PGY5 Goals and Objectives

Clinical training in the PGY5 year is spent in four different approximately three-month rotations:

• Chief Resident Rotation, University of Minnesota (all residents)

• Chief Resident Rotation, VA (all residents)

• Chief Resident Rotation, HCMC (all residents)

• Chief Resident Rotation, Regions (all residents)

Additionally, the Chief Resident at Regions Hospital has the opportunity to accompany Dr. Peter

Hilger to his private cosmetic practice, Facial Plastic and Reconstructive Surgery Specialists at

the Centennial Lakes Building in Edina, approximately once a week. Aesthetic surgery is only

practiced at select outpatient surgery centers, so this experience allows the resident access to a

broader range of the training in facial plastic surgery that is required by the American Board of

Otolaryngology. At the completion of this experience, the resident will have gained knowledge,

skills, and understanding and will demonstrate competence regarding:

• The financial difference between a private physician’s practice and a hospital based

practice

• The role of ancillary aesthetic office services

• Patient assessment and evaluation techniques of aesthetic surgical patients

• How to ensure patient safety in outpatient office surgery

• Assisting and performing primary aesthetic procedures

Goals:

The goal of the PGY5 year at all rotations is for the resident to build on clinical skills

developed in prior years, to demonstrate maturity in approach to patient care and follow-up; and

to demonstrate mastery of surgical techniques and medical management in

Otolaryngology/Head and Neck Surgery.

University of Minnesota:

At the U of M site the chief resident is not assigned a particular rotation

but allowed to choose an area of concentration or further skill refinement in Head & Neck,

Neurotology or Pediatrics. The chief resident can also choose to rotate among the three blocks

depending on the case being done that day. This allows the chief resident to set appropriate

learning and improvement goals based on self-identification of strengths, deficiencies, and limits

in knowledge and expertise.

PGY5 Objectives:

The objectives for PGY5 training follow. The learning objectives are

organized by each ACGME core competency.

Medical Knowledge: Upon completion of the PGY5 year of training residents will have:

• Demonstrated mastery of the course content in Otolaryngology/Head and Neck

Surgery

• Displayed maturity in approach to patient care and follow-up

• Explored advanced techniques and adapted them to personal style

Resident’s acquisition and application of medical knowledge will be demonstrated by above

average performance, as compared to Program Year peers nationally, on annual in-service

examination.

Patient Care:

Upon completion of the PGY5 year residents will have:

• Demonstrated the ability to provide patient care that is compassionate, appropriate,

and effective for the treatment of health problems and the promotion of health.

Patient Care—Procedural Skills:

Upon completion of the PGY5 year residents will have:

• Performed a sufficient number and variety of surgical procedures to ensure

education in the entire scope of the specialty

Communication Skills:

Upon completion of the PGY5 year residents will have:

• Effectively presented cases at Morbidity and Mortality Conference

• Demonstrated interpersonal and communication skills that result in the effective

exchange of information and collaboration with patients, their families, and health

professionals.

Practice Based Learning and Improvement:

Upon completion of the PGY5 year residents will

have:

• Engaged in quality improvement projects based on cases brought to Morbidity and

Mortality Conference

• Demonstrated the ability to investigate and evaluate their care of patients, to

appraise and assimilate scientific evidence, and to continuously improve patient care

based on constant self-evaluation and life-long learning

Professionalism:

Upon completion of the PGY5 year residents will have:

• Demonstrated a commitment to carrying out professional responsibilities and an

adherence to ethical principles that would be expected in a staff physician.

Systems-based Practice:

Upon completion of the PGY5 year residents will have:

• Participated in identifying system errors and implementing potential systems

solutions.

• Demonstrated an awareness of and responsiveness to the larger context and system

of health care, as well as the ability to call effectively on other resources in the

system to provide optimal health care.

PGY5 Research Skill Development:

• The resident may participate with a faculty member in submission for grant funding,

learning the method of grant preparation for various funding sources, and IRB

requirements

• Presents findings of required project or other research at local, regional or national

meeting

• Submits article for publication

Resident Duties

1. 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

2. Administrative:

• Serves as a the administrative chief while on rotation at all hospital sites

• Develops the resident call schedule

• Assigns caseloads

• Administers the service under Attending supervision

• Forms the link for resident feedback to the Attending surgeons

3. Educational:

• Participates in the education and evaluation of junior residents

• Teaches and evaluates the medical students

• Instructs junior residents in clinic and in the operating room.

• Presents all Morbidity and Mortality cases to the monthly meeting

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.

• Has an increased supervisory role over other residents (with Attending coverage)

and instructs them in clinic.

• Supervises (with Attending coverage) in the operating room for any case that is

approved by the attending and would not be considered a fellow level case. This

would include all general cases as well as neck dissections, facial trauma,

endoscopic sinus surgery, neck masses congenital or other, general otology

including mastoidectomy and tympanoplasty, tracheotomy, septoplasty,

turbinectomy.