What is the difference between 4yr and 6yr OMFS residency?

I'm also curious, somebody please give us a legit answer. Thanks!

-Cyrus

The age old question is back. Do a search but if you are looking for an opinion, I have one. If you think a medical degree and the associated medical education and PGY general surgery year don't make you a better surgeon then do a 4 year program. If you believe a medical education will better prepare you for your career as a surgeon, then do a 6.

It is a personal decision and in 2008, the scope of surgery is technically the same. In my opinion, the average 6 year program provides a broader scope of training than the average 4 year program but this is not true across the board. I also think that anyone who sees no value in obtaining a medical education is measuring value only in terms of $$ and not in terms of personal and professional development.

Also, obtaining the MD keeps ALL doors wide open for the future, including fellowship training, medical residency in addition to OMFS, etc.

Some might say that the MD is good advertising, etc. as well. I know I would rather send my sick grandma to a dual trained surgeon all other things being equal. If you don't like that opinion, so be it but I think the MD is worth something.

And if nothing else it will help "serve" your ego

allodyniaboneia said:

And if nothing else it will help "serve" your ego

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Good one. But anyone who would give up 2 years of high income potential and two years of his/her life to stroke his/her ego is an idiot. I intend to learn something and yes I think I will be a better OMFS for having earned the MD.

allodyniaboneia said:

And if nothing else it will help "serve" your ego

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The IAOMS training guidelines do "suggest" that the current international standard of Maxillofacial surgery training includes obtaining both dental and medical degrees.

Worldwide OMFS program list

Basically, I do think if you want to keep all of your options open (ie. more opportunties to complete subspecialty fellowships, etc.) then you should strive to obtain both degrees.

I have a question for residents/graduates of 6 year programs. Do you feel the extra 2 years was worth it from a clinical standpoint (disregarding the possible value of an M.D. from a marketing viewpoint). Do you feel that doing MS3 and MS4 rotations are preparing you to be a better clinician?

bodiddely said:

I have a question for residents/graduates of 6 year programs. Do you feel the extra 2 years was worth it from a clinical standpoint (disregarding the possible value of an M.D. from a marketing viewpoint). Do you feel that doing MS3 and MS4 rotations are preparing you to be a better clinician?

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Does it make you a better surgeon? No, I highly doubt it.



Does more education help? Sure.. throughout every clinical attachment in med school I ask myself, "what can I learn here that I can apply to OMS"? I think it can make you a more well rounded clinician in a lot of ways.

On top of helping with "marketing" in private practice... and not to mention being suggested international best practice for omfs training... it does help simply with the political aspect of our specialty. If you have any interest in practicing full scope omfs... what you do on a daily basis will often cross over with ENT and PRS practice. If you are working in a midsize to large city.. having the medical degree will help "legitimize" you (rightly or wrongly) in the eyes of those in competing specialties. Finally as I've said before, if you want to pursue subspecialty fellowships (its good to at least keep more of these options open even if you are unsure), then you should really consider completing a medical degree.

Dr.Millisevert said:

Worldwide OMFS program list

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Hadn't seen this before. Pretty cool list. There are some big gaps in it though. They list only one program in Japan, Denmark and Sweden, where I know for a fact there are many more (including my own )

Anyway, the MD issue *phew*. If I were applying in the US, I'd go for a six year program. 1) to keep my options open and 2) for personal development. I think it's great when med school is incorporated into the residency as is done in the US. However, having to do it from scratch, or almost from scratch, like in Germany and the UK.....is not so great.

If I were at the beginning of my carrier right now, then I don't care how much cool surgery you'd tell me I'd get to do with a double degree, I'd never do an extra 3-5 years of school, just to be able to learn how to raise a free fibula flap sometime later on.

And that's one of the problems OMS faces here in Europe. It takes to long to learn just the basics, before you even start your residency. And, with the limited clinical benefit of a double degree, I can't really see why there is so much pressure to make all do it.

Unless....the US model is applied, with a maximum of 2 extra years added to the program to obtain an MD and a medical licence. They did this in the Netherlands with good results.

