France V. Woissard and M.-A. Faure I. History 1.1. Professional Organization 1. 1. 1. The pioneers Abbé de L’épée (1712-1789) founded the first public school for deaf children, Paris, 1775. In 1830 Colombat published the first treatise on logopedics, which was reissued three times. Abbé Rousselot (1846-1924) began the earliest research in linguistics as a branch of the humanities. He founded the Institute for Phonetics in Paris in 1901. Many French neurologists contributed to the clarification of the neurologic basis of language and speech. Among them Broca, Marie, and Charcot. 1.1.2 La Société Française de la Phoniatrie, a scientific society, was founded by Dr. Jean Tarneaud, as published in the Journal Officiel de la Republique Française on June 2, 1932. Among the leading figures on its first board were E.J. Moure, J. Tarneaud, J. Calvet, B. Vallancien, J.-C.Lafon, G. Cornut, Y.Guerrier, and A. Appaix. 1.1.3 The Syndicat National des Médecins Spécialisés en Phoniatrie, a professional association, was created on August 24, 1966 at the suggestion of Dr. François Le Huche. Its first board included F. Le Huche (President); Hatt (Vice President); Appap (Secretary); and Astier (Treasurer). 1.1.4 The Formation Médicale Continue en Phoniatrie was created in 1997 with the goal of providing training and education in the latest professional developments. 1.2 Professional Status 1.2.1. Phoniatry gradually became a medical subspecialty of otorhinolaryngology. 1.2.2. In 1973 the Conseil National de l’Ordre des Médecins permitted the qualification in Phoniatrics to be designated a “competence.”. It was granted to any medical doctor who could demonstrate his/her applied skills in the fields subsumed under the “competence.” This professional distinction was valid until 1983. 1.2.3 At that time, the reform of medical education led to the abandonment of the “competences,” and a reduction in the number of recognized specialties. Phoniatry was one of those declassified. Since that time the Syndicat has tried to negotiate a new official status for the profession, since this situation continues to create many problems of daily practice for phoniatrists. 1.2.4. Summary Three associations represent the scientific, professional, and education aspects of the profession of phoniatry in FRANCE. Major phoniatrists include Drs. J. Tarneaud and J.-C. Lafon. 2. Present status 2.1 Education and training Three years of training are organized by the Collège Universitaire des Otorhinolaryngologistes, at the end of which candidates receive the Diplome Inter-Universitaire de Phoniatrie. The program includes both theoretical and applied courses in: Phonetics, linguistics, acoustics, communicology, psychology, and pedagogy; Anatomy of the respiratory apparatus, aerodigestive tract, nervous system, and ear; Physiology of respiration, phonation, deglutition, audition, neurophysiology, and neuropsycholinguistics; Communication disorders, including pathology of voice, speech, language, hearing, and swallowing; Treatment modalities, including surgical, medical, and functional therapies; Students are required to pass a written examination and to produce a specialty thesis. 2.2. Practice Our practice is legally recognized as a distinct medical specialty - a “Médecine à Exercice Particulier.” It is therefore fully independent of the practice of otorhinolaryngology. 2.3. Boards of the relevant associations: 2.3.1. Société Française de Phoniatrie President: Danielle Robert, MD General Secretary: Marie-Agnès Faure, MD Address: 32, rue Coquillière F-75001 PARIS 2.3.2. Syndicat des Médecins Spécialisés en Phoniatrie President: Christiane Lobryeau, MD Secretary: Yves Ormezzano, MD Address: 44, Blvd Raspail, F-75007 PARIS 2.3.3. Formation Médicale Continue en Phoniatrie President: Virginie Woisard, MD Secretary: Jocelyne Sarfati, MD Address: Unité de la Voix et de la Déglutition Hôpital Rangueil - Service Otorhinolaryngologie et Chirurgie Cervicofaciale F-31403 Toulouse 2.4. Today’s phoniatrics is officially a subspecialty of ENT. There are ten university departments providing education in phoniatry in different cities: Besançon, Bordeaux, Lyon, Marseille, Montpellier, Nantes, Paris, and Toulouse). There are 240 phoniatric physicians in France, almost all working in two or more of the specialty’s subareas. 3. Scientific contribution of FRANCE 3.1. The contribution of G. Cornut and of M. Bouchayer to the diagnosis and microsurgical treatment of benign lesions of the vocal folds is internationally recognized. L. Crevier-Buchman and A. Giovanni are advancing objective assessment of voice. With respect to technical contributions the work of the following phoniatricists has been notable: F. LeHuche, G. Heuillet-Martin, M.-A. Faure, B. Amy de la Bretèque, and J. Sarfati. The laboratories of J.-P. Marie and A. Giovanni are engaged in fundamental research on laryngeal innervation and the physiology of vocal fold vibration, respectively. 3.2. Speech and language In the field of speech and language, the efforts of C. Chevrie-Muller, M.-C. Monfrais-Pfauwadel, and F. LeHuche are noteworthy. 3.3 Hearing In the field of hearing, the work of J.-C. Lafon, L. Moatti, N. Matha, and C. Fugain is notable. 3.4. Swallowing In the field of swallowing the work of M.-C. Danois, B. Arnoux-Sindt, D. Robert, and V. Woisard have advanced the management of dysphagia. 3.5. Our profession has benefitted from significant contributions by other French speakers, including M.-L. Dutoit-Marco, F. Ogut, J. Perello, M. Remacle, V. Schweizer, K. Vrticka . . . We emphasize, of course, that all of our phoniatric colleagues have contributed to the development of our specialty, and we regret that we cannot provide each of them with individual recognition. Nov.12, 1999