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Chapter 3 The International Association of Oral and Maxillofacial Surgeons (1986–1999
Chapter 3
A wind of change
As mentioned in the previous chapter, the IAOMS had outgrown its teething problems but had not been able to assume its coordinating function largely because of the lack of funding to create a professional organization with a permanent headquarters and an executive staff. The coming 14 years would turn out to be crucial as progress was made to achieve such an organization. A series of devoted, strong-willed presidents with a clear vision, assisted by other members of the executive committee, worked steadily towards a better organization that would meet the requirements of a changing time. Another factor that contributed to the rapidly changing professional world was the collapse of the “Iron Curtain.” Several East European nations became independent and established national associations of OMF surgery that subsequently joined the IAOMS. Oral and maxillofacial surgery also grew in other parts of the world, which is reflected by the enormous increase of affiliated national associations during this period. The event that had the most impact during this period, however, was the introduction of the “Guidelines for Education and Training.”
As described in the previous chapter, the lack of a common pathway for training and education in OMF surgery had split the profession for many years. Previous attempts to achieve a consensus had failed and had even deepened the divide between the various educators and trainers. The keys to a change in attitude were the invitational conferences in Tenerife and Bermuda.
The Tenerife and Bermuda conferences (1987–1988)
The persons to be credited for taking the initiative for the Tenerife and Bermuda conferences were Wilfried Schilli, who became president of the IAOMS in 1986 after the Vancouver meeting and Rudi Fries, at that time president-elect of the European Association for Cranio-Maxillo-Facial Surgery. These two colleagues had a vision to break the deadlock that existed between the supporters of the double degree and those who stuck to the single dental or medical degree, by organizing invitational meetings with leaders of the specialty from all corners of the world.
There was no consensus within the executive committee of the IAOMS about this plan and, therefore, it was organized as a private enterprise by these two gentlemen and four former presidents of AAOMS, including Jack Gamble, Dan Laskin, Charles “Scotty” McCallum and Bob Walker. Wilfried Schilli had assured himself beforehand of the backing of his German colleagues. He had also built up a good understanding with several American colleagues, because he had been teaching throughout the U.S.A. about rigid fixation according to the AO principles.
The first invitational conference was held in Tenerife from April 26 to 29, 1987. The planning committee had invited 87 selected OMF surgeons from 36 countries, who were considered to be the leaders in the specialty in their own countries. A total of 53 attendees showed up from • A model of professional education and surgical training for future OMF surgeons. • International organizational unity. The participants also agreed on a vertical structure in which the continental organizations would determine the delegates to the IAOMS council based on the percentage of the continental members. Members of the national associations would automatically be members of the continental organization and the IAOMS for a fee.
It is of interest to note that a strong suggestion was made on the governance of the IAOMS. There was a detailed recommendation on how the executive committee should be put together along with a roster of succession. There was also a pertinent statement about the desired management of the IAOMS: “The unanimous position of
24 countries and all came at their own expense. There were representatives from Asia, Australia, North and South America, and Europe. The surprise was the attendance of György Szabó, who managed to get the permission of the then existing regime of Hungary, in spite of the strict restrictions on travel. The purpose of the meeting was to review and deliberate: • First, the education of the oral and maxillofacial surgeon and the scope of oral and maxillofacial surgery. • Second, the status of organized oral and maxillofacial surgery internationally and how to improve cooperation and more effective communication among countries to create a strong international oral and maxillofacial surgery organization and to enable the specialty to speak with one voice internationally. There were very lively discussions but the participants agreed fairly easily on the following: • The scope of the specialty and the factors that might influence the scope. • The professional education. • The surgical training (five years) of which two years of core surgical training and three years of concentrated
OMF surgical experience, or alternatively one year and four years. the Tenerife Conference was that the administrative operations of the IAOMS be conducted by a full-time, salaried and experienced administrator at a permanent IAOMS headquarters, with an additional full-time staff of at least two. The site of the IAOMS permanent headquarters preferably to be located in Europe.”
A report was drawn up which served as a working paper for the subsequent meeting a year later. This conference was held from April 28 to May 1, 1988 at the Princess Hotel in Hamilton, Bermuda. The attendance at this meeting differed slightly from the first meeting
Shown in an off-duty moment at the Tenerife conference from left to right: Drs. György Szabó (Budapest, Hungary), Mikko Altonen (Oulu, Finland), Alekso Pisceric (Belgrad, Yugoslavia), Victor M. Sada (Madrid, Spain).
