Bill Klaproth (Host): This is an AAOMS On the Go Podcast. I'm Bill Klaproth. And today, we welcome Dr. Michael Markiewicz, the Surgical Oncology and Reconstruction Section Editor for the Journal of Oral and Maxillofacial Surgery, as we talk about the JOMS Surgical Oncology and Reconstruction section. Dr. Markiewicz, welcome!

Dr. Michael Markiewicz: Thank you very much, Bill, for having me.

Host: Yeah, great to talk with you. I appreciate your time. So, Dr. Markiewicz, could you first begin by giving an overview of the types of studies and research topics that are generally featured in your section of the Journal?

Dr. Michael Markiewicz: Sure. It's a pretty broad section in that it covers, as it describes, anywhere from surgical oncology, and that can be from the surgical aspects to the perioperative management of patients such as the radiation oncology aspects, the medical oncology aspects and, of course, things such as immunotherapy and systemic therapy, which are covered under those. So that's really what it covers as far as Head and Neck Oncology. And we really accept all topics on that area.

Moving towards the Reconstruction realm, really, that's obviously with the reconstruction of head and neck ablative defects or cancer defects. And that could be anything from free bone grafts to split-thickness tissue grafts or skin grafts to the use, of course, all the way up to free tissue transfer. That's all under our realm. So, it's a pretty broad section where we see a lot of submissions on both of these areas. And of course, we welcome all of them.

Host: You know, you certainly cover a lot of ground here, a lot of broad research. Let me ask you this then, from your perspective as an editor, kind of looking ahead, what emerging trends or topics in oral and maxillofacial surgery research are you most excited about coming up in the future?

Dr. Michael Markiewicz: Yeah. It would probably have to be the non-surgical management of head and neck cancer. Especially in our field, we have some dynamo researchers who are performing this high-level research. Looking – and most of these are surgeons – but they're really focusing on risk factor stratification, how to identify patients at risk for progression from premalignant lesions to cancer, for example. How to identify from a simple biopsy using markers for those patients who may progress to full-blown cancer.

And then, of course, in the management of these patients in the perioperative setting, looking for, you know, the non-surgical techniques, which we've used forever, but really advancing that field. So, such as systemic therapy, chemotherapy, different regimens with a focus on de-escalating treatment, which reducing the intensity of treatment, but also reducing the side effects for patients. So we're seeing a lot of papers with those kinds of topics.

In addition, I think immunotherapy is obviously a big hot topic now in the past probably half decade, a decade in head and neck cancer. So we're seeing a lot of submissions with that, and not only the basic science realm, but in the translational research realm and also the application of these methods to patients. So, I think that's probably the thing I'm most excited about personally for my patients, if I'm going to admit. But also that, obviously, authors and readers I think are excited about is, you know, how are we going to find ways to do maybe less surgery on patients and treat patients in more of a medical management model?

Host: Right. Well, non-surgical management, always beneficial to the patient as well. And you talked about de-escalating treatment, which I think is good. So it's interesting to get your thoughts on this as we look ahead into the future. And these are really important things to make sure that we're watching, we're paying attention to, and I know that you will be on it in your section of JOMS.

So, speaking of your section, how do you ensure that the research published in your section is both scientifically rigorous and relevant to practicing OMSs, as that's really important as well?

Dr. Michael Markiewicz: Yeah. And that's always a slippery slope, because I think a lot of the readership, including myself, want to see innovation. You know, we want to see new techniques, new treatments, new ways to manage patients. And it usually starts off with the simplest form of research, which is a case report. Sometimes there's case reports and, to answer your question directly, how do we keep it rigorous? It really starts with our Editor-in-Chief, which is Tom Dodson. And he was my teacher way long ago and taught me how to do research. But not only that, he really holds the scientific method to a high regard with our Journal. And so, if anything, we've seen as readers, and I've seen it as an editor, if you are in editorial board meetings with him, I mean, he really wants the science to be good. So it starts from the top with him. And I think he has a kind of a paradigm, which he wants the section editors and the reviewers to follow, which is being really strict on papers and holding papers to a certain level of writing.

So you could imagine along with that comes high scientific standards. You know, they don't want to let just anything pass by. They want the Journal to be a pillar of high-quality papers. But you can imagine with that, sometimes the case reports or the single case reports, even multiple case reports, may not get by, and that can be good or bad. You know I guess you can miss something that's very innovative and that the readership would want to read. But at the same time, it's really holding it to a level of standard where observational studies are being published, good quality observational studies, good quality trials are being published.

With all that being said, you know, the Editor-in-Chief, Tom Dodson, will accept case reports and we see them published still, but they just have to be innovative. So, with all that, I think that's the goal, is to deliver the everyday clinician, the academician, the person in private practice, high-quality research that they could use in their practice. Again, randomized clinical trials, observational studies, but also to provide them with high-quality case reports if they're out there and if they make the cut so they can use those in their practice.

