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| Australia Thomas E. Havas, Bondi, Junction Professional state Phoniatrics is not practiced as a separate specialty in Australia. The management of voice disorders and benign laryngology is undertaken by both Otolaryngologists and Speech Pathologists, sometimes in conjoint clinics and sometimes independently. Laryngology and voice disorders is a recognized sub-specialty in Otolaryngology as it is within general speech pathology. Hearing disorders are managed conjointly by Otolaryngologists and Audiologists, Audiologists usually perform clinical testing. The tests are reported on conjointly by Audiologists and. Otolaryngologists and obviously any medical or surgical treatment that needs to be instigated, is done by the Otolaryngologist. Education and training There are five University departments ref Otolaryngology, Head and Neck Surgery ire Australia. Each University has several teaching hospitals and each of these teaching hospitals has an academic staff in Otolaryngology, Head and Neck Surgery. These surgeons are affiliated with the University but function through the hospital independently of the University department. A graduate degree in Speech Pathology is offered by six University departments in Australia. There are, also six departments offering degrees in Audiology. Specialist training in Otolaryngology involves an undergraduate or pest graduate degree in Medicine, which confers the basic title of M.B. B.S. Thereafter, one year of internship, two years of residency training, one year of general surgery and 4 years advanced training in Otolaryngology. Head and Neck Surgery prepares a candidate far Fellowship to the Australian College of Surgeons and Otolaryngology. This Fellowship is awarded by examination. Thereafter, to specialize in laryngology/voice disorders/phoniatrics, a further period of at least one year’s specialized Fellowship training is required. The Speech Pathology degree varies from 3 1/2 to 4 years depending on the University, A degree in Audiology is usually a 3-year Science based degree. Some speech pathologists, with interest in voice, apart from their basic Science degree, go on to do higher degrees such as a PhD and similarly for audiologists. Associations There are several professional associations, which cover phoniatrics. Firstly, there is the Australian Society of Otolaryngology, Head and Neck Surgery, Speech Pathology Australia and the Australian Society of Audiologists. There are state based voice interest groups, which are ecumenical, that is to say, they are open to Otolaryngologists. speech pathologists, teachers of voice and singing teachers. There is an Australian Voice Association (AVA) formed in 1991 which has an annual general and scientific meeting, again attended by the ecumenical group referred to above. The University of Sydney has a fledgling National “Voice Center” which is directed more towards speech pathology and the performing arts than anything else. Outstanding personalities There have been numerous outstanding personalities in laryngology and voice disorders in Australia. Perhaps the one with the most international recognition is Prof B N P Benjamin. Other senior colleagues in this field include Gerry McCafferty (Brisbane), William Comans (Brisbane), Patrick Bridger (Sydney), Ian Cole (Sydney), Malcolm Baxter (Melbourne), Neil Vallance (Melbourne), John Tomich (Adelaide), Terry McManus (Perth). There are three large Voice Clinics in the country, the Sydney Voice Clinic run by Jocelyn Priestly and myself, a Melbourne Voice Clinic run by Drs Valiance, Baxter, Dr Jenny Oates (Speech Pathologist) and Debbie Phyland (Speech Pathologist). John Tomich with Allison Bagnall runs the Adelaide Voice Clinic. In Adelaide, at the Flinders University, Allison Russell (Speech Pathologist) has done, and continues to (to significant research in voice and voice disorders, particularly with teachers. Jenny Oates (Melbourne) and Allison Russell (Adelaide) have) jointly developed a CDRom for the teaching of perceptual analysis to the students of voice. I believe they won an international award for this. Research, main topics In each of the Voice Clinics alluded to above, patients are seen conjointly by an Otolaryngologist and Speech Pathologist. A detailed questionnaire, physical history, perceptual analysis, acoustic analysis and video-endo-stroboscopy, as standard procedure, is undertaken an all patients. There lave been several collaborative studies between the Voice Clinics alluded to above and they have set the standard for the clinical practice and management of voice disorders in this continent. The St Vincent’s Voice Clinic (Sydney) run by Dr Ian Cole and Helen Brake, has a particular interest in laryngeal dystonias and together with Dr Paul Darveniza (‘Neurologist) is the center of excellence for the diagnosis anal management of these disorders in this part of the world. Literature A large amount of material has been published by the various centers and can be accessed by Medline using the aforementioned personalities as principal authors. Thomas E. Havas, Bondi, Junction F.R.C.S.(Ed.), F.R.A. C.S. F.A.C-S, Otolaryngology. Head and Neck Surgery Suite 506 253 Oxford Street Bondi Junction 2022 Fax: (02) 9 369 4463 e-mail Address: thavas@ozemail .com.au |