EuroOMFS said:

Hadn't seen this before. Pretty cool list. There are some big gaps in it though. They list only one program in Japan, Denmark and Sweden, where I know for a fact there are many more (including my own )

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I agree.. pretty cool, they need to expand it though.

EuroOMFS said:

Anyway, the MD issue *phew*. If I were applying in the US, I'd go for a six year program. 1) to keep my options open and 2) for personal development. I think it's great when med school is incorporated into the residency as is done in the US. However, having to do it from scratch, or almost from scratch, like in Germany and the UK.....is not so great.

If I were at the beginning of my carrier right now, then I don't care how much cool surgery you'd tell me I'd get to do with a double degree, I'd never do an extra 3-5 years of school, just to be able to learn how to raise a free fibula flap sometime later on.

And that's one of the problems OMS faces here in Europe. It takes to long to learn just the basics, before you even start your residency. And, with the limited clinical benefit of a double degree, I can't really see why there is so much pressure to make all do it.

Unless....the US model is applied, with a maximum of 2 extra years added to the program to obtain an MD and a medical licence. They did this in the Netherlands with good results.

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Agree. I think in the US.. Case Western (and to a lesser extent Nebraska) have been able to develop the most streamline training programs in regards to obtaining your medical degree.

The IAOMS supports streamlined training (including a medical degree)1.3 The maximum length of training following completion of the first degree should not be greater than eight years. Careful attention should be given to integrating components of dental, medical and clinical education so that an oral and maxillofacial surgeon may complete their training at an age which allows for a long and productive career.

Have you also seen the IAOMS foundation website? Similar to the AAOMS foundation site, but supports the development and improvement of oms programs worldwide
.

It is good that this is only your opinion...indeed your sick grandma would benefit from those extra 2 years of "med" school....please.

guy, if you do over 3rd and 4th year of med school, you'll have more down time, more time of doing nothing, you'll indeed end up wondering why this was such a big deal. I have med school roommates who have med school buddies at other schools..its all the same, they all work fairly hard in 3rd year and half of 4th year (b.c in truth they don't know crap at this point..akin to us in 3rd year..but by this time in a OMFS residency you would have already acquired most of this knowledge..making it that much more a waste of time).. then party. Sure they probably get to learn general surgery techniques..ok...will you EVER need to know how to do such things? However, basic assumption here is you want to do ORAL AND MAXILLOFACIAL SURGERY, and only OMFS...the modifier here is if you wanted to stray from the field and provide other surgical treatment that only would be learnt from an MD fellowship..then a six year is up your alley..

so are you sendin' your dear ole' grandma to drain an infection or because you want to see here with bigger juggs?


Whatever your motive...since you didn't clarify the reasoning of your post for the OP, I will:

OMFS dual or singly trained can do the....EXACT same things...HOWEVER if TRUE hard core OMFS procedures is NOT what you want..get a MD..

again

MD does not make you a better surgeon for OMFS, you will know more extraneous stuff though, and it will allow you to apply for fellowships that require a MD, this is where you start to stray away from OMFS and start to dabble in other people's back yards more than your own.

and

each program is unique...so they ALL have their own scope of training. Don't listen to people such as this guy making generalizations..


I interviewed at both types of programs, and my rank list reflected preference only to strong vs weak, not 4-6...me..I'm a OMFS only kind a guy...no interest in the other stuff. NO interest in med school.

Peace

servitup said:

The age old question is back. Do a search but if you are looking for an opinion, I have one. If you think a medical degree and the associated medical education and PGY general surgery year don't make you a better surgeon then do a 4 year program. If you believe a medical education will better prepare you for your career as a surgeon, then do a 6.

It is a personal decision and in 2008, the scope of surgery is technically the same. In my opinion, the average 6 year program provides a broader scope of training than the average 4 year program but this is not true across the board. I also think that anyone who sees no value in obtaining a medical education is measuring value only in terms of $$ and not in terms of personal and professional development.

Also, obtaining the MD keeps ALL doors wide open for the future, including fellowship training, medical residency in addition to OMFS, etc.