As mentioned before, the success of the Tenerife and Bermuda conferences was, in part, due to the fact that the leaders of the various national associations were invited on a personal note, instead of the representatives of the national and regional executive committees. This caused some frustration and outspoken criticism. David Poswillo, the secretary general of IAOMS, apparently had no part in these discussions. According to Wilfried Schilli, he was against this meeting for unknown reasons. He vented his anger in the secretary general’s column in the first Newsletter of 1988.
“What is not widely known is that the original invitation, which was sent only to selected people, came from the address of the headquarters of the AAOMS on specially printed paper which listed the names of several senior officers of the IAOMS. It is not surprising that without any clarification or other effort of communication, great confusion should have arisen. It is even more bewildering to read in the report of the Tenerife Conference that 18 months were spent in the planning phase. During this ‘planning period,’ there were numerous meetings, all official, of the General Assembly at Vancouver and many other opportunities for those involved in the planning committee to inform their colleagues on the Executive Committee and/or Council of the preparations and the ideas behind the proposed conference and to communicate these matters globally through the lines of communication already established by the IAOMS. That senior officers, all bearing the responsibilities of trustees of the association, should have acted without communicating on any official occasion associated with the IAOMS is bewildering in the extreme. It is this bewilderment which caused the anxiety and aggravation referred above.”
It is obvious that David was left out of the plot. It may not have been all that elegant, but it was certainly effective.
Paul J.W. Stoelinga
as 54 attendees were present again from 24 countries. The participants came again at their own expense. Some attendees from the first meeting did not show up and there were some new faces.
The meeting began with presentations from various colleagues providing feedback from the different national associations on the report from the first meeting. The participants were subsequently divided in four groups to discuss scope, education and training and international organization. From the reports of these workshops, a draft report was put together that was called: “Final summary of deliberations of the first and second invitational conferences on oral and maxillofacial surgery.” It differed very little from the report of the first meeting. This report was submitted to the IAOMS and served as a draft for the “International Guidelines for Specialty Training and Education in Oral and Maxillofacial Surgery.”
In retrospect, one only can admit that the procedure followed had the desired effect. The sheer fact that individual, influential colleagues were invited instead of official representatives of national and regional associations was the key to the success of both meetings. However, this was a mixed blessing, since some associations were not 100 percent supporters of the meetings. It was, therefore, difficult to implement the proceedings of the meetings. Yet, there was an ambiance of genuine desire to come up with something constructive. As one of the participants stated: “We should stop the fighting in our backyards if we are to make progress.”
The agreement in principle on the scope of the specialty was the deciding factor in the formulation of a sensible report that turned out to be instrumental for the development of the specialty, particularly in the countries where OMF surgery was just developing. The final document has been very helpful in many countries by convincing local health authorities to recognize the education and training of OMF surgeons. It has also served as the basis for regional documents geared to the needs of the region.
The governance of IAOMS
The selection of officers of the executive committee in the past had largely been through recommendation of the existing officers. This practice was still in place, certainly at the beginning of this period. Wilfried Schilli, for instance, was asked by Bill van de Kwast to join the executive committee in 1983 by telling him: “Wilfried, you are the first German president of the IAOMS.” These candidates were subsequently voted in by council without much
dispute. This was not necessarily bad and reflects the spirit of the time but had little to do with democracy.
At any rate, the series of presidents who came in this period and with them the other members of the executive committees, had a strong feeling that things had to be changed in order to make the IAOMS a true coordinating organization. One of the major differences, as compared to the previous period, was the regular, yearly meetings of the executive committee, which provided the much desired continuity in the governance of the association.
Wilfried Schilli spent most of his energy on the Tenerife and Bermuda conferences in order to create harmony among OMF surgeons worldwide. He also initiated the change of the editor-in-chief of the Journal. The Journal suffered from a low circulation and from a low impact on the profession. The appointment in 1988 of Paul Stoelinga turned this around. The executive committee decided to make the Journal compulsory for the regular members as of 1990, whereas the new editorial policy, with clear sections in the Journal, made the Journal a lot more attractive (see chapter 6).
hoW the eXecutiVe committee Worked
The Executive Committee in this period met at least once a year; once in conjunction with the ICOMS and during the other years, in various places of the globe. The attending members were reimbursed for their travel expenses on the basis of an economy fare, while they received a daily allowance that covered room and boarding for three days. This was not the case when meetings took place at an ICOMS. It was assumed that all members then paid their own fares, because they attended the ICOMS anyway.
