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AMERICAN ACADEMY OF OTOLARYNGOLOGY–HEAD AND NECK SURGERY

Analysis: Training Assessment and Fellowship Utilization

We also looked at subspecialty skill set sacrifice by whether or not a fellowship was completed and by each fellowship. Overall, we saw a very large percentage of practicing otolaryngologists give up at least one subspecialty area (95% for those with no fellowship versus 98% for those with a fellowship) (Table 3.3). This matters because we cannot assume that all otolaryngologists are the same and utilize all skill sets. If we see skill set sacrifices in particular areas, this may speak to a greater need of fellows in that subspecialty. For those otolaryngologists who did not complete a fellowship, 86% do not perform neurotology cases while only 3% do not perform rhinology cases. This suggests that neurotology cases require fellowship training while rhinology, laryngology, and pediatric otolaryngology skills are largely acquired during residency or produce lasting comfort to continue in this arena in some capacity. We saw the same neurotology skill set sacrifice among nearly every fellowship (aside from otology). These results imply that neurotology skill sets are unique,

difficult, and/or require narrow focus in order to have lasting comfort in this arena. Looking at the numbers in an opposite fashion, assessing based on skill set retention, we see the least broad-based skill set retention among neurotology fellowship-trained otolaryngologists. So, while others stay away from neurotology more broadly, neurotologists also tend to stay away from other subspecialties on average. Conversely, non-fellowship trained respondents have the highest average skill set retention (73% unweighted average), indicating that they are willing to perform cases across all subspecialties. Using this method of assessment, the data also demonstrate which fellowship trained respondents practice more like general otolaryngologists. Pediatric otolaryngologists were the most similar to non-fellowship trained respondents, standing at an unweighted average of 68% subspecialty skill set retention. These results may be due to having to practice across all surgical subspecialties in pediatric populations.

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THE 2023 OTOLARYNGOLOGY WORKFORCE