Laryngology Fellowship

Laryngology is a subspecialty within Otolaryngology – Head and Neck Surgery encompassing a field of knowledge that deals with disorders of voice, airway and swallowing. The laryngologist has special expertise in the diagnostic and therapeutic approaches to problems in these areas and participates in the advancement of knowledge through clinical and/or basic science research. Laryngology is a recognized area within otolaryngology training programs and further postgraduate fellowship training is an option for those otolaryngologists wishing to further their education in the field.

The American Laryngological Association (ALA), as the senior society representing the subspecialty of laryngology, has developed guidelines for developing and implementing postgraduate training in laryngology. The main focus of these guidelines is to provide a resource for new physicians and residents considering further training in laryngology or for those physicians considering offering a fellowship in advanced training in laryngology. Fellowship directors who have implemented these recommended guidelines for training are invited to provide information about their fellowships to the ALA.

History of Laryngology Fellowship Match Program

Specialized post-residency training in laryngology began in the United States in 1992 with a limited number of programs. Since the inception of Fellowship training in Laryngology, the number of programs has expanded to more than 20. These programs train over 24 candidates annually.  Due to the competitive nature of these fellowships, candidates and programs found themselves interviewing and filling positions earlier and earlier during the course of post-graduate training. To feel secure in finding Laryngology Fellowship positions, candidates needed to announce their intentions for training during their PGY 2 year. Interviews were conducted during the beginning of their PGY 3 year and acceptances made. This system of early matching prevented many interested residents from considering careers in Laryngology and forced Fellowship Programs to accept residents early before having the opportunity to interview all interested candidates. To counteract this devolving trend and to allow fellow candidates adequate training time in all areas of otolaryngology so they were better prepared to make an informed career decision, and to allow programs to interview all interested applicants, the concept of a uniform date of acceptance and/or match program surfaced.

The initial discussions regarding this process began with the ALA council in 2006. The outcome of those discussions was to develop the Laryngology Fellowship Guidelines. These Guidelines for Laryngology Education serve as a resource for resident physicians interested in laryngology and for practicing laryngologists considering developing a fellowship program at their institution. The guidelines are currently available on the ALA website. Through further discussions the concept of a formal match program for fellowship training gained support from a majority of fellowship directors.

Through the work of Marvin Fried (ALA president 2009/10), Clark Rosen (ALA member 2005), Al Merati (ALA member 2007), and others, discussions were initiated between various match programs. Discussions with the leadership of the National Resident Matching Program (NRMP) seemed most promising and on the early morning of April 29, 2010, during the Annual Meeting of the ALA in Las Vegas, NV, a meeting was held by the ALA for fellowship directors and representatives of the NRMP. The meeting on that early morning in April was the culmination of this renewed effort. The NRMP representatives presented the benefits of using a match program, discussed a timeline for a match program, the requirements for programs to participate and the associated costs. At the end of the meeting, informal commitments were made by over 80% of the program directors present to participate in an official match to be offered through the NRMP for the academic year 2012-2013.

At the ALA council meeting, which preceded the ALA Annual Meeting, it was discussed that the ALA should appoint a representative to the NRMP to facilitate communication for the Laryngology Fellowship Match program. To avoid potential conflict of interest the Council decided that the representative should not direct a fellowship program. Because of his prior participation in the process and that he does not direct a fellowship, Dr. Fried was chosen for this position. Al Merati was asked to serve as a liaison between the ALA and the AAO-HNS Section on Residents and Fellows.