Chapter 4 The International Association of Oral and Maxillofacial Surgeons (1999–2012

Chapter 4

The International Association of Oral and Maxillofacial Surgeons (1999–2012)

Modern times

With the introduction of new methods of communication and, above all, with the emergence of a new generation of leaders in the profession, a new era had begun. The IAOMS had grown into a large organization with global representation and needed to be managed accordingly.

The newly structured executive committee with energetic presidents, who had gained managerial experience in national and/or regional associations, pushed the organization further forwards. Computers and websites facilitated communication but at the same time, the issues to be tackled became increasingly more complicated and certainly involved huge financial input. On top of that a new generation of baby-boomers and generation X’ers were not used to the old fashioned, rather direct approaches from previous executive committees. The style of governance gradually changed, driven by the rapidly “globalizing” world with a generation that had different priorities as compared to past generations.

The headquarters

IAOMS Headquarters The IAOMS literally used to be run from a cardboard box. The lack of a permanent office and a less than up-todate membership administration did not do any good to the association’s reputation. The move to Rosemont, Illinois, therefore, was like a breath of fresh air. Lynne Sayler settled nicely in a rather small office that was soon filled with all sorts of boxes and other items that needed to be filed.

The purchase of a computer and printer were the first steps to a professional

organization. Lynne was wholeheartedly received by her colleagues from AAOMS and in fact took advantage of their experiences on how to run a large organization. The board of AAOMS generously let the IAOMS executive committee use their splendid board room for the meetings that usually took place Patrick Magennis

during weekends.

The first priority was to set up a better membership organization. With the help of Patrick MacGinnis, this was done in such a way that finally there was control of who had paid their dues and who had not and who received Journals and had paid for them. In previous years, this had been a major cause of frustration for both the executive committees as well as the membership. The next step was trying to set up a website, which turned out to be a harder nut to crack. Again, Patrick spent a lot of time getting this working but not being on the spot made it difficult for him to be effective. Alexis Olsson, the new assistant executive director, also worked very hard to produce the website, which went “live” in 2000.

Despite the generous Alexis Olsson

hospitality from AAOMS, it soon became obvious that the office space was too small. The search for another space in the Chicago area was, therefore, begun. The burst of the IT bubble made it somewhat easier to find a nice space for a reasonable rent.

After many discussions and visits to two selected options, the board decided on the new location in Oak Brook, Illinois. Two thousand square feet appeared to be perfect for the rapidly expanding secretariat. This move

the chichester meeting (bosham) 2

The second crisis leading to another high-level Chichester meeting occurred a few years later, just as we were thinking that “Regionalization” had been implemented and no problem existed.

Again, the vexed parties were the Americans on one side and the Europeans on the other side, although there also was a side issue with the Scandinavians. The Americans did not feel their interests had been adequately addressed, even though the ratification by the IAOMS council in Budapest should have settled the matter. The Scandinavians, largely led by the Swedes, did not feel that they had been accepted adequately within Europe, a view for which they sought support from the Japanese association.

The players around the table this time were only slightly different from the first Chichester meeting, although they were wearing different hats. The only newcomer was Don Booth, president of AAOMS, and John Helfrick, past president of IAOMS, who this time were joined by Paul Stoelinga as IAOMS president, and John Williams, who continued to represent the EACMFS, except that this time it was as its president.

The issue boiled down to a lack of understanding of what was happening in relationship to “Regionalization.” The Scandinavian association and, in particular, Sweden, felt they were being severely disadvantaged in terms of being able to achieve full membership in EACMFS and consequently, they believed the European association was in default of the IAOMS guidelines on regionalization, despite reassurances to the contrary from the officers of the EACMFS. The European association subsequently had to amend their “Rules and Regulations”, always a lengthy process, to satisfy the IAOMS concept while at the same time fulfilling the needs of the European association regarding the majority practice in Europe where both medical and dental qualifications were essential pre-requisites for the specialty. This requirement was clearly laid down by the EEC within the “Directive on Monospecialities.” At that time, the Scandinavian countries were not members of the EEC.

The reasons for the discord, together with the explanation, were accepted by the Americans at the meeting but it was not until an open confrontation at the council meeting in Vienna that the Scandinavians were shown to be at fault in their promoting an incorrect picture of the situation. At that point, the Japanese association accepted the fact that they had been misled and the issue was resolved once and for all.

As a result, the American association was again firmly on board and remained able to continue their stance on the role of both medicine and dentistry in relation to fulfilling the educational and training guidelines of the IAOMS. Honor was satisfied on all sides and there was no blood on the carpet. Chichester as a neutral venue had once again proved its value. Perhaps it was the ambiance, or maybe it was the food or beer!

John Ll. Williams

Executive Committee at retreat at Northwestern University, Chicago, 1999. Front row, from left to right: retreat facilitator Russ Massaro, Dan Laskin, Bob Cook, Luis Quevedo, Peter Banks, Andrew Linz, Kanichi Seto, Official from Northwestern University Hospital, Piet Haers, Lynne Sayler, Kent Cohenour. Second row, from left to right: Alexis Olsson, José Luis “Pino” Ferreria, Alastair Goss, Anders Holmlund, Patrick Uys, Victor Moncarz, Bob Walker, Christian Lindquist, John Helfrick, Paul Stoelinga, Marsden Bell, Official from Northwestern University.

The first board meeting at IAOMS’ new headquarters. From left to right: John Williams, Don Booth, Paul Stoelinga, José Luis “Pino” Ferreria, Lynne Sayler, John Helfrick.

turned out to be one of the best initiatives of IAOMS, because the opportunity existed to expand when it was needed and the current office offers a nice meeting room for the board and separate offices for the executive director and the president. All secretarial staff had desks with plenty of filing space.

The office was opened on February 3, 2003. The first board meeting was held in the new space in March of that year and was followed by an open house reception attended by our former hosts, the AAOMS board of directors. In short, the space could not be better.

