BackgroundThere is significant variability in undergraduate Otolaryngology – Head and Neck Surgery (OTOHNS) curricula across Canadian medical schools. As part of an extracurricular program delivered jointly with other surgical specialties, the Surgical Exploration and Discovery (SEAD) program presents an opportunity for medical students to experience OTOHNS. The purpose of this study is to review the participation and outcome of OTOHNS in the SEAD program.MethodsThe SEAD program is a two-week, 80-hour, structured curriculum that exposes first-year medical students to nine surgical specialties across three domains: (1) operating room observerships, (2) career discussions with surgeons, and (3) simulation workshops. During observerships students watched or assisted in surgical cases over a 4-hour period. The one-hour career discussion provided a specialty overview and time for students’ questions. The simulation included four stations, each run by a surgeon or resident; students rotated in small groups to each station: epistaxis, peritonsillar abscess, tracheostomy, and ear examination. Participants completed questionnaires before and after the program to evaluate changes in career interests; self-assessment of knowledge and skills was also completed following each simulation. Baseline and final evaluations were compared using the Wilcoxon Signed-Rank test.ResultsSEAD participants showed significant improvement in knowledge and confidence in surgical skills specific to OTOHNS. The greatest knowledge gain was in ear examination, and greatest gain in confidence was in draining peritonsillar abscesses. The OTOHNS session received a mean rating of 4.8 on a 5-point scale and was the most popular surgical specialty participating in the program. Eight of the 18 participants were interested in OTOHNS as a career at baseline; over the course of the program, two students gained interest and two lost interest in OTOHNS as a potential career path, demonstrating the potential for helping students refine their career choice.ConclusionsParticipants were able to develop OTOHNS knowledge and surgical skills as well as refine their perspective on OTOHNS as a potential career option. These findings demonstrate the potential benefits of OTOHNS departments/divisions implementing observerships, simulations, and career information sessions in pre-clerkship medical education, either in the context of SEAD or as an independent initiative.Electronic supplementary materialThe online version of this article (doi:10.1186/s40463-015-0059-5) contains supplementary material, which is available to authorized users.

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F irearm injury is an important cause of death and disability. Canada's age-standardized firearm-related mortality rate ranks ninth highest among 36 peer Organisation for Economic Cooperation and Development countries. 1 Between 2013 and 2017, 16 of Canada's Census metropolitan areas experienced an increased rate of firearm-related violent crime. 2 During the same period, there was a 20% increase in the homicide rate in Canada, from 1.45 to 1.8 per 100 000 popu lation, with almost half (43%) of the increase occurring in Toronto. 3 One in 3 homicides in Canada in 2016 was firearm-related, and the proportion is increasing. 3 Although homicide by firearm frequently receives prominent media attention, the majority (79%) of firearm-related deaths in Canada are caused by suicide. 4-6 Suicide is the second-leading cause of death in young people in Canada, and suicide by firearm carries the highest case fatality of all methods. 7 Data from 2 decades ago showed that older men in rural areas were disproportionately affected by suicide by firearms and that there were no differences in suicide rates across the urban-rural continuum for women. 8 Canadian statistics on firearm injuries have focused primarily on homicides and completed suicides. 9-13 Excluding nonfatal injuries substantially underestimates the burden of disease second ary to firearm injuries. 14 Nonfatal firearm injuries can lead to lasting morbidity, with major sequela that affect not only the victim but also the family. 14-17 In addition, both fatal and nonfatal firearm-related injuries place a major burden on the health care system. 16 However, nonfatal firearm-related injuries in Canada are largely unmeasured. Delineating the actual burden of firearm-related injury is essential to a coordinated public health response to this preventable cause of morbidity and mortality. Our primary objective was to describe the burden, baseline characteristics and regional rates of firearm-related injury and death in Ontario.