It is a Saturday and I just finished rounding with our weekend team. I am reminded of how weekend rounds in particular can be a great opportunity to take a little more time, connect even further with your patients and your team, and leave the fervor of the “regular” weekday for the moment. This time to be more engaged, even more thoughtful, and further deepen connections is valuable. I look at the SUO and the Annual Meeting as a way to do this with my fellow Academic Otolaryngologists. Our Annual Meeting in particular gives us the time to do this in person.
As most all of you know, it is a very different meeting than any of the other excellent meetings we attend. We have a very robust agenda, but it is designed to have a different angle on our professional lives -- with time to explore topics that we don’t typically see in other meetings -- and connect on a different level with our colleagues. It truly allows us to engage in our collective mission as Academic Otolaryngologists. Over time I have seen how our membership and leadership have grown, and with that, our Annual Meeting and activities during the year have grown.
For those who have not been to the meeting for some time, it has evolved from being more focused on Program Directors and Chairs to engage people in all roles and stages of an Academic Otolaryngologist. From new faculty to senior leadership, and everyone in-between, SUO offers something for everyone. This program will expand on SUO’s scope of applicability, engagement, and professional enrichment.
On behalf of the entire Program Committee, we are looking forward to seeing you in Chicago. I can say that this will be an excellent program. We have designed the sessions to have time to delve into different topics, and to encourage audience engagement. This is another hallmark of the SUO Meeting that I find particularly unique. Offering over 11 hours of CME this year at the Annual Meeting, and for the first time, is another important shift for the Annual meeting , and in many ways will help all of us as we need to be thoughtful about how we spend our time and resources.
Our numerous SUO initiatives have been moving forward extremely well and we have been delighted with the response from all of you. For example, the Task Force leading the Boot Camp Initiative completed their grant process, put out their RFA, and has seen a fantastic response. Similarly, the SUO Research Grant being administered by the Education Innovation Committee has completed their process and put out their RFA, with many outstanding project proposals under review. We look forward to seeing the awardees for these grant processes, and the resulting findings from their work. We are delighted that there has been incredible support to make these additional investments in our membership. I’ll also add that in doing this work, SUO has been building additional partnerships with other societies, in an effort to collaborate on the work that is impactful to us and is synergistic with other groups. This and the other work by our Society and Membership truly moves all of us forward in Academic Otolaryngology.
So far, advance registration for the meeting is double over the numbers for this period, year-over-year. As such, we are on track to eclipse every prior meeting’s attendance, and we welcome all of you. Please be sure to register as soon as possible.
You will hear more about our new member applications in this newsletter, and we are delighted to have so many talented individuals applying to join the amazing members of SUO.
The member involvement survey from earlier this year, and the more recent membership engagement survey, have been extremely helpful. We have used the involvement survey for building out a number of the committees and initiatives, as well as the upcoming program. We have reviewed the results and read your thoughtful comments. We see broadening involvement as a big step this year, and to continue in the future. The engagement survey has also helped further inform us as we continue to move forward as a Society.
There has been an incredible amount of work done on new initiatives, building on the work from the past, and laying a very firm foundation for the future. I am grateful, honored, and humbled to have the opportunity to work for you as your President this year, and welcome your thoughts at any time. Please do not hesitate to contact me, as many of you have, which includes by email at email@example.com, and through our Administrator, Emily Maurer (firstname.lastname@example.org)
I hope you also find a moment this weekend to engage, reflect, and connect, however that may be.
Anand K. Devaiah, MD, FACS
President, Society of University Otolaryngologists
Communications Committee Update
Fellow members of the SUO welcome to the late summer edition of the newsletter. I hope you all enjoyed your time off with family, on vacation or doing some adventurous activity. As the fall rolls in and the kids return to school work will only pick up. OPDO and the SUO program committee have been busy planning and coordinating the upcoming Nov meeting. We will be sending out another newsletter in late October/early November discussing what the program will be. There are multiple panels of interest to all levels of membership. Mark your calendar is now and look for further information.
