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J Otolaryngol Head Neck Surg. 2018 Jul 20;47(1):47. doi: 10.1186/s40463-018-0293-8.

Consultation diagnoses and procedures billed among recent graduates practicing general otolaryngology - head & neck surgery in Ontario, Canada.

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Department of Otolaryngology - Head & Neck Surgery, Surgical Oncology, University of Toronto, Sunnybrook Health Sciences Centre and Michael Garron Hospital, Toronto, ON, Canada.
Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada.
Department of Otolaryngology - Head & Neck Surgery, Sunnybrook Health Sciences Centre and the Odette Cancer Centre, Michael Garron Hospital, Endocrine Surgery, 2075 Bayview Ave., M1-102, Toronto, ON, M4N 3M5, Canada.
Department of Otolaryngology - Head & Neck Surgery, Hospital for Sick Children, Toronto, ON, Canada.
Department of Otolaryngology - Head & Neck Surgery, Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada.
Department of Otolaryngology - Head & Neck Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada.



An analysis of the scope of practice of recent Otolaryngology - Head and Neck Surgery (OHNS) graduates working as general otolaryngologists has not been previously performed. As Canadian OHNS residency programs implement competency-based training strategies, this data may be used to align residency curricula with the clinical and surgical practice of recent graduates.


Ontario billing data were used to identify the most common diagnostic and procedure codes used by general otolaryngologists issued a billing number between 2006 and 2012. The codes were categorized by OHNS subspecialty. Practitioners with a narrow range of procedure codes or a high rate of complex procedure codes, were deemed subspecialists and therefore excluded.


There were 108 recent graduates in a general practice identified. The most common diagnostic codes assigned to consultation billings were categorized as 'otology' (42%), 'general otolaryngology' (35%), 'rhinology' (17%) and 'head and neck' (4%). The most common procedure codes were categorized as 'general otolaryngology' (45%), 'otology' (23%), 'head and neck' (13%) and 'rhinology' (9%). The top 5 procedures were nasolaryngoscopy, ear microdebridement, myringotomy with insertion of ventilation tube, tonsillectomy, and turbinate reduction. Although otology encompassed a large proportion of procedures billed, tympanoplasty and mastoidectomy were surprisingly uncommon.


This is the first study to analyze the nature of the clinical and surgical cases managed by recent OHNS graduates. The findings demonstrated a prominent representation of 'otology', 'general' and 'rhinology' based consultation diagnoses and procedures. The data derived from the study needs to be considered as residency curricula are modified to satisfy competency-based requirements.


Consultation; Diagnoses; Medical education; Otolaryngology; Procedures; Recent graduates; Volume

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