During the fourth year, residents begin to perform advanced inpatient and operative duties and rotate as senior resident on the KUMC Blue Team. The PGY-4 resident increasingly performs major outpatient surgical procedures; such as endoscopic sinus surgery, facial plastic surgery, phonosurgery and tympanomastoidectomies; and major head and neck oncologic and reconstructive procedures.
Most of the training during this year is in the operating room. However, the PGY-4 resident continues to spend one day a week in clinic to maximize the longitudinal exposure to OTOHNS outpatient subspecialties and pre- and post-operative care. Residents also begin rotating at St. Luke's Medical Center, allowing them to gain experience at a multi-specialty private hospital.
PGY-4 residents begin to assume a greater role teaching, especially of the junior residents and rotating medical students. Residents also assume more administrative responsibility when the chief resident is occupied, as well as adopting a leadership role in the inpatient and ER consultation service.
Residents also spend one month on the Research-Clinical Competency-Radiation Oncology rotation, which allows residents to further their PGY-3 research, as well as complete the required Practice-Based Improvement Project. A faculty mentor and the departmental Resident Research Committee oversee this project, which involves identifying an existing problem in OTOHNS patient care and implementing a solution. In the Radiation Oncology Department, residents learn principles of treatment.