The interface of academic and community practice in medical and graduate medical education

Historically, the interaction between academic departments of otolaryngology-head and neck surgery and the community practice of the specialty has been erratic, anecdotal, and often strained. A general sense of autonomy and isolationism that has characterized many university programs coupled with a paranoia on the part of many practitioners with respect to concerns about protecting their patient base have led to an uneasy relationship. Difficulties with managed care now threaten this relationship even more. It is clearly time to seek a solution that can enhance the educational opportunities for medical students and residents.