PGY-5

The PGY-5 rotations are split evenly into 3-month blocks between the four major campus locations, and at each site, the PGY-5 functions as chief resident of service: Montefiore Einstein East, Montefiore Einstein West (chief of Head & Neck team), Jacobi, and Northwell. The Chief Resident is responsible for all patients in the assigned hospital's otolaryngology service and outpatient management. This year represents the highest level of responsibility for decision-making in inpatient management. The resident is responsible for weekly assignments of residents to surgical and clinic coverage, as well as supervision of the junior residents and the rotating medical students in conjunction with the faculty.

In the operating room, the Chief Resident shares responsible with the attending physician for teaching other residents. As surgeons, they perform the more intricate otologic, facial plastic and reconstructive, and head and neck surgery. Included will be advanced work in otoneurological and skull base surgery, phonosurgery, revision plastic and otologic cases, and complex endoscopic and conservational head and neck cases. They are trained in robotics, 3D imaging for localization, and other highly technical state-of-the-art procedures. At Montefiore Einstein West, the PGY-4 functions as chief resident of the peds team, but the PGY-5 may opt to take the lead resident role with respect to complex pediatric patients if necessary to bolster his or her educational experience.

On the day of graduation, which is usually on or about June 20, chief residents present the conclusion of their research to their peers, faculty, and the graduation guest speaker. Typical, this work has already led to or will lead to a peer review publication.

All PGY-5 residents give a full 60-minute grand rounds presentation on their chosen topic.

Once PGY-5 residents have cleared all of their key indicator minimums, they may seek approval of their site director and the program director to spend up to 1-week per rotation doing an elective of their design to enhance their education. Obtaining permission is contingent on satisfying the site director that all resident clinical responsibilities will be covered in the PGY-5’s absence. Furthermore, the PD must approve that the resident has an excellent standing in the residency program and that the proposed activity has appropriate design and supervision. Activities might include more time to finish a research project, a global health trip, or working in a private physician’s office.

One PGY-5 is selected by faculty to be Administrative Chief Resident, for which responsibilities include making yearly schedules, planning resident activities, and interacting with the Chair and Program Director about miscellaneous resident issues that arise over the course of the year.

In the spirit of leadership development, all PGY-5s are chiefs of not only their rotation but also of an administrative arena. These arenas include but are not limited to Academics, Global Health Initiatives, Resident Wellness, Medical Student Recruitment, Alumni Relations, and Quality Improvement.

PGY-5 Logistics

The PGY-5 on Moses West Head & Neck team ultimately has leadership responsibility for all resident-driven care of adult otolaryngology inpatients and consults. This includes assigning junior residents to surgical cases and clinics each week, medical student duties, coordinating this work with the peds chief resident, emailing weekly schedule to all residents and faculty, and assuring that hand-offs and communication with attendings and other services are performed appropriately. The PGY-5 reviews and sees all adult consults with the junior residents as well as provide backup support to the on-call residents, with attending backup for them. In the operating room, the West PGY5 performs complex pediatric surgery, numerous otologic procedures, advanced sinus surgery, and facial plastic surgery. This resident also covers the most complex head and neck surgical procedures, essentially functioning like a head and neck fellow for three months. Attend the H&N conference Monday 8-9 am, and the otology conference Monday 9-10 am.

The East PGY-5 functions as chief of the Moses East service. This includes assigning the East PGY-2 and 3 residents to surgical cases and clinics each week, medical student duties, emailing weekly schedules to all, and assuring that hand-offs and communication are managed appropriately regarding Weiler patients. This resident also covers the most complex surgical procedures, gaining insight into a “mini-fellowship” in certain subspecialties, particularly rhinology and laryngology. The PG-Y5 spends some time in subspecialty clinics to fortify clinical skills. They maintain awareness of these clinics, including the multispecialty allergy clinic, assigning coverage as indicated.

Rotation goals:

• Be comfortable with diagnosis and treatment of all outpatient conditions seen by subspecialists at a tertiary referral ambulatory care center.
• Provide effective leadership.
• Competently perform complex otolaryngology procedures in outpatients.

PGY-5 resident responsibilities at LIJ: The Chief Resident spends a large amount of their time in the operating room in the treatment of patients with significant diseases with a major leaning to Otology cases. They are in charge of daily resident assignments for cases in the OR and service patients' continued care. The Chief Resident reviews all consultations. They are responsible for setting up the call schedule as well as coordinating the presentation for the Mortality and Morbidity conference, Grand Rounds, Pathology, and Voice conferences.

The PGY-5 Jacobi rotation allows the chief resident the most responsibility and autonomy, with extensive experience running a service and clinic. Case volume is heavy in plastics, trauma, and head and neck. Lifestyle is easier here, allowing for wellness opportunities.