Dr. Sismanis, why did you choose to specialize in
Otolaryngology? What attracted you in the field then and what attracts you now?
My father, the late Dimitrios
Sismanis, was one of the first post WWII Otolaryngologists of Athens. He has had an excellent training under
professor Theodoros Dimitriadis (https://docplayer.gr/4587313-Professor-theodoros-dimitriadis-a-pioneer-greek-otolaryngologist.html),
a giant Otorhinolaryngologist even with today’s standards. In the early years of his career, he
performed procedures such as tonsillectomies, adenoidectomies, and
septoplasties at a small clinic accommodating 3-4 beds, which was located at
the back of our home in Zografou. Later on, he stopped operating at home and
took his patients to various clinics of Athens, including the clinic of
Aristides Evgenides, presently known as Evgenidion Hospital. Evgenides was himself an
otorhinolaryngologist and a good friend of my father’s, whom I had gotten to
know and still remember very vividly.
Often times I would accompany my father at this clinic and to assist him
in surgeries. II performed my very first
procedure in Greece, a septoplasty under local anesthesia in the late
seventies.
When I started my residency in the
United States in 1973, I was mainly interested in the field of General Surgery,
however, I never forgot my father desire not only to follow his steps but also
to have my training in the United States, which he was considering the Mecca of
Otorhinolaryngology. As I was exposed to
the Otolarhinoyngology during my second year in Surgery, I realized that this
was the specialty I should pursue, and I think that I made the right decision.
You are doubly subspecialized in Head and Neck Surgical
Oncology and Otology-Neurotology. What qualities should the aspiring surgeon
possess to succeed in these fields?
In the United States, if you are
planning to pursue a university career, after your formal 5-year training in
Otorhinolaryngology, getting a fellowship in one the subspecialties
(Otology-Neurotology, Head and Neck Surgery, Rhinology, Pediatric, Laryngology,
etc.) is most often required. The prospective applicant for a subspecialty
fellowship should possess good knowledge of Otorhinolaryngology, should have
exhibited an outstanding performance during his/her residency years, have
strong recommendation letters from the people who have trained him/her, and be
enthusiastic to spend an extra, usually, 2 years in fellowship training. Most fellowships in the US are very
competitive and have 1 or 2 at most positions. Since I was planning to return
to the University of Athens following my training in the US, I felt compelled
to acquire extra training in otology, neuro-otology and Head and Neck
surgery. I need to mention that in the
80s it was unheard-of in Greece for a physician to restrict his/her practice in
a subspecialty only such as the otology.
You hold an outstanding publications record in the field -4854
citations as of August 2019- and you have published both in basic and clinical
science. How, in your opinion, could someone combine research activity and
clinical practice? How do you see the role of Surgeon-Scientists in modern
healthcare?
Clinical or basic research along
teaching are imperative facets of Academic Medicine. Clinical practice alone by faculty members
without conducting any research is nothing more than practicing your specialty
under the roof of a Medical School. It
is research that generates new knowledge, something that gives unique
fulfillment and sense of accomplishment to the researcher. In the US there are a number of private
Medical centers especially in the field of Otology, some of them having an
affiliation with Medical School, which have contributed tremendously in
acquiring new knowledge. Typical example
is the House Ear Institute of Los Angeles, a pioneering center for otologic and
neuro-otologic diseases. The role of the clinician-scientist is very important
because he/she has first-hand experience from the patient’s bedside of the
various medical disorders, which need to be addressed by basic clinical or
science research.
You are an Academic Otolaryngologist for almost four decades.
What in your opinion makes a competitive applicant? What are you looking for in
an applicant and what would your advice a medical student, aspiring to pursue a
career in Otolaryngology?
A competitive applicant first of all
should be certain about his/her decision to become an Otolaryngologist-Head and
Neck surgeon. The applicant should be
very enthusiastic about the specialty he/she has elected to pursue and work
very hard towards achieving this goal.
Prior to applying for residency, it is very helpful to have a rotation
through an otolaryngology residency program and preferably have a mentor in the
field whom he/she will shadow for a period of time. An inspirational faculty
member often works as a stimulus to attract outstanding applicants to the
specialty.
What do you expect to change in academic Otolaryngology, in
terms of residence training and clinical practice over the next decade?
Artificial intelligence and
simulation technologies will be integrated in the everyday teaching and
practice of Medicine and will play a significant role in training of
residents. The applicant qualifications
will continue to increase and acceptance by residency programs will become more
competitive. Hopefully the calamity of physicians burn-out syndrome (sense of
failure and self-doubt, feeling, helpless, trapped, defeated, loss of
motivation), something affecting close to 40-50% of physicians in the US and is
due in part to the advanced technology, will soon be properly addressed. The good news is that the specialty of
Otolaryngology is one of the least affected specialties.
Thank you very much Dr. Sismanis for sharing your experience
and thoughts with THE HEAD AND NECK BLOG. It is such a great honor to include
you in the Expert Opinions Section!
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