OMS questions answered here

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rockstar2525

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Hey all, I'm a med school applicant and usually post in those forums, but thought I'd offer my services here. I see there are a couple of postings about OMS and most of them are answered in typical SDN fashion where someone shares one bit of anecdotal evidence. I currently work at the AAOMS, in the dept of Advanced Education and Professional Affairs. I know something about the residency programs and a lot about OMS professional affairs; scope of practice, trauma call, credentialing/privledging, current issues being discussed by house of delegates, etc. If you have any quesitons send them my way. I obvioulsy don't know everything, but the stuff I do know is documented as fact and a step above anecdotes ;)
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Let me get this straight....

You're a pre-med (not yet a medical or dental student)?
You work for AAOMS as your full-time job right now?

I'm sure you have plenty of brochure info, but no one will know about specific residency scoop/info/the good/and the bad than current residents, faculties, and staff.

Although I'm sure you can provide general info about OMFS, but I doubt you have specifics about residencies. I have been in contact with Mary Allaire at AAOMS when I have general questions and she has been great in answering all my questions and concerns. Nonetheless, great to have you and I'm sure there are plenty general questions for you.
 
Wow Yah-E,
That was a pretty unfriendly response, especially for you...

Bad day?

AjM
 
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yeah stay positive bro... there are enough OMS informants to go around. No need for jealously... no i am not attacking you so no need to come back at me. Just give this person a chance to help someone out!
 
Oh, no, no, no...guys...my post wasn't intended to be malicous at all. I was just making sure that I understood what he had typed. Resources are great and like I said earlier, great to have him here answering general questions. Heck, he knows more than I do about AAOMS and what's going on there.

Sometimes we get the wrong impression when reading in forums. :thumbup: Want to clarify before I get bashed!
 
Yah-E's post has a point. The OP certainly has some valid information in regards to how the AAOMS is run, but as far as actual information about residency work, procedures, or post-grad work, all the info he could share is also ancedotal.
 
defend your SDN boy Gav :D . Seriously I agree...I just thought it came off a bit rude. I think Yah-e's posts are awesome so i am not knocking his opinion but just as i defended his opinion when the residents hated on him, I will back up anyone else who wants to inform me about OMS (esp. since I am too lazy to research the info myself :D) So whether worthless info or not... it is still info and should be up to the readers to interpret as useful and/or not to appreciate. But like I said, I agree with Yah-e in the fact that i would rather get info from someone who has 1st hand insight but beggers cant be choosers. :thumbup: lets keep the peace boys... we are in this fight together. Back to a better topic... come on NBDE scores.... :idea:
 
Yah-E said:
Let me get this straight....

You're a pre-med (not yet a medical or dental student)?
You work for AAOMS as your full-time job right now?

I'm sure you have plenty of brochure info, but no one will know about specific residency scoop/info/the good/and the bad than current residents, faculties, and staff.

Although I'm sure you can provide general info about OMFS, but I doubt you have specifics about residencies. I have been in contact with Mary Allaire at AAOMS when I have general questions and she has been great in answering all my questions and concerns. Nonetheless, great to have you and I'm sure there are plenty general questions for you.
Click to expand...

Yes, you are correct in your assesment, and I take no offense to this post. You are right, I don't know the good bad and the ugly about specific residency programs, that's why I said I know SOMETHING about residency programs. What I do know about is legislation that is going on in each state, which states allow greater scope of practice, what the AAOMS ParPath states about different procedures, etc. For example, I glanced through a thread that was debating what OMSs actually end up doing, some said they "shuck teeth all day" others debated that they do more orthagnathic surgery. Since I compile the results of our scope of practice survery I can tell you statistically how OMSs are speding their workdays. If you already have this info, that's great, I'm not pretending to know more, just offering what I do know...
 
Sounds great! Glad to have you be of resource.
 
So what are most OMS's spending their days doing?
 
and how much are they making doing it? Give me a breakdown. 2 days for extractions raking in 12k, the 1 day for orthognathic and 1 day for face lifts? about how much could a person expect to make realistically? Is there an average salary info just for OMS?
 
I know that residency hours (per week) will vary between different programs, but what is a rough average and an approxiamate range that a resident can expect to put in for their program?

grtuck
 
I've been hearing this lately. Perhaps you can confirm this?

In certain areas, in order to obtain malpractice insurance, private practice oral surgeons must be affiliated with a hospital? That would suck if it was true, cuz you'd always have to be on call. :eek:
 
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adamlc18 said:
So what are most OMS's spending their days doing?
Click to expand...

