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for the people that will be beginning residency in OMFS in the next few months...what are you doing/reading in preparation so that you can 'hit the ground running.'
preparation for pgy1 OMFS
- Thread starter ironlung
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Is the PGY-1 year at all OMS institutions the same (is it always an OMS rotation first)?
ironlung said:
One of the first years at my school told me to pick up The Clinician's Manual of Oral and Maxillofacial Surgery by Kwon and Laskin and The Basics of Anesthesia by Stoelting and Miller. So far, I've only thumbed through them, and they seem to be solid.
You guys think it is worth it to buy the new (Third edition) Fonseca Oral and Maxillofacial Trauma text ($300+)?
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You need to read Fonseca's 7-volume series and have your own pair of #150 forceps.
In all seriousness, here is what I wish I had known better for my first year of residency. This is obviously biased by my experiences in my program:
1. Infections: Know your fascial planes and associated anatomy as they relate to odontogenic infections. Know which spaces to drain intraorally and which to drain extraorally. Know when to get a CT (deep neck). Read about the bugs and appropriate antibiotics. Know which ones can be drained in the ER by yourself (superficial, no potential airway issues) and which ones need to go to the OR with your upper-level resident (deep neck spaces, likely airway management needed). Also try to get a feel for which patients need to be admitted and which ones can be sent home on outpatient follow-up. Just like with all patients, have as much info and work-up done as possible before you call your chief so that you will have an answer to any questions he has. When you're working up a patient, try to approach it with the mentality of "what all is he going to ask about this patient."
2. Dentoalveolar: Know how to pull teeth. Period. Know what the incisions for 3rd molars looks like. Read about alveoloplasty and tori removal.
3. Lacs: Know how to close complicated lacerations and make them pretty, every other service will see your sutures and judge you accordingly. Know what type of sutures to use deep (usually vicryl) and what to use on the skin (6-0 prolene for me). Know about everting wound edges, and excising ragged edges with a blade to avoid widened scars. Remember, if the ER calls you for a lac, it's usually because it was too complicated for them (or they were too busy).
4. Probably won't need it, but I would read about cricothyrotomy, tracheotomy and the relevant anatomy. I also read it from anesthesia and general surgery sources because it is interesting how they all have different viewpoints. Chances are slim that you'll never need it, but 3 of my other fellow residents have done at least one emergent crico. If things go south with a patient and you're the only one standing around with "surgeon" on your nametag, you might be the one that gets handed the scalpel. Remember to tell someone else to get some suction. And change your underwear when you're done.
Most of this can be found in Fonseca's 2 or 7 volume series in your library, and other books as well. I know I blathered off a bunch of stuff, but this is just to give you things to think about and start the ball rolling.
In all seriousness, here is what I wish I had known better for my first year of residency. This is obviously biased by my experiences in my program:
1. Infections: Know your fascial planes and associated anatomy as they relate to odontogenic infections. Know which spaces to drain intraorally and which to drain extraorally. Know when to get a CT (deep neck). Read about the bugs and appropriate antibiotics. Know which ones can be drained in the ER by yourself (superficial, no potential airway issues) and which ones need to go to the OR with your upper-level resident (deep neck spaces, likely airway management needed). Also try to get a feel for which patients need to be admitted and which ones can be sent home on outpatient follow-up. Just like with all patients, have as much info and work-up done as possible before you call your chief so that you will have an answer to any questions he has. When you're working up a patient, try to approach it with the mentality of "what all is he going to ask about this patient."
2. Dentoalveolar: Know how to pull teeth. Period. Know what the incisions for 3rd molars looks like. Read about alveoloplasty and tori removal.
3. Lacs: Know how to close complicated lacerations and make them pretty, every other service will see your sutures and judge you accordingly. Know what type of sutures to use deep (usually vicryl) and what to use on the skin (6-0 prolene for me). Know about everting wound edges, and excising ragged edges with a blade to avoid widened scars. Remember, if the ER calls you for a lac, it's usually because it was too complicated for them (or they were too busy).
4. Probably won't need it, but I would read about cricothyrotomy, tracheotomy and the relevant anatomy. I also read it from anesthesia and general surgery sources because it is interesting how they all have different viewpoints. Chances are slim that you'll never need it, but 3 of my other fellow residents have done at least one emergent crico. If things go south with a patient and you're the only one standing around with "surgeon" on your nametag, you might be the one that gets handed the scalpel. Remember to tell someone else to get some suction. And change your underwear when you're done.
Most of this can be found in Fonseca's 2 or 7 volume series in your library, and other books as well. I know I blathered off a bunch of stuff, but this is just to give you things to think about and start the ball rolling.
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toofache32 said:
Excellent post, Smithers!
I like the new 2 volume Peterson's (aka Ghali's) for obvious reasons.
5. Mandible fractures: Diagnosis and treatment, including rigid vs non-rigid, open vs closed, favorible vs unfavorible, AO vs Champy, etc. Know it!
6. Medical management of OMS patients: Good chapter in the two volume Peterson's
7. Eval of the trauma patient: Good chapter in Fonseca's two volume trauma series.
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toofache32 said:
I believe the new Peterson's 2 Vol. series would be a good buy. Probably all you need for the first year. I also have the 2 vol. Trauma series and the Knowledge updates. Clinics of OMS are good to look at in the library. Also check out the ENT clinics. OMS Secrets sort of sucks but I still read it. ENT secrets is also supposed to be good. My advice it to read everything you can get your hands on and operate as much as possible. Toofache, I wish I was you right now anesthesia boy. Congrats on grad from MS.
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Okay, enough of you OMFS people with your gay tv doctor avatars (whats up with loving dr. house?)... you guys should represent dentists more......
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dentwannabe said:
How can you not like House, MD? That guy is hilarious. Who doesn't like watching a physician with a bad attitude towards patients? It is refreshing and very entertaining. Much more exciting than House, DDS would be....a story about a brash dentist addicted NO who solves the really tough cases. "Ok team, what can cause white plaques on the tongue, dementia, and rampant caries?...And every patient lies about flossing."
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omfsres said:
I agree with this. I've got the new Peterson's on CD-ROM and I really like it. I have some of the OMS Knowledge Updates I ran through the xerox in the clinic late one night, and I like those as well. I have the ENT, Plastics, and OMFS Secrets and I think the OMFS is just OK, the ENT is better on the topics which are relevant, and Plastics is sometimes useful.
The clinics series can be found at www.theclinics.com . About 1-2x per year they have a free "30-day trial" which give you free access to ALL the online journals (which go back to maybe 2001) in PDF format. I've downloaded over 400 of these articles to my hard drive from the OMFS Clinics, Atlas of OMFS Clinics, Otolaryngology Clinics, Plastics Clinics, Facial Plastics Clinics, and Anesthesia Clinics. Keep an eye on that website.
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toofache32 said:
Thanks for that tip. I'll be sure to download all their shiite.
How do you know about luxators? I thought you only used periotomes. You'd be better off scraping the stone out of the sink trap in my lab.omfsres said:
