Otolaryngology Program Directors Research Articles

Interview Invitations for Otolaryngology Residency Positions Across Demographic Groups Following Implementation of Preference Signaling

Preference signaling is a new initiative in the residency application process that has been adopted by 17 specialties that include more than 80% of applicants in the 2023 National Resident Matching cycle. The association of signals with interview selection rate across applicant demographics has not been fully examined. To assess the validity of survey-based data on the association of preference signals with interview offers and describe the variation across demographic groups. This cross-sectional study examined the interview selection outcomes across demographic groups for applications with and without signals in the 2021 Otolaryngology National Resident Matching cycle. Data were obtained from a post-hoc collaboration between the Association of American Medical Colleges and the Otolaryngology Program Directors Organization evaluating the first preference signaling program used in residency application. Participants included otolaryngology residency applicants in the 2021 application cycle. Data were analyzed from June to July 2022. Applicants were provided the option of submitting 5 signals to otolaryngology residency programs to indicate specific interest. Signals were used by programs when selecting candidates to interview. The main outcome of interest was the association of signaling with interview selection. A series of logistic regression analyses were conducted at the individual program level. Each program within the 3 program cohorts (overall, gender, and URM status) was evaluated with 2 models. Of 636 otolaryngology applicants, 548 (86%) participated in preference signaling, including 337 men (61%) and 85 applicants (16%) who identified as underrepresented in medicine, including American Indian or Alaska Native; Black or African American; Hispanic, Latino, or of Spanish origin; or Native Hawaiian or other Pacific Islander. The median interview selection rate for applications with a signal (48% [95% CI, 27%-68%]) was significantly higher than for applications without a signal (10% [95% CI, 7%-13%]). No difference was observed in median interview selection rates with or without signals when comparing male (46% [95% CI, 24%-71%] vs 7% [95% CI, 5%-12%]) and female (50% [95% CI, 20%-80%] vs 12% [95% CI, 8%-18%]) applicants or when comparing applicants who identified as URM (53% [95% CI, 16%-88%] vs 15% [95% CI, 8%-26%]) with those who did not identify as URM (49% [95% CI, 32%-68%] vs 8% [95% CI, 5%-12%]). In this cross-sectional study of otolaryngology residency applicants, preference signaling was associated with an increased likelihood of applicants being selected for interview by signaled programs. This correlation was robust and present across the demographic categories of gender and self-identification as URM. Future research should explore the associations of signaling across a broad range of specialties and the associations of signals with inclusion and position on rank order lists and match outcomes.

What Prospective Applicants Look for on Otolaryngology Residency Websites.

To determine what prospective residency applicants look for on otolaryngology residency program websites. Survey. The survey was distributed in a virtual format through Google Forms. A link to the survey was given at the University at Buffalo Otolaryngology Chautauqua, sent to Otolaryngology program directors with requests to forward to PGY1 residents and Otolaryngology interest groups, sent to medical school Otolaryngology interest group leaders, posted on Twitter through several accounts, and on otomatch.com. A 45 item survey was given to fourth year medical students applying to otolaryngology, re-applicants applying to otolaryngology, and first year otolaryngology residents who had recently matched. Data collected included participant's age, sex, race and ethnicity, current status in school/residency program, and their type of medical degree (MD or DO). Participants were then asked to mark the components listed that they wished to see. Components were separated into 5 categories: Application/Selection Criteria, Employment Aspects, Program Features, Social/Community, and Faculty/Contact Information. Data was analyzed using Mann-Whitney and Kruskal Wallis tests when appropriate. P value <.05 was considered statistically significant. One hundred one surveys were collected. Sixty-four (63.4%) participants were fourth-year medical students, 32 (31.7%) were first-year residents, and 5 (5.0%) were re-applicants. Thirteen of the items on the survey were sought by 80% or more of respondents. Ninety-nine (98.0%) of the participants wanted to see a current resident list with photos and 97 (96.0%) wanted to see the intern year schedule online. Eighty-five percent agreed that salary and benefits information would be valuable on residency websites. Women expressed significantly more interest in salary (P = .034), benefits (P = .026), and parking information (P = .048). Our study provides insight on key items to include on residency program websites. Websites that contain information that applicants want to use can be helpful for application decisions in the future.

