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When I arrived as the Chair of Otolaryngology – Head and Neck Surgery at Houston Methodist Hospital five years ago, our department was still a division under Neurosurgery. Alongside my faculty of four physicians, we had an ambitious vision for the future. Six months into my tenure as Chair, we faced an unprecedented global pandemic. Millions were sick and dying worldwide, with few treatment options and many questions for the medical community. Innovative solutions, new treatments, and research were urgently needed to combat COVID-19 and its aftermath. The pandemic drastically altered basic clinical practices, such as scoping patients, and required us to find safe methods to perform airway surgeries, including tracheostomies for our sickest COVID-19 patients, while ensuring the safety of our staff, residents, and faculty. At the core of our strategic vision is the creation of a vibrant educational program. To that end, we set out and established a top-tier, ACGME-accredited Otolaryngology – Head and Neck Surgery residency program. Achieving this required faculty with experience in training residents, sufficient funding to support the best training experiences, and the development of beautiful clinical, educational, and simulation training sites. Enhancing collaboration with other medical institutions in the area was also crucial. We have expanded our educational reach by becoming the primary clinical and research training site for the Texas A&M Engineers in Medicine (EnMed) program. Every week, our research meetings are filled with EnMed students and our faculty, allowing us to benefit from their insights into medical devices and the physics of medicine. This collaboration has opened new avenues for clinical and research curiosity, leading to patents, publications in medical device journals, and presentations at medical device conferences. We are also broadening our national and international impact by training medical students from various institutions. Furthermore, we have launched our inaugural Annual Area High School Internship Program in Otolaryngology – Head & Neck Surgery. Subspecialty fellowships are integral to our educational strategic vision. By offering the expertise to train subspecialists, we aim to provide the highest level of care for our patients. In 2023, we received AAFPRS approval for a Facial Plastic and Reconstructive Surgery Fellowship, and we also help train a neurotology fellow in collaboration with area healthcare institutions. More fellowships are forthcoming. Our team is committed to fostering a spirit of learning and collaboration that will propel us into the future. New collaborations with institutions of higher learning and industry will transform the way residents are trained. The days of being siloed in a single institution are behind us, and it only makes sense to utilize scarce resources to benefit as many academic institutions as possible. Research has always been the foundation of academic medicine, but government funding has been declining, with NIH grant funding decreasing over the last decade. Successful clinical operations have become the new normal for funding research and educational programs. Academic medicine is a continuum that feeds itself—from clinical practice to research to education and back again. Recognizing the shifting paradigm of academic medicine, we have explored alternative funding sources to support our research initiatives. We have engaged industry in over 10 sponsored studies, where we help vet and improve new products poised to enter our specialty. We have established charitable funds to support faculty-initiated research protocols and allocated resources for travel to raise awareness of our new department at national meetings. Additionally, I have dedicated funds to hire two research coordinators, two clinical research fellows, a statistician, and a big data/AI researcher to assist our faculty in maximizing their research potential. This research foundation is crucial to the continued development of our department's strategic vision. However, to make our educational and research visions a reality, we needed to grow our clinical volume and faculty. In just five years, we have expanded to 30 faculty members, making us the largest adult academic Otolaryngology – Head & Neck Surgery Department in the greater Houston area. Our team now includes 16 subspecialists and 14 generalists, all of whom are committed to our shared vision. In order to accommodate this growth, we now have over 65,000 square feet of space dedicated to the department’s mission. Our department is only five years old, which is extremely young in the medical community. I do not expect us to compete in the basic science arena with institutions that have a century's head start. However, when people look back 100 years from now, I hope they will point to us and say, “That’s where the Big Data/AI revolution really began.” We have the capabilities to achieve this, thanks to our faculty, our ongoing research, and the support of the Houston Methodist Academic Institute. That’s where we’re going.