Otolaryngology residency training: resurgence of the specialty.

Five decades ago, otolaryngology dealt primarily with infectious diseases of the head and neck. The quality of otolaryngology residency training programs was inconsistent and mostly determined by the institution and local faculty. The specialty flourished by developing new expertise in all facets of head and neck medicine and surgery through the leadership of outstanding clinicians and scientists in private practice and universities. Otolaryngology programs subsequently grew from weak divisions within a department of surgery with few faculty members to departments of otolaryngology with full-time, mostly fellowship-trained faculty. Teaching shifted from resident-to-resident to faculty teaching. Organized medicine encouraged systematic quality improvement and periodic review of programs for accreditation. Residencies were also bolstered through Medicare, Medicaid, and Veterans Administration hospitals, which provided funds for growth but limited flexibility of the faculty schedules. The American Academy of Otolaryngology/Head and Neck Surgery shouldered an enormous load of teaching and maintaining unity of the specialty from its birth to the present.