Our organization has continued to develop inter-specialty relationships to expand offerings to our members. The AAOHNS and SUO leadership have been in discussions to formulate a plan for integrating boot camps into residency educational processes. This collaboration is a first for our organization and we are looking for great things to come of it.
Our committees are vibrant and continue to work even during the summer vacations. I am hoping that this newsletter continues to be informative and would be pleased to address any issues or topics of interest. Please forward me your ideas.
Mark K Wax MD FACS FRCS(C)
Chair, Communications Committee
AcademyU—your online otolaryngology education source
The AAO-HNSF has many resources available for lifelong learning for all stages of career. This section of the newsletter highlights various new and innovative approaches available through AcademyU.org, your online otolaryngology education source over the past 6 months.
New FREE resources include:
A comprehensive Otolaryngology-Head and Neck Surgery online curriculum is now available. It was developed as a joint project between the AAO-HNS/F and the other specialty societies in Otolaryngology-Head and Neck Surgery. This unique educational resource has links to references, videos and other content from the Academy and Specialty Societies to support the topics. We continue to develop this and add content, including surgical videos, which can serve as a one stop shop for most of our specialty.
- AAO-HNSF Primary Care Otolaryngology, 4th Edition
The newly revised ebook on Primary Care Otolaryngology, 4th Edition is a free resource designed to expose all practitioners to the fundamentals of otolaryngology-head and neck surgery. Each chapter reviews the basics of common ear, nose, and throat problems—including a new chapter on sleep medicine. Since this handbook is designed to expose all practitioners to the fundamentals of otolaryngology–head and neck surgery, it can facilitate the recognition of potentially serious problems that should be referred to an otolaryngologist, as well as provide guidance on how to manage uncomplicated problems that can be taken care of by a patient’s primary care provider. We believe that medical students and allied health professionals will find this book both practical and informative in helping you develop the skills necessary to be excellent clinicians.
- Podcasts – learning on the go!
Making Sense of Reflux Testing
More than a Headache: Migraine Management for the Otolaryngologist
A Day in the Life Series: Life in Private Practice
A Day in the Life Series: The Academic Setting and Work-Life Balance
Richard V. Smith, MD
Coordinator for Education, AAO-HNSF
Gender Disparity Committee Update
The number of women in medical school (52%), otolaryngology residency (31%) and clinical or academic practice has steadily increased. However, leadership positions in academics continues to lag behind. This is not unique to Otolaryngology. Despite the introduction of programs and initiatives in corporate America designed to move women in to leadership positions the reality is that the numbers are stagnant. Recent numbers show that this year’s Fortune 500 had 33 female CEOs or 6.6%. Junior and mid-level women are unaware of opportunities and how to pursue them.
The Working Mother Research Institute1 released a survey of 2,280 women and 749 men of different races, ethnicities, experience levels and industries. The results highlight the differences between men and women as they climb the leadership ladder and identify 4 major gaps that result in women failing to advance.
- Awareness/Knowledge Gap
Women are less likely than men to have a clear vision of how they want their careers to advance and men underestimate the barriers women face. 48% of men say they have received detailed information on career paths in the past 2 years and only 15% of women say they have ad those discussions.
- Relationship Capital Gap
More men than women recognize the critical importance and benefits derived from networking, mentoring and sponsorship in elevating one’s personal profile, developing one’s brand and filling allies to help move up. While many organizations have Women’s Leadership groups, it doesn’t translate to the local politics of an organization and all politics are local.
- Career Aspiration/Risk-Taking Gap
It is important to visualize oneself at the top, to seek role models and to be encouraged can’t be overestimated as a key piece to the puzzle. 59% of men aspire to be CEO vs. 40% of women. The need to “raise your hand” even if you don’t already have all of the qualification. Michael Kaufmann, CEO of Cardinal Health, told me once that if a position is posted that has 5 pre requisites, a women that has 4 of the 5 won’t apply saying she isn’t qualified. A man will apply that has 3 of the 5 pre requisites and think nothing of it, because they will learn the skills along the way.
- Culture Gap
Real implementation and holding organizations accountable to drive measurable results. Many diversity programs are checking the box for advancing women but need to rise to the same degree of importance as meeting the budgetary bottom line for a department.
