Trends in Laryngology Fellowship Training: A Survey Study of Graduates and Directors.

Abstract

To date, there has not been a comprehensive evaluation of laryngology fellowship training content or structure, and trainee and mentor perceptions of preparedness for practice remain unexplored. An anonymous survey was emailed to known fellowship-trained early-career laryngologists (Graduates) and fellowship Directors. Survey questions explored demographics, fellowship structure, case types and load, autonomous practice, comfort in treating a variety of laryngological disorders, and current practice environment. Descriptive analysis, Chi-square analysis, and Mann-Whitney U tests were performed. 85 known fellowship Graduates and 32 fellowship Directors were contacted, and a 60% response rate or higher was obtained. When asked to report confidence in the independent practice of a variety of laryngologic disorders, Graduates expressed confidence across the vast majority. Directors expressed confidence with more consistent and higher levels of agreement than Graduates. Graduates report less exposure and less confidence in swallowing disorders and transcervical operations. Increased confidence scores are noted among Graduates with more frequent autonomous experiences. Most Graduates report a near even distribution of voice, upper airway, and swallowing disorders in their current practices with 51% seeing more swallowing disorders than in fellowship training. Most recent Graduates of laryngology fellowship training programs feel adequately trained for their current practice. Graduates express less training and less comfort in caring for patients with swallowing disorders as compared to voice and breathing disorders, despite this being a large part of their practice. Autonomous clinics and ORs as well as additional training in swallowing disorders and transcervical operations could benefit future fellows.