The 2022 Otolaryngology Workforce report highlights many areas of growth and strength, but also reveals trends that may impact the career of every otolaryngologist in the United States. Otolaryngology continues to be one of the most competitive residencies to obtain. Subspecialization has continued at unprecedented levels with 75% of current trainees pursuing post-residency subspecialty fellowships. Academic faculty ranks have grown across the country. While otolaryngology residency training programs are defined by their commitment to training, the academic training programs sit as a gatekeeper to the specialty. - Are training programs doing right by the specialty in general? Why and why not? What responsibility should our programs have to the field in general?- What about the research arms race? As otolaryngology-head and neck surgery remains competitive, more students are taking a year off for research to add their CV. What impact is this having on our specialty?- Do the desires and preferences of those in academic impact the specialty in ways we can describe? Does this create any intended or unintended disadvantages?- Is there value to clinical exposure to comprehensive otolaryngology practices? Practices outside of a traditional academic model?- Should there be alternate pathways for training? Why or why not?- What happens if we do absolutely nothing about the current trends? The assembled panel, led by Albert L. Merati, MD will highlight various areas of these topics and work to foster discussions of all these questions. Audience participation is expected—everyone has opinions and strong feelings.