Dr. Rosenfeld acknowledged he could not predict whether some otolaryngologists would use the subcertification as a way to attract more basic pediatric cases but said it should not be a problem for other otolaryngologists. There are only several hundred otolaryngologists who might be eligible for pediatric subcertification, compared with over 10,000 who have a primary certificate, he said. Only about 25 additional fellowship-trained pediatric otolaryngologists emerge each year, a number too small to impact the caseload of general otolaryngologists, he added.
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August 2010“As with any process, there may be some who seek subcertification for personal gain or a competitive advantage, but I am sure the vast majority will not,” Dr. Rosenfeld said. Overall, subcertification should benefit patients, clinicians and the specialty by acknowledging the richness of the discipline and by appropriately recognizing individuals with advanced training, he said.
Dr. Rosenfeld expects the subcertification to move forward eventually; he just isn’t sure when.
“It’s basically inevitable, in the nature of a subspecialty, to move from accreditation to subcertification,” he said. “It’s the natural evolution of defining a body of knowledge in a subspecialty area. And the only thing that slows it down is politics, generally, which can be substantial at times.”
The Maturation of Pediatric Otolaryngology
1919
Surgeon Herbert Coe, MD, dedicates his practice solely to the care of children. D. Crosby Greene reports that the Department of Diseases of the Throat at Children’s Hospital Boston has performed 2,028 operations.
1930s
Dr. Coe petitions the American College of Surgeons (ACS) for a separate pediatric surgery section. The ACS denies his petition out of fear that it would splinter an already fragmenting field.
1940
Dr. Coe approaches the American Academy of Pediatrics (AAP) with his idea of establishing a special section for pediatric surgery. The request is denied.
1948
Resistance to Dr. Coe’s idea is softened and he is asked to serve as first chairman of the Surgical Section of the AAP.
1950s
Three prominent full-time pediatric otolaryngologists come to the forefront in North America: Seymour Cohen in Los Angeles, Blair Fearon in Toronto and Charles Ferguson in Boston.
1965
Stephen Gans and C. Everett Koop establish the Journal of Pediatric Surgery.
1966
H. William Clatworthy organizes the Committee on Postgraduate Education and Residency Training with the Surgical Section of the AAP to define and standardize training in pediatric surgery.
1968
Sylvan Stool and Marvin Culbertson, Jr., post a notice for an informal gathering of those interested in pediatric otolaryngology, to be held at the AAP meeting. About 20 otolaryngologists and audiologists attend.
1969
The ACS forms an advisory council for pediatric surgery.
1970
The American Pediatric Surgical Association (APSA) is formed.
1972
After two prior rejections, the American Board of Surgery (ABS) accepts a petition from C. Everett Koop to approve a written exam that would grant a Certificate of Competence in Pediatric Surgery.
1973
The AAP pediatric otolaryngology group formalizes as the Society for Ear, Nose, and Throat Advances in Children (SENTAC).
1975
Charles Bluestone and Sylvan Stool create the first formal pediatric otolaryngology fellowship at the Children’s Hospital of Pittsburgh.
1985
Fifty-six otolaryngologists from the U.S. and Canada meet in Bermuda and decide to form the American Society of Pediatric Otolaryngology (ASPO).
1992
The American Board of Otolaryngology (ABOto) receives approval from the American Board of Medical Specialties to create a Certificate of Added Qualification (CAQ) in Pediatric Otolaryngology. The ABOto has not, to date, offered such specialty certification, however.
1995
The otolaryngology residency review committee of the Accreditation Council for Graduate Medical Education (ACGME) develops criteria for accrediting pediatric fellowships.
2001
The ABS creates a Pediatric Surgery Board.