During this period, it appeared necessary to expand the office space to accommodate a new person on the staff, who would be responsible for marketing the association and development and fundraising for the Foundation. Kerry Spaedy was chosen for this position and began working at the IAOMS in July 2006. Kerry Spaedy, director of marketing and development, 2006–2011

A new era of governance

With John Helfrick at the reigns, a true new era had begun. One of the first moves, under his governance, was to have the executive committee really assess the role of the IAOMS in this global world. Two very special sessions were organized under the guidance of an expert John Helfrick, president, mediator, Russell Massaro, one 1999–2001 in Chicago in 1999 and one a year later in Amsterdam. Both sessions focused on an analysis of the strengths, weaknesses and opportunities of IAOMS and how the association should proceed to address the various problems that lay ahead.

The result was a clear mission statement and the formulation of a vision. These were later implemented in the bylaws of the IAOMS. From these sessions, a strategic plan evolved with specific aims to be achieved within well-defined time frames. After ample discussions within the executive committee, the plan was modified and brought to the invitational conference in Durban in 2001. There it was discussed at length and changes were suggested that were implemented in the next version. The plan was meant to serve as a guideline until 2007 with periodic progress assessments and, if necessary, adjustments at each meeting of the board or executive committee.

Discussions during these two special sessions also centered on the “International Guidelines for Specialty Training and Education” as accepted in Buenos Aires in 1992 and later modified in Budapest in 1995. As there was no consensus within the executive committee with regard to the desired degrees before OMS training could begin, a serious confrontation threatened to take place again between mainly Europeans on one side and Americans and Japanese on the other.

The enormous cohesion that existed after Tenerife and Bermuda had disappeared, as had the spirit that went along with it. An emergency meeting was organized between IAOMS president John Helfrick; the president of AAOMS, Dan Lew; the president of EACMFS, John Williams; and Paul Stoelinga, IAOMS president-elect and a former EACMFS president. This meeting took place in July 2000 in Bosham, near Chichester in the south of England.

Eventually, after long discussions, a compromise was reached on the wording of the document’s preface. It took a lot of convincing to finally get this modification accepted and then proposed to council in Durban in 2001. The

final document, however, was agreed upon again, much to the relief of everyone involved

(see addendum). A practical change in the governance of the association was also introduced by John Helfrick. The executive committee had expanded so much it was now too large to be efficient. Additionally, it was also rather expensive to meet every year with a group of almost 20 people from all over the globe. Nonetheless, a lot of daily work needed to be done, preferably by a relatively small group of people.

For this reason, a new table of organization was proposed and accepted by the executive committee and later by council. A small group of officers would form the board, which would, along with the executive director and assistant executive director, take care of the daily affairs. The board would consist of the president, the presidentelect, the past-president and the treasurer. This made the running of the association a lot more practical and efficient. This board would also meet more frequently, often taking advantage of regional association meetings to convene. When urgent decisions had to be made by the executive committee, this was done either by mail or postponed until the next ICOMS.

Apart from these major issues, some less catching but certainly important issues were tackled: • The 2000 edition of the “Parameters and Pathways:

Clinical Practice Guidelines for Oral and Maxillofacial

Surgery,” as prepared by AAOMS, was endorsed by the IAOMS. Many affiliated associations followed this good example. • The manual for preparing an ICOMS was thoroughly revised so as to meet the changing demands of the

IAOMS and to accommodate a much larger attendance. • The education committee, under the leadership of Alastair Goss, was restructured to include all chairmen of regional educational committees. This was done not only to improve international cooperation but also, above all, to improve understanding among the regions. The education committee was asked to review the “International Guidelines for Specialty Training and Education in Oral and Maxillofacial Surgery” again and to formulate a core curriculum for developing countries with the idea in mind of commencing educational programs in these countries. They were also to come up with a plan for certification of trainees from these countries. Unfortunately, their proposals were not accepted by the executive committee for various reasons. Core programs proved difficult to define because the regions differed in their needs, while IAOMS was hesitant to provide certificates simply because the IAOMS is not an accrediting body. It was generally felt that this was a national or regional responsibility.

At the same time a communications and technology committee was established as it was thought that this would be important in times where new technologies Daniel Lew

were overwhelming the specialty. This committee had a promising start but never became productive.

A very important and far reaching decision was the change of the Journal’s publisher, preparations for which were already completed by the previous executive committee. It had become obvious that the Journal was losing money instead of being a source of income. After consultation with the association’s legal counsel and the evaluation of several proposals from various publishers, including one from Munksgaard, Harcourt Brace (later taken over by Elsevier) was chosen for its acceptable offer. The transition became effective in 2001. This move turned out to be beneficial to IAOMS with regard to the profitability of the Journal. As a result of the change in publishers, for the first time in its 29-year history, the main asset of the association, the Journal, became profitable.

Peter Banks (left) and John Helfrick (right) present Rudi Fries his “Distinguished Fellowship” award.

2001: The 15th ICOMS, Durban

The “reign” of John Helfrick came to an end in Durban in May 2001. South African OMF surgeons, under the chairmanship of Patrick Uys, organized the first ICOMS on the African continent. This meeting, again, had a very special flavor because of the personal touch of the organizers. The attendance was somewhat disappointing — 539 registrants with 127 accompanying persons but the organization and hospitality were unsurpassed.

The conference featured a special trainees’ session that was very well attended as a number of trainees were

Independent Members

General Assembly

Executive Director (Ex-Officio)

Executive Assistant

Administrative Assistant

Director, Marketing Communications & Development

Membership Associate

iaoms organization chart

Individual Oral & Maxillofacial Surgeons

Affiliated Nations

Regional Associations Council

Executive Committee

Board of Directors and Budget & Finance Committee

• President • President-Elect • Past-President • Treasurer

Three At-Large Regional Members

Foundation Board of Trustees

Regional Representatives

• Africa • Asia • Europe • Latin America • North America • Oceania

Non-Voting Members

• Journal Editor • Education Committee

Chairman • HADR Committee

Chairman • ICOMS Committee

Chairman • IT Advisory Committee

Chairman • Research Committee

Chairman

sponsored by their national benefactors, while a few were supported by the IAOMS Foundation. The biggest event was the Invitational Conference, to which all national presidents were invited, along with all IAOMS councilors. As mentioned before, the topic was the draft strategic plan, which received lots of comments and suggestions for improvement. A revised version would later be sent to all councilors, who approved the new version in 2003 in Athens, after which it was published in the Newsletter, including an accompanying budget.