Some might say that the MD is good advertising, etc. as well. I know I would rather send my sick grandma to a dual trained surgeon all other things being equal. If you don't like that opinion, so be it but I think the MD is worth something.

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jaiceman said:

It is good that this is only your opinion...indeed your sick grandma would benefit from those extra 2 years of "med" school....please.

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In my opinion, physicians are better trained to care for the medically compromised than dentists (surgically and medically, that is). My dental school has both tracks and there is no difference b/t the procedures and hand skills the 4s vs. the 6s have but the dual trained residents clearly know more medicine and the benefits of that knowledge show on a regular basis.

On the flipside, if dentoalveolar surgery is your thing, dentists have been doing that forever with very little relative risk to the patients. At my dental school, some of the OS part timers don't care how sick the patient is, they just say go get that tooth and the patients always do fine. Exodontia is not afterall a very invasive surgery. I would still rather a sick patient of mine be treated by someone who has a lot of experience dealing with the very sick and 6 year guys get much more experience there.

You are absolutely right on that account...and you obviously have a sytem in motion at UNC to comment on...great program by the way. But once again, I am not quite sure if it is more medical training which makes them shine, or the strength of the 4 year cirriculum to begin with.. would some of the residents chime in? How much of medicine is learnt in the 2 yrs of med school vs the 4 yrs of OMS service? I have a feeling it will end up being a final product of the overall residency vs the med school.

I mean the med school attached to my dental school is a top 40, don't know how much more you would learn...but compare to MGh w/ Harvard, and the contribution of the medical school education would be more significant in my estimation. Could it be a case that 4 yr guys at UNC gets screwed over b.c they don't want the 6 yrs guys re-hashing stuff by repeatung lectures, so they inadverently just end up knowing less medicine than other 4's?

servitup said:

In my opinion, physicians are better trained to care for the medically compromised than dentists (surgically and medically, that is). My dental school has both tracks and there is no difference b/t the procedures and hand skills the 4s vs. the 6s have but the dual trained residents clearly know more medicine and the benefits of that knowledge show on a regular basis.

On the flipside, if dentoalveolar surgery is your thing, dentists have been doing that forever with very little relative risk to the patients. At my dental school, some of the OS part timers don't care how sick the patient is, they just say go get that tooth and the patients always do fine. Exodontia is not afterall a very invasive surgery. I would still rather a sick patient of mine be treated by someone who has a lot of experience dealing with the very sick and 6 year guys get much more experience there.

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That is possible. I do not have significant experience with any strictly 4 year programs.

servitup said:

That is possible. I do not have significant experience with any strictly 4 year programs.

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All the 6-year dual degree residents I have talked to say they get one thing out of their 2 med school years: Vacation. And an expensive one at that, seeing as how they give up their 50K stipend and instead take about that much in student loans instead. Many of them try to get dental jobs moonlighting.

Most of the med school rotations would be a complete waste of time for a surgeon. However, you can sort of use the MD to justify broad scope oral surgery to ENT and Plastics that will try to push you out of their "turf".

But don't be suprised when ENT and Plastics still consider you a "f'ing dentist", even with your MD. Its sad, but true. Our medical collegues are arrogant and really do think that we went to dental school because we were inferior applicants.

Jaybe said:

But don't be suprised when ENT and Plastics still consider you a "f'ing dentist", even with your MD. Its sad, but true. Our medical collegues are arrogant and really do think that we went to dental school because we were inferior applicants.

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"What do you call a doctor who didn't get into medical school?".....

For a number of years, applicants had to have better grades to get into the dental school our hospital is affiliated with, then to get into med school. This may have changed, but the difference is still negligeble. When I was applying for dental school, there were 4,5 students competing for each place at the dental school, and a little less than 4 competing for each place at the medical school.

Jaybe said:

All the 6-year dual degree residents I have talked to say they get one thing out of their 2 med school years: Vacation. And an expensive one at that, seeing as how they give up their 50K stipend and instead take about that much in student loans instead.

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I hope you realize that they do not truly believe that when they joke about it. The problem is: when you openly share your true opinion, there will always be some of your DDS colleagues who get their panties in a wad and think you are an arrogant jerk. I know probably 50 MD-integrated residents or graduates and nearly every one of them did it because they believe it provided them superior training.

