The PGY-1 year is now administered by the Department of Otolaryngology and as such allows for rotations in fields more related to our specialty. Call is in-house or home, depending on the specific rotation.
The PGY-2 year provides a broad introduction to the medical and surgical management of patients encompassing all subspecialties of Otolaryngology. Exposure is particularly strong in general and pediatric otolaryngology, including management and surgery of difficult pediatric airways. Approximately 4-5 in-house calls are taken per month covering Upstate, Crouse, and the VA (Upstate and Crouse are physically connected and the VA is less than a block down the street). While on the Upstate rotation, residents takes in-house call each Friday. Backup is provided by the senior resident taking home call.
This is a multisubspecialty rotation with exposure to all aspects of Otolaryngology including pediatrics, head and neck surgery, facial plastic and reconstructive surgery (including trauma and craniofacial), laryngology, and rhinology. The service consists of a PGY-1, 2, 4, and 5 along with both adult and pediatric nurse-practitioners. The PGY-2 is involved in the management and care of all patients on the service and both inpatient and emergency department consults. Operative experience during this rotation is immediate and plentiful with a strong concentration in pediatrics, including pediatric airway cases. The PGY-2 resident also participates in a variety of craniofacial cases performed by our facial plastic surgeons and fellow such as cleft lip and palate repairs, pharyngeal flaps, cranioplasties for craniosynostosis, and repair of various craniofacial anomalies. While on this rotation, the resident spends one half-day per week in the University head and neck oncology clinic. An additional two days per month are spent in a general otolaryngology clinic with a facial plastics focus.
This rotation allows the resident an opportunity to work with our adjunct faculty members within the community. The service consists of a PGY-2 and 5. As the junior resident, there are an ample amount of general otolaryngology cases within the two ambulatory surgery centers on the Crouse campus. Tonsillectomy, adenoidectomy, myringotomy, uvulopalatopharyngoplasty, septoplasty, and functional endoscopic sinus surgery are performed almost daily at these centers. There is also the opportunity to scrub otology cases in the main OR performed by two fellowship-trained otologists that operate at Crouse. The resident is responsible for covering one half-day of laryngology clinic at Upstate weekly where the resident will obtain experience in evaluating patients with voice disorders. An additional half day per week, the resident will obtain experience in evaluating patients with hearing loss and chronic ear disease at one of our two weekly otology clinics. A few times per month, a third half-day is spent within the Cleft Palate and Craniofacial Clinic. There the resident will be actively involved in the multidisciplinary approach to evaluating and managing patients with various congenital anomalies. Additionally, the resident is responsible for preparing and presenting patients at the twice-monthly multidisciplinary Head and Neck Tumor Board.
This rotation allows the resident the opportunity to work as a specialist within the VA system. The service consists of a PGY-2 and 5. There are two full operative days per week and the junior resident operates with both the chief resident and attending on a variety of cases encompassing all disciplines of Otolaryngology. One operative day is dedicated to rhinology cases and allows the resident to work with our fellowship-trained rhinologist. There is an additional day dedicated to minor outpatient surgical procedures that allow the resident to learn the fundamentals of facial plastic and reconstructive surgery. While at the VAH, the resident is responsible for covering one full day of a general otolaryngology clinic at the VA.
The PGY-3 gains experience includes a significant rhinology and facial plastics caseload. Residents also begin their research projects during dedicated research time. Approximately 4-5 in-house calls are again taken covering Upstate, Crouse, and the VA. Backup is provided by the senior resident on home call.
This rotation provides a significant experience in rhinology and facial plastics surgery. Each week is split between our fellowship-trained facial plastics surgeons and our fellowship-trained rhinologist. The resident will learn the full breadth of cosmetic and reconstructive facial plastics surgery including clinical evaluation and operative management. Both clinical and operative time is spent with a focus on inflammatory nasal disease and tumors of the sinonasal cavity, and the skull base. The resident is also responsible for covering one half-day of head and neck clinic at Upstate weekly.
