American Head & Neck Society

Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.

American Head & Neck Society | AHNS


The mission of the AHNS is to advance Education, Research, and Quality of Care for the head and neck oncology patient.

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Online Membership Application

Step 1 of 5

20%

Active (USA and Canada; $400 annually)

Licensed physicians and surgeons who are actively engaged in prevention, diagnosis, treatment, and rehabilitation of patients with neoplasms and other diseases of the head and neck and:
  1. Are a Diplomate of a particular specialty Board such as the American Boards of Otolaryngology, Surgery, or Plastic Surgery or equivalent credentials; and
  2. a significant portion of the practice is devoted to the care of patients with head and neck tumors (must submit a case list with application); and
  3. have evidence of academic activity such as one paper published on cancer of the head and neck.

Upgrading from Resident to Active Status ($400 annually)

Resident (formerly Candidate) members who have completed all training and are
  1. A Diplomate of a particular specialty Board such as the American Boards of Otolaryngology, Neurological Surgery, or Plastic Surgery; and
  2. Actively engaged in diagnosis, treatment, and rehabilitation of patients with neoplasms and other diseases of the head and neck (must submit a case list with application unless graduated from ATC-approved fellowship training).

International (formerly Corresponding $100 annually)

Licensed surgeons and physicians who specialize in the treatment of neoplasia and diseases of the head and neck residing in a country other than the United States or Canada.

Resident (formerly Candidate; $25 annually)

Trainees currently enrolled in, or recently graduated from an approved residency program in Otolaryngology, Plastic Surgery, or General Surgery or a Fellowship Program approved by the Advanced Training Council.

Associate ($100 annually)

Dentists, Physician Assistants, Nurse Practitioners, Speech Pathologists, Registered Nurses, Surgical Educators, and other Advanced Practice Professionals with a special interest in the field of head and neck oncology. Licensed physicians and surgeons whose practice is not significantly engaged in prevention, diagnosis, treatment and rehabilitation of patients with neoplasms and other diseases of the head and neck (i.e. do not meet criteria for ACTIVE category) are also eligible.

Medical Student ($25 annually)

Trainees currently enrolled in, or recently graduated from an accredited allopathic or osteopathic medical school.
Name(Required)
MD, PhD, FACS, etc.
Have you recently graduated from an AHNS Advanced Training Council fellowship?(Required)

Contact Information

Address(Required)
What type of address is this?(Required)

Other Background Information

Gender(Required)
How do you self-identify?(Required)
Please select all that apply.
MM slash DD slash YYYY
Type of Practice(Required)
If other, please enter the type of practice.

Medical Specialty(Required)

Pre-Medical Education

Medical School

If still in medical school, please enter your anticipated graduation year.

Internship

Residency

If still in Residency, please enter anticipated completion year.

Fellowship

Other Education and Licensure

Please provide the name, location of institution, and type of service.
College Membership: I am...(Required)
Do you plan on OR have you already applied to the FACS, FRCS, or Equivalent(Required)
What organizations are you planning on/did you apply to?(Required)
Accepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.
Accepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.
Accepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.

Supporting Documents

Please upload your CV. Please include applicable publication information on your CV. If you are a medical student and do not have a CV, you may upload a copy of your resume.
Accepted file types: jpg, gif, doc, docx, pdf, odt, Max. file size: 15 MB.
Accepted file types: jpg, png, gif, pdf, Max. file size: 2 MB.

Download a sample case listing for format and requirements.

Please submit a case listing SIGNED by the Chief of Service or Department Chairman or Division Chair from each institution.

An applicant for Active Fellowship shall provide documentation that a significant portion of current activity is devoted to the care of patients with head and neck tumors. Such documentation will include a listing of at least 35 patients managed within the last year. A significant portion of practice can be concerned with managing patients with neoplasms and other diseases of the head and neck. You may use your own judgment in selecting and listing your most appropriate 35 cases.

Accepted file types: jpg, gif, pdf, png, Max. file size: 2 MB.

Sponsors

The two names should be ACTIVE members who have agreed to propose you for membership. One sponsor must be someone who can attest to your clinical/work skills. For International applicants, one sponsor may be an International member.

Please use the fields below to select your Sponsors and they will be contacted by and will respond directly to the AHNS office. To expedite the process, please notify your Sponsors to expect an email from AHNS regarding this.

How many sponsors do you have?(Required)
If you do not know someone who can serve as your sponsor, our office will follow up with you directly.

Application Fee Payment

If payment by check is necessary, please click "save and continue later" and contact [email protected].
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Credit Card(Required)
American Express
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MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Expiration Date
 
Only click the "Submit Application" button once. Double-clicking may result in duplicate applications and charges.
Fellowship Director Name(Required)
Department Chair or Division Chief during your fellowship(Required)
If the Chair/Chief is also the Fellowship Director, instead please enter another faculty member from your fellowship program who is an AHNS member.

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AHNS, 11300 W. Olympic Blvd, Suite 600
Los Angeles, CA 90064
ph: (310) 437-0559 / fx: (310) 437-0585
[email protected]

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