Descriptive Analysis of Otolaryngology Program Directors with a Focus on Gender Disparity.

To describe and analyze the demographics and academic backgrounds of United States otolaryngology program directors (PD) and assess gender disparity in the field. This was a cross-sectional study in which an online search using publicly available sources was performed to gather information on PDs for 125 United States otolaryngology programs from May 14, 2021, to May 30, 2021. Data collected included PD appointment year, age, gender, resident gender breakdown, degree, as well as training location and graduation year. There were 69.6% programs with a male PD and 30.4% with a female PD. Ninety percent of PDs have an MD degree and 9.6% have a DO degree. The current average age of PDs was 49.9years old (range 35-79). Males were older than females PD (51.0 vs 47.1years, P = 0.045) and have served a longer time as PD (7.1 vs 4.8years, P = 0.019). There was no significant difference in other variables collected. There were 27.3% of program directors that held the position of professor, 44.5% associate professor, and 28.2% assistant professor. The most common subspecialty practiced by otolaryngology PDs was head and neck oncology. Disparity in women's representation in otolaryngology still exists, but the program director leadership position demonstrates better parity. There is an equal percent representation when examining female PDs and female otolaryngologists in academic medicine. Continued efforts to encourage women to enter and become leaders in otolaryngology are necessary moving forward.

Open Bedside Tracheostomy: Safe and Cost Saving but Underutilized Nationally.

To evaluate open bedside tracheostomy (OBT) and compare it with open operating room (OR) tracheostomy and bedside percutaneous dilatational tracheostomy (PDT) in complications and cost. To determine the tracheostomy practice patterns of academic otolaryngology programs. Retrospective cohort study and cross-sectional study. Public hospital and tertiary care hospital. Otolaryngology program directors were surveyed to determine their institutions' tracheostomy practice patterns and the factors preventing the implementation of open bedside tracheostomies. A retrospective chart review was done of tracheostomies performed at our institutions from 2009 to 2019 for prolonged mechanical ventilation. Complications, length of intubation, comorbidities, body mass index, demographics, mortality rates, and decannulation rates were recorded. A cost analysis between OBT and PDT was conducted. Data from 802 patients were analyzed for 449 OBTs, 206 PDTs, and 147 open OR tracheostomies. Complication rates were low. PDTs were more likely to have perioperative tracheal bleeding (P = .028) and mucus plugging (P = .006). OBTs were performed on sicker patients with a higher Charlson Comorbidity Index than PDT and OR tracheostomies. The cost of OBT was less than that of PDT. The survey response rate of tracheostomy practice patterns was 46%. The otolaryngologists at the responding programs all conducted OR tracheostomies, while 52.7% did OBTs and 30.9% PDTs. OBT can be done safely in patients with multiple comorbidities and has a cost that can be less than PDT. Despite these benefits, only 50% of academic institutions routinely performed OBT.

Otolaryngology Program Director, House-Staff, and Student Opinions: Step 1 Pass/Fail Score Reporting.

To compare otolaryngology program director, house-staff, and medical student perspectives on the score reporting change of USMLE Step 1 to pass/fail. Separate electronic surveys were sent to program directors of ACGME-accredited otolaryngology programs (Cronbach's alpha = .87), otolaryngology house-staff (Cronbach's alpha = .91), and medical students interested in otolaryngology (Cronbach's alpha = .76). Among the 51 otolaryngology program directors that completed the survey (response rate of 46.8%), 17.6% favored reporting USMLE Step 1 as pass/fail. A majority believed the reporting change would make it more difficult to screen (74.5%) and objectively compare applicants (82.4%). Step 2 CK scores will be more important to most program directors due to the reporting change (83.7%). Of the 93 house-staff that completed surveys, most did not favor the reporting change (61.3%). Over half (54.0%) of the 87 medical students that completed surveys did not support the scoring change, and most (65.5%) did not feel that it would decrease anxiety around residency applications (65.5%). Most house-staff and medical students felt that the scoring change would put non-U.S. MD students at a disadvantage (65.6% of house-staff, 69.8% of medical students). Most survey respondents do not agree with the decision to report Step 1 as pass/fail. Despite its intended goals, most do not believe pass/fail Step 1 reporting will improve medical student well-being and believe it will put certain student populations at a greater disadvantage.