Leonard Kaban was the Presidential Lecturer, and he talked about the biomedical technology revolution and the opportunities and challenges that we are facing.

The executive committee also approved a motion to accept Oceania as a new region. A lot of discussion within the Asian association had preceded this move but eventually both sides agreed to split up.

A novelty in Durban was the Foundation luncheon where Philip Tobias, an internationally acclaimed paleoanthropologist, presented a brilliant talk on “The hominid fossils of Africa with special emphasis on their facial and dental features.” The lunch raised money for the Foundation and this event would become a tradition for each ICOMS to come.

Three members of the executive committee, Peter Banks, Kent Cohenour and Jürgen Reuther completed their tour of duty. Peter especially had been instrumental in bringing about the changes in the governance of IAOMS. His particular sense of humor often caused a much needed tension break during meetings of the executive committee.

Kent’s input, too, can hardly be overestimated. He was responsible for a thorough analysis of the financial situation and subsequently for the proper budgeting and yearly financial statements that were approved by a registered accountant. Today these activities sound like an open door but these processes were lacking in previous years when General Secretaries were also the treasurers. Jürgen had played an important role in the discussions about the infamous “Guidelines.”

At the gala dinner Rudi Fries received a rightly deserved Distinguished Fellowship. He was the second oral and maxillofacial surgeon to receive this award. The role Rudi Fries had played in the policies of the specialty both in Europe and worldwide would be hard to be fully recognized. Special credit should be given to his tireless efforts to make contacts with first the Eastern European colleagues and later also with several African colleagues. This was almost always done at his own expense.

Thanks to Rudi Fries, many openings were made and the current educational programs in different parts of the world were largely initiated because of his constant pleas. He is a true icon of our specialty, not bothered by self image.

Another person who needs to be mentioned here is Alastair Goss. He stepped down after six years as chairman of the education committee and ex officio member of the executive committee. Alastair made the education committee work, unlike all previous committees. The inventory made in 1994 about the status of training worldwide, under his chairmanship, was truly a major effort and proved the importance of this committee for the governance of the association.

He was also responsible for the report on “The international growth and development of the surgical specialty of oral and maxillofacial surgery in the nineties,” which was the result of a follow-up survey, carried out in 2001. Questionnaires were sent to 54 national associations with a response of 41. It showed a marked shift towards a longer training period, as compared to the survey from 1992. Most likely the influence of the “Guidelines on Education and Training” as first published in 1992 and amended in Budapest, in 1995 and Durban, in 2001. This report also showed the wide scope of practice that exists worldwide.

His efforts to produce a core curriculum for less developed countries was equally important but appeared to be difficult to achieve for reasons mentioned before. He was followed in his role as Chairman of the educational committee by Nabil Samman, who would continue on the same route, while also becoming heavily involved in IAOMS initiated and sponsored educational programs. The last person to be mentioned is John Frame who was the editor of the Newsletter from 1990 to 2001. He also retired and was replaced by Alexis Olsson, the assistant executive director.

The presidency was taken over by Paul Stoelinga with a new executive committee, because several new members had been voted in. The most important change was the appointment of John Williams as the new treasurer, since the board would now be in charge of the association’s daily affairs. John found himself thrown in deep waters despite his previous experience in both national and European affairs. American bookkeeping differs from European book keeping and even the terminology used is different in the two regions. Nevertheless, a decent three-year rolling budget was presented at the first board meeting. The finances were in proper shape supported by a handsome profit that was made by the South Africans on the XVth ICOMS in Durban. The aim was to run the association with the money received from the dues and to spend the dividends and interests on special activities as outlined in the strategic plan. Alastair Goss, chair of the education committee, 1995–2001

Paul J.W. Stoelinga, president, 2001–2003

First IAOMS-sponsored educational course

One of the main things initiated during the period that Paul Stoelinga was president was the first IAOMSsponsored educational program in Hat Yai, Thailand. This program officially began on 17 March 2002 but was preceded by two years of preparation, including negotiations with the Thai Association of Oral and Maxillofacial Surgeons and officials of the Prince of Songkla University in Hat Yai and, of course, the IAOMS Foundation under its new Chairman Marsden Bell. The location in the south of Thailand was chosen so as to facilitate participation by trainees from other, neighboring, countries, in particular Indonesia. Henk Tideman, who was familiar with the region and the leaders of the Thai association, played an important role in making the program happen.

The success of this project, completed in 2005, exceeded all expectations. Some 150 very enthusiastic young colleagues of Thailand and seven neighboring countries attended and the teachers, from Europe, Asia, Argentina and the United States did an outstanding job. The “Thai project” became an example of how educational projects should be organized and was successfully transplanted

later to Peru, Indonesia and East Africa in versions adapted to the local needs. The European association used this model for a similar program in Iasi, Romania.

The IAOMS had finally fulfilled one aspect of its mission statement i.e. “The mission of the International Association of Oral and Maxillofacial Surgeons is to elevate the quality of healthcare worldwide through the advancement of the art and science of oral and maxillofacial surgery.” The dissemination of knowledge to less privileged countries would from now on be a constant issue in the policies of the IAOMS.

In this context it is important to mention the efforts to assist Africa as the last region to link up with IAOMS. Paul Stoelinga had made contacts in Durban to initiate the establishment of an African association and to seek their representation on the executive committee of the IAOMS. There were two further African associations at that time, apart from South Africa. Egypt and Nigeria representing the north and the west but the east was lacking. Through contacts in Kenya and Tanzania it was possible to create an East African association that represented nine East African nations. Professor Symon Guthua from Kenya became its first president.

At its founding meeting there were only 15 registered oral and maxillofacial surgeons, all trained outside their countries but as a result of newly established training programs in Nairobi (2001) and Dar es Salaam (2005) and with the help of the IAOMS supported educational program, a rapid increase of locally trained colleagues has occurred. In 2003, at the ICOMS in Athens, it was decided by the Africans present at that meeting, that a Pan African association should be established. It was for the next president, José (Pino) Ferreria, to attend their first meeting in 2005. The governance of the association became more demanding because of the ambitious strategic plan, which implied all sorts of initiatives. The Executive Secretary was overwhelmed with work and the executive director simply could not physically keep up with the demands. Victor Moncarz was a non-salaried executive director and could only spend a limited amount of time on IAOMS business.

