Background: Oral cavity cancer surgery and management in India are delivered by multiple specialties, including general surgery(GS), ENT, Oral-Maxillo Facial Surgery (OMFS), Head and Neck(HNS) and Surgical Oncology(SO). We hypothesize that a mismatch exists between these specialities in formal training and independent surgical practice, and that structured training would be associated with greater operative independence and confidence. Methods: A cross-sectional online survey was conducted among surgeons from multiple specialties across India . Descriptive analysis, Fisher's exact test, Chi-square, and Mann-Whitney U were applied (p<0.05). Results: 75 surgeons from different speciality backgrounds participated. 80% (60/75) lacked a formal Head and Neck Oncology fellowship training; Of these, 53.3% independently operated on oral cavity cancers (Fisher's p=0.0006). Structured training predicted operative independence over limited exposure (OR 5.83, p=0.0015). OMFS had the highest fellowship rate (64.7%) versus SO/HNS (13.3%; χ²=23.05, p<0.0001; pairwise OR=0.08, p=0.0007). Fellowship-trained surgeons demonstrated significantly higher confidence in composite resection (median 5 vs 3, U=720.5, p=0.0002), neck dissection (p=0.0014), and reconstruction planning (p=0.0044). Thirty-six percent met a composite high-risk definition (operating without fellowship or microvascular training), highest in SO/HNS (60%) versus OMFS (5.9%; χ²=14.21, p=0.0008). Despite this, 77% believed formal fellowship should be mandatory. Conclusion: A systemic credentialing gap exists in Indian oral cavity cancer surgery. Most independently operating surgeons lack formal training yet overwhelmingly endorse its necessity. The paradox of SO/HNS carrying the lowest fellowship rates while managing the most complex cases reflects a training pipeline failure requiring urgent policy intervention.