Are otolaryngology residents ready for independent practice? A survey study.

ObjectiveWe surveyed otolaryngology program directors (PDs) and recent otolaryngology residency graduates on the operative autonomy of graduating residents and their comfort with independent practice.MethodsAn anonymous survey was sent to otolaryngology PDs and recent graduates of training programs (members of the Young Physicians Section [YPS] of the American Academy of Otolaryngology‐Head and Neck Surgery Foundation). Questions were developed around the 14 key indicator procedures (KIPs) defined by the Accreditation Council for Graduate Medical Education.ResultsFifty PDs (43% of PDs) and 152 recent graduates (6% of YPS members) responded. Over 90% of participating PDs felt their graduating residents were either somewhat or extremely comfortable performing 12 out of 14 KIPs. Among the 12 procedures PDs felt their graduating residents were comfortable performing, 57% to 95% of recent graduates also felt either somewhat or extremely comfortable performing them by graduation. Similarly, at least 90% of responding PDs felt their residents achieved meaningful autonomy in the last 2 months of residency prior to graduation for 11 of 14 KIPs. For these same 11 procedures, 74% to 95% of recent graduates indicated they achieved meaningful autonomy. The procedures that PDs and recent graduates felt required the most surgical assistance were ossiculoplasty/stapedectomy, rhinoplasty, and mastoidectomy. All PDs agreed or strongly agreed that graduating residents are comfortable operating and taking call as general otolaryngologists, compared to 86% and 93% of recent graduates.ConclusionMost PDs and recent graduates agree that residents are well‐prepared for general otolaryngology practice with the exception of select KIPs.Level of evidence: 4.

COVID-19's Impact on the 2020-2021 Resident Match: A Survey of Otolaryngology Program Directors.

Objective:To determine the impact coronavirus disease of 2019 (COVID-19) will have on the 2020-2021 otolaryngology (OTO-HNS) resident application cycle.Methods:A cross-sectional survey targeting OTO-HNS program directors (PD) was created and disseminated via email to PDs on May 28th 2020. Descriptive analyses of the 19-question survey was performed, and free text responses for certain suitable questions were thematically categorized into groups determined to be relevant during analysis.Results:Twenty-nine of 123 solicited PDs (23.6%) completed the survey. Nineteen (65.5%) respondents indicated they would not host away rotations (AR) in 2020, and 9 (31.0%) reported that they would consider away rotators without home programs. Regarding the historical importance of AR, 21 (72.4%) PDs stated they were either “extremely” or “very” important in evaluating candidates. Sixteen (55.2%) PDs stated that virtual interviews would impact their ability to properly gauge candidates and 12 (41.4%) were unsure. Eight PDs (27.6%) stated their evaluation of candidates will likely change, with a shift toward an increased reliance on letters of recommendation, research involvement, and clerkship grades. The large majority of PDs—25 (86.2%)—were not worried that the COVID-19 pandemic would affect the abilities of new interns beginning in 2021.Conclusion:Virtual interviews and engagement activities will mostly supplant sub-Is and AR for the 2020-2021 OTO-HNS application cycle. Surveyed PDs largely believe these will be insufficient in providing a comprehensive assessment of candidates, and will similarly limit applicants’ ability to gauge residency programs. Criteria utilized to evaluate students is expected to change.