The Board, therefore, suggested the hiring of a salaried part-time executive director, who would physically be present in the office and could guide the expanding staff in coping with the growing work load. The executive committee agreed with this plan after approving the job description drawn up by the board. This, for the time being, was the final step in the process of changing the governance of IAOMS into a true professional organization. John Helfrick expressed his willingness to take the job and was appointed in Athens.

Victor Moncarz, executive director, 1999–2003

2003: The 16th ICOMS, Athens

The XVIth ICOMS took place in Athens, Greece, in May 2003. The change to Athens was made, after a site visit by Peter Banks in 1999 when it became clear, that the original location, Corfu, did not have a hotel that could accommodate a meeting of the size of an ICOMS. The promised venue, at the time the choice was made by Council, simply had not materialized.

The organization of the conference was chaired by Angelo Angelopoulos assisted by his local committees and a Congress organizer represented by a rather shrewd lady. She promised a reception at the Acropolis and several other unique events, when a delegation of the Executive Committee went for a site visit. Unfortunately several of her promises did not come through but the conference turned out to be excellent thanks to the hard work of the Organizing and Scientific Committees. Much to the chagrin of the Executive Committee, however, no profit was made on this conference. The Iraq war and an outbreak of SARS made many Americans cancel their trip to Greece. The attendance was, therefore, somewhat disappointing (approximately 800 participants) but the ambiance of Athens made up for this drawback.

Again, an invitational conference was held this time on a very ambitious topic: “Standardizing and Advancing of Quality of Care in Oral and Maxillofacial Surgery.” It drew some 130 participants from all regions of the world and was preceded by four introductions from John Helfrick, Nabil Samman, Henning Schliephake and Alexis Olsson. They addressed the following sub-topics: • Role of practice guidelines. • Clinical pathways. • Education and training. • Research and communication. The full report of this conference was published in the Newsletter of March 2004. It appeared that the five participating regions had different priorities but all agreed on the need to promote “evidence-based practice” while admitting that this was insufficiently available in the current practice. The participants agreed, however, on the need for improving the website so as to promote education and communication. This was a desire that was soon to be met.

Shown during the 16th ICOMS opening ceremony are from left to right: Victor Moncarz, José Pino Ferreria, Paul Stoelinga, John Helfrick.

The Foundation luncheon in Athens was extremely well attended and the guest speaker, Professor Stefanos Geroulanos, entertained the participants with an outstanding lecture on “Ancient Medical Practice: What else could you expect in a country that was the home of Hippocrates? The presidential lecture was presented by Henk Tideman, the topic being “Vita brevis est longa art,” translated from Hippocrates: Life is short, the art is long. He presented his view on the development of the specialty mixed with his personal experience, which made an impressive talk.

An unforgettable boat trip through the Aegean Sea with visits to some small islands was the highlight of the social program, organized as a half-day break away from the scientific program. This was a much appreciated novelty in the organization of an ICOMS.

At the usual Gala Dinner, John Frame, the editor of the Newsletter from 1990–2001, received the IAOMS Distinguished Service Award for his outstanding service during this period. This award had been established two years previously. José (Pino) Ferreria took over the presidency. John Williams became president-elect and Don Booth became the new treasurer.

The inauguration of Pino in Athens was enthusiastically welcomed by a large delegation of Argentineans who were present at the gala dinner. The first president from Latin America gave an impressive introductory speech.

The new board of directors set off in the new headquarters in Oak Brook making use of new electronic means of communication, such as all correspondence and minutes of meetings sent by e-mail. The Newsletter was also sent by e-mail but on popular demand, as the new executive director called it, this was turned around in 2005.

Alexis Olsson, the new editor of the Newsletter, really met the target of distributing at least two Newsletters a year. It also contained relevant information including a yearly report in 2003, which was very informative for the membership. An executive director that was physically present at the office and who could guide the growing staff really made the difference. Meetings of the Board and Executive Committee were much better prepared and initiatives to further improve the governance were plentiful. There was also time for some highly necessary updates on documents that were often consulted, such as a policy on co-sponsoring meetings and above all the guidelines for organizing an ICOMS. The latter needed constant updates because of the expanding IAOMS activities that had to take place during these conferences and also because of the increasing financial implications. The times were long gone that an ICOMS was just a meeting of a few hundred colleagues.

Another important activity was the questionnaire that was sent to all national associations to assess the profile of the specialty of Oral and Maxillofacial Surgery. The results of this survey were quite revealing in that there appeared to be a large emphasis on dentoalveolar surgery but a growing expansion into the full scope of the specialty. Unfortunately, the response was somewhat disappointing, which made the outcome less representative.

The work of the new treasurer, Don Booth, in this period was impressive. Don clearly had a feel for investments because the assets of the association grew at an incredible rate, freeing money for some upcoming events that would benefit the leadership of all national associations but also was put to use for some projects that were included in the strategic plan. It was quite reassuring for the Executive Committee to realize that the finances were in good order, firmly in the hands of a very capable person.

Pino, in the meantime, represented the IAOMS all over the world. The growing number of affiliated nations and members coupled with an increasing interest in international cooperation caused him to visit Asian countries in particular, aside from the usual regional conferences and meetings in Latin America. The most rewarding of all was his visit to Nairobi in Kenya, where he represented the IAOMS at the founding meeting of the African Association of Oral and Maxillofacial Surgery (AfOMFS). The African colleagues, from then on, took their well-deserved seat in the Executive Committee, which would contribute to better communication with this continent.

José Luis “Pino” Ferreria, president, 2003–2005 Don Booth, treasurer, 2003–2009

Although there are still many problems within this large continent, with many countries of different cultural backgrounds, a modest start had been made. The IAOMS literally sponsored this historical event.

The Education Committee under the chairmanship of Nabil Samman was very busy indeed with the increasing requests for educational programs, in particular from Asian and Latin American countries. He managed to mobilize enough teachers to cope with this demand.

