For Professionals

NewYork-Presbyterian

Otolaryngology Residency Training Program

About the Program

Photo of resident and advisor in the NewYork-Presbyterian ENT residency program faculty


Overall goals

  • To provide residents with education in the comprehensive evaluation, and medical and surgical management of patients of all ages having diseases and disorders of the ears, upper respiratory and upper alimentary systems and related structures, and the head and neck.
  • To provide residents with a set of core knowledge and understanding of the medical sciences relevant to the head and neck, upper respiratory and digestive systems, chemical senses, allergy, communication sciences including audiology, speech pathology, rehabilitation and the vestibular system, and endocrinology and neurology as they relate to the head and neck.
  • To provide residents with graduated responsibility in the diagnosis and medical treatment of disorders of the ears, upper respiratory and digestive systems and related structures of the head and neck, and in the surgical management of those disorders – including surgical indications, contraindications, perioperative care, and follow-up.
  • To train residents in the six core competencies: patient care, medical knowledge, interpersonal and communication skills, practice-based learning and improvement, professionalism, and systems-based practice.
  • To prepare residents for the independent practice of medicine and surgery at the completion of training.

Rotations

PGY-1

Columbia ENT is a busy but very rewarding 3-month rotation of your intern year. Along with a PGY5 and a rotating anesthesia intern, you are responsible for the adult inpatient service, including daily floor care, coordinating with consulting services, admissions, and discharges. You also get significant operative exposure, as primary surgeon in small pediatric cases (largely ear tubes, tonsillectomies, and adenoidectomies), as well as assistant surgeon in larger head and neck cases, including microvascular free tissue transfer. In addition, you help cover resident clinic, which includes both general and subspecialty clinics. The resident team follows clinic patients longitudinally, from initial visit and pre-operative evaluation through surgery to postoperative and long-term follow up. You also take "buddy call" with the PGY-4s during this rotation, which allows you to learn the basics of seeing consults and managing patients overnight and on the weekend but with the close supervision of a senior resident.

As an intern on the surgical intensive care unit at NYP-Columbia, you will have the opportunity to work in a well-supported, interdisciplinary team to manage medically-complex surgical patients. In typical ICU-style, you will learn to compartmentalize problems and manage these complex patients by organ system. You will be the primary contact for your patients, advocating for every step of their care from performing bedside procedures to liaising between surgical and medical teams following the patient. The rotation includes one to two 24-hour shifts per week, during which you will care for all of the patients on the unit overnight — requiring greater responsibility and autonomy, these shifts will challenge you and push you a step closer into becoming a competent resident and physician. This rotation is a great opportunity to work with your peers from anesthesia, emergency medicine, and various surgical subspecialties. You will also have many chances to learn, perform, and teach bedside procedures, from blood draws to bedside echocardiograms.

Columbia pediatric surgery is a one-month general surgery rotation completed during your intern year. You are typically on service with 1-2 other interns, as well as multiple more senior residents and additional physician assistants. Along with the other interns and PAs, you are responsible for the floor management of the inpatients on service. In addition, you spend a significant amount of time in the operating room, assisting with basic pediatric cases including appendectomies, cholecystectomies, inguinal hernias, and lymph node excisions. You also help with seeing consults during the day, which you manage with close oversight from more senior residents and fellows. You will take in-house call during this rotation, where you see consults independently and staff with your fellow who is on backup call at home. Overall this rotation helps build you confidence and independence with consults and helps you practice basic surgical technique.

The anesthesia rotation at Columbia is a chance for residents to see what happens on the other side of the curtain before, during, and after an operation. As an intern on anesthesia, you will have the opportunity to learn about immediate pre- and post-operative screening and care from the anesthesiology standpoint. Intra-operatively, there are various scenarios in which you will learn about the pharmacology and physiology involved in analgesia, sedation, and paralysis. In addition, there will be a plethora of procedures to practice, from IV and arterial line placement to intubation and other forms of airway management.