I wrote this in a PM, but may be helpful to all:

The answer to what OMSs do all day is mostly pull 3rd molars and do implants. The thing to know though, is that OMSs who spend the majority of their time this way do so because they CHOOSE this.
All OMS residents, whether dual degree or single degree, are trained in cosmetic procedures and a wide scope of surgeries during residency. All OMSs come out with the same OMS training and are qualified to to the same things. The dual degree only provides more background in other parts of the body, which is arguably advantageous, but technically makes no difference in determining scope of practice. The determining factor in what you spend your time doing after residency is whether you choose to work in an academic center or private practice. Private practice guys make money, and lots of it. These are the guys that shuck teeth and do implants all day. They do these two procedures all day because these are the most lucrative. 3rd molar extraction is fully reimbursed by insurance at about $1200 a set. A good OMS can do 3-4 sets/hour. Implants are considered cosmetic, so patients must pay full price out of pocket. One implants also goes for about $1200, and they can do a couple of these an hour too (cha-ching!). We have a couple OMSs who only do implants in CA and are making $800,000+ per year. While these OMSs are qualified to do, say orthognathic surgery, they elect to not do this at their practice because orthognathic surgery can take up to 8 hours and the reimbursement is only 40-50% (dep on insurance). So if your goal is to make money "shucking teeth" is the way to go. Plus, since they own their practice they can determine their own hours. The guy making $800K is working all the time, but we have some members who work 3 days a week (golf on the other two) and still pull in $200K. After finishing residency, the avg OMS in private practice starts at about $150K. The avg income in private practice varies because it really depends on what procedures they are doing, but the range is $175K-250K.
If your goal is to have a wide scope of practice, working at an academic center/hospital is what you should do. The OMSs there do all kinds of things from cleft palate repair, orthognathic surgery, bone grafting, trauma and cosmetics. The academic centers pay less (avg $125,000-175,000/yr) and will give less freedom for you to determine your own hours (translate-you will work more). The benefits are they will pay your pension, they pay some of your malpractice insurance, and your days will be more challenging and interesting.
The bottom line is, your OMS practice can be whatever you make it.

The difference between states is whether OMS are "allowed" to perform cosmetic procedures without an additional one year fellowship in cosmetic procedures. If the state HAS adopted the ADA definition of denistry (AAOMS is working to get ALL states to develop this definition) then OMSs can do cosmetic procedures; rhinoplasty, chin deformities, etc. right after they finish residency. If the OMS lives in a state that has adopted a modified version they may be limited by a "laundry list" which is individual to each state, and have to do the additional year long fellowship in order to practice a full scope of cosmetic privleges. I'd like to note that being able to do cosmetics depends state legislation, not whether the OMS is single or dual degree. The dual degree graduate receives the same training in cosmetic procedures as a single degree, but the MD behind their name is a huge selling point for patients.
 
GatorDMD said:
and how much are they making doing it? Give me a breakdown. 2 days for extractions raking in 12k, the 1 day for orthognathic and 1 day for face lifts? about how much could a person expect to make realistically? Is there an average salary info just for OMS?
Click to expand...

Most OMS choose one area and specialize in it, particularly if it's cosmestics. Patients don't want to get a rhinoplasty from the same guy that pulls wisdom teeth (no matter how qualified he may be to do so). Like I said in previous post, most choose between private practice or academic centers and a smaller number choose to do only cosmetics. There are few who do all three on a regular basis. There is a delicate balance between the private practice docs and the hospital docs though, because generally the guys in private practice send the more difficult cases to their colleagues at the hospital. Sometimes this is good because the private practice may not be equipped to accomodate an extensive procedure, and it is a good learning opp for the residents at the hospital. However, if this happens too much, the hospital docs get annoyed though because they think the private practice guys are "lazy" and don't want to spend time doing procedures they won't be reimbursed for. This issue of where to send patients comes up most often in orthognathic surgery. Cleft palate goes to hospital, 3rd molars to private practice, but orthognathic surgery is somewhere in between. AAOMS is working on this issue right now, but the jury is still out...
 
Thank you for the informative thread.
 
grtuck said:
I know that residency hours (per week) will vary between different programs, but what is a rough average and an approxiamate range that a resident can expect to put in for their program?

grtuck
Click to expand...

The bad news is that because OMS residency programs don't receive Graduate Medical Education (GME) funding, they are not required to abide by the <80 hrs/week law that other medical residency programs do. Our Advanced Ed Manager is currently conducting a study on which programs abide by the 80 hr/week rule anyway and which don't, but from the info she has gathered thus far, it looks like most OMS residents are averaging 100 hours a week.
 
This was an extremely informative post. I would just like to add a bit about acedemic OMS. I think it is definitly the was to go if you're interested in doing huge cases and expanded scope. I am currently planning to go into acedemics for this reason. If you think about it, your residents write all the hospital notes, screen all the trauma calls, and completely have the patient ready to go in the OR as soon as you walk in. It doesn't get any better than that. Another thing is that most hospitals will provide a faculty clinic in which all your overhead is covered. But a portion of your profits will go to the institution. So you're either paying overhead or the hospital. It can be very profitable if you develope a successful faculty practice. I don't think most people became oral surgeons to shuck wisdom teeth and place implants, It sucks that people limit their practice because that's what makes the big bucks. I'm not putting down private practice guys by saying this because somebody has to do these procedures the right way.
 
Doggie said:
I've been hearing this lately. Perhaps you can confirm this?

In certain areas, in order to obtain malpractice insurance, private practice oral surgeons must be affiliated with a hospital? That would suck if it was true, cuz you'd always have to be on call. :eek:
Click to expand...

This is a practice management question, which isn't really my area, so I asked one of the women who works in that dept and her reply was that off the top of her head she thinks that this is false, but still will get back to me with a definite/documented answer. What I can tell you now though is that I know we have a few docs who are not affiliated with any hospital at all and still have malpractice insurance. However, I am not sure if this differs by state, I'll get back to you.
Also, after reading the results of the scope of practice survey I found that MOST docs in private practice are affiliated with at least one or two hospitals. They don't do surgery there, but have priviledges there in case of emergency. The stats from the survey so far (1200 responded to the survey) show that %OMS affiliated with #hospitals are; 3%=0, 29%=1, 29%=2, 20%=3, and 19%=4+. Of the doctors surveyed, 81% of them take trauma call. The # days/nights that they are actually on call varies a lot though from 7 days a year to five nights a week. Some of the private practice docs split call, so if there are four surgeons in a group practice they rotate and are only on call one week out of every four weeks.
The trauma call issue is a sticky one, this is where one of the biggest turf battles is being fought between OMS, plastics and ENTs. Some OMSs don't want to take call (why would they?) and so they are losing ground in the hospital. I know that AAOMS and ROAAMOS works hard to encourage OMSs to take trauma call so that OMS can maintain status and credibiltity in hospitals.
 
In regarding to residencies:

1) I've heard more and more residencies are or have converted back to a 4-year from a 6-year residency (Miami and Univ Mich for example), what type of info does AAOMS have on this topic?

2) Is it a tough process to increase residency size (# of residents a residency take each year). I heard that Nova OMFS is trying to increase their residency size from 2/yr to 3/yr. Is this true from AAOMS stand point? Any info on that?

:thumbup: :thumbup: :thumbup: :thumbup: :thumbup: for you for helping us out!
 
Doggie said:
I've been hearing this lately. Perhaps you can confirm this?

In certain areas, in order to obtain malpractice insurance, private practice oral surgeons must be affiliated with a hospital? That would suck if it was true, cuz you'd always have to be on call. :eek:
Click to expand...

I just talked to OMSNIC and they said that requirements to gain malpractice insurance vary by insurance company, not state. Most OMSs (all AAOMS members) are insured by OMSNIC and they do NOT require a hospital affiliation. If you were to get malpractice insurance through a different provider they may or may not require hospital affiliation. If it is not required and you elected not to have an affiliation you have to explain in great detail what you would do if an emergency occured in your office and prove that your office has the necessary equipment to handle any situation that may arise. So it's possible, but like I said before, most OMSs have some hospital affiliation.
 
I recently finished a three week externship in an OMFS program (one which offers both 4 and 6 yr. track options and is dental school affiliated) and here's what I gathered as far as work weeks are concerned:

1st yr. interns: These guys literally never leave the hospital it seems. I started my days at 650 for morning rounds and ended usually by 6pm. I came in a couple of times for other late-night calls as well...not once, however, did I ever actually see one of the 1st years actually leave. They start their days at 6 for pre-rounds (i.e., they get up at 5 or so), have to do post-afternoon-rounds in the evening if they're on call (which they are for a full week, every other week), and then be ready to take any overnight call that is so imperative it can't wait until the a.m. (which doesn't happen very often except for when the dept. is responsible for mandible trauma call, which is every 3 mos.; nevertheless, during my 3 weeks which didn't fall under trauma call there were numerous occasions where I know the 1st yrs. were at the hospital until 10-11pm).