Program Directors’ Opinions About Otolaryngology Resident Teaching Medical School Anatomy

PurposeTo evaluate whether otolaryngology residency program directors (PDs) provide residents to teach pre-clinical medical students anatomy and to outline their perceptions of this practice.MethodsAn anonymous online survey was sent to active U.S. otolaryngology residency PDs in 2019, assessing each program’s involvement in teaching medical student anatomy.ResultsForty-five of 121 (37.1%) of surveyed otolaryngology PDs responded. Sixteen of the 44 (36.4%) residency programs that were associated with a medical school provided residents to teach anatomy (“Teaching Programs”). The 29 (64.4%) remaining programs did not provide residents (“Non-teaching Programs”). No significant differences were found between Teaching and Non-teaching Programs (P<0.05) for the size of the program, the presence of fellowships, the size of medical school, whether residents had won teaching awards, or the number of otolaryngology residency applicants from that school. In general, all PDs responded positively about residents teaching medical school anatomy. Non-teaching Programs primarily cited not being approached by the medical school as a reason for not providing residents to teach.ConclusionThe majority of respondent otolaryngology PDs have a positive view of residents teaching medical students but few do it. Otolaryngology departments will need to take the lead on developing opportunities to put students and residents together for anatomy education.

Editorial introductions

Editorial introductions

The Effects of Pass/Fail USMLE Step 1 Scoring on the Otolaryngology Residency Application Process.

To investigate how the decision to report United States Medical Licensing Examination (USMLE) Step 1 score as pass/fail will influence future otolaryngology residency application and match processes. Survey study. An anonymous and voluntary survey approved by the Otolaryngology Program Directors Organization was administered to academic faculty members from April 24, 2020 through May 19, 2020. Two hundred fifty-seven surveys were received from department chairs (17.5%), program directors (24.1%), associate program directors (12.5%), and department faculty (45.9%). USMLE Step 1 has been the most heavily weighted metric for offering interviews (44.0%), and it has correlated with residents' medical knowledge (77.0%) and in-service performance (79.8%) but not with surgical skills (57.6%) or patient care (47.1%). In total, 68.1% disagreed with the decision to make USMLE Step 1 pass/fail. This change is anticipated to lead to an increase in significance of USMLE Step 2 CK (89.1%), core clerkship grades (80.9%), elective rotation at the respective institutions (65.7%), Alpha Omega Alpha and other awards (64.6%), and letters of recommendation (63.8%). The new scoring is also anticipated to especially benefit students from top-ranked schools (70.8%), increase medical students' anxiety/uncertainty regarding obtaining interview invites (59.1%), and negatively affect international (51.4%), doctor of osteopathic medicine (45.9%), and underrepresented students (36.9%). Indication that USMLE Step 2 CK will significantly increase in weight varied according to department position (P = .049), geographic region (P = .047), years of practice (P < .001), and residency program size (P = .002). Most academic otolaryngologists disagreed with changing USMLE Step 1 scoring to pass/fail and believe that it will increase other objective/subjective metrics' weight and put certain student populations at a disadvantage. N/A. Laryngoscope, 131:E738-E743, 2021.

Flipping the Classroom in Otolaryngology Residencies.

ObjectiveTo understand the use of the flipped classroom (FC) - learning core content prior to an academic session, with class time devoted to applying this content - in otolaryngology residency education.MethodsAn electronic survey of 107 otolaryngology program directors (PDs), including demographic details, the flipped classroom perception instrument (FCPI), and the otolaryngology programs' current use of FC.ResultsForty-four (41%) PDs completed the FCPI. Seventy-one point one (71.1%) of respondents were male, 60% were 30-49 years, and the remainder were older. Sixty-two percent (62%) had fellowships associated with their program, 21.7% of programs used the FC model Very Often, 17.4% Somewhat Often, 28.3% Sometimes, 17.4% Somewhat Rarely, 8.7% Very Rarely, and 6.5% Never.Attitudes toward FC principles were positive with modes “strongly agree” for all, except for “online modules enhance learning” where the mode was “slightly agree” with significantly higher scores for PDs over age 50 than for those younger (4.17 vs. 3.63, p=0.033). There were no other significant differences comparing male vs. female PDs, younger vs. older PDs, smaller vs. larger programs, programs with or without fellowships, programs with 100% vs. <100% board exam pass rates, or programs in different geographical regions. The pre-class activity mean score was 4.34 (95% CI 4.12-4.56) and the in-class mean score was 4.18 (95% CI 3.99-4.37). There was no significant correlation between the likelihood of using a flipped classroom and attitude scores.ConclusionPDs value both the pre-class and interactive in-class principles of FCs but only 37.8% of programs use FC often, suggesting that practical approaches to implementation in this group could improve education in this population.