Contrary to what a lot of IAOMS Fellows thought, these meetings were no pleasure trips, even though some attractive cities were chosen as meeting places, mainly because they had hub airports. The meetings would last for two full days and required a lot of attention from the members of the committee, since the agendas were typically quite ambitious. The common denominator of all these meetings, however, was that half of the committee members had a jet lag of at least six hours. It was, therefore, not unusual to see some people with closed eyes while discussions took place.
The agendas contained items such as reports from the president and secretary general, which included the financial statement and budget for the next year. These were based on rather vague accounts and presented in a casual manner, certainly at the beginning of this period. They definitely would not be considered adequate in present times but the association was much smaller in those days and professional personnel were lacking.
A lot of time was spent on the upcoming ICOMS with all its implications, both regarding its scientific content, as well as financial matters. The meetings also had reports from the editors of the Newsletter and the Journal, including the financial implications but above all the distribution of the Journal to its members. This was a consistent source for concern, since the membership administration could not keep up with the changes that occurred and did not manage to coordinate its administration with that of the publisher.
There was usually a report of the chairman of the Education Committee, which commonly caused quite a bit of discussion. The chairmen of the other committees were only present at ICOMS meetings and usually had little to report. The remaining part of the meetings would be used on topics such as discussions on the desirability to create a fund that could sponsor educational activities and the establishment of a permanent office. The latter was a constant issue and gained in actuality towards the end of this period.
These meetings were conducted — and still are — in an American fashion, which is rather unusual for non-Americans, to say the least. There was and still is, a lot to learn for newcomers. The president chairs the meeting and allows for free discussions to take place. So far, quite understandable.
When he senses that a consensus or majority is in the making, he then asks whether there will be a motion on the table. He cannot do that himself. One of the committee members has to formulate this motion, after which it needs to be seconded by another member. Then follows a ritual that probably stems from the early days of the American constitution. The president asks: “All in favor, say ‘yea’,” followed by: “All against, say ‘nay.’” Without counting the votes, he then inquires about members abstaining. This all happens very quickly and I am quite sure that many non-American members of the executive committee must have wondered when they were laying in bed after a long day of meeting, fighting their insomnia because of jet lag, what had taken place and what they had voted for. Considering the adopted policies over the years, however, they had not been sleeping all the way.
Paul J.W. Stoelinga
1989: The 10th ICOMS, Jerusalem
Wilfried Schilli’s presidency ended in 1989 in Jerusalem, where the 10th ICOMS was held. Unfortunately, the appointed chairman, Jacob Epstein, had passed away the year before the meeting. He was replaced by E. Rorien, who, with his committee, did a wonderful job. The conference was again very well organized but poorly attended because of the political situation. A total of 439 participants were present, of whom only 224 were members of IAOMS, and 108 were accompanying persons. Together with the president, David Poswillo stepped down as secretary-general, a position he had occupied for six consecutive years. During his period of stewardship, the financial standing of IAOMS — despite the crash of October 1987 — had remained strong and quite undamaged by the collapse of the international markets. Yet, the funds available were not sufficient to create a permanent office with a professional staff, a wish of all the executive committees of the coming years. It is also rather tragic that this great contributor to the specialty was somewhat bitter about the invitational conferences held in Tenerife and Bermuda. He personally was not invited because he did not agree with the strategy of organizing these meetings outside the context of the IAOMS.
