Mentoring Today for Our Future

Douglas D. Backous, MD, speaks at a mentorship program at the Seattle Science Foundation in July 2024 to encourage underrepresented high school and college students to pursue medicine.Greetings, and I hope you are all enjoying the summer months. Fun, family, friends, and some time off are in order. In thinking about this column, several issues flooded my mind that differ in content, but merge along the common idea of, “What do we want otolaryngology to be in the near and distant futures?” How we mentor each other and encourage young people to join our ranks is foundational in answering that question. Mentoring has many different definitions. My favorite is, “a learning relationship that helps people grow, develop, and achieve their goals.” Roll with me for a few moments, and I welcome your thoughts in feedback. I cannot do justice to all the incredible work being done by many people in our specialty, but let me highlight a few.

The Future Is in Great Hands

July marked an enormous milestone as we announced the selection of Rahul K. Shah, MD, MBA, as the next Executive Vice President and CEO of the American Academy of Otolaryngology–Head and Neck Surgery and its Foundation (AAO-HNS/F). Dr. Shah was chosen after a rigorous process, ending with the approval of his hire by the AAO-HNS/F Board of Directors (BODs) on July 10. I believe you will find Dr. Shah to be committed, innovative, collaborative, energetic, and enthusiastic in his approach to leading our Academy. We feel that he is the right person to lead us, bringing new ideas and directions that will build on the great work accomplished by James C. Denneny III, MD, over the past 10 years. The “changing of the guard” will occur on December 2, 2024, after a one-month overlap in November. Your BODs are working to ensure a smooth transition and to provide Dr. Shah with the resources he needs to have an early and lasting impact.

Thank you to each member of the Search Committee, the executive leadership team, and the staff of the AAO-HNS/F. The Academy needs to be strong to be a resource for otolaryngologists at all levels of their careers.

Bridging the Gender Divide

When I think about the future of our specialty, I think about the gaps that we have yet to bridge. In the past eight months, I have been privileged to hear Jennifer R. Grandis, MD, speak twice on the pay disparity between genders in medicine. She gave a thought-provoking and challenging John Conley, MD Lecture on Medical Ethics on this topic at the AAO-HNSF 2023 Annual Meeting in Nashville, Tennessee, and a compelling talk at the 2024 Combined Otolaryngology Spring Meetings in May. Aside from being a respected surgeon and mentor to many, she has committed a large portion of her academic career on a scholarly approach to identifying the key issues driving the gender-gap in pay, academic promotion, and lifestyle/career opportunities. She calls out the need for significant change and identifies many of the complexities involved in achieving equal pay and career opportunities for women.

Ellen M. Friedman, MD, is a friend who mentored me during my residency at Baylor College of Medicine in Houston, Texas. Her Cotton-Fitton Endowed Lecture in Pediatric Otolaryngology given at the AAO-HNSF 2021 Annual Meeting, titled, “What You See Depends on Where You Stand,” was compelling, humbly delivered, sincere, and honest. It also stung. It challenged me to explore my own biases, find ways to support women in my group practice locally, and find ways to support the needed change at a national level.

This year I have engaged in identifying tangible ways the AAO-HNS/F can support women in otolaryngology to achieve parity in opportunity at their institution or practice. Our Academy seeks to empower all our members to be supported in their own institutions and practices to ask for equal pay for their work. I asked Yelizaveta (Lisa) Shnayder, MD, Chair of the Women in Otolaryngology (WIO) Section, to work with the section and deliver a Position Statement on pay equity. This statement will go to the Physician Payment Policy (3P) Workgroup and then the Executive Committee, followed by a presentation to the Board for approval. Although this is only one step in a long process to achieve equality at every level of our specialty, a Position Statement is a significant step. As my personal journey for awareness and change continues, I challenge each of us to support equity for women in our own practices and institutions. 

Thank you, Dr. Grandis, Dr. Friedman, and Dr. Shnayder, for energizing our Academy membership to push forward on this issue.

Building a Path to OTO

Identifying students early in the education pipeline and encouraging them to pursue STEM curricula in the hopes that a fraction will choose medicine as a career pathway and otolaryngology as a specialty is essential to our future. Mentorship is central to this process. I would like to give a shout-out the COOL-OTO program spearheaded by Michael Hoa, MD, that will take place in conjunction with the Annual Meeting in Miami. Michael Hoffer, MD and Hillary Snapp, AuD, PhD, from the Miami Miller School of Medicine, are working with Dr. Hoa to offer a simulation course to underrepresented high school students in the Miami area Monday, September 30. A Sinus Dissection Course, sponsored by Medtronic and coordinated with the Black Otolaryngologist Network, is being offered September 29, also during the Annual Meeting. Shannon D. Fayson, MD, has organized a group of leaders to inspire students with a hands-on experience for this event. Romaine F. Johnson, MD, is leading an effort by the Harry Barnes Society to host a student forum on the same day. The forum will be open to anyone who would like to participate in engaging discussions on diversity, equity, and inclusion and the continuation for grants for medical student rotations in otolaryngology. These opportunities will open the eyes of many young and talented people from underrepresented backgrounds and challenge them to build lofty goals.

Thank you to all involved with these activities and the other mentorship programs going on this year in our specialty.

Mentorship is needed for members at all levels of their careers. The leaders of each of our Sections are exploring a more formalized program that would provide needed guidance for members who are starting their careers, pondering career changes, switching practice styles, and even providing guidance about timing retirement for older members. I look forward to what we can create. Our greatest asset is each other. I look forward to members guiding members through career choices at every level.

Should Medical Students Publish or Perish, Too?

In July, OTO Open published a compelling paper¹ looking at research production among otolaryngology residency applicants. The authors report an increase from a mean of 8.4 abstract publications and presentations in 2016 to 17.2 in 2022. The difference in research production between matched and unmatched applicants is significant. The authors speculate this may indicate a bias toward “research-heavy” residency candidates. The authors call for a closer examination of this trend as we define our future workforce in otolaryngology. AAO-HNS/F Past President Albert L. Merati, MD, and AAO-HNS/F President-elect Eugene G. Brown III, MD, RPh, will be addressing this topic and several others in the second edition of “Crucial Conversations” at the Annual Meeting. I highly recommend you attend this important session on September 29 to express your views.

Each of these topics, although different, converge on how we can support each other and future colleagues. Although few have an “easy fix,” a persistent and organized approach by all of us will slowly create meaningful and measurable change. Our Academy can provide the foundational support and platform to empower members to serve all communities, including the underserved. I am proud to be an otolaryngologist. Together we are one.

Reference

1. Smith, D.H., Zeitouni, J., Kim Thiesse, N. and Bowe, S.N. (2024), Trends of Rising Research Production Among Otolaryngology Residency Applicants. OTO Open, 8: e170. https://doi.org/10.1002/oto2.170