History of the American Academy of Craniomaxillofacial Surgeons
In July of 2009, two major surgical conferences were convened that attracted oral and maxillofacial surgeons from 11 different countries and virtually every state in the Union to travel to Oregon for the purpose of education, exchange of ideas, scholarly exercise, and fellowship. “Technological Advances In Head and Neck Oncology and Craniomaxillofacial Surgery”, was a multidisciplinary scientific meeting focused on head and neck cancer, maxillofacial reconstruction, and craniofacial / orthognathic surgery. The event demonstrated the intense interest that is present in a substantial and growing cadre of American oral and maxillofacial surgeons that are either fellowship trained in or have developed subspecialty practices in oral and maxillofacial oncologic surgery, reconstructive microvascular surgery, pediatric craniofacial surgery or cranio-maxillofacial trauma. The “Mt. Hood Summit” which took place at Timberline Lodge immediately after the Technological Advances meeting, was organized for the purpose of holding a dialogue about how the specialty of oral and maxillofacial surgery can best position itself within a changing health care environment, amongst competing interests and varying priorities. Recommendations were made by some of the most prominent academic surgeons in the United States in this regard and the conclusions and recommendations of those present were outlined in a letter to the President of the American Association of Oral and Maxillofacial Surgeons, Dr. Lynn White.
Background
The scope of practice for U.S. oral and maxillofacial surgeons has historically been essentially the same, regardless of degree. One reason for this was the fact that faculty at many United States training programs had previously lacked experience and training in so-called “expanded scope” areas, such as head and neck oncology, microvascular surgery, and pediatric cleft and craniofacial surgery. In years past, if an OMS graduate wished to obtain training in any of these areas, then he or she was forced to seek it outside of the specialty, in either otolaryngology or plastic surgery. However, this began changing at the turn of the 20th Century due to dedicated fellowship training programs in head and neck oncologic surgery, microvascular reconstructive surgery, and pediatric craniofacial surgery. Specifically, formally recognized and accredited advanced training fellowships significantly increased the opportunities available to those graduates of US oral and maxillofacial surgery programs wishing to expand their scope of practice. Standing on the shoulders of OMSs trained in Otolaryngology (Eric Dierks and Bryce Potter), Plastic Surgery (Jeff Posnick), and in Europe (Robert Ord and Joseph Helman), and other notable American pioneers (Robert Marx and Tim Turvey) dozens of North American-trained OMSs began providing comprehensive head and neck, microvascular, and pediatric craniofacial surgery at various training institutions around the country. Just as the development of and training in orthognathic surgery contributed to the evolution of the U.S. specialty from oral surgery to one of oral and maxillofacial surgery in the late 1960’s and 1970’s, so to did fellowship training in head and neck surgery have a transformative effect on the specialty today.
Technological Advances In Head And Neck Oncolgoy And Craniomaxillofacial Surgery, July 24-26, 2009
The Governor Hotel, Portland, Oregon
The “Technological Advances” meeting was by all accounts a tremendous success. Approximately 260 surgeons and other health care providers attended the event, of which approximately 200 were oral and maxillofacial surgeons. The course was divided into three days, each of which highlighted various technological innovations that have affected the fields of head and neck surgery, reconstructive maxillofacial surgery, and craniofacial/orthognathic surgery. Drs. Bill Bell, Dan Buchbinder, Rolf Ewers, Beat Hammer, Tony Pogrel, Alexis Rapidis, Rainer Schmelzeisen, Steve Schendel, Gwen Swennen, and Tim Turvey delivered keynote lectures that emphasized computer planning and intraoperative navigation, custom implants, and endoscopic approaches for a variety of cranio-maxillofacial applications. Dr. Jatin Shah and Joe Gruss examined the past, present and future of head and neck surgery and maxillofacial surgery; Carl Snyderman presented state of the art endoscopic skull base techniques; and Dr. Maria Sieminow gave a riveting presentation on her experience with facial transplantation at the Cleveland Clinic. Oral abstract presentations, given by a dozen fellowship-trained academic OMSs were embedded into the scientific program that complemented a hands-on workshop dedicated to computer planning and intraoperative navigation. The course was co-sponsored by Legacy Health System, with significant funding support provided by thirteen corporate partners. Virtually all of the reviews were highly positive and the feedback has been so encouraging that the meeting was planned again for 2011.
The Summit On Mount Hood, July 26-27, 2009
Timberline Lodge, Mount Hood, Oregon
Immediately following the close of the Technological Advances meeting, 45 academic oral and maxillofacial surgeons convened at Timberline Lodge for the “Summit on Mt. Hood”. Topics of discussion included: international training and scope of practice; the impact of head and neck, microvascular, and pediatric craniofacial fellowships on North American Oral and Maxillofacial Surgery; the current status of academic oral and maxillofacial surgery; the current and future training avenues in maxillofacial surgery; and the accreditation of fellowships. The discussion was congenial albeit spirited, and passions were raised regarding a number of issues that have been brought to light over the last several years as the specialty has evolved and the scope of practice significantly expanded.
Timberline Society, July 20-21, 2011
Two years after the Mt. Hood Summit, again surrounding a meeting on Technological Advances in Craniomaxillofacial Surgery, more than 50 OMS educators from around the world reconvened in Oregon under the banner of the “Timberline Society”. Updates on the current status of training in head and neck oncology, microvascular surgery, craniomaxillofacial trauma and pediatric surgery were again presented by Drs. Bryan Bell, Rui Fernandes, Mark Engelstad and Tim Turvey. Leon Assael and Barrie Evans discussed the current and future state of OMS education in the U.S. and Great Britain respectively, and Angelo Cuzalina provided a perspective from the American Academy of Cosmetic Surgery. Rainer Schmelzeisen and James Brown reviewed opportunities for clinical research in Germany and the United Kingdom and provided insights into oral and maxillofacial surgery in Europe. Steve Roser presented on the importance of engaging the American College of Surgeons in matters related to healthcare and OMS. Another document was drafted out of the meeting, “Infinite Cornucopia in an Era of Change and Opportunity: Fellowship training, medicine and the future of North American Oral and Maxillofacial Surgery”, which called for OMS education reform, accreditation reform and formal affiliation with the American College of Surgeons. Finally, in a summation lecture by Bob Ord, a call was made to create a new, independent organization, dedicated to craniomaxillofacial surgery. In an almost unanimous vote, the group agreed to form what would later be called The American Academy of Craniomaxillofacial Surgeons (AACMFS).
The charter meeting of the AACMFS was held the following year in Boston at the Massachusetts General Hospital. More than 75 surgeons met within the historical confines of the Ether Dome and formally created and incorporated a new surgical society. After agreeing on a working set of bylaws, Dr. Leonard Kaban was voted in as its first President.