It doesn’t necessarily take a crystal ball to see the bigger future of otolaryngology, but the details can sometimes be a little murky. ENTtoday asked four newly minted chairs of otolaryngology departments how they made it to their positions, what they feel is the most important aspect of leadership, and what they feel the future holds for academic medicine. Below are their answers, edited for length and clarity.
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April 2022
Work hard, be kind, and do the right thing.
NAUSHEEN JAMAL, MD
Chair, Otolaryngology– Head and Neck Surgery
University of Texas Rio Grande Valley School of Medicine, Edinburg, Texas
I’m the eldest of three girls. My parents immigrated from Bangladesh to Australia and then to the United States, and I learned to speak English in preschool. I went to college in Philadelphia, medical school in Houston, did my otolaryngology residency in New York, and earned a fellowship in laryngology in Los Angeles. After my fellowship, I was a faculty member at Temple University at the Lewis Katz School of Medicine, and really enjoyed being involved in education. After a year or two, I took over as clerkship director and really enjoyed mentoring medical students.
Next, I became the associate director for the residency program and, later, program director. I always had a strong interest in education and great mentorship from my chair, who recognized that was something I enjoyed. He helped me grow into those roles.
When my chair left to become dean at The University of Texas Rio Grande Valley School of Medicine, he recruited me to serve as designated institutional official (DIO) for the Accreditation Council for Graduate Medical Education (ACGME), which oversees and accredits all of the graduate medical education programs at an institution. I’m now also one of seven women in the U.S. who chair otolaryngology departments.
There are three rules I have for myself when I’m wondering how to address a situation or make a decision. The first is to work very hard at addressing that situation. The second is to be kind when, for example, I have to tell someone something they may not want to hear. And the third is to do the right thing, even if it’s going to make someone unhappy with me. When we’re in leadership roles, our goal isn’t to make everybody happy. This was something I had to learn the hard way when I transitioned from being a program director of a single department to DIO for the ACGME. I had to interact with people from all backgrounds and cultures in that role.
I have a particular interest in taking care of the head and neck cancer population and the rehabilitation they need after their cancer care. Patient safety and quality improvement is a real area of interest for me. We do a good job of guiding our residents to become good clinicians and good surgeons. Traditionally, we’ve done a great job with basic science and translational and clinical research. I think we need to continue to evolve the education we provide to make our systems safer and provide a higher quality of care.
His childhood otolaryngologist became his mentor.
MAS TAKASHIMA, MD
Chair, Department of Otolaryngology–Head and Neck Surgery
Houston Methodist Hospital, Houston, Texas
When I was six years old, I was diagnosed with a cholesterol granuloma in the petrous apex and needed surgery. My parents had just immigrated from Japan to Texas and didn’t speak English. They brought me to Baylor College of Medicine, where I saw Dr. Paul Johnson [in the photo above, on the right] on the otolaryngology faculty. Dr. Johnson was amazing both as a clinician and a human being—he was so kind to my parents at a very stressful time. Since my condition was chronic, I would have follow-up appointments with him every three to six months from elementary school through high school. As a young adult, I told Dr. Johnson I was interested in medicine. He gave me advice, and after college I wound up doing a rotation with him. It was a life-changing relationship. After I graduated from medical school, Dr. Johnson was very supportive of my application to otolaryngology. I became an otolaryngology resident at Baylor College of Medicine, being trained by the doctor who had taken care of me since I was six years old.
I enjoy the interactions and relationships that come with teaching. I was a residency program director at Baylor for 14 years. Now, I have former residents all over the country with whom I keep in touch. It’s a great feeling to know you’re training all of these amazing otolaryngologists who are out there helping people.
I’ve aspired to use what I’ve learned in my 18 years of academics to build my own department, as well as a new ACGME otolaryngology residency program at Houston Methodist. We currently train residents from three different programs: Baylor College of Medicine, University of Texas Medical Branch in Galveston, and the University of Texas in Houston. This is partly because we have a high surgical volume with tertiary and quaternary care patients. It’s also because Houston Methodist is an academic and research institute that prides itself on innovation and state-of-the-art care. We have a director of innovation who interfaces with artificial intelligence companies like Google and Amazon, and an entire floor of the hospital is dedicated to innovation.
Otolaryngology’s pioneering spirit should shape its future.
KONSTANTINA M. STANKOVIC, MD, PHD
Chair, Otolaryngology–Head and Neck Surgery
Stanford University School of Medicine, Stanford, Calif.
I’m a neurotologist and auditory neuroscientist. I trained at Harvard University and MIT, and spent many years practicing at Massachusetts Eye and Ear and Harvard before coming to Stanford as the Bertarelli Foundation Professor and chair of the department of otolaryngology–head and neck surgery. In my new role, working together with my colleagues, we have an opportunity to not only preserve, but also to dramatically improve sensory function, diagnoses, and therapies of diseases that affect the head and neck region.
