Abstract
Throughout the history of medicine in latitudes, changes in attitudes (Changes in Latitudes, Changes in Attitudes. Jimmy Buffet, 1977), have been characteristic. This familiar refrain from one of Jimmy Buffet's hits reflects what has occurred in head and neck surgery the past three decades. Over the past 30 years the American Board of Otolaryngology has steadily increased the requirements for approved training in general surgery in addition to lengthening the duration of the training in otolaryngology that is required to become board certified. During this decade, further requirements have been imposed such that all individuals who wish to become board certified must now have 5 years of approved postgraduate residency training, at least 1 year of which must be in general surgery. Today, approximately 25% of the residency programs in otolaryngology—head and neck surgery throughout the United States require 6 years of training, including 2 years of approved residency
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