2nd yr. residents and up-- Much better hours than the 1st years but still quite intense. Usually 12 hour days at the minimum with call duties added on top (but call can be q4-6). Overall, bascially less scut work and more actual

The biggest insight I gained to which I was least aware prior to this was how much political infighting goes on b/w OMFS, ENTs, and Plastics. While this varies per institution/hospital, in general this appears to be a common problem. It basically boils down to lots of folks competing for the same pie, with each claiming greater expertise than the other. For OMFS folks this mainly applies to anytime they try to tackle a surg. that is not approached intra-oral or falls out of the realm of the max./mand. I could go on at length about this but that's not the point here....

As someone mentioned in a previous post, OMFS residents most definitley do not fall under the 80hr./week guideline. As one of the residents here stated when we asked him how much he'd missed out on during resideny
(he is a father of several children), "you name it I wasn't there...soccer games, school plays, birthdays, anniversaries" Would he do it all over again, though, we asked? "Of course"............Did I enjoy it? Extremely so.
 
omsres said:
I am currently planning to go into acedemics for this reason.
Click to expand...

Good, b/c you're going to need the residents to keep you from killing somebody, Tuffy.
 
Congradulations, you killed another thread TX OMFS!
 
omsres said:
Congradulations, you killed another thread TX OMFS!
Click to expand...

I can tell by the amount of time you 2 guys spend on this site that you are about as interested in med school as I am.

TX OMFS, did OMSRES share my step 1 books with you? Or is he still a gunner?
 
I tried to, but TX OMFS can't read. He studies by picture flash cards. :laugh:
 
I guess it didn't help that the pictures in the books were already colored.
 
I'm curious about the general surgery year of the OMS residency. In general, is it the same for both 4 and 6/7 yr programs. If so, how do the 4 yr residents do...ie. are they missing anything by not doing the MD years. Thanks for any input.
 
Maybe I should have just said...how do the 4 yr residents perform on General Surgery considering that they have not completed MS3 and MS4. AAOMS states that the surgical service is the same for all OMS residents as it is for medical specialties.
 
I'm bumping this thread. So much good info here.
 
oms fan said:
Maybe I should have just said...how do the 4 yr residents perform on General Surgery considering that they have not completed MS3 and MS4. AAOMS states that the surgical service is the same for all OMS residents as it is for medical specialties.
Click to expand...

Speaking as a 6 year oms resident, I would think that it would be extremely difficult to perform at the level of a medical school graduate in general surgery. I think that they can get the work done, but may need more guidance from upper levels as far as what tests to do, critical care, ATLS etc. I could be wrong though. I'm basing this off my experience as an intern in the ER prior to medical school. Eventually I could function at the level of my medical counterparts, but there were things that didn't know that I know now after being in medical school for the past 3 months.
 
Thanks omsres.

Last week I spoke with a friend/mentor who is the assistant director of admissions at a 6yr program and he told me similar info. He highly recommends the 6 yr program...even though he is a single degree (back then it was only three yrs for OMS). He did say though that if you go to a very strong 4yr program that you can be just as well trained and it won't make much difference in the long run in private practice. His main point was that the MD can only make you stronger, won't hurt you, and if you are going to spend 4 yrs in residency...why not do two more.
 
rockstar2525 said:
This is a practice management question, which isn't really my area, so I asked one of the women who works in that dept and her reply was that off the top of her head she thinks that this is false, but still will get back to me with a definite/documented answer. What I can tell you now though is that I know we have a few docs who are not affiliated with any hospital at all and still have malpractice insurance. However, I am not sure if this differs by state, I'll get back to you.
Also, after reading the results of the scope of practice survey I found that MOST docs in private practice are affiliated with at least one or two hospitals. They don't do surgery there, but have priviledges there in case of emergency. The stats from the survey so far (1200 responded to the survey) show that %OMS affiliated with #hospitals are; 3%=0, 29%=1, 29%=2, 20%=3, and 19%=4+. Of the doctors surveyed, 81% of them take trauma call. The # days/nights that they are actually on call varies a lot though from 7 days a year to five nights a week. Some of the private practice docs split call, so if there are four surgeons in a group practice they rotate and are only on call one week out of every four weeks.
The trauma call issue is a sticky one, this is where one of the biggest turf battles is being fought between OMS, plastics and ENTs. Some OMSs don't want to take call (why would they?) and so they are losing ground in the hospital. I know that AAOMS and ROAAMOS works hard to encourage OMSs to take trauma call so that OMS can maintain status and credibiltity in hospitals.
Click to expand...
What is the ROAAMOS? You said that both the AAOMS and ROAAMOS work hard to encourage OMSs to take trauma call.
 