Otolaryngology has an illustrious history—we were the first to introduce the use of the operating microscope in surgery, which transformed all of surgery. And we introduced cochlear implants, which are the most successful sensory prostheses to date. Additionally, just three years after Edison patented incandescent lights, it was Scottish surgeon John McIntyre who put a miniature bulb in an endoscope so that he could better examine the larynx.
I think what’s truly exciting about the future is staying true to the pioneering spirit of our predecessors. That means we need to identify developments that are relevant for our patients and then boldly step out and help further develop and tailor these scientific and technological trends to improve patient care. Throughout my career, I’ve enjoyed meeting outstanding leaders from all walks of life. There have been patients who’ve shared inspiring stories, trainees who’ve had unbelievable obstacles before them but pushed through to get where they are today, researchers who discovered new therapies for all sorts of diseases, and clinicians who lead cross-disciplinary teams. It’s most interesting, inspiring, and exciting to me to see how we can accomplish so much more together than any one of us can alone.
There’s evidence from cognitive science research that diagnostic reasoning relies not only on the application of scientific knowledge, but also on the process of pattern recognition. This includes reasoning strategies that are based on the memory of previously encountered patients. Going forward, medical education must contain both the imparting of scientific knowledge and the rich exposure to concrete cases during practical training. In terms of research, we need to really advance and incorporate new technologies and ways of thinking into clinical care, translating that into better devices, sensors, and therapies.
You don’t have to be an extrovert to be a good leader in medicine.
DANA CROSBY, MD, MPH
Chair, Otolaryngology–Head and Neck Surgery
Southern Illinois University School of Medicine, Springfield, Ill.
My journey to becoming a doctor wasn’t the typical path many people take. I didn’t always know I wanted to be a doctor. I didn’t have any physicians or healthcare workers in my family. Neither of my parents went to college, but they’re both incredibly hard workers—my mom worked as a secretary at a casket factory and my dad works at the water treatment plant in our small hometown in western Pennsylvania.
In high school, I liked science and math and people. In college, I realized the way to marry my passion for science and helping people was to be a doctor. Toward the end of college, I shadowed somebody in medical school and just knew that’s what I was meant to do. I wouldn’t have gotten here without my parents’ constant support. I owe my success to them entirely.
Becoming department chair was never part of my career plan, to be completely honest. I came from a smaller academic program and was given opportunities early on. If I get an unexpected opportunity, I’m the kind of person who will work really hard to make sure I do that job well. Early in my career, I was given the opportunity to be the residency program director, which I still am. I’m introverted and quiet, but I learned that I can still be a mentor and a leader. When I began practicing academic medicine and stepped into that program director role, I learned there’s a lot of value to being an introvert. There’s more than one way to be a leader and to help people through their careers.
Historically, we’ve focused a lot on didactic lectures, where a person stands in front of a classroom and delivers a lecture, and learners sit and try their best to absorb it. It’s well documented that this isn’t the best way for adults to learn. I think we’ll continue to innovate the way we teach, whether it’s through simulation or flipped classrooms, both of which have become very popular. I also think we’ll continue to advance in terms of surgical skills and models. There’s a lot of technology we can utilize to do all sorts of things that we could never have imagined in the past. We can make high-fidelity models that learners can practice on before engaging in actual patient care. I think there’s a lot that will happen in the intersection of research and education.
We’re in such an exciting time because technology continues to advance at a rate that’s sometimes faster than we can keep up with. But implementing those technological advances in medicine and surgery will allow us to continue to do what we do in a less invasive way. That’s certainly very true of my specialty, rhinology and endoscopic skull base surgery.
Renée Bacher is a freelance medical writer based in Louisiana.
Unlimited Funding Wishlist
We asked these department chairs what they might want for their departments, given unlimited funding:
“A state-of-the-art simulation center to provide the latest simulation-based education for a residency program. I think simulation is such an important aspect of education—not only for traditional clinical learning, but also on addressing patient safety events and developing comfort with difficult conversations.” —Nausheen Jamal, MD
“In general, departments are always in need of more research funding and the ability to get state-of-the-art equipment. I’ve been very lucky to have a supportive institution. Not everything new is better, but providing the opportunity for residents to be exposed to new technology is important for their education.” —Mas Takashima, MD
“Endowments to pursue groundbreaking research now that government funding is increasingly difficult to obtain and may involve multiple revisions and resubmissions of grant applications. Endowments would allow us to continue to work at full speed by allowing more time to be spent in creative pursuits.” —Konstantina Stankovic, MD, PhD
“I would be most interested in finding ways to provide care to patients who have the most difficulty in accessing it. As an academic center surrounded by a really rural area, that’s what we struggle with the most. Cases often come to see us from four or more hours away. How does a patient without a car or without money for gas get to us?” —Dana Crosby, MD