Otolaryngology residency and fellowship training. The resident's perspective

Based on the success rate of US otolaryngology graduates on the American Board of Otolaryngology Certification Examination, it would appear that otolaryngology training is quite good. However, it is not clear that all aspects of training are equal in quality, not only between programs but also within a single program. One indication that there may be areas of weakness is the fact that despite the perceived national shortages of primary care physicians in the United States and the overabundance of specialists, 25% of the approximately 260 graduating otolaryngology residents extend their training beyond specialty training to subspecialty levels (Manpower Committee of the American Academy of Otolaryngology-Head and Neck Surgery, unpublished data obtained from chief resident questionnaires, 1990-1992). The most popular area of fellowship training is facial plastic surgery, followed by neurotology and head and neck oncology. Pediatric otolaryngology fellowships make up most of the balance. Most of the fellowships are well structured and are 1 year in duration. Others are more like apprenticeships and may be of shorter duration. A few are 2 years long and include a significant research commitment reserved for individuals entering academic practice.