PGY-2

PGY2 residents have four 3-month blocks split evenly between each of our four campuses: Montefiore West, Montefiore East, Jacobi, and Northwell. Residents build on the PGY1 experience by accepting graduated responsibility in the ambulatory sites, hospital units, and operating rooms and by taking first call. In their training PGY2, residents are carefully supervised by the attending physicians and the more senior residents.

In the operating room, they assist in major operations and perform various procedures, refining techniques learned in the PGY1 year regarding tracheotomy, myringotomy, and adenotonsillectomy, while gaining exposure to techniques of septoplasty, basic sinus procedures, myringoplasty, lymph node biopsy, and adult endoscopy procedures. He/she improves familiarity with the use of the operating microscope and endoscopes.

As part of this and subsequent years, they will gain extensive experience in maxillofacial and penetrating and blunt trauma to the head and neck since JMC is a Level 1 trauma center. When on Moses West, the PGY2 is assigned to the pediatric otolaryngology team at the Children’s Hospital at Montefiore. This involves responsibility for all otolaryngology inpatients and being the point of first contact for inpatient and emergency room consults. The majority of most days on this rotation will be spent operating with one of our five pediatric otolaryngology attendings and, to a lesser extent, spending time with these attendings seeing outpatients.

At Moses East, the experience relates more toward outpatient surgery on adults and procedurally-oriented office hours, such as Botox injections, nasal endoscopy with debridement, turbinate coblation, and transnasal esophagoscopy. Whereas almost all pediatric care on the Moses campus happens on the West campus, the NICU is located in Weiler Hospital on the East campus, so residents there will have responsibility for children in the NICU with otolaryngology issues. They also cover Weiler Hospital, which is a level II Trauma Center and a 403-tertiary care hospital, and therefore generates some consults, but at a much lower rate than at Moses.

PGY-2 Logistics

The PGY2 on Moses West is assigned to the pediatrics team. This involves first response to all inpatient and ER consults from the Children’s Hospital at Montefiore. The pediatrics PGY2 is usually in the operating room every day and is expected to spend 1-2 sessions per week in the peds clinic when there are no cases to cover.

Some cross coverage between services is needed to comply with work hour regulations. When the PGY2 is post-call, operative coverage will be provided as needed from the Moses West PGY3 on the H&N team. When the West PGY3 is post-call, the peds PGY2 will assist with adult consults. Moses ped ORL team:

• Acquire competency in evaluating and treating common pediatric otolaryngology conditions.
• Gain familiarity in managing complex pediatric otolaryngology conditions.

The PGY2 assigned to Moses East gets an introduction to a primarily outpatient responsibility. Surgical responsibilities include covering general adult otolaryngology procedures such as laryngoscopy, nasal endoscopy, uvulopalatoplasty, and septoplasty. This resident has frequent exposure to general otolaryngology office hours, including an introduction to office-based procedures. The PGY2 also serves as the point of first contact for consults from adjacent Weiler Hospital, including the NICU, although this composes a minority of the experience relative to outpatient care rendered at the Hutch.

Rotation goals:

• Build a foundation for outpatient otolaryngology care
• Gain familiarity with common otolaryngology issues in a NICU
• Learn general otolaryngology surgical procedures in adults

PGY2 and 3 Resident Responsibilities at LIJ: Residents are exposed to extensive pediatric surgery and adult surgery due to the presence of both the adult and pediatric hospitals at LIJMC. CCMC (Cohen’s Children Medical Center) is a major pediatric tertiary referral center for Queens and Long Island.

They are introduced to the multidisciplinary management of patients with head and neck cancers with preoperative diagnostics, tumor board evaluations, and postoperative care. In the outpatient department, they are taught correct management of the patient, not only clinically but also how to navigate the health system and communicate with patients and their families. With its wealth of clinical material, the Hearing and Speech Center is available for teaching basic audiologic and speech principles.

PGY2's Jacobi rotation is their least busy rotation but is very popular because of the autonomy and opportunity to see more trauma than at other sites. For the PGY5 as well, the slower pace allows a valuable respite to plan, contemplate, and reflect. Although faculty supervise all patient care at Jacobi, residents have a particular sense that they are managing patients independently, which provides an opportunity for personal growth. Dr. Stupak, the site director, and the voluntary staff have facial plastics expertise, which is another strength of rotation. The PGY2 and 5 work together closely, allowing the junior resident a chance to learn perspectives from someone on the other end of the training experience.