Academic Head and Neck Surgery: Educating Our Future

Secondly, such education should be based not only on multidisciplinary care but also on evidence-based care. As these are rare diseases, much care for head and neck patients has been anecdotal, but various practice guidelines have been developed and are being modified based on existing and evolving evidence; these should not only be followed but also taught so that current and future care is standardized and likely more effective and efficient.

Thirdly, selected individuals should be targeted for physician-scientist or physician-public health professional training in order to affect more global advances in prevention, detection, and treatment. Previously, we have stressed research training for all. However, I would argue that this is misguided and that very, very few completing such training will continue research efforts in their academic careers. Consequently, we should provide such added training only for those who are genuinely interested and have the potential for such a career.

Finally, we should codify head and neck oncologic training, and the easiest means would be as a certificate of added qualification. As care becomes more complex and individualized as well as centralized to tertiary care centers, this training will need to mirror this change so that we have a well-trained surgical work force, but this training must also be standardized with some degree of quality control.

A Future of Head and Neck Surgery

In summary, I find the demographic and epidemiologic trends with the shift in the histologic and etiologic patient mix re-energizing for the field and the future potential for patient-centered, individualized care exciting. Changes in the treatment paradigm and challenges (financial and otherwise) to tertiary centers will be threatening. However, as head and neck surgeons we must be active participants in such change and work to shape the future of head and neck cancer care for the public good. While being advocates for our patients through the process of multidisciplinary care is critical in the present, it is through the training of future surgeons that we benefit the most patients and the public at large.

Head and Neck Cancer Statistics Resources

• National Cancer Institute’s Surveillance, Epidemiology, and End Results Web site: http://seer.cancer.gov
• Morbidity and Mortality Weekly Reports: www.cdc.gov/mmwr .
• Shiboski CH, et al. Tongue and tonsil cancer: increasing trends in the U.S. population ages 20-44 years.

©2006 The Triological Society