Review Committee Update
A major revision of the Common Program Requirements Sections I-V was approved by the ACGME February 2019 and went into effect July 1, 2019. There are three versions: Common Program Requirements (Residency); Common Program Requirements (Fellowship); and Common Program Requirements (One-Year Fellowship). A tracked changes version (TCC) of each of these new Common Program Requirements is available on the ACGME website: WhatWeDo/Accreditation/Common Program Requirements. The current program requirements for all specialties accredited by the ACGME were updated and posted to the respective RC webpages. The One-year Fellowship Common Program Requirements were used for Pediatric Otolaryngology. The Fellowship Common Program Requirements were used for Neurotology. The Residency Common Program Requirements were used for Otolaryngology-Head and Neck Surgery. A tracked changes version (TCC) and a clean copy of each set of these requirements are available on the RC webpage: Program Requirements and FAQs and Applications. The applications have also been updated; the FAQs have been updated but not yet posted.
Two major changes in the new Common Program requirements relate to scholarly activity and board pass rate. The new scholarly activity requirements include a broad list of domains (programs must demonstrate accomplishments in at least three domains) and multiple methods for demonstrating dissemination. This change is reflected in the new ADS template used to report faculty scholarly activity for the current (2019-2020) ADS Annual ADS Update. The specialty-specific board pass rate requirements were replaced with a common requirement that applies to all specialties. This will apply to the upcoming annual program reviews the RC will conduct January/April 2020.
An important new feature of the new Common Program Requirements is the indication of where RCs may and must further specify. Specialty-specific requirements that either were overridden by a new Common Program Requirement (e.g., those for program director support) or were located in a section of the Common Program Requirements where RCs are not permitted to further specify (e.g., program director responsibilities) are shown as deleted in the tracked changes version (TCC) of each set of the current specialty requirements. The new Common Program Requirements where RCs must further specify include several where there is no current specialty specific requirement. These include the following:
- II.B.4.b) minimum number of core faculty;
- IV.B.1.b).(1) patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health;
- IV.C.1 structure curriculum to optimize educational experiences, the length of these experiences, and supervisory continuity; and, notably for the fellowships,
- IV.E allow independent practice option.
The RC has drafted proposed focused revisions for all three sets of current specialty-specific requirements. These will be posted for public comment by this November, with an effective date of 7/1/2020.
The self-study/10-year site visit program was revised due to the backlog of site visits and shortage of field staff. Programs that have not already submitted a self-study will be assigned a new self-study date with an approximate 10-year site visit date 24 months later. Programs that have submitted a self-study will be assigned a new approximate 10-year visit date. The information for each program will be updated in ADS by the end of September.
As was unveiled at the SUO meeting November 2018 and discussed in the SUO newsletter in the Spring, the case log system for OHNS has been changed in some important ways. The new system will go live after the case logs for all 2019 graduates have been archived and related reports have been generated. At that time, all currently logged cases will automatically be updated to the new system. Key changes in the new system are the following.
- The updated organization is anatomically based, and in general it is classified along progressive categories of complexity.
- It facilitates unbundling by requiring the use of separate codes to capture the resident experience. All CPT® codes appear only once in the case log with the exception of ossicular chain reconstruction codes which do not exist apart from tympanoplasty codes.
- It was simplified by removal of duplicate codes and by collapsing larger categories of available CPT® codes into an all-encompassing CPT® code (e.g. there is only one code for image guided needle biopsy).
- Some codes have been assigned to particular categories to capture operative experiences, which may differ from the typical use of the CPT® code in real life. The most dramatic example is 60252 which is used in the case log to document central compartment neck dissection not thyroidectomy.
- Non-operating room procedures that have CPT® codes such as Epley maneuvers, needle biopsy and transtympanic injections were added to the case log.
- New categories, such as sleep, were created to address past gaps in the log.
- The equipment dropdown list was expanded to include ultrasound and sialendoscopy.
