Can You Go Home Again?

In the Netherlands, competition exists between otolaryngologists and plastic reconstructive surgeons regarding who will perform the reconstructive surgeries. In the institutions where he trained, Dr. van den Brekel said, he was impressed that both specialist groups performed these surgeries together.

One of the problems I encountered when I returned home, he said, was that thyroid surgery is done by otolaryngologists in the US and Canada, but is done by general surgeons here. While in general otolaryngologists have more experience with this anatomy than general surgeons and I gradually have been doing more and more of these, it has been hard to change the system because of the surgical referral pattern here in the Netherlands.

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Germany

Christian Simon, MD, PhD, completed a fellowship in head and neck surgery at the University of Texas M. D. Anderson Cancer Center in Houston in 2002-03, under Jeffrey N. Myers, MD, PhD, Erich M. Sturgis, MD, MPH, and Helmuth Goepfert, MD, and a second fellowship in plastic and reconstructive surgery of the head and neck at Washington University in St. Louis in 2003-04, with Bruce Haughey, MD, and Brian Nussenbaum, MD. Dr. Simon then returned to Germany, working for a year in Tübingen before coming in 2005 to the University of Heidelberg, where he is an assistant professor in the Department of Otolaryngology-Head and Neck Surgery.

Medical educators make sure you are very well trained and are perfectly ready to perform surgery when you leave, Dr. Simon said. Because of the excellent training he received in the United States, he was well recognized when he returned to Germany, and his surgical career took off. I was immediately put in charge of otolaryngology cancer cases and all the reconstructions, he said. They also named him to the National Cancer Center Board. That was a huge advantage, since I was only 34 years old when I returned, he said. I also came back with a wonderful understanding of multidisciplinary head and neck cancer care, which is something you don’t receive in Germany.

Because the resources in Germany, particularly in the large medical centers, are as accessible as they are in the United States, Dr. Simon found that the approaches and procedures he learned translated well to his settings in Germany. I could apply everything I learned, he said.

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Puerto Rico

Héctor M. Santini, MD, encountered a very different experience after his training. After completing a fellowship in head and neck oncologic surgery in 1984-85 at M. D. Anderson under the former chair, Dr. Goepfert, Dr. Santini returned home to Puerto Rico. He is now an associate professor of otolaryngology-head and neck surgery in the medical training program for the Damas Hospital in Ponce, Puerto Rico, and also has a private practice.