Editorial introductions

Editorial introductions

Pain management and prescribing practices in otolaryngology residency programs

To understand the knowledge, competency and influencing factors regarding postoperative opioid prescribing practices among Otolaryngology Residents. To understand the educational background and resources regarding pain management and opioid prescribing among Otolaryngology Residency Programs. An anonymous electronic survey was distributed to Otolaryngology residents in the greater New York City area. Subjects reported their preferred pain management prescription for eight common otolaryngology surgeries. Questions addressed opioid and non-opioid prescribing influences, use/knowledge of pain management resources, and prior opioid prescribing education (OPE). An anonymous survey was distributed to US Otolaryngology Program Directors addressing resident prescribing influences and OPE in residency training programs. Thirty-Five residents and fifteen PDs participated. Resident opioid prescribing was widely variable with averages ranging from 3.8 to 21.1 narcotic pills among eight standard otolaryngology surgeries. Attending/senior preference was believed to largely influence resident prescribing habits among residents (3.66, ±6.68), and PDs (4.73, ±0.46). Only 20% of programs had formal OPE in place, consistent with the 65.71% of residents who reported no prior OPE. A large inconsistency in Otolaryngology resident postoperative pain management exists, despite their responsibility to provide analgesic therapy. The lack of formal OPE programs in US Otolaryngology residency programs may lead to outside factors unrelated to surgery influencing these prescribing practices. This brings light to the need of Otolaryngology Resident OPE to assist in standardizing prescribing practices, provide meaningful patient education on opioid use and disposal and educate residents on the risk assessment tools offered to provide the most appropriate and safe analgesic therapy to patients.

Trends in Post‐Interview Communication Practices

Postinterview communication between residency programs and applicants is common during the US residency match process. To date, current communication practices between otolaryngology residency programs and applicants have not been studied. The objectives of this study were to characterize the frequency and type of postinterview communication and perceptions of how this communication influences ranking behavior of match participants. Survey. A national survey of Accreditation Council for Graduate Medical Education-accredited otolaryngology programs was distributed via the Otolaryngology Program Directors Organization. Program directors were surveyed regarding methods and content of postinterview communication, perceived impact that communication has on final rank lists, and current interpretations of the National Resident Matching Program (NRMP) Code of Conduct. Thirty-three of 106 program directors (31.1%) responded. Thirty-eight percent of programs that responded initiate at least some form of postinterview communication. The program director most commonly initiated communication, typically in the form of an email. A minority of respondents (12.1%) indicated that specific information is revealed regarding rank status. Thirty-two percent of respondents indicated that communication initiated by applicants may influence final rank list. Twenty percent of respondents interpret the current NRMP Code of Conduct as allowing programs to reveal rank positions to applicants, and 63.6% of respondents as allowing applicants to reveal intended rank positions. The results of this study demonstrate that postinterview communication practices within otolaryngology vary widely. Program directors perceive that postinterview contact between applicants and programs has limited impact on ranking behavior. NRMP rules for postinterview communication between programs and candidates are interpreted variably by program directors. NA Laryngoscope, 129:607-612, 2019.

Current Wellness Practices among Otolaryngology Residencies.

