Residents are expected to demonstrate appropriate pre-operative planning and a complete and current knowledge of the patient. Residents on the individual services are expected to recall facts relating to the patient's disease process and to be familiar with the anatomy of the planned surgical procedure. Surgical approaches must be understood, and the resident should be able to defend the particular approach chosen. Alternative approaches must be understood and outlined by the residents. Adherence to proper, skillfull, and safe surgical technique is required. Resident participation in surgical procedures is determined by their level of training and ability, and not by whether or not the patient is private or teaching.
Close working relationships with operating room personnel are encouraged. Residents are expected to be in constant attendance of the patients until the patient is in the Recovery Room. Progress relative to these objectives is evaluated through close faculty review and a monthly Morbidity and Mortality Conference. Further monitoring is performed by focused quality assurance reviews and, more recently, by outcome studies and national resident operative statistics made available through the American Board of Otolaryngology(see figure comparing national average)of resident operative procedures to NYEE resident procedures).
The chief resident of the respective service assigns residents to particular cases. Residents are expected to assess their own surgical results in consultation with faculty. Senior residents and faculty closely supervise appropriate intra- and post-operative care. This process of progressive supervision permits each resident within each year to establish his or her level of autonomy and clinical judgment in the operating room (or the clinic) while being closely monitored by the faculty and peers.
For example, a first year resident begins performing a tonsillectomy with a faculty member, and after more than twenty tonsillectomies and depending on the skill of the resident, the faculty member may elect to have a senior resident assist the junior resident with the faculty member present for the critical aspects of the surgery. At the fourth year of training, the resident would be allowed to begin a surgical procedure, such as a thyroidectomy, and the faculty would be present for the critical phases of the procedure. However, New York State law and the program policies, require the faculty to be present for all resident surgeries.