This is dedicated time that allows the resident to design and implement a research project under the direction of a faculty member. Opportunities are broad and collaboration with faculty at the College of Medicine and Syracuse University is common. Physical and monetary support is provided for both basic science and clinical research although funding through grants is strongly encouraged.
To comply with ACGME work hour regulations, this rotation was established to cover the post-call resident. The resident on this rotation covers either the PGY-2 or 3 who has been on in-house call the previous evening. This rotation is thus an amalgamation of the entire PGY-3 experience with the resident covering the clinical and operative workload at each site.
This rotation allows the resident to learn both the scientific principles and clinical applications of allergy testing and treatment. Time is spent with both a pediatric and adult general allergist at their office. Additionally, the resident spends time within the office of one of our adjunct faculty members, a past president of the American Academy of Otolaryngic Allergy. Each resident also attends the annual Resident Forum of the American Academy of Otolaryngic Allergy in Dallas, Texas, during either PGY-3 or 4.
The PGY-4 resident begins performing more complex head and neck cases and otologic cases with one of the fellowship-trained community otologists. A significant amount trauma reconstruction is also common. Call is now taken at home with the PGY-4 covering Community Campus and providing backup to the in-house junior resident on call. A stipend is also provided for attendance at meetings and conferences of the residents choosing.
The PGY-4 resident spends time performing more advanced cases in rhinology, laryngology, and head and neck cancer. A significant amount of traumatic reconstructive surgery is also performed with our facial plastic surgeons. As a senior resident on the service, the evaluation of inpatient and emergency department consults by the junior residents is overseen.
The resident performs a significant amount of otologic cases with a fellowship-trained otologist. Additional experience in general otolaryngology, particularly endoscopic sinus surgery is gained. A unique aspect of this rotation is temporomandibular joint surgery performed by one our adjunct faculty members, a DDS, MD. One day per week is spent with one of our adjunct faculty at St. Josephs who exclusively performs endocrine surgery. The resident will learn how to evaluate and manage patients with disorders of the thyroid and parathyroids and act as resident surgeon on all endocrine surgeries. One half-day per week is spent at University covering the pediatric otolaryngology clinic and one half day per week is spent covering the facial plastics clinic.
Research projects began during PGY-3 are continued. Poster and podium presentations at regional and national meetings are encouraged; additional funds beyond the general stipend are provided for each presentation. Manuscript submission is expected for at least one project prior to completion of the year.
The chief year entails a significant amount of operative experience. Surgeries encompass advanced cases within each subspecialty. Of particular note is neurotologic, anterior skull base, and advanced head and neck cancer ablations and reconstruction, including free flaps. The PGY-5 supervises and directs all patient care. The PGY-4 and PGY-5 residents are responsible for training junior residents as well as medical students on service. Home call is taken covering Community Campus and providing backup to the in-house junior resident on call.
The PGY-5 performs all advanced cases on the service. All subspecialties are represented at Upstate, and thus the operating experience is diverse. The rotation is particularly strong in head and neck ablation and reconstruction, complex craniomaxillofacial reconstruction, and neurotology.
Three days per week are spent performing otologic surgery with two fellowship-trained otologists. A variety of general otolaryngology cases are also covered including basic head and neck cases. The NICU at Crouse is responsible for neonatal airway evaluations and laryngotracheal reconstructions. Additional cases may be performed at two Crouse-affiliated ambulatory surgery centers within walking distance, particularly facial plastics cases with a community facial plastic surgeon, general plastic surgeons who are adjunct faculty of our department, and an oculoplastic surgeon. One half-day per week is spent in the University Hospital otology clinic.
The PGY-5 at the VA essentially runs the otolaryngology service, i.e. they schedule all elective cases. There are two operative days per week, one of which is dedicated to rhinologic cases with our fellowship-trained rhinologist. Facial plastics cases are also frequent as our facial plastics fellow has her own clinic at the VA. One entire day per week is dedicated to local procedures, the majority of which are skin lesions requiring resection and primary closure or local flap reconstruction. One day per week is spent within the VA general otolaryngology clinic.