The IAOMS had also established a Research Committee to encourage and facilitate research activities within the IAOMS by serving as a forum that brings senior researchers and surgeons together to develop an environment to initiate basic, translational and clinical investigations. The committee was co-chaired by Stephen Feinberg and Henning Schliephake.

2005: The 17th ICOMS, Vienna

The organization of the XVIIth ICOMS in Vienna was in the hands of Rolf Ewers and his very capable staff. He, unfortunately, received little backing from the Austrian association, despite the original bid from this association but without any hesitation, took the risk himself to organize this congress in the superb setting of Vienna. He was not disappointed as a record number of delegates (1,400) came to the meeting. Apart from the excellent scientific program, the social program was superb, blessed by magnificent weather. The whole conference took place in the “Hofburg Palace,” the original residence of the Habsburgs and was dedicated to Rudi Fries, a well-deserved honor and unique in the history so far of the IAOMS. The opening ceremony in the well-known “Redoutensaal” was a very special event, enlightened by music from Richard Strauss. It would be hard to find a better experience, sitting in that room of splendor, listening to his music.

The invitational conference for this ICOMS focused on “Using Technology to Advance the Specialty.” The topic was very appropriate in the quickly changing times where modern technology tends to bring about a revolution in communication. Not surprisingly, the event drew a large attendance from all over the world.

A novelty of this ICOMS was the first research symposium, which was organized by Stephen Feinberg and Henning Schliephake. More than 30 colleagues from all around the globe expressed their interest in actively participating in research interest groups.

Another highlight of the conference was certainly the presidential lecture by Michael Cohen Jr. on the topic: “Some disorders of bone.”

The Foundation enjoyed a very successful luncheon with its speaker, Christoph Wagner-Trenkwitz, who spoke on “Music in Vienna; Quotation of Mozart: the best place in the world for my profession.” There was not one attendee who doubted that statement!

The whole conference will always be remembered by those who attended as one of the best ever organized, particularly under the charming but also very capable leadership of Gabriele Millesi, who was in charge of the daily affairs with her committee. At the gala dinner, Wilfred Schilli received the award of Distinguished Fellow. At last, a well-deserved recognition for his pioneering work and far-reaching vision. At the end of the meeting the presidential chain was handed over to John Williams. Rolf Ewers, chair of the 17th ICOMS

Gabriele Millesi John Ll. Williams, president, 2005–2007

Futures Summit I

In his inaugural speech, John mentioned two important strengths of our specialty; “We are big enough to be taken notice of and small enough to be able to launch pilot programs, should that be deemed necessary.” How true this prophecy would turn out to be. He also described several obvious problems that seemed to have been ignored, particularly by those in government responsible for any sort of healthcare manpower planning and not just in the OMFS specialty.

On this basis, the new president welcomed OMFS leaders from around the world to attend a conference in Chicago in April 2006 to address issues of this nature the “Futures Summit I.” John told his audience that he trusted that those in attendance would bring some very serious thoughts regarding the need to involve the younger generation in decisions that would affect their future. It was the success of the Vienna conference that made it possible for the Board to even contemplate such a major event as the Summit for a non-ICOMS year.

The Summit was also seen as a natural follow-up to the strategic plan of 2004, a “re-thinking” of how the association could move forwards in order to satisfy the

needs of the emerging generations of X, Y and beyond. The Summit convened with an essential element, a group of some 90 IAOMS members who were as representative as possible of the future leadership of all six regions. A “futurist,” Ed Barlow, served as the event’s coordinator, assisted by Breda Bover, a psychologist and professor in adult learning. Between them, they facilitated the two-day conference that was subtitled, “Aligning the IAOMS with Continuous Change.”

The whole meeting will be remembered by the many participants, who came from all corners of the world, as an eye-opening experience. As a result of this meeting, it became obvious that the association and the specialty itself needed a very different approach in order to reach future participants, the emerging generations.

The principal outcome of this first meeting was to establish a task force, which was charged with exploring emerging trends and issues which affect the OMFS profession and making particular recommendations to ensure the provision of an adequate workforce for the future needs of the global population. (see sidebar below)

Another issue which emerged from the Summit was the need to develop a new website for the facilitation of better communication and educational opportunities. From the proposals submitted, after extensive discussion and planning meetings on the part of the Board and Executive Committee, an Indian company, EDC, was chosen on the basis of its very competitive bid. Several months later, the resulting redesigned website was launched during the 19th ICOMS in Bangalore.

The key message, however, that came out of the “futures” event was the association’s need to increase its flexibility in governance in order to embrace the upcoming generations of leaders and members. For instance, while the association’s finances had gradually been brought into a structured format by recent treasurers, which enabled developments like the Summit and new website to be afforded, additional financial problems were developing. During the period from 2003 to 2007, the association’s administrative expenses had risen by 65 percent. While it was clearly time to check this trend in order to grow and expand its capabilities, association leadership voted in a six percent increase in membership dues over the next five years.

The IAOMS Foundation also sought additional means of generating funds during this period due to the commitments the IAOMS had made for educational programs in developing countries, the most significant of which was an educational program in East Africa where there was extensive political change. In this region, a governmental model reflecting almost exactly what had transpired in the European Region had been formed where nine countries had established an economic community with the declaration that there was to be freedom of movement, freedom to reside in any of the countries and to work there.

The IAOMS educational program in East Africa began in September 2006 with some 20 attendees. John Williams, accompanied by Paul Stoelinga, who had done all the initial work, and Julio Acero, attended the launch

first task force formed to study future specialty

At the Futures Summit I, a “Task Force” on the future of the profession of oral and maxillofacial surgery was established with Gabriele Millesi serving as the chair. The task force’s work focused on six issues covering all the main struggles of the profession and of IAOMS members, from young to old: • Collaboration with and integration of professions related to emerging science and technology (multidisciplinary). • Extending the productive work life of the retirement-eligible members of the profession. • Establishing the profession as a great place to work (image and awareness building). • Earn and learn approach to education/training and development of future members of the profession. • Alternative approaches to work environment and work process (project work, etc.). • Maintaining knowledge and competency among the practicing professionals.