Bob Walker followed through, emphasizing the need for visibility of the IAOMS, by proposing educational meetings between ICOMS meetings and by stressing the importance of the Newsletter. The usual membership, education and scientific committees were revived by appointing new members and chairmen. Dan Laskin, the past president of the period 1980–1983, took the position of secretary general. David McGowan, a professor of oral surgery in Glasgow, was appointed editor of the Newsletter in 1986. He changed the Newsletter into a very informative format but it
still appeared only once a year. He was followed by Professor John Frame from Birmingham, U.K., in 1989, who planned to increase the frequency to twice a year but also found it difficult to put that into effect. The Executive Committee in this three-year period was very busy creating support for the “Guidelines” that were Wilfried Schilli, president, to be discussed and hopefully 1986–1989 accepted at the next council meeting in 1992 in Buenos Aires. For this reason, Bob Walker wrote personal letters to all presidents of all national associations to pave the way for an open forum discussion at the ICOMS in Buenos Aires. The Education Committee, under the guidance of John Helfrick, scrutinized the wording of the Bermuda document and put together the final version. The “Guidelines” were extensively discussed in Buenos Aires, where it became apparent that some opposition against the formulation of the preface existed, in which it was stated: “It is most desirable for this training to be David Poswillo, secretary formalized and that the oral and maxillofacial surgeon general, 1983–1989 possesses both the D.D.S. or D.M.D. degree, or equivalent and the M.D. degree, or equivalent.” Yet, the “Guidelines” were accepted by a vast majority of council members and were printed in the International Journal in 1992. The recommendations regarding the organizational structure of international OMF surgery were never published and unfortunately did not receive the attention that they deserved. Another important change was proposed and accepted whereby it was decided to hold an ICOMS every two years instead of three years. It had long been felt that the impetus after an ICOMS was easily lost in the years between these meetings, where little activity took place. This change became effective in 1995.
Bob Walker, president, 1989–1992 John Frame, editor of the Newsletter, 1989–1999
1992: The 11th ICOMS, Buenos Aires
The 11th ICOMS in Buenos Aires in April 1992 was a great success, thanks to the outstanding organization of the Argentinean committee, chaired by José “Pino” Ferreria, with a record attendance of 920 registrants, of whom 460 were members, 355 were trainees and 105 were accompanying persons.
José “Pino” Ferreria, chair of the 11th ICOMS
Executive committee and council members at the 11th ICOMS in Buenos Aires. Front row, from left to right: Bob Cook, José “Pino” Ferreria, Henrique Mueller, Dan Laskin, Bob Walker, Hans Dieter Pape, Wataru Yoshioka, Wilfried Schilli, Rudi Fries.
Bob Cook, president, 1992–1995
The next president was Bob Cook from Australia who was seconded by Dan Laskin as the secretary general. Bob had been a very active council member since 1983 and was well known in the professional world. He was to be the last president to serve a three-year period. During his presidency, the association really started to grow and the various committees, such as education, scientific and membership, were given clear instructions on what was to be expected. One of the important decisions made was that the education committee was asked to conduct a survey of educational and training policies in affiliated nations. The result of this survey then served as the basis for the education conference at the ICOMS in Budapest
Most importantly, the Executive Committee discussed the necessity of establishing a Foundation in order to assist in educational activities worldwide. Once the decision was made to form the Foundation, Bob really went out of his way to find funding and succeeded in securing a commitment from Mr. Walter Lorenz of $250,000. During his presidency, again, extensive discussions took place regarding the possibility of establishing a permanent central office and an executive secretary. It was thought that the donation of Walter Lorenz would provide the money necessary for establishing such an office and employing an executive secretary. Plans were put on paper, including the financial consequences, which resulted in the appointment of a part-time executive director, assisted by an executive secretary. The position was taken by Dan Laskin, a former president and previous secretary general, assisted by Ellie Coyne, a part-time secretary. Council also approved a change in the organizational structure that better reflected the importance of the various regions in the world, whereby from then on, the Executive Committee would include members representing the regional associations.
1995: The 12th ICOMS, Budapest
The 12th ICOMS took place in Budapest in 1995, organized by György Szabó and his staff. Some 900 participants from all parts of the world attended the meeting. Financially, it also turned out to be successful. The IAOMS received a substantial profit, which was necessary to continue with their ambitious plans.
Several novelties were introduced at this meeting, including an educational conference at which Alastair Goss presented the results of the survey on education and training policies in the various affiliated national associations. This document provided invaluable information previously unknown to the profession.
At this conference, a lively discussion also took place regarding a proposed wording change in the preface of the document on education and training, as accepted in Buenos Aires. The council finally agreed on this change, but the wording would continue to be a topic for discussion for the coming years and would finally be resolved in 2001 in Durban.
the chichester meeting
There were two occasions when a potential crisis arose, necessitating meetings of senior members of various organizations in order to retain the structure and policies of the IAOMS.
The first of these occurred following the publication of the “IAOMS Guidelines on Education and Training,” which had been developed and agreed upon during the council meeting in Buenos Aires in the autumn of 1992. The wording used in the document was seen by some as dogmatic and based very much on the practice throughout Europe. However, both the North American and Scandinavian associations, together with the Japanese, felt severely disadvantaged by the wording in relation to the need for a full medical qualification and threatened to resign from the association unless this section was replaced.
