CHONC study plan

Map the anatomic compartments of the head and neck (oral cavity, pharynx subsites, larynx, neck levels) and label them from memory on a blank diagram

Explain mucosal field cancerization, dysplasia-to-carcinoma progression, and the molecular drivers (TP53, CDKN2A, PIK3CA, HPV E6/E7) in your own words

Distinguish HPV-positive oropharyngeal biology from tobacco/alcohol-associated disease, including p16 as a surrogate marker

List the T and N categories for oral cavity, oropharynx, larynx, and nasopharynx and state the anatomic boundary that separates each adjacent category

Apply the AJCC staging rules to six written vignettes and assign stage group with justification for each T/N/M assignment

Differentiate the HPV-positive oropharyngeal staging system from the HPV-negative system and identify where they diverge

Sequence the pretreatment workup (history and exam, cross-sectional imaging, PET-CT indications, panendoscopy, dental evaluation, nutrition and speech baseline) for three clinical scenarios

Interpret the significance of extranodal extension, depth of invasion, and margin status in staging and prognosis

Construct a tumor board summary for four cases naming the disciplines involved and the specific question each consultant must answer

Compare primary surgical resection versus primary chemoradiation for locally advanced larynx and oropharynx cancer, listing selection factors that favor each

Describe when induction chemotherapy, concurrent systemic therapy, or adjuvant therapy after surgery is indicated and what evidence class supports it

Draft a shared-decision conversation outline covering voice, swallowing, and survival tradeoffs for a patient choosing between larynx preservation and total laryngectomy

Outline the steps and key anatomic hazards of neck dissection by level, including structures at risk (spinal accessory nerve, thoracic duct, marginal mandibular nerve, phrenic nerve)

Describe reconstructive ladder options (primary closure, local flaps, regional flaps, free tissue transfer) and match each to a defect scenario

Explain margin interpretation and the management implications of close versus positive margins

Identify perioperative risk factors and the elements of preoperative optimization for major head and neck resection

Explain fractionation principles, dose constraints for critical structures (spinal cord, parotids, mandible, larynx, constrictors), and the rationale for altered fractionation

Compare IMRT, VMAT, proton therapy, and brachytherapy in terms of indications and tradeoffs

Summarize mechanisms, common regimens, and major toxicities of platinum agents, taxanes, fluoropyrimidines, and checkpoint inhibitors

Describe acute versus late radiation toxicity timelines and the surveillance schedule after definitive treatment

Build a prehabilitation and rehabilitation timeline from diagnosis through 12 months posttreatment covering speech, swallowing, nutrition, and shoulder function

Distinguish trismus, dysphagia, xerostomia, osteoradionecrosis, and hypothyroidism by presentation, prevention, and management

Describe screening and management approaches for depression, distress, and caregiver burden in this population

Outline survivorship surveillance for recurrence, second primary tumors, and late effects, including the role of HPV-related risk stratification

Identify quality metrics relevant to head and neck cancer care (time to treatment, margin rates, nodal yield, unplanned readmission, tracheostomy outcomes) and describe how they are measured

Apply a root-cause analysis framework to a written near-miss scenario involving a mislabeled pathology specimen or a wrong-site procedure

Explain informed consent, capacity assessment, and conflict-of-interest principles as they apply to oncology practice

Describe the structure and function of an institutional review board and the ethical requirements for human-subjects research

Integrate all domains by working through eight mixed-discipline vignettes under timed conditions

Re-review every missed item from weeks 1 through 7 and write a corrected explanation for each

Recite from memory the high-yield staging boundaries, dose constraints, and toxicity timelines

Build a final-week review sheet limited to items you still miss on two consecutive attempts