The task force’s first step was to design two questionnaires, one for members of IAOMS and one for trainees only. Both were designed to give the task force and the association a tremendous amount of potentially important feedback. Results of the surveys were disseminated at the Bangalore ICOMS in November, 2007.

At the 18th ICOMS in Bangalore, 25 years of IAOMS leadership: Front row from left to right: John Helfrick, Bob Cook, John Williams, Dan Laskin, José Luis “Pino” Ferreria. Back row from left to right: Peter Banks, Wilfred Schilli, Bob Walker, Rudi Fries, Paul Stoelinga.

of this program in Nairobi where the letter of agreement was signed by all involved, including the vice chancellor of the University. A similar document was later signed in Dar es Salaam, Tanzania, where half the courses would be held.

Another milestone for the association’s finances, which would have far-reaching effects in the organization’s future, came in the form of a proposal from 18th ICOMS chair, Kishore Nayak. This fundamental proposal concerned the reimbursement by the national OMFS association host to the IAOMS for the work done on behalf of each ICOMS on the development of congresses, which entailed 10 percent of registration revenue and 20 percent of exhibition revenue being returned to the IAOMS to compensate them for the work done centrally.

2007: The 18th ICOMS, Bangalore

The Bangalore conference was an enormous success with another record attendance of 1,780 delegates, including 590 trainees and 148 accompanying persons attending a colorful social scene in magnificent surroundings. A generous donation of two recent textbooks “Oral & Maxillofacial Pathology” by Marx and Stern and “Essentials of Orthognathic Surgery” by Reyneke, allowed every delegate to receive their own copies. Trainees had a separate symposium on trauma, followed by a huge open air party.

A reintroduction, to the delight of many, was a golf tournament in aid of Foundation funds and the Foundation Luncheon was also totally sold out. This was the second ICOMS with a larger than expected turnout, so much so that improvised lecture rooms had to be erected to create a tented area! It was just as well that the conference coincided with India’s dry season.

An intriguing presentation at this meeting came from James Johnson, the invited Presidential Lecturer. He put the question forward whether the various health systems are converging to a world health policy.

At the end of the conference, Nabil Samman was installed as President. He introduced a different emphasis on work to be addressed with the introduction of Special Interest Groups (SIGs). He nominated two starter topics — cleft/facial deformities and head and neck cancer/ reconstruction — and appointed two small committees, led by Tim Turvey and Moni Kuriakose, respectively, to advance the projects. Each group was to draw up draft SIG guidelines together with a governance structure. Although the groups were self-financed, scholarships were sought from industry to enable selected candidates access to Fellowship programs linked between different centers around the world.

Two important changes were also made to the governance structure of the association. In order to address the issue of appropriate timings for conferences in different regions of the world, it was decided that the presidency should run on a fixed two year cycle, commencing on Nabil Samman, president, 2007–2009

John Williams presents Nabil Samman with the presidential chain. Members of the executive committee during the Bangalore ICOMS. From left to right: John Lowry, Sanjiv Nair, Paul Sambrook, Gabriele Millesi, Paul Stoelinga, Alexis Olsson.

Attendees of the 2008 Futures Summit II.

outcome audit of task force surveys

The priorities demonstrated in answers to the questions differ between the six regions. The general conclusions drawn, however, may be summarized as follows: 1 A need to have core surgical skills which should include: • Dentoalveolar surgery; • Management of clinical pathology, including infections; and • Trauma, as an integral part of a trauma team and aspects of implantology related to the need for pre-implant surgery or reconstructive surgery following ablation. 2 Education and training must be appropriate to the desired clinical practice and tailored to save time. Double qualification should not be seen as a threat. 3 Ability to deal with emerging technologies: • Tissue engineering and regenerative medicine; • Nanotechnology; • Improved 3-D imaging; and • Intra-uterine surgery. 4 Both members and trainees considered that the image of the specialty should be improved amongst the general public. 5 The general recommendation was that each national or regional association should analyze their individual situation and deal with it. January 1st of the appropriate year. Secondly, the issue of reimbursement to the association regarding ICOMS income, as proposed by Kishore Nayak, was formally adopted.

Nabil carried on with efforts to promote educational programs in various Asian countries. He travelled extensively, not only in Asia but also in the other continents as a means of increasing the visibility of the IAOMS. He put steps in place to develop an electronic platform that would augment the educational value of IAOMS’ programs, which would enhance the reach of the association’s educational programs. He also aimed to facilitate advanced training in the areas traditionally regarded as subspecialties, namely cleft lip and palate/craniofacial deformities and head and neck cancer. Under the SIGs concept, advanced training fellowships were planned throughout the world.

At this time, membership numbers showed an increase from 1,000 in 1963 to almost 5,000 in 2008. A further reflection of the growth in membership resulted in the appointment of a membership associate at IAOMS headquarters. Additionally, the increasing workload for the IJOMS editor-in-chief prompted Piet Haers to propose a structure with three assistant editors to improve the workings of the Journal. He would remain as editor-inchief, responsible for overseeing each edition and also for the overall policy of the Journal.

A second “Futures Summit” followed in 2008 where the results of the workforce survey were examined, together with the progress made in the preceding two years plus the survey results communicated at the invitational conference in Bangalore.

2009: The 19th ICOMS, Shanghai

The Conference in Shanghai was another huge success with a massive attendance of 1,503 delegates from 76 countries. It is of particular interest to note that the meeting was organized by the Chinese and Hong Kong associations together. Their excellent cooperation had resulted in a superb and well organized meeting. Not surprisingly, the majority of the attendees came from Asia, with the Chinese being the largest contingent.

The Foundation Luncheon was again completely sold out with a lecture and practical demonstration on Tai Chi that had all participants actively involved! An innovation was the Past-Presidents Luncheon, held on the top floor of the Trade Centre with commanding views over the whole of Shanghai that was attended by 11 past presidents and their wives as well as the president-elect.

The prestigious Presidential Lecture at this event was presented by Ghali E. Ghali, who talked about the evolution, current status and future of maxillofacial surgery.

In the run up to the congress, the association and the foundation had been very busy in Dar es Salaam where, thanks to a generous donation, two operating theatres and their associated facilities had been built and equipped. The new facilities would enable trainees, in particular, to gain additional surgical experience.

