The training of head and neck surgeons: the care of head and neck patients: 2002 Presidential Address, American Head and Neck Society.

Two years ago in San Francisco, our president, Jesus E. Medina, MD, in his inspirational address entitled “Tragic Optimism vs Learning on the Verge of More Change and Great Advances,” analyzed the factors that influence the decision of residents to select advanced fellowship training in head and neck surgery. He challenged us to be flexible and reminded us that the future belongs to those who are learners and can cope with change, not to those who are learned and live in the past. The following year, responding to that challenge in his presidential address, Ernest A. Weymuller, Jr, MD, explained how the American Head and Neck Society had modified fellowship training, making it more flexible and permitting 1-year fellowships with appropriate curricula. He warned us about disturbing trends in applications to otolaryngology residencies and challenged the leadership of the specialty to modify residency program requirements. I consider the head and neck fellowship program to be the most important accomplishment of our society. Originally conceived as a response to “dabblers,” those individuals without adequate training or experience to appropriately care for patients with head and neck cancer, the goals of the fellowship program have matured through the years. The curriculum has changed, and the intent now is not simply to graduate competent head and neck surgeons but also to train the researchers and teachers who will be the future leaders of our specialty. Just as we have come to rely on evidence-based medicine to analyze the outcome of medical treatment, I thought it would be worthwhile to study our fellowship program to determine if our graduates are indeed achieving the goals that we have set for them. To do this, I created a questionnaire that was sent to all of the graduates of our approved fellowships during the past 11 years. This questionnaire asked for information about the residency training of the fellows, the current nature of their clinical practice, their research accomplishment, and their degree of satisfaction with their practices. The study was limited to North American graduates of Advanced Training Council–approved fellowships. This decision was made with difficulty. Our international members have become one of the greatest strengths of our society. One of the most important achievements of our fellowship programs has been the training of international graduates who return to their home countries, where they become the leaders of our specialty abroad. They were excluded from this survey, not because of a lack of respect for what they have accomplished but because the nature of medical practice overseas is so different from practice in North America that comparisons would be meaningless. I also did not include graduates of those fellowships that are not approved by our Advanced Training Council, recognizing that there are some unapproved fellowships From the Section of Head and Neck Surgery, Departments of Surgery and Otolaryngology, Long Island Jewish Medical Center, The Long Island Campus of the Albert Einstein College of Medicine, New Hyde Park, NY. PRESIDENTIAL ADDRESS