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 year rotating through general surgery services and other ACGME-required services for six months. These services include:

  • Vascular surgery
  • General pediatric surgery
  • Surgical oncology/endocrine surgery
  • Anesthesia
  • Intensive Care Unit

The benefit of these services to ENT residents is evaluated on an annual basis and alterations to the PGY-1 schedule are made as suggested by residents and approved by the Program Director for the Department of General Surgery.

The remaining six months of PGY-1 are spent on Otolaryngology services, primarily managing inpatient care. Interns are typically assigned to a clinic or surgical cases that are appropriate to their level of training. They also do not take primary call on Otolaryngology services, however they spend multiple nights shadowing PGY-3 residents on call to prepare them for future call duties.


PGY-2 residents divide their time between the operating room and clinical setting. PGY-2 residents become very proficient at airway management (tracheostomy, direct laryngoscopy, etc.) and general pediatric procedures. Services in the PGY-2 year include:

  • VA
  • Pediatrics
  • Facial Plastics/Laryngology
  • Head and Neck Surgery

PGY-2 residents handle all inpatient consultation on these rotations.


PGY-3 residents divide their responsibilities between the clinic and the operating room, gaining significant experience with otologic procedures, sinus surgery, and head and neck procedures. Services include:

  • Rhinology/Sleep
  • Otology
  • Head and Neck Surgery

PGY-3 residents also spend time offsite at Williamson Medical Center/Cool Springs Surgery Center to get exposure to general otolaryngology practice.

Six months of the PGY-3 year is dedicated to research.


The PGY-4 year is mainly focused in the operating room, helping residents gain significant experience with multiple head and neck procedures. Sevices include:

  • Head and Neck Surgery
  • Otology
  • Facial Plastics/Laryngology
  • Pediatrics

The PGY-4 year also builds on previous experience with Otologic Surgery, Septo-rhinoplasty, and Facial Reconstruction. The PGY-4 on the pediatric team is the service chief and performs many complex cases, including:

  • Cleft lip/palate repair
  • Pediatric sinus surgery
  • Excision of congenital masses
  • Tracheal reconstruction

PGY-5 (Chief)

PGY-5 residents are the chiefs on all services and direct the rising residents. The PGY-5 year is spent mostly in the operating room, gaining significant experience in advanced surgical cases and finessing surgical skills with increased independence. Services include:

  • VA
  • Head and Neck Surgery
  • Rhinology/Sleep
  • Otology

At the VA, the chief has significant autonomy and directly mentors a 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)

  • Rhinology, Skull Base Surgery, Allergy, Sleep Surgery Services (PGY-3 and PGY-5)
  • Facial Plastics and Reconstruction, Facial Trauma, Laryngology, Adult Consult Service (PGY-2, PGY-4, and PGY-5)
  • Head & Neck Service (PGY-2, PGY-3, PGY-4 (2), and PGY-5)
  • Otology/Neurotology Service (PGY-3, PGY-4, PGY-5)

Monroe Carell Jr. Children's Hospital at Vanderbilt

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

VA Hospital

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

Williamson County Hospital/Cool Springs Surgery Center

  • General Otolaryngology Service (PGY-3)

Call Schedule

Every night, a lower-level Resident (PGY-2 or PGY-3) and a senior-level Resident (PGY-4 or PGY-5) are on home 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 each night.

Rising Residents

The rising resident is on a rotating call schedule with a pool of ten peer-level residents, meaning the rising resident will be on call an average of once every tenth night. Rising residents are responsible for seeing and managing all consults and floor issues. They can discuss patients with senior residents. They directly contact attending physicians to discuss management plans while on call.

Senior Residents

The senior resident on call takes back-up call and is available to assist rising residents as needed. The ten senior residents are also included 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: the same senior resident is on back-up call for Friday evening - Monday morning, an on-call average of one weekend out of every ten weekends.

Our service shares call for facial trauma with the Plastic Surgery and Oral & Maxillofacial Surgery services. Our department is on call for facial trauma every third day.