The Americans argued that their extensive training in anesthesiology equipped them with more than adequate knowledge and experience to satisfy the requirements for the general care of the patient under critical clinical circumstances. Equally adamant were those members from European countries for whom a fully registerable qualification in both medicine and dentistry was the only way that a person could satisfy the requirements of both the IAOMS and the European Medical Board for recognition as an OMS specialist in the EEC. Scandinavia was outside the EEC at that time.
The EACMFS and the AAOMS were charged with resolving their very significant differences, yet not disrupting the overall attempt at harmonization proposed by the Buenos Aires agreement, to which over 70 countries had been signatories, including the contentious parties.
Accordingly, the following individuals arranged a summit meeting at a neutral venue of a small city on the south coast of England, Chichester: • Professor Daniel Lew, president of the AAOMS, • Dr. John Helfrick, president of the IAOMS, • Dr. Paul Stoelinga, president of the EACMFS, and • Dr. John Williams, secretary general of the EACMFS
Basically, they were told to lock the door and throw away the key until such a time as they were able to send a cloud of white smoke through the chimney.
The solution came in the concept of “regionalization.” The guidelines were standards, which were the same wherever you trained or worked. However, how you achieved these inviolable standards was entirely a matter for regional or national trainers and registering bodies to resolve.
Qualifications were equally a regional or national responsibility and once the concept of regionalization was introduced were both superfluous to the guidelines and potentially, inflammatory. As such, they should be eliminated from the document.
These recommended changes enabled everyone to maintain their own positions and formed the basis of the modifications in the education and training document put to the council and ratified in Budapest in 1995.
Everyone thought they could breathe again but despite this approach, there remained dogmatic individuals who, instead of seeing this as a true breakthrough, continued to try to force their own point of view, failing in the process to recognize that there was more than one way to achieve the same outcome. People had to be able to achieve a common approach, yet in different ways, as appropriate to their own needs and circumstances.
All present were able to return, satisfied, to their own councils with no one having to give one iota on their principles.
John Ll. Williams
At the request of the Executive Committee, the Scientific Committee, under the chairmanship of Kursheed Moos, organized a consensus conference on condylar fractures. This was one of the highlights of the meeting, with excellent speakers and it was attended by a large crowd. The proceedings
György Szabó, chairman of the 12th ICOMS organizing of this conference were published committee in the Journal. It was also the first meeting at which the president invited a speaker to present the “Presidential Lecture.” Hermann Sailer from Zürich had the honor to be the first such speaker. The next Executive Committee was chaired by Rudi Fries, a former president of the European Association Rudi Fries, president, for Cranio-Maxillo-Facial 1995–1997 Surgery (EACMFS) and one of the driving forces behind the Tenerife and Bermuda conferences. Rudi had many contacts in East Europe with colleagues who had been totally unaware of the development of the specialty in the world. He had several contacts in the Arab world and in some African countries. He was very much committed to promoting the involvement of Eastern European colleagues in the EACMFS and in the IAOMS and in advancing the specialty in the less privileged world.
As a result of his numerous trips, he knew the key persons in the various countries and was, therefore, the right person in the right place at this crucial time in the history of the IAOMS. It was particularly the establishment of the Foundation in 1996, under the chairmanship of past-president Bob Cook that would enable the IAOMS to eventually become active as an initiator of educational programs in the developing world. The members of the Executive Committee, after a long discussion, decided to install a board of trustees for the Foundation, separate from the executive committee of IAOMS. It is of interest to note that this decision was reversed some ten years
later (see chapter 5).
The “Bylaws” and “Rules and Regulations” underwent several adjustments and additions because of the changes that took place during this period, including the ruling that members of the Executive Committee could vote at council meetings. The past president would also get a vote in the Executive Committee but the most important change involved the inclusion of regional representatives so as to have proper representation of all parts of the world on the Executive Committee.
This implied a considerable extension of the number of members on the Executive Committee but the decision really improved the committee’s communication with the regional associations. North and Latin America, Europe and Asia, including Oceania, from then on were permanently represented on the executive committee of IAOMS. This decision was fully in line with the recommendations as expressed by the participants of the invitational conferences in Tenerife and Bermuda.
Last, but not least, an important decision was taken about the governance of the IAOMS, which included moving the IAOMS headquarters to Chicago in 1998 and the appointment of a full-time executive secretary.
