The PGY-5 year is spent entirely at Maimonides Medical Center. One resident is selected as the Executive Chief Resident. All chief residents are responsible for organizing the day-to-day operations of the service and participate with the program director to develop conference and call schedules. In the clinic, the chief resident is a resource for the junior residents and medical students. He/she works with the attending in the clinic, which functions in a consultative capacity, to develop a differential diagnosis, work up and a treatment plan for the patient. In the operating room, the chief resident assumes a leadership role, developing the surgical plan and reviewing it with the other residents and attendings involved in the patient care. Rare, unusual or exceptionally difficult surgical cases typically involve the PGY-5 resident. He/she is expected to review the literature and develop competence discussing such cases. At this level, the resident spends time in the practitioner's office in a one-on-one experience, gaining an appreciation of the complexities necessary to perform a first time evaluation of outpatients in a private office setting, as well as office management.
The PGY-4 and-5 residents are responsible for orthopedic emergency call when they are assigned with members of the faculty. They provide back-up supervision for the PGY-2 and -3 residents who initiate the orthopedic evaluation of the injured patient. Should a patient require admission or emergent surgery, the PGY-4 or -5 resident assumes primary responsibility with immediate supervision by a member of the faculty.