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.