1997: The 13th ICOMS, Kyoto
The 13th ICOMS took place in Kyoto, Japan and was organized by Kenichi Seto and his organizing and scientific committees. Because of the large number of Japanese attendees, this became one of the best attended ICOMS in the history of the IAOMS. Again, several novelties were introduced, of which the invitational
President Bob Cook addressing council in Budapest. From left to right: György Szabó, José Luis “Pino” Ferreria, Rudi Fries, Bob Cook, Dan Laskin.
At the Budapest ICOMS, President Bob Cook thanks Walter Lorenz’ widow, Barbara, for the gift of $250,000.
Rudi Fries passes on the presidential chain to Peter Banks. Piet Haers is congratulated for his new role as editor-in-chief of the Journal by the outgoing editor, Paul J.W. Stoelinga.
“Leadership Conference” was the most important. The participants discussed items such as: • Helping underdeveloped countries improve services. • Establishing uniform accreditation standards and developing methods of outcome assessment. • Financing educational opportunities. • Promoting an expanded scope of capabilities. • Establishing the OMS’ ultimate area of expertise. • Preparing oral and maxillofacial surgeons to meet competition from other specialties. • Increasing the scope and participation at the ICOMS. • Increasing IAOMS membership among fellows and trainees. The proceedings of this conference were distributed among the representatives of national and regional associations. This conference set a trend for many years to come, as from this ICOMS on, invitational conferences were held covering various subjects of interest for national and regional leaders in the specialty. Another policy for future ICOMS was the publication of abstracts of the free papers in a supplemental issue of the Journal so as to make them accessible to the international readership.
Another new event introduced at this meeting was the “Great Debate.” In the future, this would be a fixed part of the scientific program, dealing with topics prone to evoke controversy. Each topic was introduced by two speakers; one for and one against, after which a rebuttal occurred, followed by an audience vote. At this ICOMS, the topics were: “Odontogenic Keratocysts” and “Disc Replacement after Discectomy.”
In hindsight, this was also a very successful meeting not only because of the excellent Japanese organization but also because it demonstrated the growing sense of international cohesion. It certainly attracted more Asian attendees than ever before and, thus, made the IAOMS a true international coordinating organization to which many national associations turned for advice and assistance.
The last president of this period was Peter Banks, who much to his chagrin, served only for eighteen months, the shortest period ever for a president. This had to do with the fact that the Kyoto meeting was in September 1997, whereas the next ICOMS in Washington took place in April 1999. During his tenure, however, the final steps were set in place to create a permanent office and to attract a full-time executive secretary. The AAOMS generously offered a small space for a reasonable rent at their new headquarters in Rosemont, Illinois.
The Executive Committee held its first meeting in the AAOMS building in December 1998. Peter, along with John Helfrick, spent much time, selecting a candidate for the position of executive secretary. In January 1999, Lynne Sayler became the first executive secretary. This, in retrospect, may be called a milestone in the history of the IAOMS. A dream of many previous presidents and members of the executive committees had come through. How right a decision this turned out to be!
There were, however, further developments that made this a true transitional period. The presence of regional representatives at the Executive Committee meetings allowed for direct information about regional matters of interest. For the first time in the history of IAOMS a real worldwide representation was present that appeared to be very useful, particularly in the way relevant information was exchanged. It also promoted the camaraderie among
Lynne Sayler, executive secretary
From left to right: Kenichi Seto, chair of the 13th ICOMS, Kyoto and Tsuyoshi Kawai, chair of the scientific committee.
delegates from around the world. Most importantly, it helped to establish well-functioning regional associations along the lines of the structure of IAOMS, notably in Asia and Latin America.
Another very important change introduced during this period was the appointment of a treasurer and a Finance Committee who would prepare and approve the budget and a yearly financial statement, checked by a certified accountant. Kent Cohenour was chosen as the first treasurer of IAOMS. This was thought to be necessary in the context of a new job description for the appointment of a new executive director, since Dan Laskin had announced his resignation as of the end of 1998. Victor Moncarz was suggested for this position, which was confirmed by council at the Washington meeting in April 1999.
Last but not least, the search for a new Journal editorin-chief resulted in the appointment of Piet Haers as the successor of Paul Stoelinga. After 12 years, Paul resigned from his post, leaving the Journal in a very healthy condition.
