Residency Rotation and Call Schedule

Clinical Rotation and Call Schedule

The close geographic proximity of our three primary medical centers is a major benefit to residents on call - there is no driving between medical centers - just a quick walk from site to site when needed.

Clinical Rotation by Program Year

PGY-1 (Intern)

Residents spend their PGY-1 (intern) year rotating through general surgery and otolaryngology head and neck surgery (OHNS) services during thirteen 4-week blocks. When they are on an off-service (non-OHNS) rotation, residents rotate through six general surgery rotations:

  • Vascular surgery
  • Pediatric surgery
  • Surgical oncology/endocrine surgery
  • Burn intensive care unit
  • Plastic surgery
  • VA surgical clinics

Importantly, the educational benefit of each off-service rotation is evaluated on an annual basis and alterations to the PGY-1 schedule are regularly made as suggested by residents.

The remaining seven rotations of PGY-1 are spent on OHNS services, primarily managing inpatient care on the Head & Neck and Facial Plastic, Laryngology, and Adult Consult services.

PGY-1 residents do not take primary call on OHNS services; however, they spend multiple nights shadowing junior (PGY-2 or -3) residents on call to prepare them for future call duties.


PGY-2 residents are responsible for handling all in-house and emergency consultations while becoming very proficient at airway management and general pediatric procedures. Services in the PGY-2 year include:

  • Head & Neck Surgery
  • Facial Plastic, Laryngology, and Adult Consult
  • Pediatric Otolaryngology
  • VA Otolaryngology


PGY-3 residents spend the majority of their time in the operating room being introduced to advanced sinus, ear, and head & neck surgery. They also have dedicated/protected research time. Services include:

  • Head & Neck Surgery
  • Rhinology & Sleep surgery
  • Otology/Neurotology
  • Research

During their time on the Head and Neck service, PGY-3 residents also spend time offsite at Williamson Medical Center and Cool Springs Surgery Center to gain exposure to general otolaryngology practice.


The PGY-4 year is mainly focused on developing skills in advanced head, neck, and plastic surgical procedures. Services include:

  • Head & Neck Surgery
  • Facial Plastic, Laryngology, and Adult Consult   
  • Pediatric Otolaryngology
  • Rhinology & Sleep surgery

The PGY-4 on the pediatric team is the service chief and performs many complex cases including cleft lip/palate repair, tracheal reconstruction, and pediatric ear surgery.

PGY-5 (Chief)

PGY-5 residents are the chiefs on all services and direct all other residents. While spending most of their time in the operating room fine tuning their skills, they direct in-patient on consult care of their respective services. These services include:

  • Head & Neck Surgery
  • Facial Plastic, Laryngology, and Adult Consult   
  • Rhinology & Sleep surgery
  • Otology/Neurotology
  • VA Otolaryngology

At the VA, the chief has significant autonomy and directly mentors the PGY-2 in the clinic and operating room.

Clinical Rotation by Location

Our Otolaryngology-Head and Neck Surgery residents rotate at:

Vanderbilt University Medical Center (Adult Hospital)

  • Head & Neck Service (PGY-1, PGY-2, PGY-3, PGY-4 (2), and PGY-5)
  • Facial Plastic, Laryngology, and Adult Consult Service (PGY-1, PGY-2, PGY-4, and PGY-5)
  • Otology/Neurotology Service (PGY-3, PGY-5)
  • Rhinology and Sleep Surgery Service (PGY-3, PGY-4, PGY-5)

Monroe Carell Jr. Children's Hospital at Vanderbilt

  • Pediatric Otolaryngology Service (PGY-2 (2) and PGY-4)

Nashville Veteran Affairs Medical Center

  • VA Otolaryngology Service (PGY-1, PGY-2 ,and PGY-5)

Williamson County Hospital/Cool Springs Surgery Center

  • General Otolaryngology Service (PGY-3)

Call Schedule

In 2021, our residency switched to a night float system. Every night, a junior resident (PGY-2 or PGY-3) and a senior resident (PGY-4 or PGY-5) are on call for Vanderbilt University Medical Center, Monroe Carrell Jr. Children's Hospital at Vanderbilt, and the Veteran's Administration Hospital. An attending specific to each hospital is also on call. The close geographic proximity of our three medical centers is a major benefit to residents on call: there is no driving between medical centers—just a quick walk from site to site when needed.

Junior Resident (PGY-2 and PGY-3) Call

Except for holidays, there is an in-house junior resident during the week, Sunday night through Thursday night. Junior residents take such night float call in one week (PGY-3) or two week (PGY-2) blocks. PGY-2 residents cover 6 weeks of nights and PGY-3 residents cover 4 weeks of nights. Weekends (Friday night through Sunday day) are home call covered by two different junior residents. During call, junior residents are responsible for seeing and managing all consults and floor issues. Junior residents can discuss patients with senior residents, who act as backup from home. Junior residents directly contact attending physicians to discuss management plans while on call.

Senior Residents (PGY-4 and PGY-5) Call

The senior resident on call takes back-up call from home and is available to assist the in-house junior residents as needed. The ten senior residents are in a single call pool and rotate the on-call schedule:

  • Weekday call: senior residents take back-up home call on average every tenth night.
  • Weekend call: a single senior resident is on back-up home call Friday evening through Monday morning, an on-call average of one weekend out of every ten weekends.

Facial Trauma Call

We share call for facial trauma with the Plastic Surgery and Oral & Maxillofacial Surgery services. Our department is on call for facial trauma every Tuesday, Thursday, and third Saturday.