Residency Program

At Weill Cornell Medical College, we jointly sponsor a residency training program with our colleagues in the Department of Otolaryngology-Head and Neck Surgery at Columbia University College of Physicians and Surgeons. Our residency program is fully accredited by the ACGME and includes rotations at New York-Presbyterian Hospital/Weill Cornell Center on East 68th Street, New York-Presbyterian Hospital/Columbia Center on West 168th Street and Memorial Sloan-Kettering Cancer Center. We accept 4 residents per year. The Department Chairman at Columbia is Lawrence R. Lustig, MD.

Read more about the residency program, and on the rotations at NewYork-Presbyterian/Columbia and Memorial Sloan-Kettering.

If you have any questions about our program please feel free to contact Iris Bernard, Residency Coordinator at (212) 305-3399.

Applications for Residency Training. Like all other Otolaryngology programs, we will be using the NRMP for the 2015 residency match. Applications for residency can be completed using the MyERAS website - http://www.nrmp.org/residency/main-residency-match/#. Apply to ACGME program #2803511074: NewYork-Presbyterian Hospital/Columbia and Weill Cornell. Interview dates will be announced in the near future.

Residency Rotations. Of a total of 60 months of training, residents spend 27 months at Weill Cornell, 24 months at Columbia, 6 months at Memorial Sloan-Kettering and 3 months on research. Some detailed information on the rotation at Weill Cornell is included below.

General Goals and Objectives: All Sites

The Otolaryngology/Head and Neck Surgery Residency Training Program of NewYork-Presbyterian Hospital provides residents with complete education in the comprehensive medical and surgical care of patients with diseases and disorders that affect the ears, nose throat, head, and neck. The educational program combines core basic science knowledge of otolaryngology and the communication sciences with the clinical aspects of diagnosis and medical and/or surgical therapy for related ailments.

General Goals and Objectives: NewYork-Presbyterian/Weill Cornell

First Year Residents PGY-2 [OTO-1]

Educational Program

Knowledge Base: At the completion of the first year of specialty training, the resident will have the following knowledge:

  • Basic science knowledge as contained in the 1st year of the Basic Science Course, including anatomy, physiology, embryology, pathology, genetics, the upper aerodigestive tract; the communication sciences (including audiology and speech pathology and rehabilitation); the chemical senses; prevention of disease; neoplasms, deformities, and disorders of the ears, face, neck, and mandible; plastic and reconstructive surgery; and allergy, endocrinology and neurology as they relate to the head and neck
  • Thorough knowledge of head and neck anatomy [through detailed dissection during the Head and Neck Anatomy course]
  • Understanding of the indications, risks, contraindications of a wide variety of Otolaryngologic surgical procedures for adult and pediatric patients.
  • Understanding and knowledge of temporal bone anatomy, mastoid drilling technique, middle ear prostheses placement, implantable hearing devices
  • Understanding of treatment of maxillofacial trauma using plating techniques
  • Knowledge level demonstrated by above average performance, as compared to Program Year peers nationally, on annual in-service examination

Clinical Skills Development

By the end of the first year of training, the resident should have been trained in the following skills and procedures:

  • Medical histories and physical examinations of the head and neck
  • Evaluation and treatment of common adult otolaryngologic problems [both inpatient and outpatient]
  • Placement of IV's; drawing blood; performing ABG's
  • Case presentations at morning and afternoon rounds
  • Preoperative and postoperative evaluations of patients, admissions and discharges
  • Management of the service with guidance from the chief residents and relevant Attendings, and/or Director of Resident Education
  • Triaging and initiating care of otolaryngologic emergencies [both adult and pediatric] with supervision of Chief Residents and Attendings
  • Performance of the following procedures: Tracheotomy, trach changes, tonsillectomy and adenoidectomy, closed reduction of nasal fractures, microscopic otoscopy and myringotomy and tube (M&T) insertion, fiberoptic laryngoscopy, flexible laryngoscopy, fine needle aspiration biopsies, oral biopsies, minor surgical procedures (ear lobe repair, incision and drainage, minor excisions, soft tissue trauma), microscopic ear examination with cerumen removal, treatment of epistaxis.
  • Development of personal style should include: self-assessment regarding work quality, ethical practice; ability to work as part of a team, and within a health care network; short-term planning, long-term planning; meticulous record keeping, including medical chart notes, informed consent, clinical administrative reports as assigned; efficient work habits.