Probably the most time-consuming effort of Peter Banks was the drastic and thorough revision of the bylaws and rules and regulations. The many changes in the association’s governance, along with the various decisions taken on different subjects over the past several years made these changes necessary. It took an eloquent Englishman to do this job and in that sense, he qualified perfectly well.
1999: The 14th ICOMS, Washington, D.C.
The 1990s ended with the 14th ICOMS in Washington D.C. Unfortunately, this was not a well-attended meeting, despite the president’s efforts to attract the attention of his American colleagues for the event. The event’s organization was largely done by the AAOMS’ professional staff and lacked the personal touch that was the hallmark of previous ICOMS.
The theme for the invitational conference was: “Harmonization of education and training in oral and maxillofacial surgery worldwide.” This very relevant topic gave rise to lively discussions on how to establish centers of excellence in developing countries. The conclusions of this conference were summarized and sent to all participants and councilors. The following recommendations were made: • There is a need for the receiving country to organize the training for oral and maxillofacial surgery. For that reason a local, national association will be necessary to serve as a partner when discussing possible assistance from the IAOMS or regional association. • When planning a training center that would be a candidate for international assistance, the presence of a local OMF-surgeon to act as a liaison person is mandatory. • If possible, conceptual and financial support from the country in which the training center will be located should be received. • Cooperation between IAOMS and the regional and national associations is necessary for the center to be successful. The IAOMS will assume a coordinating function in that all activities should be made known to the IAOMS secretariat. • The IAOMS will remain active with regard to harmonization of training and education, whereby the education committee will produce a working paper on how this can be achieved based on the draft of “Basic program of training in oral and maxillofacial surgery,” as circulated at the meeting.
Peter Banks, president, 1997–1999
Presentation of colors at the Opening Ceremony of the ICOMS in Washington, D.C.
•It was felt that there is a need for certified programs following the guidelines from IAOMS. The IAOMS will provide a template against which national associations can match their programs. • Continuity in support was felt to be of paramount importance. For that reason, only a limited number of training centers, strategically positioned in the various regions, can be supported. The various regions were asked to come up with suggestions, particularly our African colleagues. When reading these very sensible recommendations, one can only wonder why this has not been implemented in full. At present, the IAOMS still lacks the pertinent information necessary to play a role as overseer of all activities, while cooperation with some regional associations still leaves much to be desired.
On this occasion, Bob Cook was honored as a “Distinguished Fellow of IAOMS.” He was the first to receive this award, since the category of “Honorary Fellow” had been changed by the executive committee to apply to individuals who were not oral and maxillofacial surgeons but had made special contributions to the specialty. Bob had been involved for many years in the governance of IAOMS and was the first chairman of the IAOMS Foundation.
Budget and membership fee
Since the inception of the IAOMS, the membership fee was $15, an amount that went unchanged until 1990. From the beginning, with a short interruption, members also had the option to be a life fellow, which implied a one-time fee of $300. This fee was raised to $500 in 1990. The rationale behind the “life fellow” idea was to build up a corpus of money that would generate income from interest and dividends.
Considering the fact, that in the beginning, membership only grew on a modest scale from around 500 to 1,000 members, it is not surprising that the lack of funds kept many executive committees from expanding their activities. The situation became slightly better in the second half of the 1980s, mainly because of the considerable profit made at the 9th ICOMS in Vancouver, which was very well-handled by David Poswillo. He transferred the money into British pounds and made a handsome profit by changing the money back again into US dollars some years later, due to a more favorable exchange rate.
The growth of the membership in these years also accelerated, which further contributed to a more stable financial situation. However, the yearly budgets in these years still did not allow for needed initiatives to be financially supported. It is, therefore, not surprising that it was decided in 1990 to increase the membership fee to $85. This went along with the decision to make the Journal compulsory for Fellows.
Since that time, the fees have increased to keep pace with inflation rates, while additional income has been generated by institutional and individual subscriptions to the Journal. The category of life fellowship was discontinued in 1993. Until this book’s publication date, there were some 400 life fellows but this number will gradually become less and less and finally disappear altogether. Modest profits from ICOMS’ in the ensuing years and the donation from Walter Lorenz also improved the financial situation considerably.
An important change in the dues structure was decided upon in 1997. After many discussions about the need to adapt the dues for the less privileged world and to create an attractive vertical membership for national associations which joined with all their members, these policies were finally implemented in 1998.