You spend 3 months during intern year on the Cornell ENT service. You are principally on the adult service. With the supervision of a PGY2 and PGY5, you and a rotating anesthesia intern are responsible for the inpatient management of the adult service, including basic floor work and communicating with consulting services. You also get the opportunity to operate, including acting as primary surgeon for small pediatric cases (i.e. tonsillectomies, adenoidectomies, myringotomies and tube placement) and some adult cases (i.e. tracheostomies), as well as assisting in larger cases. You are also typically in resident clinic 2-3 afternoons a week. This includes both general as well as subspecialty clinics. The resident team follows clinic patients longitudinally, from initial visit and preoperative evaluation through surgery to postoperative and long-term follow up. You also take "buddy call" with the PGY4s during this rotation, which allows you to learn the basics of seeing consults and managing patients overnight and on the weekend but with the close supervision of a senior resident.

You will spend one month as the intern on Cornell plastic surgery. During this rotation, you are responsible for the floor management of inpatients followed by the plastic surgery service. You typically share this responsibility with another intern. You also frequently get to assist in the operating room, where your teaching focuses primarily on wound-closure technique. This is also an opportunity to build rapport with the plastic surgery residents and attendings who you will work closely with during your ENT residency. You take weekend call approximately every other weekend; you cover daytime home call both days while nights are covered by general surgery.

You will spend one month as the intern on Cornell neurosurgery. During this rotation, you, along with a team of neurosurgery physician assistants, are responsible for the inpatient management of neurosurgery floor patients. You also spend multiple days each week in the operating room, typically assisting on cases that are performed in conjunction with ENT, including transsphenoidal approaches to the pituitary and anterior cervical discectomy and fusion surgeries. This is also an opportunity to build rapport with the neurosurgery residents and attendings who you will work closely with during your ENT residency. You take Saturday daytime call every weekend, where you manage floor patients with the oversight of both a junior and senior neurosurgery resident.

For your general surgery block, you join a busy trauma/general surgery service at Jamaica Hospital in queens. With the other two interns on service, you rotate on a 3-day 24-hour call, post-call, and "swing" schedule. On call, you are responsible for the inpatient management of all floor patients and also respond to and manage all traumas, with the assistance of your more senior residents. On "swing" days, you get a change to learn simple general surgery operations (including tracheostomies, gastrostomy tube placements, appendectomies, and others) and also assist in attending clinic. This extremely busy service pushes you to become an efficient and organized practitioner, and also gives you independence with inpatient management, in the operating room, and in clinic.

 

PGY-2

As the pediatric junior resident at Cornell, you develop your core skills of performing tonsillectomies, adenoidectomies, myringotomies and small soft tissue cases under the direct supervision of three great peds ENT faculty. The longitudinal 1 on 1 teaching allows them to track your surgical skills and tailor their teaching appropriately. Much of this time is spent at the DHK ambulatory center, where PA support allows you to focus on operating and not on patient transport, putting in orders and sending prescriptions. You are also the primary consult resident, who is responsible for seeing pediatric consults from the floors, ICU and emergency department. You staff these with your senior resident and eventually the attending as well. You are also responsible for floor management with the help of an anesthesia intern, and share primary call with a five-resident call pool.

As the head and neck junior resident at Cornell, you are exposed to a wide variety of head and neck surgical cases. You serve as primary surgeon on minor head and neck cases, including lymph node excision, tracheostomy, direct laryngoscopy and bronchoscopy, and adult tonsillectomy. When appropriate, you also serve as primary surgeon or first assistant on major head and neck cases, including neck dissection, thyroidectomy, and parotidectomy. You also serve as primary surgeon or first assistant on operative trauma cases, depending on the level of complexity. In addition to operative responsibilities, you spend 2-3 afternoons per week in resident clinic; you follow these patients longitudinally from initial presentation to surgery to post-operative care. You are also responsible for oversight of the floor management of the adult service by the intern on service, and share primary call at the Cornell campus in a five-resident call pool.

As the PGY-2 at Columbia, you serve as the primary adult and pediatrics consult resident. This exposes you to a wide range of pathologies, which helps develop your organizational and triage skills. You become very comfortable managing the range of common inpatient consults, including airway emergencies, foreign bodies, head and neck infections and facial trauma. In addition, you cover operative cases (both adult and pediatric cases) and assist in clinic as you are able. You spend two weeks of the 3 month block on night float and share weekend call in the five-resident call pool.

