title: Head and neck surgical subspecialty training in Africa: Sustainable models to improve cancer care in developing countries.
abstract: Cancer poses a health crisis in the developing world where surgery is the mainstay of treatment for head and neck cancers. However, a shortage of surgeons with appropriate skills exists. How do we train head and neck surgeons in developing countries and avoid a brain drain? The ideal model provides appropriate affordable training leading to establishment of head and neck cancer centers that teach and train others.
  
  
  
  Different head and neck surgery training models are presented based on the personal experiences of the authors. Surgical exposure of head and neck fellows in Cape Town and (potentially) in Nairobi is benchmarked against programs in the United States.
  
  
  
  Surgical exposure in Cape Town is equivalent to that in the United States, but more appropriate to a developing world setting.
  
  
  
  Training can be achieved in a number of ways, which may be complimentary. Fellowship training is possible in developing countries. © 2016 Wiley Periodicals, Inc. Head Neck 39: 605-611, 2017.
authors.affiliation: Division of Otorhinolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa.
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Fagan
authors.affiliation: Department of Head and Neck Surgery, University of Texas MD, Anderson Cancer Center, Houston, Texas.
authors.forename: Mark
authors.initials: M
authors.lastname: Zafereo
authors.affiliation: Department of Surgery, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
authors.forename: Joyce
authors.initials: J
authors.lastname: Aswani
authors.affiliation: Department of Head and Neck Surgery, Vanderbilt Bill Wilkerson Center, Nashville, Tennessee.
authors.forename: James L
authors.initials: JL
authors.lastname: Netterville
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins Head and Neck Cancer Center, Baltimore, Maryland.
authors.forename: Wayne
authors.initials: W
authors.lastname: Koch
mesh_terms: D002173:Cancer Care Facilities / Q000458:organization & administration*; D003906:Developing Countries; D004503:Education, Medical, Graduate / Q000379:methods*; D005257:Fellowships and Scholarships / Q000458:organization & administration; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D017145:Models, Educational; D020380:Needs Assessment; D011203:Poverty; D018570:Risk Assessment; D013019:South Africa; D000071077:Surgical Oncology / Q000193:education*
keywords: Africa; developing countries; developing world; fellowship; head and neck cancer; humanitarian; outreach; subspecialty; surgery; training