Resident Duties

These include:

  • Responsible for the daily care of the adult inpatient service
  • Performs medical histories and physical examinations
  • Identifies and treats common problems, i.e. Place IV's, draw blood, perform ABG's, present at morning and afternoon rounds
  • Performs preoperative and postoperative evaluations of patients, admissions and discharges
  • Manages the service with guidance from the chief residents and relevant Attendings, and/or Director of Resident Education
  • Required to be in clinic as assigned by the Program Director and/or Chief Resident
  • Participates in the weekly basic science lecture series
  • Attends all required courses and conferences
  • Responsible for emergency room consults (with the supervision of an Attending and Chief Resident)
  • The tracheotomy resident schedules and performs preoperative evaluations. The resident reviews the chart, subsequently discusses the appropriateness of the procedure with the Attending, and coordinates with Anesthesia and the primary care team regarding time and date of the surgery.

Progression of Responsibilities

  • By learning to evaluate inpatient and emergency consults, by contributing to the post-operative care of a wide variety of Otolaryngology patients, by operating as outlined below, and by being in charge of the tracheotomy service, the first resident acquires skills that prepare him/her for increasing responsibilities as a second year resident.
  • Clinical Skill Progression
Definitions used throughout this description

regarding clinical procedures and operations:

  • General Supervision (the treatment/procedure is furnished under the Supervising Physician's overall direction and control, but the Supervising Physician's presence is not required during the performance of the procedure/treatment).
  • Direct supervision (the Supervising Physician must be present in the office suite or in the unit (as applicable), and immediately available to furnish assistance and direction throughout the performance of the treatment/procedure. It does not mean that the Supervising Physician must be present in the room when the treatment/procedure is being performed).
  • Direct Visual Supervision (the Supervising Physician must be in attendance with the patient and the resident while supervising the performance of the treatment/procedure).
    • Procedures are performed under direct visual supervision of an attending physician.
    • After a resident is duly assessed, the Attending will supervise directly the following procedures:

Procedures and Supervision

Procedure Level of Supervision Supervisor Number Required Comments
Tracheotomy

Trach Changes
Direct-Visual

Direct
Attending 24 They will not perform this procedure unsupervised, except in a life threatening emergency. Direct visual supervision until determined by the chief resident that they may do it alone.
Tonsillectomy and Adenoidectomy Direct-Visual Attending 20 After adequate experience is determined by the Attending they will be able to perform this technique under direct visual supervision.
Closed Reduction of Nasal Fractures Direct-Visual Attending 3 After 3-5 complete reductions, as determined by the Attending, they will be able to perform this technique under direct visual supervision.
Microscopic otoscopy and myringotomy and tube (M&T) insertion Direct-Visual Attending 16 After performing 20 procedures they should be able to perform this technique under direct visual supervision.

Second Year Residents PGY-3 [OTO-2]

Educational Program

Knowledge Base: Ther Resident:

  • Continues to attend 2nd year of (2 year cycle) Basic Science Series, during which content emphasized includes: radiologic oncology, laser physics, wound healing, laryngeal physics, voice measurement, language development, acoustics, auditory brainstem response, otoacoustic emissions, impact of hearing loss.
  • Via Microvascular Surgery Course, understands the physiology of and repair techniques for small vessels [This course may be taken in either the 2nd or 3rd year of specialty training.]
  • Understands the rationale, content and implementation of diagnostic workup for neoplasms; accomplished by literature review, and case presentations at the interdisciplinary Head and Neck Tumor Board.
  • Knowledge level demonstrated by above average performance, as compared to Program Year peers nationally, on annual in-service examination

Clinical Skills Development

The resident:

  • Builds on clinical skills developed as a first year resident.
  • Develops skill with lasers including CO2, YAG and Argon beam after proper requirements are met (under direct visual supervision of Attendings)
  • Develops skill with the following procedures: submandibular gland excision, thyroglossal duct cyst excisions, septoplasty, turbinectomy, and basic nasal endoscopy including minimal FESS as well as Caldwell Luc procedures
  • Develops skill in fracture management

