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Fragmentation in General Surgery: The Case of Head and Neck Surgery

Arch Surg. 1990;125(5):679. doi:10.1001/archsurg.1990.01410170127027.
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To the Editor.—I read with interest the commentary by Dr Paul Friedmann.1 While I appreciate that this is a focus of some concern for general surgical training programs, there were some statements made in the article which, in my opinion, are factually unfounded and may indeed provide an undeserved misunderstanding on the part of the reader. There is no question that general surgeons have been involved in surgery of the head and neck for decades. Some continue to be leaders in this anatomical region. Head and neck surgery has been slated as one of the principal components in the menu prescribed in the training of general surgical residents, even though clinical exposure has changed over time.

As evidenced by the numbers excerpted from the report of the General Surgery Residency Review Committee and those available from the data bank of the Otolaryngology—Head and Neck Surgery Residency Review Committee,


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