Prime Time for Pediatric Otolaryngology: ASPO seeks subcertification

With pediatric otolaryngology continuing to evolve, the American Society of Pediatric Otolaryngology (ASPO) is exploring subcertification in the field, saying it is specialized enough that it deserves recognition. The society has approached the American Board of Otolaryngology (ABOto) about the possibility and is working on defining the knowledge base that would be required for a physician to become subcertified as a pediatric otolaryngologist.

But previous subcertification processes have shown that it can be a sensitive topic, and the ABOto is emphasizing the importance of keeping the lines of communication open as the process goes forward.

ASPO President-Elect Richard Rosenfeld, MD, MPH, who is chairing the effort for pediatric subcertification, said the purpose is to give proper recognition for advanced knowledge and isn’t meant to erode general otolaryngologists’ share of pediatric cases.

“It recognizes it as a distinct body of knowledge and experience within the broader discipline of otolaryngology—many pediatric otolaryngologists have advanced training and experience beyond what you get in residency,” Dr. Rosenfeld said. “We absolutely want to avoid at all cost any suggestion of making this a surgical qualification where you have to do XYZ number of tonsillectomies.”

Subcertification, in general, can be case-based, determined by a physician’s performance of certain types of procedures or by a physician’s mastery of a certain body of knowledge. Subcertification for pediatric otolaryngology would fall into the latter category, Dr. Rosenfeld said. And it would most likely be a written exam, with or without an oral component. He anticipates the completion of the subcertification process some time in the next two to five years but said there is no rush.

“It’s resurfaced that people want this designation— the question is why.”
—Gerard Healy, MD

The Process

To become subcertified, a doctor would have to complete an accredited fellowship in pediatric otolaryngology and pass an exam. Dr. Rosenfeld said the exam would include areas of additional knowledge beyond basic knowledge learned in regular residency, such as clinical genetics, developmental anatomy, child development and growth, advanced reconstructive surgery of the pediatric airway, management of foreign bodies and foreign material ingestion in infants and children, neoplasms of the head and neck in children and other areas.

But there would be an alternate pathway for about seven or eight years, during which physicians who hold a primary otolaryngology certificate could qualify for pediatric subcertification without an accredited fellowship.

Dr. Rosenfeld said the society is trying to avoid creating division within the field of otolaryngology.