Pediatric Otolaryngology Training Program and Surgical Exposure in Western Province, Saudi Arabia; Toward Surgical Competency in Pediatric Otolaryngology

Introduction: King Abdulaziz University, in the Western Province of Saudi Arabia, in collaboration with King Saud Bin Abdulaziz University, has had a pediatric otolaryngology fellowship program in place since 2013, but no clear competency surgical caseload has been identified.

 

Objective: To review the surgical load at the otolaryngology department in Saudi Arabia and to compare the currently implemented fellowship program with international standards.

 

Methods: This was a descriptive cross-sectional study performed in King Abdulaziz University (KAU) hospital and King Saud Bin Abdulaziz University hospital. The number of otolaryngology surgeries was collected from the hospitals’ medical records for all patients <18 years who underwent surgical interventions from 2013 to 2018. The data collected were compared with the accreditation council for graduate medical education (ACGME) international benchmarks.

 

Results: The average annual number of procedures performed versus benchmarks were 10.2 Vs. 20 for congenital anomalies procedures (p=0.003), 15.7 Vs. 12 for head and neck surgeries (p=0.231), 3.4 Vs. 30 for otology procedures (p<0.001), 11.8 Vs. 5 for closed airway procedures for children<3 years (p=0.088), 16.8 Vs. 5 for endoscopic airway procedures for children>3 years (p<0.001), 9.4 Vs. 8 for open airway procedures (p=0.439), 172.2 Vs. 50 for endoscopic interventions (p=0.006), 34.6Vs. 40 for rhinology procedures (p=0.189) and 2.8 Vs. 5 for facial plastic surgeries (p<0.001).

 

Conclusion: The number of surgical endoscopic airway procedures and head and neck surgeries meets the international benchmarks, whereas procedures of congenital anomalies, otology, rhinology and facial plastics do not meet the international benchmarks within a single year, so a reduction of the two-year fellowship to one year would not be appropriate.