CHONC study guide
CHONC · Work through your exam, one topic at a time.
The Certified Head and Neck Oncologist (CHONC) credential is intended for clinicians who manage cancers of the oral cavity, pharynx, larynx, sinonasal tract, salivary glands, thyroid, and skin of the head and neck, and who want a structured way to demonstrate depth beyond general oncology or otolaryngology training. Candidates typically come from surgery, radiation oncology, medical oncology, and related specialties working within multidisciplinary teams. The CHONC study guide has 8 sections and about 2,284 words.
01Head and Neck Anatomy and Tumor Biology
Know the fascial compartments and the routes of spread that follow them: the parapharyngeal space as a crossroads, the retropharyngeal nodes as a first echelon for nasopharynx and posterior pharyngeal wall, and the pre-epiglottic versus paraglottic planes for laryngeal cancer. Be able to trace the recurrent laryngeal nerve in the tracheoesophageal groove and the relationship of the facial nerve to the parotid (the nerve is not intraparotid in the classic sense; it divides within the gland and its plane matters for surgical questions).
340 words, about 2 min02Head and Neck Cancer Evaluation and Staging
You must know the AJCC principles: clinical (cTNM) versus pathologic (pTNM) staging, the meaning of the prefix (c, p, y for post-treatment, r for recurrence), and that staging is site-specific. For head and neck, the mucosal primary, nodal disease, and extranodal extension (ENE) drive stage.
325 words, about 2 min03Multidisciplinary Treatment Planning
Treatment planning in head and neck cancer is fundamentally a function-preservation and risk-stratification exercise. You must understand when single modality suffices (early-stage disease, favorable pathology) versus combined modality (advanced disease, adverse features).
314 words, about 2 min04Surgery for Head and Neck Cancer
Surgical questions reward understanding of margins, reconstruction, and functional consequences. Know that oncologic resection aims for clear margins (commonly described in millimeters, with frozen section assessment), and that margin status is a dominant prognostic factor.
278 words, about 1 min05Radiation Therapy and Systemic Therapy
Know that radiation is delivered in fractions, that total dose and fractionation matter, and that altered fractionation (hyperfractionation, accelerated) can improve outcomes in some settings at the cost of toxicity. Understand the concept of the planning target volume and organs at risk, and why sparing the parotids, spinal cord, and mandible matters.
285 words, about 1 min06Rehabilitation, Supportive Care, and Survivorship
Head and neck treatment profoundly affects speech, swallowing, and appearance. Know that early involvement of speech-language pathology improves swallowing outcomes, that prophylactic swallowing exercises can reduce dysphagia, and that laryngectomy patients require alaryngeal communication planning (tracheoesophageal speech, electrolarynx, esophageal speech).
286 words, about 1 min07Quality, Safety, and Practice Management
Know the vocabulary: process versus outcome measures, quality indicators, and the role of multidisciplinary tumor boards in improving care. Understand surgical safety practices including time-outs, site marking, and structured handoffs.
214 words, about 1 min08Research, Ethics, and Professionalism
Understand study designs: randomized controlled trials as the strongest for causal inference, cohort and case-control designs for observational questions, and the meaning of bias (selection, information, confounding). Know levels of evidence and the difference between statistical significance and clinical significance.
242 words, about 1 min