These are smart people for the most part. Sacrificing 2 years and $30-100 thousand in tuition not to mention the gen surg year is not "for the vacation." Your buddies were just afraid to hurt your feelings with their true opinion.

servitup said:

I hope you realize that they do not truly believe that when they joke about it. The problem is: when you openly share your true opinion, there will always be some of your DDS colleagues who get their panties in a wad and think you are an arrogant jerk. I know probably 50 MD-integrated residents or graduates and nearly every one of them did it because they believe it provided them superior training.

These are smart people for the most part. Sacrificing 2 years and $30-100 thousand in tuition not to mention the gen surg year is not "for the vacation." Your buddies were just afraid to hurt your feelings with their true opinion.

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I don't think they were afraid of hurting his feelings. He is an orthodontic resident if I'm not mistaken.

servitup said:

I hope you realize that they do not truly believe that when they joke about it. The problem is: when you openly share your true opinion, there will always be some of your DDS colleagues who get their panties in a wad and think you are an arrogant jerk. I know probably 50 MD-integrated residents or graduates and nearly every one of them did it because they believe it provided them superior training.

These are smart people for the most part. Sacrificing 2 years and $30-100 thousand in tuition not to mention the gen surg year is not "for the vacation." Your buddies were just afraid to hurt your feelings with their true opinion.

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This is true. I often downplay my med school training to not hurt any 4 yr's feelings. The bottom line is, med school is valuable and you get a tremendous amount education from med school and teaches you to think fundamentally different. All the courses you take, 3rd and 4th year clerkships, USMLE1, 2, 3 and all the shelf exams you take for each rotation helps you to become a competent doctor in managing the whole patient. This is not even including 1 year of general surgery. Medical management is not simply about 2 months of internal medicine and 4 months of general surgery as a rotating resident. I don't regret going to med school a bit and if i were do it all over again, i would in a heartbeat. But thats just my opinion.

Squished Rat said:

I don't think they were afraid of hurting his feelings. He is an orthodontic resident if I'm not mistaken.

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I know that. I knew that when I posted my message.

my bad. didnt know if you knew. did you pass CITA?

servitup said:

The age old question is back. Do a search but if you are looking for an opinion, I have one. If you think a medical degree and the associated medical education and PGY general surgery year don't make you a better surgeon then do a 4 year program. If you believe a medical education will better prepare you for your career as a surgeon, then do a 6.

It is a personal decision and in 2008, the scope of surgery is technically the same. In my opinion, the average 6 year program provides a broader scope of training than the average 4 year program but this is not true across the board. I also think that anyone who sees no value in obtaining a medical education is measuring value only in terms of $$ and not in terms of personal and professional development.

Also, obtaining the MD keeps ALL doors wide open for the future, including fellowship training, medical residency in addition to OMFS, etc.

Some might say that the MD is good advertising, etc. as well. I know I would rather send my sick grandma to a dual trained surgeon all other things being equal. If you don't like that opinion, so be it but I think the MD is worth something.

Click to expand...

This is rather interesting.... My program is a 6-year-dual-degree program. Our main attending is a single degree person and arguably one of the best OMFS in the nation. Yet, he is but a "dentist."

On one occasion, we had a trauma patient enter the ER on a plastics trauma call night (we rotate trauma calls with ENT and plastics). The patient (incidentally, she happened to be a "citizen," as opposed to the regular d!p****s that walk into our ER), through one way or another, found out that my attending was far more superior than the other attendings in the other services. Needless to say, the plastics people werent too happy when the patient requested my attending for rendered services.

servitup said:

The age old question is back. Do a search but if you are looking for an opinion, I have one. If you think a medical degree and the associated medical education and PGY general surgery year don't make you a better surgeon then do a 4 year program. If you believe a medical education will better prepare you for your career as a surgeon, then do a 6.

It is a personal decision and in 2008, the scope of surgery is technically the same. In my opinion, the average 6 year program provides a broader scope of training than the average 4 year program but this is not true across the board. I also think that anyone who sees no value in obtaining a medical education is measuring value only in terms of $$ and not in terms of personal and professional development.