Objectives To determine if and how resident emotional health is monitored among otolaryngology training programs and to determine what wellness resources are available to otolaryngology residents. Study Design Survey. Setting Tertiary academic medical centers. Subjects and Methods An anonymous 50-item survey sent via REDCap to the 107 allopathic American otolaryngology program directors (PDs). Results The response rate was 44%, of whom 47.7% regularly surveyed emotional health among their residents. A total of 33.3% used the Maslach Burnout Inventory, and 61.9% used another scale or did not know. Eighty-one percent of surveys were anonymous, and 45% surveyed yearly, which was mandatory in only 33.3% of programs. Whether surveys took place was not related to PD or program demographics. In total, 72.7% of programs utilized faculty mentors for their residents; 88.6% had a wellness lecture within the last year; and 74.5% had no-cost mental health resources with extended hours as required by the American Council of Graduate Medical Education. Within the last year, 31.8% had provided seminars in mindfulness or meditation. Seventy-five percent had financially supported social events for their residents; <15% supported athletic or mental wellness activities. Healthy foods were provided by 36.4%, and 67.4% of programs gave their residents days off in addition to vacation days for medical or dental appointments. Residents were allowed a mean 18.76 vacation days and 3.73 additional wellness days. Conclusion There is no standard practice for measuring and monitoring emotional health by otolaryngology programs. Programs struggle to offer interventions to prevent burnout, with 25% noncompliant with the wellness requirements mandated by the American Council of Graduate Medical Education.

Diversity in Otolaryngology Residency Programs: A Survey of Otolaryngology Program Directors.

Objective As the population of the United States becomes increasingly racially and ethnically diverse, it is important that the medical profession reflect these changes. Otolaryngology has previously been identified as one of the surgical subspecialties with the smallest presence of those underrepresented in medicine. In the context of this study, the term underrepresented in medicine is defined as blacks, Latinos, Native American, and Native Hawaiians. The purpose of this study was to describe the current state of otolaryngology residency programs in terms of diversity of resident and faculty cohort, explore general interviewing practices, and investigate recruitment of underrepresented in medicine applicants. Study Design Survey via electronic questionnaire. Setting Academic otolaryngology residency programs. Subjects and Methods A 14-item survey was distributed to 105 program directors asking them to consider their program's past 15 years of existence. Results With a response rate of roughly 30%, we found that over one-third of responding programs had matriculated 1 or fewer underrepresented in medicine residents. There was a statistically significant association between the number of underrepresented in medicine faculty and the number of underrepresented in medicine residents matriculated ( P = .02). Conclusion The authors stress the importance of underrepresented in medicine faculty mentorship. Although not statistically significant in this study, increasing the number of underrepresented in medicine applicants interviewed, as well as recommending outreach programs, may help to improve underrepresented minority matriculation into residency programs as demonstrated in the literature.

National trends in otolaryngology intern curricula following Accreditation Council for Graduate Medical Education changes.

In 2016, Accreditation Council for Graduate Medical Education (ACGME) requirements for curriculum and resident experiences were modified to require entering postgraduate year (PGY)-1 residents to spend 6 months of structured education on otolaryngology-head and neck surgery (ORL-HNS) rotations. We aimed to determine how ORL-HNS training programs have adapted curricula in response to 2016 ACGME curriculum requirement changes. Survey study. A national survey of ACGME-accredited ORL-HNS programs was distributed via the Otolaryngology Program Directors Organization. Thirty-seven program directors responded (34.9%). Most common ORL-HNS rotations included general otolaryngology (80.6% of programs, up to 6 months) and head and neck oncology (67.7%, up to 4 months), though more months are also spent on other subspecialty rotations (laryngology, otology, rhinology, and pediatrics) than previously. All programs continue at least 1 month of anesthesiology, intensive care unit, and general surgery. Programs have preferentially eliminated rotations in emergency medicine (77% decrease) and additional months on general surgery (48% decrease). Curricula have incorporated supplemental teaching modalities including didactic lectures (96.3% of programs), simulation (66.7%), dissection courses (63.0%), and observed patient encounters (55.5%), to a greater degree following ACGME changes. More interns are involved in shared call responsibilities than in previous years (70.4% vs. 51.8%). A stable minority of interns take the Otolaryngology Training Examination (approximately 20%). New ACGME requirements have challenged ORL-HNS training programs to develop effective 6-month rotation schedules for PGY-1 residents. Significant variation exists between programs, and evaluation of first-year curricula and readiness for PGY-2 year is warranted. NA Laryngoscope, 1811-1816, 2018.