Resident
Organization
of the
American
Association
of
Oral
And
Maxillofacial
Surgery
 
Who are all the current OMFS residents on SDN and what residency are you with? I know of 5 (I know there are more lurking), but lets list them for all so the current OMFS applicants can direct any questions your way pertaining to your residency.

Come on now Docs, don't be shy!
 
I was wondering what people out there have heard about the program at the Univ of Michigan. I does not seem to be talked about too much, but from those people that i've talked too they seem to think it is great. Plus what is this about them going to a 4 yr program
 
Yah-E said:
Who are all the current OMFS residents on SDN and what residency are you with? I know of 5 (I know there are more lurking), but lets list them for all so the current OMFS applicants can direct any questions your way pertaining to your residency.

Come on now Docs, don't be shy!
Click to expand...

Answer any questions About CASE OMFS/MD program
 
Yah-E said:
Who are all the current OMFS residents on SDN and what residency are you with? I know of 5 (I know there are more lurking), but lets list them for all so the current OMFS applicants can direct any questions your way pertaining to your residency.

Come on now Docs, don't be shy!
Click to expand...

LSU New Orleans/Charity Hospital!!! Yea baby, Yea!
 
BSSO said:
I was wondering what people out there have heard about the program at the Univ of Michigan. I does not seem to be talked about too much, but from those people that i've talked too they seem to think it is great. Plus what is this about them going to a 4 yr program
Click to expand...

Too much med school, too much med school influence...
 
MAXFAC said:
Answer any questions About CASE OMFS/MD program
Click to expand...

What made you decide to do the extra 2 years for the MD vs a 4 year residency? Also, I dont mean to sound ingnorant, but what is PGY-I??
 
MAXFAC - - - - Case Western OMFS
River13 - - - - -LSU, New Orleans OMFS
Toofache32 - - UT Southwestern/Parkland OMFS

Come on, I know there are more of ya out there!

BTW, PGY-1 means Post Graduate Year #1
 
Parkland / UT Southwestern, Dallas, TX.

I feel sort of naked now.
 
toofache32 said:
Parkland / UT Southwestern, Dallas, TX.

I feel sort of naked now.
Click to expand...


Me too...except we both come from big programs w/lots of residents... :)
 
adamlc18 said:
What made you decide to do the extra 2 years for the MD vs a 4 year residency? Also, I dont mean to sound ingnorant, but what is PGY-I??
Click to expand...

Case's OMFS/MD program is 5 years long
 
adamlc18 said:
What made you decide to do the extra 2 years for the MD vs a 4 year residency? Also, I dont mean to sound ingnorant, but what is PGY-I??
Click to expand...
Our program is 5 years OMFS/MD, We have 13 months devoted completely to medical school, that during PGYII which is equivalent to MSIII, we have one course during PGYI that we attend with Med students which is Physical Diagnosis, we have to pass step I of USMLE exam before starting the program on July 1st, this is a medical school requirement to start clinical clerkships with med students in PGYII. I think the intern year is an important transitional year from dental school, coz let me tell you OMFS residency is a different ball game, if you think dental school is stressfull think again, especially when you are ON CALL every other night, you have to do morning rounds on inpatients everyday, case presentations, journal club, ongoing research project, work up for orthognathic cases on the same week. It's a lot of fun though,it's been three month I'm enjoying it to the max.
Why did I chose to do MD? because it gives you extra medical training that you need to manage very sick patients, which you have to learn on your own if you are a single degree, but in terms of surgical skills, I don't think the MD will give you any extra skill , but it will come handy when you are dealing with medical insurance companies who does not want to pay you for a procedure because you are a DDS or DMD while they will pay ENT for the same procedure.
Hope that was helpful
 
MAXFAC said:
Our program is 5 years OMFS/MD, We have 13 months devoted completely to medical school, that during PGYII which is equivalent to MSIII, we have one course during PGYI that we attend with Med students which is Physical Diagnosis, we have to pass step I of USMLE exam before starting the program on July 1st, this is a medical school requirement to start clinical clerkships with med students in PGYII.
Click to expand...

Thanks, that was helpful. Are there any other programs that are 5 years long for the MD?
 
adamlc18 said:
Thanks, that was helpful. Are there any other programs that are 5 years long for the MD?
Click to expand...

Univ. Nebraska's program is also 5-year MD/OMFS...don't know of any others
 
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