During your time as the PGY-2 at the VA medical center, you act as the sole resident for the ENT service on most days of the week, and are responsible for all surgical cases, consults, and clinic. As such, you have the opportunity book your own surgical cases, seeing patients both pre-and post-operatively, and follow them through all stages of treatment. Twice a week, you are also joined by a senior resident from Mount Sinai. During your time at the VA you do not have any weekend call responsibilities and instead take primary in-house call at Columbia in a five-resident weekend call pool.

 

PGY-3

As the PGY-3 at Cornell you serve as the primary adult consult resident. You also oversee consults seen by our wonderful ENT PA Melissa and round on any admitted consults who require active follow up. The PGY-3 surgical experience primarily focuses on sinus cases, however there is also exposure to laryngology procedures as well. You work with a number of different attendings learning endoscopic sinus surgery, septoplasty, and transsphenoidal approaches.

During your 3-month research block, all of your time is dedicated to research and you have no inpatient or call responsibilites. The research block is a very structured experience, and planning for the rotation begins early during your PGY2 year with identification of a primary research mentor, project proposal and critique by the resident research committee, and revision. Research mentors can be chosen from Cornell, Columbia, or MSK faculty, and faculty are always eager to work with residents. You are able to take advantage of the wealth of research support at both Columbia and Cornell including a dedicated IRB coordinator, statistical support, literature review staff at the library, and opportunities for financial funding for your project, if needed. Most research projects result in publication in well-regarded journals.

At Memorial Sloan Kettering, you serve as a member of the head and neck surgery team. You and your team members share the responsibility of managing inpatients, seeing consult patients, and operating. The surgical experience focuses primarily on open and endoscopic head and neck procedures and there is a wide range of case complexity. Many patients at Memorial Sloan Kettering have complex oncologic history, which makes cases challenging, interesting, and very valuable from an educational perspective.

As the third year resident at Columbia, you are gain both a wide range of operative experience as well as a great deal of autonomy with regard to patient care. You serve as the primary contact for established consult patients, and follow them longitudinally from presentation to resolution of their otolaryngology concerns. Additionally, you oversee Head and Neck Clinic, from diagnosis to surgical planning and long term follow up. You also coordinate a monthly multidisciplinary tumor board, adding depth to your understanding of the head and neck cancer patients you follow weekly throughout the block. Operative experience ranges from basic otology and rhinology cases to complex head and neck resections and reconstructions.

 

PGY-4

As the PGY-4 at Cornell, you serve as the chief of the Pediatric ENT service. Similar to your PGY4 responsibilities at Columbia, you oversee the inpatient management of admitted children with a wide range of complex medical issues including laryngotracheal stenosis, acute/chronic airway obstruction, congenital neck masses, neck/face/sinus infections, voice issues, among others. Many pediatric patients at Cornell also have complex comorbidities including organ transplants, cardiopulmonary anomalies, craniofacial syndromes and rare immune deficiencies. During this rotation, you also oversee all pediatric ENT consults seen by the consult resident. Operatively, you perform a wide variety of otologic, laryngological, facial plastic and reconstructive and advanced pediatric procedures. Common surgeries performed by the PGY4 include tympanoplasty, ossicular chain reconstruction, cochlear implantation, type 1 laryngoplasty, microdirect laryngoscopy with treatment of vocal fold pathology, septorhinoplasty, facial reconstruction of Mohs defects, open and/or endoscopic zenker’s diverticulectomy, pediatric rigid and flexible bronchoscopy, sistrunk excision for thyroglossal duct cyst, cleft lip and palate repairs, branchial cleft cyst excision and laryngotracheal reconstruction. You also often take junior residents through more basic pediatric cases including tracheostomy, adenotonsillectomy, turbinate reduction, incision and drainage of neck abscess and tympanostomy tube placement.

The rotation at Lincoln Hospital provides an incredible experience treating the underserved population of the South Bronx. Lincoln hospital is part of New York City's public hospital system, which serves as a safety net for many of the city's residents. Working with an excellent group of three attendings, you serve as the senior resident practicing a mix of general otolaryngology, head & neck surgery, and rhinology in both the outpatient and inpatient care setting. This rotation provides an opportunity to manage general otolaryngology conditions autonomously, while honing surgical skills performing subspecialty procedures. In addition, this rotation gives you the experience working in a community hospital center.