Reduced membership fees were offered to members from countries with a GDP of less than $7,500 per capita, based on the data presented by the United Nations Human Development Index. It made the administration of membership somewhat more complicated but has served its purpose well until now. This change made it more attractive for colleagues from less developed countries in Africa, Asia, East Europe and South America to join. In fact, this did happen as membership of these countries increased. The first association to adopt vertical membership was the Dutch, soon followed by the Argentineans, the Swiss and later the Hong Kong association.
Until 1999, the IAOMS’ financial matters were dealt with by the secretary general, who was assisted by Andrew Linz, a former
President Peter Banks with the award recipients. From left to right: Bob Cook, Peter Banks, Ellie Coyne, Andrew Linz.
Andrew Linz
IAOS executive committee member (1974–1980) and loyal supporter of IAOMS, who mainly advised on investments. A formal treasurer was finally appointed in 1999, which turned out to be a very good decision, since real expertise in these matters proved to be quite beneficial for the association (see chapter 4).
Epilogue
During the period 1986–1999, the IAOMS gained tremendously in terms of importance and professional status. The more than doubling of the membership from 1,737 to 3,778 and the growth in the number of affiliated associations from 25 to 52, also signaled the association’s growing impact worldwide. It was particularly the concept of regionalization that appeared to be instrumental in achieving global approval for the “Guidelines of Education and Training” but also for other activities, as will become evident in the next chapter.
Another major step forwards was the establishment of the Foundation. Bob Cook’s plan to establish the Foundation was amended and agreed upon at the ICOMS in Budapest. The further development of the Foundation will be described in chapter 5.
The tireless efforts of all presidents during this period paid off, since many contacts were made that had paved the way for better relations among colleagues worldwide. The weight of the presidential job had grown enormously and the position had become crucial for the success of the IAOMS.
Presidents not only visited national association meetings in different parts of the world, they also attended regional conferences, meeting with much larger groups of colleagues than ever before. Invariably, they were received with due respect, which increased the visibility of the association. These regional meetings were often also used as opportunities to informally meet with members of the executive committee that lived in those areas. In short, the association gained in its professional conduct and was ready to make the next jump. the lost chain
The chain, a rather valuable ornament donated by Andy Linz in 1971, was a precious thing to travel with but also a matter of great concern to all presidents. From the beginning of the tenure, a decision had to be made as to where to store it when not in use. There was the possibility to store it in a safe at a bank, or to keep it at home in a safe place where potential burglars would not find it. Both options had their advantages and disadvantages, as many presidents experienced.
In case an official trip had to be made, a visit to the bank had to be made when it was stored in a safe, which was time consuming and a bit of a nuisance. Keeping it at home was more user-friendly, but a constant reason for some worry. Each president made a choice and so did Bob Walker. On one occasion when Bob needed the chain, a truly nervous search was made at the Walker home. The chain, however, appeared non-findable and Bob took its loss as a real gentleman, not planning on losing face. He simply had a new one made at his own expense.
The story would have gone untold if the lost chain had not eventually turned up. The matter of the fact is, however, that it did turn up when Emily (Bob’s wife) decided on a real cleaning exercise, including various cupboards and closets. Sure enough, it turned up behind a stack of cloths or sheets. Apparently, Bob or Emily had hidden it away too well so as to hide it from the eyes of unwanted guests. In hindsight, it was a good investment, but Bob was left with an attractive but pretty useless, trophy. Where it is currently hidden is unknown.
Paul J.W. Stoelinga
References
Banks P., Personal communication. Cook R., Personal communication. Fries R., Personal communication. Schilli W., Personal communication. Walker R., Personal communication. Editorials, International Journal of Oral and Maxillofacial Surgery, 1988–2000. Final Summary of the Deliberations of the First and Second Invitational Conferences on Oral and Maxillofacial Surgery. Planning Committee: Rudolph Fries, Jack W. Gamble, Dan M. Laskin, Charles A. McCallum, Wilfried Schilli and Robert Walker, 1988. International Guidelines for Specialty Training in Oral and Maxillofacial Surgery. International J Oral Maxillofacial Surg. 1992: 21; 130–32. Leadership Conference Compendium of all contributions. Kyoto 1997. Editor: PJW Stoelinga. Minutes of the Ex. Committee meetings of the period, 1986–1999. Minutes of Council meetings of the period, 1986–1999 Newsletters, 1986–1999. McGowan D., until 1989, Frame J., until 1999. Report on the First Invitational Conference on Oral and Maxillofacial Surgery, Tenerife, 1987.