Also, obtaining the MD keeps ALL doors wide open for the future, including fellowship training, medical residency in addition to OMFS, etc.

Some might say that the MD is good advertising, etc. as well. I know I would rather send my sick grandma to a dual trained surgeon all other things being equal. If you don't like that opinion, so be it but I think the MD is worth something.

Click to expand...

This is rather interesting.... My program is a 6-year-dual-degree program. Our main attending is a single degree person and arguably one of the best OMFS in the nation. Yet, he is but a "dentist."

On one occasion, we had a trauma patient enter the ER on a plastics trauma call night (we rotate trauma calls with ENT and plastics). The patient (incidentally, she happened to be a "citizen," as opposed to the regular d!p****s that walk into our ER), through one way or another, found out that my attending was far more superior than the other attendings in the other services. Needless to say, the plastics people werent too happy when the patient requested my attending for rendered services.

Doggie said:

This is rather interesting.... My program is a 6-year-dual-degree program. Our main attending is a single degree person and arguably one of the best OMFS in the nation. Yet, he is but a "dentist."

On one occasion, we had a trauma patient enter the ER on a plastics trauma call night (we rotate trauma calls with ENT and plastics). The patient (incidentally, she happened to be a "citizen," as opposed to the regular d!p****s that walk into our ER), through one way or another, found out that my attending was far more superior than the other attendings in the other services. Needless to say, the plastics people werent too happy when the patient requested my attending for rendered services.

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If your attending trained in 2008, I bet he would get the MD (I know, I know, EE thinks a PhD would be better). Obviously the specialty has been taken to a new level by predominantly single degree faculty. What he does now compared to what he did in training is much different. In 20 years, I would wager that predominantly dual-trained surgeons will be the ones pushing the specialty to newer and greater heights.

servitup said:

If your attending trained in 2008, I bet he would get the MD (I know, I know, EE thinks a PhD would be better).

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Why not get both MD and PhD?

Dr.Millisevert said:

Why not get both MD and PhD?

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Why not drive a '98 Corolla the rest of your life?

EuroOMFS said:

Why not drive a '98 Corolla the rest of your life?

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Funny...yet so true......

It's so ironic in this day and age that the reimbursement for a neck dissection/resection pays about the same as 1 dental implant....yet in the public's eye one person is a "reconstructive surgeon" and the other is but a "dentist"....

Dr.Millisevert said:

Why not get both MD and PhD?

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Can you advertise yourself as a Dr. Dr. Dr?

Doggie said:

Can you advertise yourself as a Dr. Dr. Dr?

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In Germany, double qualified OMSs are Dr. Dr. and Prof. Dr. Dr. if they´re double qualified and hold an academic position.

Sunny_1225 said:

Perfect example of how dental students don't know **** about finance.

It's not 2 years of high income potential.

it's 2 years of high income potential, over 50 YEARS OF APPRECIATION.

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I majored in accounting in college smartass. Your conclusion is not accurate. Try again later.

Iwantmydds said:

Alot of the posts above imply that dentist are below the MDs. In my country, dentists are respected as much as the MDs. I really dislike the fact that MDs look down on dentists in America because alot of ppl i know including myself had grades higher than majority of the med school average GPAs. Just had to throw in my opinion. Disregard it if you would like.

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You have it wrong, in this country dentists and MD's are looked upon very similarly and MD's in the private world do not look down upon their DDS collegues. What you are reading here is a bunch of residents and students caught up in a very political academic world, and they like to bitch and moan a lot. Truth is, once they graduate they will find that their scopes of practice are very nicely laid out for them, some of their best friends and most likely neighbors will be those same MD's they thought they despised, and all will be hunky-dory.

And my thoughts on the MD program, it is completely not needed for a dentoalveolar practice, but I certainly am happy i attained one just for the fact i feel more comfortable treating medically compromised patients, think it made my gen surgery year more high yield, there is a certain comfort in knowing you now have the opportunity to do anything in the medical field if you so choose down the road, and made a ton of new friends on top of it.

sorry 'bout the length, just my