January 2010 was the first occasion when the presidency changed hands with the New Year. The Board marked the occasion with a meeting in Hong Kong that was attended by members of the Shanghai organizing committee as a small “thank you” celebration. Larry Nissen was now in the driver’s seat and was immediately faced with challenges over the organization of the next congress in Santiago. This led to the Board appointing a permanent conference organizer to assist with future ICOMS. Additionally, the increasing use of IT in all aspects of the specialty led the Board to establish an IT Advisory Committee, not for the first time!

For some time, the issue of the IAOMS acting as an accrediting body had been sought by many national OMS associations. This need was becoming greater, predominantly in countries where no such mechanism was available. In 2010, the Board established a group to look into the practicalities of performing this function when it was requested.

The occurrence of a series of natural disasters around the world raised the question in 2010 of what IAOMS could do to provide oral and maxillofacial surgical assistance when needed. Don Booth, past treasurer and North American representative, was asked to investigate an IAOMS disaster relief team. As a result of his efforts, the IAOMS Humanitarian Aid and Disaster Relief (HADR) Committee was formed to look in to this and make recommendations. Its first action was a credentialing course that was held immediately prior to the Santiago ICOMS.

Members began to easily and quickly stay on top of news related to the specialty when the association began offering the IAOMS Weekly e-News Bulletin in 2010. These brief missives provided short encapsulations of pertinent news items from around the world and quickly became a member favorite.

Members of the IAOMS Board of Directors with the organizing committee of the 19th ICOMS and members of the host of the Presidential Chain Ceremony, the Hong Kong Association of Oral and Maxillofacial Surgeons.

In an effort to attract the future leadership of the IAOMS, during the fall of 2010, Council voted for free membership for all OMFS trainees with options for either printed or electronic IJOMS subscriptions for a nominal fee. As a result, by the summer of 2011, IAOMS trainee members had ballooned from 2010’s count of 110 to nearly 600!

In 2011, IAOMS leadership continued with its quest to attract and keep trainee members through several new ventures including the formation of a separate trainees association, the International Association of Oral and Maxillofacial Surgeon Trainees (IAOMST), which was rolled out during the 20th ICOMS in Santiago.

E-learning opportunities that began in 2009 with the web-lecture series “ProjecTrain” (initiated and managed by OMS trainee Satheesh Prabu) expanded in 2011 and will continue into 2012 with regular online clinic-pathology conferences and live online debates between specialty leaders on current controversies. A member from Vanderbilt University in the U.S.A., Steven Press, (with collaboration from his colleagues in North Carolina) provided the next steps in unique trainee and member benefits with two programs. The first program was a histopathological series for viewing on any Internet connection in the world. The series included a written didactic component and copies of digitally scanned histopathology slides that would allow viewers, essentially, to turn their computers into microscopes using free software to view the slides and take snapshots.

Steven Press second shared project focuses on trauma and reconstructive surgery and involves the sharing of medical modeling technology with members worldwide.

Finally, OMFS trainees worldwide were treated to a long-time AAOMS trainee benefit, an online manual of familiar OMFS terminologies, medications and procedures. Done in cooperation with AAOMS, under IT committee chair Alexis Olsson’s supervision, the manual was revealed to trainee members at the Santiago ICOMS and rolled out to all trainee members by the end of 2011.

The research committee continued its outreach to the six regions of IAOMS by offering research symposia at national and regional OMS conferences. The committee also received co-sponsorship from the IAOMS for the Research Summits hosted by AAOMS in 2009 and 2011.

At the past-presidents’ luncheon in Shanghai. From left to right: Nabil Samman, John Williams, Bob Walker, Rudi Fries. Participants in the Tai Chi demonstration during the Foundation luncheon. Foreground: Alexis Olsson.

Outgoing President Nabil Samman gives new President Larry Nissen some words of advice prior to passing on the presidential chain in January 2010. Wei-liu Qiu (back row, center) with his committee members.

2011: The 20th ICOMS, Santiago

The enormous growth of the number of attendees to the ICOMS that had begun in Vienna in 2003 reached its height in Santiago. For the first time in the history of IAOMS, more than 2,000 participants were registered, including accompanying persons. There was a massive attendance from Latin America; in particular, Brazil and Chile but Asia, Europe and U.S.A. were also well represented.

The Invitational Conference was about technology, information and the future of IAOMS. There were many speakers addressing the advantages of the new technology to communicate, with particular emphasis on its use for education. This technology opens new avenues, particularly for the less- developed world in that interactive Luis Quevedo, chairman of teaching via the web becomes the 20th ICOMS organizing committee available for them. E-learning in general will take off and will probably replace conventional teaching to a large extent. Later in the conference, a special symposium was held on: “Training of Oral and Maxillofacial Surgeons: Leveraging Technology.” The faculty represented each of the six regions.

At the opening ceremony, Luis Quevedo announced that the 20th ICOMS was dedicated to Bob Walker. He had passed away unexpectedly in July, 2011. In attendance were Bob’s wife Emily and his three children. The dedication received a standing ovation from the audience.

A special feature of the conference was the reformation of the International Association of Oral and Maxillofacial Surgeons in Training (IAOMST), an effort spearheaded by Bob Woodwards (U.K.) and Piet Haers (U.K.) who were both active in the original IAMFST which had been founded in 1989. More than 100 enthusiastic trainees attended the formation meeting, where plans were made to begin by forming six regional groups to explore its potential.

The scientific content was superb, with four major symposia on topics such as: Facial reconstruction, complications in orthognathic surgery, new developments in research, and the role of implants in OMF reconstructive surgery. In addition, another 16 symposia and more than 40 free paper sessions completed the program.

Jay Malmquist (U.S.A.) gave the Presidential Lecture: “Education, Research, Technology, and Innovation: The Foundation of an Exceptional Specialty.” traveling With the chain

The chain is a fairly heavy and expensive ornament since it is made of pure gold, with a medallion of the IAOMS logo set in the center. Most presidents would pack it in their carry-on luggage when boarding planes for formal visits to national or regional meetings, so as to make sure it did not get lost at some airport. This meant that the chain’s heavy metal would set off the alarm at security check-ins, which often caused quite an upheaval before boarding. Presidents frequently had to explain why they were carrying such a valuable chain and what it represented.