So, that's something that's always talked about. And I think trying to keep the standards high is a goal while also keeping the readership in mind and making sure we have all their needs met as well.

Host: Yeah, I love how you say it starts at the top, and holding papers to a certain level of writing. The standard is the standard, and the standard has been set high. And you and your colleagues certainly are keeping it there, setting these high scientific standards.

You mentioned moving forward, if someone is doing this, looking for innovation. Have there been any challenges in curating content for this section of the Journal, especially with rapid advancements in surgical technology and techniques?

Dr. Michael Markiewicz: I think there has. And I think we all know we live in the era of social media, which is incredibly powerful.

Host: Yes.

Dr. Michael Markiewicz: Yeah. And so, we're on a podcast right now, and so… and I love podcasts. I listen to them daily on a long run or while working out or just during a long drive. And I think they're an incredibly good way to give people information quickly, which is why we're on here. So I think it's really good content. And then, of course, the other social media sites such as Instagram, Facebook, or so on.

But if you talk to residents nowadays, I mean, just only a decade ago, it was still a standard of practice and the biggest thing you could feel good about as a resident or a young trainee or young faculty – or anyone – was to get a paper published. And I've had this conversation with residents and it's quite interesting that – in fact, one who was a great resident, graduated a few years ago – made the comment saying, I remember, "Oh, you know, I would argue that I think Instagram is replacing journals as our way to get information out there and get science out there." And I think that statement actually is not completely untrue. I think it's false. I'll tell you why, but there's some merit to it in that how easy is it – and to be honest, you could tell people have fun with it – just to do a quick surgery or a couple cases and to publish your reel on social media or to publish your video. And you get the likes and you get the comments and your peers can see it that day, versus going through the peer review process of going to the website for the Journal – which is easy to use, easier than it's ever been – but still you've got to put a cover letter, you need to submit, you need to have two reviewers at least really rigorously review the paper, and then tell you if it's good enough or not. And often, it may not be good enough upfront, but they will suggest minor revisions or major revisions, and of course sometimes even rejection. And all that work just to get a rejection or to get a lot more work on your plate.

Host: Right.

Dr. Michael Markiewicz: When you're in academia, it's great, because you want to build your CV. I think it's our job. You know, a famous attending of mine always said, "If you're not publishing it, you're not doing it." You know what I mean? That if it's not in the journal, no one knows you're doing it.

That's changed so much, because you can just throw this on LinkedIn or any other site and quickly get the content out there and people know you're doing it. So, that's another way now. And in fact, there's sometimes even more, in certain demographics, more viewership on these things. So, but the thing is people don't realize, and we know all these and we actually joke about them, we have all of us surgeons, we know people out there who do a lot of this stuff, and some of the content is just out of this world, and it's great. And I always say it should be in a journal. Some of it should not. And the problem is you have the wow effect where it has maybe some good music, some good graphics, and it's not peer reviewed. So, you could just submit it to upload it within a minute. How easy is it? You know, we all can do that with a couple of clicks. No one's reviewing the content. No one needs to review it. And it could be almost thought of as dogma. Because when you have someone with a couple hundred thousand or a million followers, “wow, well, they must be good and know what they're talking about”. And sometimes, by the way, that's the case. So, I'm not trying to say it's not. But at the same time, there's definitely content out there that most surgeons, I mean, we all have conversations about it where we would not want residents to learn that. We would not want fellows to learn that. We would not want other surgeons to learn that. It's not the way to do things.

Host: Right.

Dr. Michael Markiewicz: But because it has some glitz and glamour, it looks good. So, in the end, I think social media is really good. I think it can be used as a tool to educate. We've done this with other journals where you can actually publish the journal's content on social media. So I think that's a way to get things out there if you're going to try to hit certain demographics. Let's face it, certain residents just don't pick up the journal anymore and it's not their fault, it's just the way it's done. You know, even though I'm kind of disappointed in that. So I think, long story short, I think social media used in the correct avenue and the correct purpose is really powerful and good, but it can be bad.

Host: Yeah, very true. I mean, you want this information to be peer-reviewed. You want it vetted and accredited, right? I mean, that's the gold standard. Yes, you can put the YouTube video together, the Instagram Reels video together. And that's great, like you say. And, you know, most of the time it's probably good, but you really want AAOMS behind you, right? And JOMS saying, "Hey, we've reviewed this. And, yes, this procedure or this new innovative technique, yes, we believe in this and we think that you can use this safely on your patients." Isn't that right?

Dr. Michael Markiewicz: Exactly. And I would also say, Bill, that if you truly want this to get out there and, like you said, you brought up a great point, AAOMS to say, "Hey, we're going to put this in a white paper and give this as our guidelines." Actually, you can do it, it's rare, but they're not going to say, "Reference this Instagram reel. We're going to write a summary paper and use this article," that instead of saying an article, they're going to say, "See so and so's post on July 4th, 2024."

