72.7 per cent, n = 8) and second (27.3 per cent, n = 3) years (Figure 3a), with varying interest in procedural specialties (Figure 3b). Students’ perception of their knowledge of airway anatomy and related clinical scenarios significantly improved after the workshop (p = 0.001 and p = 0.002, respectively) (Figure 3c). All attendees indicated that the workshop increased comfort with procedures, and the students were ‘very likely’ to recommend the workshop to colleagues. Nearly half of the students (54.5 per cent) indicated they were ‘very interested’ in exploring otolaryngology – head and neck surgery further through an elective module after this workshop, indicating potential long-term effects of this initiative. The workshop enabled students to interact with otolaryngology – head and neck surgery residents and faculty, which may also facilitate mentorship.

Fig. 3. (a) Workshop survey respondents’ number of year(s) in medical school. (b) Post-workshop interest in procedural specialty. (c) Comfort level with airway anatomy and clinical scenarios, before and after workshop. Bar plot size represents median. Wilcoxon matched-pairs signed rank tests were used to compare and test statistical significance (p < 0.05).

Contribution to scientific literature is an important consideration for the rigorous otolaryngology – head and neck surgery residency application process.^{Reference Kaplan, Riedy and Grundfast4} The centralised research platform using Trello Board facilitates the sharing of information about otolaryngology – head and neck surgery specific conferences, research-related resources and ongoing projects in the department. It is a community resource being used by numerous faculty members, residents and students at our institution (Table 1). This centralised platform serves to foster collaboration across all levels of training, and ultimately helps trainees to develop relationships with faculty members for research and career mentorship.

Table 1. Cumulative Trello Board usage six months after implementation

*Active membership involves the creation, addition or modification of a research project card. ^†Medical students prior to the start of core rotations. ^‡Medical students after the start or completion of core rotations.

Implementation of the initiatives presented here are a first step towards early exposure to otolaryngology – head and neck surgery. Students with several years of early exposure to a specialty, rather than a few short weeks during their third or fourth year of medical school, may be better equipped to determine if that specialty aligns with their career goals.^{Reference Sethia, Sheehan, Danforth, Essig, Teknos and Elmaraghy9} Formalised mentorship programmes^{Reference Sethia, Sheehan, Danforth, Essig, Teknos and Elmaraghy9} that take place early in medical training and elective modules, both in-person and virtual,^{Reference Chao, Frost, Brody, Byrnes, Cannady and Luu10} can help students gain a more thorough understanding of the specialty and allow well-informed decisions about pursuing otolaryngology – head and neck surgery as a future career.