As the PGY-4 at Columbia, you, along with another PGY4, serve as the chief of the Pediatric ENT service. You oversee the inpatient management of admitted children with a wide range of complex medical issues including laryngotracheal stenosis, acute/chronic airway obstruction, congenital neck masses, neck/face/sinus infections, voice issues, among others. Many pediatric patients at Columbia also have complex comorbidities including organ transplants, cardiopulmonary anomalies, craniofacial syndromes and rare immune deficiencies. During this rotation, you also oversee all pediatric ENT consults seen by the consult resident. Operatively, you perform a wide variety of otologic, laryngological and advanced pediatric procedures. Common surgeries performed by the PGY-4 include tympanoplasty (both endoscopic and microscopic), ossicular chain reconstruction, cochlear implantation, type 1 laryngoplasty, vocal fold nodule/polyp excision, open and/or endoscopic zenker’s diverticulectomy, pediatric rigid and flexible bronchoscopy, sistrunk excision for thyroglossal duct cyst, branchial cleft cyst excision and laryngotracheal reconstruction. You also often take junior residents through more basic pediatric cases including tracheostomy, adenotonsillectomy, turbinate reduction, incision and drainage of neck abscess and tympanostomy tube placement.

 

PGY-5

As chief of the service at Columbia, you not only get more graduated, independent responsibility in managing floor patients but you also have administrative responsibilities in assigning OR coverage, clinic coverage, and developing the daily schedule. From an operative standpoint, you take on a larger role as primary surgeon in advanced head and neck cases. At Columbia we perform our own reconstruction after head and beck ablation so you will be relied upon to improve your microsurgical skills as the block progresses. You are responsible for overseeing proper management of consults during the day and serve as backup for consults during weeknights.

As the non-administrative chief resident, you are primarily an operative resident. You cover both advanced otology (tympanoplasty, ossiculoplasty, mastoidectomy, cochlear implantation, lateral skull base cases) as well as plastics cases (functional septorhinoplasty, Moh's reconstruction, cosmetic facial plastics) during the course of your rotation. You generally manage the resident Otology clinic with an Otology attending physician and cover responsibilities for the administrative chief when he/she is away. It is a wonderful opportunity to perfect previously learned techniques, and also given the light administrative load allows you to seek other operative/shadowing opportunities that will enhance your training before either an academic fellowship or private practice.

As the Cornell Red Chief you act as the head of the inpatient service and administrative manager of the Cornell team. Similar to Columbia, you manage the daily distribution of residents between the OR and clinic as well as oversee the adult consult and inpatient services. You are the primary surgeon for the majority of complex head and neck cases, and manage the head and neck clinic patients as well ensuring that they obtain a proper work up, performing the case as the primary surgeon in the OR, managing their post-operative care on the floor, and serving as continuity for their follow up visits. As the manager of the daily schedule, you also have the flexibility to scrub into general cases or cases relevant to your chosen subspecialty on days where the head and neck schedule allows. The red chief serves as back up call during the week and for a quarter of the weekends of a given block. Chief residents do not have any assigned primary call responsibilities. Finally, as the administrative chief, you work closely with the chair and site director to make improvements to the daily functioning of the service, and have the opportunity to choose and invite guest speakers for grand rounds.

Memorial Sloan Kettering Cancer Center has a large head and neck service with 12 attendings, 5 fellows, the NYP PGY-5 and PGY-3, and occasional rotators from the surgical oncology fellowship, endocrine fellowship and elsewhere. There is also a cadre of Physician Assistants who take care of all floor work, help with consults and assist in the OR with orders and retracting. As a PGY-5, you are an acting fellow and will be assigned to a team of attendings to run their service. You spend most of your time operating, both at the beautiful and well-run ambulatory surgery center as well as the main campus. The call pool is split amongst all fellows and rotators. You will continue to hone your skills as primary surgeon for thyroidectomy, parotidectomy, partial glossectomy and other major head and neck cases, as well as participate in large cases such as mandibulectomies and tracheal resections. There is a high volume of rare pathologies such as ameloblastomas and sarcomas which gives you good exposure to these important but infrequently-seen diseases.