So, to your point, even from the author or the poster or, you know, people who are doing that, if they really want to put their good work out there, you can do both. You know the one thing I think is fun, like our residents actually do and other programs do, which I think is really cool and a lot of fun is – and it gets them involved too, and they're proud of it – is that they will publish a paper. And then, very quickly, they'll say, "Our department just published this paper in the Journal of Oral and Maxillofacial Surgery on this topic. Please see this PubMed link below,” and you can type this in and go find the article if you want. And also, since it's published, you could just reference it and you could put your picture, your figures in there and I think that's a nice thing to do. And I think that's great. That kills two birds with one stone. You published in a peer-reviewed journal. And then also, now you're promoting research and you're promoting peer-reviewed research. And I think it's a win-win for everyone.

Host: Yeah, there are some really good points, Dr. Markiewicz, absolutely. It's called the Journal of Oral and Maxillofacial Surgery, not the Instagram of Oral and Maxillofacial Surgery. Come on, people.

So what would you like to see more of? And we were just talking about, hey, you could do this and put a video out on YouTube, but what advice would you give to researchers looking to publish in the Journal of Oral and Maxillofacial Surgery? Someone that says, "Yeah, okay, I could do this on Instagram. I want to do this the right way. I want to go through this. I want it to be vetted, peer reviewed." What are tips and strategies and things they need to know to do this? And are there certain things that you're looking for?

Dr. Michael Markiewicz: Yeah, I don't think there's anything in particular we're looking for in our section. I think we take all-comers with regards to surgical oncology and reconstruction. So, we will take all of it. There's some things where we're not looking for, to be honest. There's some if it's basic, basic, basic science. Often they're great papers. It's just not probably appropriate for our readership. So those are tough sometimes.

But no, I mean, I think if it's translational research or if it has a surgical edge to it and focus, we would love to have it, especially if it's high quality.

I think for researchers looking to publish in the Journal or any journal, but let's just say ours, I think, the Editor-in-Chief, Tom Dodson, has really spent a lot of time and work on curating the Guide for Authors for it.

And I think when you're a young resident, a young faculty, a young surgeon who wants to publish, it's often very daunting of a task to… "Where do I start with?" Like, you have the data, you know you have the results maybe, you've gone through, you've done the appropriate things, you've gotten your IRB approval, all these things, but how do I write a paper?

And actually, Tom has done a great job of writing two articles now on how to write a research paper. And it's very accessible. So there's that. And it actually really gives a cookbook guide on how to write a research paper, which I use myself. And then, also, going back to, I think, reading the Journal's Guide for Authors, that's incredibly helpful, because he's really taken the time. And I think it's a problem if people don't read that, and then they submit and then it's like, "Sorry, you obviously didn't read this, and we could have really corrected these issues beforehand." And we'll say, "Read the Guide for Authors. Please resubmit this paper."

So, I think going to the Journal's website, it's really comprehensive now. The Editor-in-Chief has spent a lot of time on this, and going through things would be very helpful, and really would allow authors to submit their best work to the Journal.

Host: Yeah, AAOMS.org/JOMS if you're looking for that information. Well, this has really been interesting, Dr. Markiewicz. Before we wrap up, is there anything you want to add about the Surgical Oncology and Reconstruction section of JOMS?

Dr. Michael Markiewicz: Just that I think someone who treats head and neck oncologic patients, head and neck cancer patients, I think this is a really important section. And, the reason being, I think, as the listeners and readers know, there's multiple specialties who treat head and neck cancer, and I don't think any are better than the others, but I think we're very good at this.

But to be relevant, we have to do research. And if you’re not, there's so many people in our specialty doing amazing work, in the field of Head and Neck Oncology and Reconstruction and so innovative. And that's probably where we've actually done the best, is we've been so innovative in our specialty because I think that's how we think as most of us are dentists also by training. But I think really we got to put good quality research out there, maybe even combine with our other colleagues because if we don't do that, then no one knows that we're doing it. So, I think I would just encourage people to do research on their patients for those who do head and neck oncology and try to publish it.

Host: Absolutely. I think that's an important statement that you just said, Dr. Markiewicz, to be relevant, you have to do research. So that sums it up. Really good stuff. And like you said, good quality research and being innovated, it's important. And we need people to make these discoveries and innovations as we move the field forward for sure.

Dr. Michael Markiewicz: Absolutely.

Host: Yeah. Well, Dr. Markiewicz, thank you so much for your time. This has really been enjoyable.

Dr. Michael Markiewicz: Thank you, Bill. I really appreciate it.

Host: Yeah, absolutely. And once again, that is Dr. Michael Markiewicz. And for more information, again, visit AAOMS.org/JOMS. And if you found this podcast helpful, please share it on your social media, as we've been talking about social media. Make sure you do that for us. We would appreciate it. And make sure you subscribe so you don't miss an episode. Thanks for listening.