Major Metropolitan Areas Understaffed by Academic Otolaryngology Programs

by Linda Kossoff •

What is the geographic distribution of U.S. otolaryngology residents and what opportunities currently exist for otolaryngology residency program expansion?

BOTTOM LINE

Findings indicate that residency training program expansion could be effectively prioritized in cities that exhibit a low training-to-population ratio.

BACKGROUND: The presence of academic medical centers and residency programs positively impacts the quality of care provided to surrounding communities, but there continues to be an uneven distribution of residency programs throughout the United States. Past findings show that otolaryngologists are frequently over-represented in established, population-dense cities.

STUDY DESIGN: Geographical study.

SETTING: Department of Otolaryngology, Texas Tech University Health Sciences Center, Lubbock, Texas.

SYNOPSIS: Researchers determined otolaryngology residency programs’ locations and size as well as population data from their corresponding metropolitan areas. They then calculated the number of otolaryngology trainees per 100,000 people within the associated metropolitan area. Findings showed that the average number of residents per 100,000 people across all metropolitan areas serviced by otolaryngology programs was 2.07 but that substantial variance exists for many major metropolitan areas. Cities with low trainee numbers per 100,000 people included Phoenix (0.20), Las Vegas (0.26), Dallas (0.26), Atlanta (0.33), and Miami. The other surgical subspecialties demonstrated similar distributions. Metropolitan centers with a population >1 million and without full academic representation in otolaryngology included Charlotte and Raleigh, NC; Orlando and Jacksonville, Fla.; Austin, Texas; Providence, R.I.; and Grand Rapids, Mich. Authors noted the potential connection between the lack of residency programs and a lack of education spending and/or availability of training positions.

CITATION: Smith DH, Case HF, Quereshy HA, et al. Geographic distribution of otolaryngology training programs and potential opportunities for strategic program growth. Laryngoscope. 2023;133:1600–1605.