Applicant Perspectives on the Otolaryngology Residency Application Process

It has been nearly 25 years since medical students were queried regarding their perspectives on otolaryngology-head and neck surgery (OHNS) residency selection. Understanding this viewpoint is critical to improving the current application process. To evaluate the perceptions of 2016 OHNS residency applicants regarding the application process and offer suggestions for reform. In this cross-sectional study of anonymous online survey data, a 14-question survey was designed based on resources obtained from a computerized PubMed, Ovid, and GoogleScholar database search of the English language from January 1, 1990, through December 31, 2015, was conducted using the following search terms: (medical student OR applicant) AND (application OR match) AND otolaryngology. The survey was administered to 2016 OHNS residency applicants to examine 4 primary areas: current attitudes toward the match, effect of the new Otolaryngology Program Directors Organization personal statement mandate, sources of advice and information, and suggestions for improvement. In January 2016, an email was sent to 100 program directors asking them to distribute the survey to current OHNS applicants at their institution. One follow-up reminder email was sent in February 2016. A link to the survey was posted on the Otomatch.com homepage on January 28, 2016, with the last response received on March 28, 2016. Survey responses regarding the residency application process. A total of 150 of 370 residency applicants (40.5%) responded to the survey. Of these, 125 respondents (90.6%) noted applying to programs in which they had no specific interest simply to improve their chances of matching. Applicants intended to apply to more programs than they actually did (63.6 vs 60.8; r = 0.19; 95% CI, -0.03 to 0.40). Program directors advised fewer applications than other sources; however, 58 respondents (38.7%) did not receive advice from a program director. A total of 121 respondents (80.7%) found online program information to be insufficient. Finally, 90 of 140 respondents (64.3%) noted that they would agree to a hard cap on applications, among other suggestions for improvement. Several main themes emerged from the data, providing a foundation for process improvement opportunities: careful consideration to applicant mentorship, including peers; uniform set of criteria for residency program websites; and investigating alternative match platforms, which may allow hard caps, flagging programs of higher interest, or wave application cycles. Overall, the otolaryngology applicant provides a unique perspective regarding the current state of the match and potential opportunities for system-wide improvement.

Otolaryngology Residency Program Research Resources and Scholarly Productivity.

Objective To delineate research resources available to otolaryngology residents and their impact on scholarly productivity. Study Design Survey of current otolaryngology program directors. Setting Otolaryngology residency programs. Subjects and Methods An anonymous web-based survey was sent to 98 allopathic otolaryngology training program directors. Fisher exact tests and nonparametric correlations were used to determine statistically significant differences among various strata of programs. Results Thirty-nine percent (n = 38) of queried programs responded. Fourteen (37%) programs had 11 to 15 full-time, academic faculty associated with the residency program. Twenty (53%) programs have a dedicated research coordinator. Basic science lab space and financial resources for statistical work were present at 22 programs (58%). Funding is uniformly provided for presentation of research at conferences; a minority of programs (13%) only funded podium presentations. Twenty-four (63%) have resident research requirements beyond the Accreditation Council for Graduate Medical Education (ACGME) mandate of preparing a "manuscript suitable for publication" prior to graduation. Twenty-five (67%) programs have residents with 2 to 3 active research projects at any given time. None of the investigated resources were significantly associated with increased scholarly output. There was no uniformity to research curricula. Conclusions Otolaryngology residency programs value research, evidenced by financial support provided and requirements beyond the ACGME minimum. Additional resources were not statistically related to an increase in resident research productivity, although they may contribute positively to the overall research experience during training. Potential future areas to examine include research curricula best practices, how to develop meaningful mentorship and resource allocation that inspires continued research interest, and intellectual stimulation.

