Clinical Training and Certification
Successful completion of the AHNS head and neck fellowship has several requirements, all of which could be affected by the COVID-19 pandemic. Throughout the year, the trainee’s performance is continually observed and assessed by the program director and faculty with semi-annual formal evaluations and structured feedback provided on the trainee’s performance. Prior to completing the fellowship, the program director provides an attestation of the trainee’s performance and satisfactory completion of the training program. The ATC has the ultimate responsibility for certification of fellows enrolled in the accredited programs, with this certification depending upon a number of factors, perhaps the most important of which is the program director’s final assessment of his or her fellow’s readiness for program completion. With three months remaining in the training year 86% of responding program directors feel their trainees have already achieved readiness for independent practice as head and neck surgeons. Just as importantly, 96% of responding fellows feel comfortable with their technical skills as ablative head and neck surgeons, and 73% have achieved similar levels of comfort with microvascular procedures. Moreover, in the current training year, 82% of fellows have already logged over 100 major head and neck operations. This analysis suggests that the current fellow class will comfortably achieve readiness for certification by the ATC by the completion of their fellowship year.
For any individual program whose educational experience may have been more adversely affected, the ATC would give careful consideration of a request to extend a fellow’s experience. Extension of training is certainly not a straightforward “solution”, however. Such an extension of training will raise many logistical concerns, including the extension of credentialing and malpractice coverage. Trainees and their families often have relocation plans and employment contracts that may not permit extension of training beyond June 30. Finally, the ATC and program director must consider the effect this will have on the clinical experience of the incoming fellow. Clear goals for satisfactory completion of training should be recommended and directed by each fellowship program as deemed necessary by the program director and teaching faculty, taking into consideration the individual needs, circumstances, and desires of the trainee. As with any training year, but particularly given the ongoing impacts of COVID-19 for this year, the ATC will review, provide guidance where necessary, and support requests for training extension in the best interests of its trainees.