As security people are probably not selected because of their scholarly performances, an explanation, such as being the president of the International Association of Oral and Maxillofacial Surgeons, was generally not well understood. This often lead to some embarrassing moments where a senior security officer had to be consulted, while a long line of impatient passengers were staring at you.

I learned quickly to carry the chain in the velvet bag that I inherited from my predecessor, John Helfrick and put it in my pocket. This avoided hand searching my carry-on luggage and having to have a long discussion with the person checking me. This bag, by the way, used to envelop a fancy whisky bottle and the rumor goes that Peter Banks had introduced this means of carrying the chain.

Once approaching security, I would put it in front of them and tell them I was representing an international group of surgeons. This would reduce the time wasted considerably but still the chain could cause a lot of excitement at various borders in all continents. At one of these borders, the person who checked me suggested it was a chain worn by a mayor of a big city. Half sleepingly, I nodded yes, and much to my surprise, I was waved through. This appeared to be luminous thought and I have since boarded planes many times as the mayor of the very little town where I live. No questions asked anymore!

Paul J.W. Stoelinga

Luis and his committees had done a wonderful job and added the much-appreciated local touch, exemplified by a beautiful opening ceremony, featuring dance and music of Chile and a Chilean Evening. They can be rightly proud of their achievement, because Latin America has made a distinct footprint in the IAOMS. Leadership positions at IAOMS went through significant changes, starting with the resignation of Piet Haers as IJOMS editor-in-chief and the appointment of his replacement, Nabil Samman. After many years of service, John Helfrick stepped down as executive director. He received a well-deserved Distinguished Fellowship at the Gala Dinner.

Nabil Samman was presented with a “Distinguished Service” award for his many years of service to IAOMS. Don Booth received an “Outstanding Committee Member” award for his pioneering work on the newest IAOMS committee, the Humanitarian Assistance and Disaster Relief Committee.

At the meeting, the new Executive Director, Barbara Morrison, was introduced. She will be present full-time in the IAOMS office and brings with her the management skills appropriate for the fast growing association.

Of course, a new president, Kishore Nayak, took over at the

Kishore Nayak, IAOMS president, 2012–2013 end of the 2011 calendar year with Piet Haers as the presidentelect. The beginning of 2012 also saw the launch of the redesigned website, which had been upgraded to better suit the technologies that had developed since the last site upgrade in 2007. In addition, two new committees were established, notably the IT Technology Committee, chaired by Alexis Olsson and the Humanitarian Assistance and Disaster Relief Committee, chaired by Don Booth. The affiliation of three national associations was approved: Seychelles, Bulgaria and Serbia. This brought the total number of affiliated national associations to 78.

Barbara L. Morrison, new executive director of the IAOMS

7,000

6,000

Number of Members 5,000

4,000

3,000

2,000

1,000 iaoms membership

0

1963 1965 1970 1975 1980 1985 1990 1995 2000 2005 2011 Year

Epilogue

When reflecting on the history of the IAOMS, as described in chapters 2, 3 and 4, there are several facts that catch the eye. • First, the enormous expansion of the membership, from a mere 500 in 1962 to approximately 6,000 in 2012. This growing membership went along with a steady increase of affiliated national associations from the original seven to 78 (see addendum). This definitely reflects the growing understanding that the interests of the specialty are best served by a worldwide representation of oral and maxillofacial surgery. • Second, considering the tremendous growth in numbers of attendees at the international conferences and particularly those from Asia, it becomes clear that the specialty has spread worldwide and will probably continue to do so. It seems to go along with a global trend in which Asia is becoming a major player, although, to a lesser extent, this also applies to

Latin America and Africa. • Third, the positive effect that the concept of regionalization has had on the organization of the regional associations, notably Asia, Latin America and Africa. They all have restructured their loose organizations into firm regional associations with a structure compatible with that of the IAOMS. • Fourth, the overriding impression one gets, when reading the decisions of the various Executive

Committees, that a lot of these decisions were never implemented. It seems that some of them simply disappeared and were hidden in the drawers of filing cabinets, only to turn up again after several years and be debated as if no previous discussions had ever taken place. • Fifth, the missed opportunity to create a truly harmonized professional specialty with a vertical structure of international organization, as was suggested by participants at the Tenerife and Bermuda conferences. This recommendation was simply ignored, probably because people were distracted by the enormous efforts that were necessary to get the education and training document accepted. • Sixth, there is no doubt that the success of the Journal, with its prime position, has contributed to the growing interest in joining IAOMS. • Seventh, the activities of the Foundation that has made educational programs possible in various parts of the world. This has contributed substantially to the popularity of IAOMS and could be considered an example of effective assistance to the developing world.

2010–2011 IAOMS Executive Committee. Front row, from left to right: Luis Quevedo (Chile), Cesar Guerrero (Venezuela), Stephen Feinberg (U.S.A.), Bob Woodwards (U.K.), Kishore Nayak (India), Larry Nissen (U.S.A.), Nabil Samman (Hong Kong), John Helfrick (U.S.A.), Alexis Olsson (U.S.A.), Joe Piecuch (U.S.A.). Back row from left to right: Antoinette Pearson (U.S.A.), Kerry Spaedy (U.S.A.), Lynne Sayler (U.S.A.), Moni Kuriakose (India), Julio Acero (Spain), Paul Sambrook (Australia), Ademola Olaitan (Nigeria), Boyd Tomasetti (U.S.A.), Kenichi Kurita (Japan), Lobo Leandro (Brazil), Piet Haers (U.K.).

References

Ferreria J., Personal communication Helfrick J., Personal communication Samman N., Personal communication Stoelinga P., Personal communication Williams J., Personal communication International Guidelines for specialty training in Oral and Maxillofacial Surgery. Final version as adapted in Durban, 2001. Minutes of the Board meetings of the period 1999–2011 Minutes of the Executive Committee meetings of the period 1999–2011 Minutes of Council meetings of the period 1999–2011. Newsletters, 1999–2011. Alexis Olsson and Kerry Spaedy.