Editorial introductions

Current Opinion in Otolaryngology & Head and Neck Surgery was launched in 1993. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of otolaryngology and head and neck surgery are divided into 11 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Ravi N. SamyRavi N. SamyRavi N. Samy, MD, FACS is an Associate Professor in the Department of Otolaryngology – Head and Neck Surgery at the University of Cincinnati/Cincinnati Children's Hospital Medical Center. Dr Samy's practice includes pediatric and adult otology, neurotology, and skull base surgery. He also serves as the Program Director of the Neurotology Fellowship and the Adult Cochlear Implantation Program. He earned his BS in Zoology and then MD from Duke University. He completed a residency at Stanford University Medical Center followed by a fellowship in otology/neurotology/skull base surgery at the University of Iowa Hospitals and Clinics. He is an active member of the American Academy of Otolaryngology/Head and Neck Surgery (AAOHNS) and the American Neurotology Society (ANS). He is also a Fellow of the American College of Surgery. He is certified by the American Board of Otolaryngology with a Certificate of Added Qualitifications in Neurotology. Dr Samy's special interests are pediatric and adult otology, neurotology, skull base tumors (such as acoustic neuromas) and synthetic biology/nanorobotics for the treatment of cholesteatoma. His publications have appeared in such journals as Otolaryngology Head and Neck Surgery, Archives of Otolaryngology Head and Neck Surgery, Otology and Neurotology and Laryngoscope. Rodney C. DiazRodney C. DiazRodney C. Diaz, MD FACS is an Associate Professor of Otolaryngology – Head and Neck Surgery at the University of California at Davis, USA. He attended the University of California at Berkeley, where he obtained his baccalaureate with distinction in Astrophysics. He received his MD degree from the University of California at Davis. He remained at UC Davis completing his general surgery internship and residency training in Otolaryngology – Head and Neck Surgery. He then completed a clinical fellowship in Otology, Neurotology, and Skull Base Surgery at the Michigan Ear Institute. Dr Diaz currently serves as the Residency Program Director for the Otolaryngology Department at UC Davis Medical Center. He is a Diplomate of the American Board of Otolaryngology with subspecialty board certification in Neurotology. He is a fellow of the American College of Surgeons and is a member of several otolaryngology organizations, including the American Academy of Otolaryngology – Head and Neck Surgery, the Association for Research in Otolaryngology, the American Neurotology Society, the Politzer Society, the Society of University Otolaryngologists, and the Otolaryngology Program Directors Organization. Dr Diaz's clinical practice is centered on otology, neurotology, and management of lateral skull base lesions including acoustic neuromas and other tumors. His research interests include development of new methods for repopulating the hair cell depleted sensory epithelium. Dr Diaz serves as a board member for the Speech-Language Pathology, Audiology, and Hearing Aid Dispensers Board for the State of California Department of Consumer Affairs. Scott C. FullerScott C. FullerScott C. Fuller MD, FACS is an Associate Physician in the Department of Otolaryngology at the University of California, Davis School of Medicine. He is a Fellow of the American College of Surgeons, and is also affiliated with the Academy of Otolaryngology/Head and Neck Surgery and the Alpha Omega Alpha Honor Society. Dr Fuller received his BA in Physical Education from the University of California, Davis before moving to the University of Tennessee, Knoxville to complete his MS in Microbiology and his MD from the University of Tennessee Health Science Centre, Memphis. He undertook his residency at the University of California Medical Centre, Sacramento in Otolaryngology/Head and Neck Surgery followed by a fellowship in Head and Neck Oncology, Skull Base, and Microvascular Reconstructive Surgery.