In 1985, at the inaugural meeting of the American Society of Pediatric Otolaryngology, physicians met to discuss many challenges in the field, including the need for subcertifcation.1 A mere 36 years later, subcertification in complex pediatric otolaryngology (CPO) is becoming a reality with plans for the first American Board of Otolaryngology–Head & Neck Surgery (ABOHNS)-sponsored CPO examination to be held in November 2021. Members of the ABOHNS Board of Directors and otolaryngologist proponents of CPO are to be congratulated for accomplishing this Herculean task. Not surprisingly, controversy has accompanied discussions regarding CPO every step of the way—similar to the controversy that occurred when changes in accreditation, certification, and even fundamental questions such as whether physicians should be licensed were proposed in the past.2 Discussion and the inevitable controversy are part of the process of any major endeavor and in the end serve to improve the final result. With each incremental step in the organization and certification of the specialty over the past 100 years, we have thrived as a specialty and, ultimately, patients have received higher quality care.