Resident Duties

  • Performs all first year responsibilities under direct visual supervision; progressively adds additional procedures and responsibilities to armamentarium.
  • Presents tumor cases at tumor conferences. Under guidance of Attendings, organizes the content of presentations for this conference.
  • Performs Panendoscopy (direct laryngoscopy, esophagoscopy and bronchoscopy) in the operating room.[1]
  • Performs laser procedures[1]
  • Assists in all tumor surgical cases.
  • As Consult Resident, is responsible for seeing and following adult consults service, as well as tending to adult ER consultations. This resident should formulate a plan and institute it after discussing the cases with the chief and/or Attending.
  • Responsible for scheduling surgeries.
  • Carries out mandible, trimalar and other basic fracture cases. [1]
  • Other surgeries for the second year include submandibular gland excision, thryoglossal duct cyst excisions, septoplasty, turbinectomy, and basic nasal endoscopy including minimal FESS as well as Caldwell Luc procedures. [1]
  • Assists on major surgical procedures.
  • Develops skill with lasers including CO2, YAG and Argon beam after proper requirements are met. These surgeries should be performed under direct visual supervision with the exception of septoplasty and turbinectomy, which can be performed under direct supervision after the resident has completed more than 20 -30 cases.
  • Attends rounds every AM & PM and is expected to take night call.
  • Attends all required courses and Grand Rounds.

Progression of Responsibilities

  • By being in charge of the adult and ER consults, formulating diagnoses and treatment plans with the Chief Resident and Attending, participating in the multidisciplinary Tumor Board conference, and by operating, the 2nd year resident acquires skills that prepare him/her for the increasing responsibilities of the OTO 3 year.
  • Permitted to perform medical histories and physical examinations and to record such in patient charts. Also, formulation regarding diagnosis, treatment plans, progress notes and doctor's orders may be recorded in patient charts.
  • Permitted to perform all the above and all procedures that a first year resident may perform, plus the following additional procedures listed below. These procedures are performed under the direct visual supervision of an Attending physician. After residents have completed the minimum required number, the resident may perform these procedures under direct supervision.

Procedures and Supervision

Procedure Level of Supervision Supervisor Number Required Comments
Submandilar Gland Excision Direct-Visual Attending 4 They will not perform this procedure unsupervised, except in a life threatening emergency. Direct visual supervision until determined by the chief resident that they may do it alone.
Local Resection Cancer Mouth Direct-Visual Attending 3
I&D Neck Abscess Direct-Visual Attending 3
Lymphangioma, Cystic Hygroma Direct-Visual Attending 2
Fracture Reduction
Maxilla - Le Fort Direct-Visual Attending 5
Le Fort II Direct-Visual Attending 2
Le Fort III Direct-Visual Attending 2
Malar (zygomatic) Direct-Visual Attending 5
Mandibular
Closed
Direct-Visual Attending 5
Open Direct-Visual Attending 5
Esophagoscopy
Diagnostic With foreign body Direct-Visual Attending 5
removal Direct-Visual Attending 5
With structure dilation Direct-Visual Attending
Esophagoscopy
Diagnostic, new born Direct-Visual Attending 10

Third Year Resident PGY-4 [OTO-3]

Educational Program

Knowledge Base: At the completion of the third year of specialty training:

  • The resident should demonstrate an evolving mastery of the course content in Otolaryngology/Head and Neck Surgery.
  • Continues to acquire information about advanced topics in the field, such as medical and surgical aspects of disciplines of otology and neurotology, head and neck oncology, sinonasal surgery, plastic and reconstructive surgery and advanced cases in pediatric otolaryngology, including repairs of congenital defects and airway reconstruction.
  • Knowledge level demonstrated by above average performance, as compared to Program Year peers nationally, on annual in-service examination.

Clinical Skills Development

By the end of the third year of training, the resident:

  • Builds on clinical skills developed as a first year and second year resident.
  • Develops skills to perform major head and neck procedures include parotidectomy, thyroidectomy, radical neck dissection, major vessel surgery, nerve grafting, craniofacial resection and other ablative procedures. Plastic procedures include myocutaneous flaps, free grafts, rhinoplasty, rhytidectomy, blepharoplasty, and facial reanimation. [1]
  • Develops microvascular surgical skills necessary to dissect, resect, manipulate and repair small structures: End-to-end arterial anastomosis techniques: interrupted technique; continuous suture technique; one-way-up technique; end-to-end venous anastomosis; peripheral nerve repair; interpositional vein graft [Accomplished via the Microvascular Course, if not taken as a second year resident].

