Otolaryngology–Head and Neck Surgery Training and Service Delivery: An International Survey

Abstract

Importance

Highlighting the global disparities in otolaryngology training and, ultimately, service delivery, emphasizing the need for equitable access to training resources and programs.

Objective

To describe the relationship between the quality, content, and location of otolaryngology–head and neck surgery training and education and the resulting impact on the delivery of otolaryngology care globally.

Design

An online cross-sectional survey to otolaryngologists, gathering information on their training and education experiences, and factors influencing their choice of training location and practice.

Setting

The online survey was available in multiple languages, distributed via national and international professional otolaryngology societies, snowballing and social media.

Participants

The respondents were practicing otolaryngologists representing all seven World Health Organization regions.

Exposures

World Bank income groups classification.

Main Outcomes and Measures

Our expected outcome was that subspecialty training and access to educational resources were significantly readily available to respondents from high-income countries, leading to more confidence in performing complex procedures post training.

Results

A total of 91 participants were included in the analysis, with 47 (52%) practicing in high-income countries and 44 (48%) in low- and middle-income countries. Sixty-one participants (67%) were male. Subspecialty training and access to educational resources were significantly less available in low- and middle-income countries, leading to lower confidence among low- and middle-income countries physicians in performing complex procedures. High-income country respondents reported better access to diverse training resources and felt more prepared for a broader range of procedures.

Conclusion and Relevance

Significant disparities exist in OHNS training resources and subspecialty training opportunities between high- and low-middle-income countries. There is a critical need to integrate complementary training and educational modalities into local systems. Addressing the shortage of educational resources and promoting open-access initiatives in low-middle-income countries are essential steps toward enhancing surgical education and improving global otolaryngology healthcare outcomes.