- The Review Committee felt it was important to capture data regarding clinical management of such diagnoses as newborn hearing loss and complications of otitis media to gain a sense of trainees’ exposures to the workup and treatment of patients whose interventions may not be operative. The committee has not set minimums or targets for these clinical management categories. However, residents need to log these patient diagnoses moving forward so that the OHNS educational community can gain insight into the medical management experiences in our specialty.
Liana Puscas, MD
American Board of Otolaryngology-Head and Neck Surgery Update
The American Board of Otolaryngology-Head and Neck Surgery (ABOHNS) wanted to provide this update to the SUO membership.
- The ABOHNS started working on a new website in August 2019. A critically important part of the redesign is doing User Experience (UX) research. During the AAO-HNSF Meeting in New Orleans, we arranged for five focus groups to begin this research, which included program director and resident focus groups. Many thanks to the SUO members that participated.
- As reported last year, the major change to the 2019 oral exam was two examiners per candidate in each of the five practice areas. From an operational standpoint, everything went very well (other than an unexpected April snowstorm…). After the exam, the board received highly positive feedback from examiners and candidates about this change. The ABOHNS plans to continue with two examiners per candidate for the upcoming 2020 oral exam.
- The ORTA process went very successfully in 2019. The Board thanks all the residency program directors, faculty, and residency program coordinators for their excellent and timely assistance with the process. For the 2019-2020 application cycle, we will continue with the same process as last year.
- For SUO members that participate in the ABOHNS Continuing Certification program, year 2 of CertLink will begin on January 1, 2020. For year 2, all 8 practice areas will be available and access to the platform through a tablet app will be available. The ABOHNS also is working collaboratively with the AAO-HNS for the Academy to provide CertLink participants with up to 10 CME credits for participation in year 2.
The ABOHNS is looking forward to seeing everyone at the upcoming SUO/OPDO/AADO Annual Meeting in Chicago.
All the Best,
Brian Nussenbaum, MD, MHCM
Boot Camp Task Force Update
Novice trainees enter residency faced with many challenges. They often lack the technical and non-technical skills as well as confidence, to manage routine or emergent clinical situations. Their concerns are justified by evidence suggesting reduced efficiency and increased mortality in hospitals at the start of the academic year (“July effect”). Introductory boot camps, described as transition courses, exist in various surgical specialties and the first otolaryngology boot camp was developed a decade ago with subsequent others established across the country.
In January 2018, SUO assembled a Task Force to explore 1) the current landscape of otolaryngology boot camps, 2) a structured and standardized curriculum, and 3) resource and financial considerations. In short, 8 U.S. regional otolaryngology boot camps were identified accommodating less than 70% of the novice resident cohort. Although there are similarities between the courses, the curriculum is diverse. Resident registration fees were the main source of revenue. Varying amounts of equipment and supplies were provided as in-kind donations by industry.
The Task Force endorses the establishment of a coordinated network of regional simulation-based boot camps with structured curricula to bolster and standardize all incoming otolaryngology residents’ basic knowledge and skills intended to prepare them for safe, effective management of patient emergencies. Specific recommendations include: 1) development of additional regional boot camps and growth of existing boot camps, offered over multiple dates each summer; this structure will afford enough redundancy for individual programs to send residents to a boot camp without compromising their own program operations, 2) standard set of simulations offered by every regional boot camp, so all residents are assured an opportunity to develop basic skills, 3) efforts to stay fiscally lean, taking into account the needs for equipment, supplies and simulation center support, and 4) establishment of start-up grants from professional organizations.
This year SUO allocated $50,000 of grant funding annually for 3 years to support these initiatives. The AAO-HNS/F generously offered administrative assistance to coordinate logistics and planning. A comprehensive and detailed report, including announcement of grant awardees, will be presented at the fall meeting.
Submitted by Sonya Malekzadeh on behalf of Task Force Members:
- Otolaryngology Head and Neck Surgery and Communication Sciences at Duke University was granted departmental status as of July 1, 2019
- Ohio State University's Department of Otolaryngology-Head and Neck Surgery was approved for a residency complement expansion by the RRC in 2019. The residency program will now have 5 residency positions each year beginning with the March 2019 match.
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