Resident Duties

  • In charge of the Pediatric Consult Service
  • Supervises first and second year residents
  • Observes the first year residents and instructs them in clinic as well as in the operating room.
  • Supervises the second year residents in the clinic as well as in the operating room for the following cases; panendoscopy, tracheotomy, septoplasty, turbinectomy, and basic facial fractures.
  • Functions as the otology and plastic resident. Participates in major otologic surgery including middle ear exploration, acoustic neuromas, VII nerve sections, stapedectomy, mastoidectomy, tympanoplasty, excision of glomus tumors and reconstruction of aural atresia. [1]
  • Participates in major head and neck as well as other major cases.
  • Substitutes for the chief while the chief is absent.
  • Participates in all major Otolaryngological Surgeries in all realms of the specialty, including Plastics, Otology/Neurotology, Head and Neck surgery and Pediatric ENT. Major head and neck procedures include parotidectomy, thyroidectomy, radical neck dissection, major vessel surgery, nerve grafting, craniofacial resection and other ablative procedures. Plastic procedures include myocutaneous flaps, free grafts, rhinoplasty, rhytidectomy, blepharoplasty, and facial reanimation. [1]
  • Performs endoscopic sinus surgery. [1]
  • Participates in the microvascular surgery course (if not completed as a second year resident)
  • Performs medical histories and physical examinations and to record such in patient charts. Formulates diagnosis and treatment plans.
  • Writes progress notes and doctor's orders in patient charts.

Progression of Responsibilities

  • By functioning as the Otology and Plastics Resident, by serving as the Pediatric Senior in charge of the Pediatric Otolaryngology service and overseeing the Pediatric junior resident, by operating, and by substituting when the Chief is away, and by taking back-up call overseeing more junior residents, the third year resident acquires skills that prepare him/her for the increasing responsibilities as a program year four resident.
  • May assume some administrative duties as delegated by the Program Director.
  • May act for Chief Resident in his/her absence.
  • Develops increasing independence of function by taking back up call for first year and second year residents.

Fourth Year Residents (Chief) PGY-5 [OTO-4]

Educational Program

Knowledge Base: The fourth year resident:

  • Should demonstrate mastery of the course content in Otolaryngology/Head and Neck Surgery
  • Knowledge level demonstrated by above average performance, as compared to Program Year peers nationally, on annual in-service examination

Clinical Skills Development:

  • Builds on clinical skills developed in prior years, and gives evidence to Attendings of maturity in approach to patient care and follow-up; i.e. the fourth year resident should demonstrate mastery of the surgical techniques and medical management in Otolaryngology/Head and Neck Surgery.
  • Explores advanced techniques and adapts them to personal style.

Resident Duties

Clinical:
  • Under the supervision of the Attendings, manages the service and is responsible for all patients on the otolaryngology service
  • Makes final decisions regarding management under Attending supervision
  • Can operate with direct visual supervision when he/she feels comfortable with a particular case.
  • Runs the clinics under Attending supervision
  • Supervises the ward service under Attending supervision.
Administrative:
  • Develops the resident call schedule
  • Assigns caseloads
  • Administers the service under Attending supervision
  • Forms the link for resident feedback to the Attending surgeons
  • Arranges grand rounds speakers
Educational:
  • Participates the education of junior residents
  • Teaches the medical students
  • Instructs junior residents in clinic and in the operating room.

Progression of Responsibilities

  • Acts in a supervisory role within the operating room setting and when performing procedures outside the OR when the responsible Attending is immediately available by telephone and readily available onsite when needed.
  • The Attending physician must be present for the key portion of the procedure. In an emergency situation, when a supervising physician is not present, the resident shall document the emergency treatment provided by said resident. This shall include the nature of the emergency, the treatment provided, and the contact of the supervising physician. With arrival of the supervising physician, he/she will concur with the resident and contact the Attending physician for appropriate management decisions.
  • As Chief Resident, is fostered in development of skills in supervisory and administrative skills, such as organizing Grand Round Schedule
  • Has an increased supervisory role over other residents [with Attending coverage] and instruct them in clinic.
  • Supervises [with Attending coverage] in the operating room for the following cases: panendoscopy, tracheotomy, septoplasty, turbinectomy, and basic facial fractures.
  • Attends a monthly meeting with the Program Director and Associate Director to explore resident concerns or feedback, and provide guidance on administrative responsibilities.
  • Other administrative duties may be assigned as needed by the Program Director.

[1] Under direct visual supervision of Attendings

Location and Contact