6yr vs. 4yr OMFS Programs

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rochrome

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What are the pros and cons of going into a 6 year or a 4 year OMFS program?

I understand that at 4 year programs that you don't receive an MD, but does that really matter when your saving 2 years?

Is a 4 year geared towards someone who just wants a private practice to extract 3rds all day? and a 6 year for someone who wants to be doing surgeries like cleft lip/palate and trauma in hospitals?
 
What are the pros and cons of going into a 6 year or a 4 year OMFS program?

I understand that at 4 year programs that you don't receive an MD, but does that really matter when your saving 2 years?

Is a 4 year geared towards someone who just wants a private practice to extract 3rds all day? and a 6 year for someone who wants to be doing surgeries like cleft lip/palate and trauma in hospitals?

You can read the other threads to get your answer but I'll add this:

Yesterday in clinic, an implant case came up and suprise suprise, a sinus lift was in order. This junior student asked a senior student for advice and this came out "You should figure it all out today because Dr xxxxxx is here only once every 2 weeks and he is an MD oral surgeon". Nevermind the fact that we had 3 other faculty there with YEARS of experience. The MDer is a fresh grad. I'd take advice from any of them anyday...just funny that the MD makes him superior in their eyes.

Just something to think about. At our school at least, there is a perceived superiority among the GP-bound students who aren't immersed in the OMFS applicant world.
 
There are excellent 4 year programs, and very mediocre 6 year programs. Whether or not to get the medical degree is a personal choice you have to make, knowing that if you want to be on faculty or part of a hospital system, you may be limited without it. That is the only clear advantage to the MD.

The training you receive will be entirely dependent on your program. In the 6 year programs, you spend 2 years in medical school, so it's still only a 4 year surgical experience. When I interviewed, at the 4 year programs, you spend more months on service than in the 6 year programs. That meant more exposure and actual cutting in the shorter program.

To assume an MD OMFS is a superiorly trained surgeon by default is ENTIRELY based on the wrong detail. The real fact that matters is where they were trained, what their exposure was, and their abilities. Those facts have nothing to do with the MD.
 
There will be no difference in the amount of money you make if you have an MD or a certificate. I have friends practicing right now who are both 4yr and 6yr guys. Of the 3 friends who are 6 year guys they all tell me that if they had to do it over again they would find a good single degree program and go there. They all felt the 4 yr guys got a lot more experience cutting cases than they did. Howevere the MD guys are probably better at managing there inpatients. I feel that is of little benefit to us as OMFS bc MOST of our patients are healthy and the one that aren't we can manage just fine. They trend is more guys/gals applying to single degree programs. Why put off making all that money for 2 extra years when there is not that much benefit. Just my opinion.
 
Ok since the 4 & 6 year programs have virtually identical surgical experience, does that mean having a 4 year degree wouldn't limit anyone from a fellowship? Or do some fellowships require both degrees? Basically, are the 4 year guys limited in any way?
 
some fellowships are limited by not having an MD but these are mostly the cosmetic, and a few oncological (not to sure about these though, just heard that). You will get more surgical experience from a single degree program, doesn't mean better guidance/experience but definite more experience.
 
I find it difficult to believe that four year residencies have more surgical experience as a general rule. This all depends on the program and the amount of actual OR time spent by residents while on service.

I will chime in and agree that the additional knowledge acquired in medical school is usually peripheral to the specialty as it pertains to a T & T style private practice, and definitely is not a financial boon. However, having worked with both 4 and 6 year residents in a hospital setting involving medically compromised patients, those with the MD certainly do seem to have an edge.

Also, if there is a chance of doing academics or having a heavily hospital based practice the extra degree can help in a legal sense (depending on the state) and gives a little extra "street cred" with medical colleagues who don't necessarily have a profound understanding of what our specialty involves.
 
I find it difficult to believe that four year residencies have more surgical experience as a general rule. =

Look it up on the program webpages. To be accredited, a program must provide 30 months on service. Many 4 year programs provide up to 36 months, while MD programs often provide only the minimal 30 due to the rigerous med school requirements, and the full general surgery year required to obtain a medical license.

Over the 4 years, they get half a year extra oral surgery exposure in some 4 year programs.

Some places are different than others, but in general....
 
Look it up on the program webpages. To be accredited, a program must provide 30 months on service. Many 4 year programs provide up to 36 months, while MD programs often provide only the minimal 30 due to the rigerous med school requirements, and the full general surgery year required to obtain a medical license.

Over the 4 years, they get half a year extra oral surgery exposure in some 4 year programs.

Some places are different than others, but in general....

Did you really look at all the programs' websites nationwide? Again, you are quoting on-service times for high end 4 year programs, and low end 6 years and calling it a general trend. Statements like "many 4 year programs..." or "MD programs often..." do not provide overall good comparisons. I'm at a six year that does 35 months of OMFS and interviewed at some that did over 40. Also, it's worth clarifying that surgical experience is not predicated on the time on service alone, but also by what is done during that time. Neither of these factors is determined by whether a program integrates an MD or not.
 
I don't think anyone here is denying that there is variation from program to program, however as a general guideline you will get more exposure to OMFS surgery on average in a single degree program. AGAIN this is not always the case. Having friends all over the country, at single and dual degree programs, the majority would agree with this. I researched the hell out of this before deciding which direction to go. A lot of programs have you on service your first year and you will be holding stick or running clinic, then you are gone. When you return as a senior guy that is when you get all your true exposure. This is usually about eighteen months, which is just fine. It all boils down to what you wnat to do when you get out, in my opinion. Neither choice is limiting, but deciding on a single or dual degree can open some doors a little easier.
 
It is one of the most expensive decisions you will ever make. It will cost you 2 years of your peak earnings as an opportunity cost to do a 6 year program for little gain in the vast majority of cases. That number could mean $1.5 million in lost income plus the costs you incur during medical school.... something to consider. Mostly a personal choice because objectively it makes no sense in the big picture for the majority of those who take that path.
 
It is one of the most expensive decisions you will ever make. It will cost you 2 years of your peak earnings as an opportunity cost to do a 6 year program for little gain in the vast majority of cases. That number could mean $1.5 million in lost income plus the costs you incur during medical school.... something to consider. Mostly a personal choice because objectively it makes no sense in the big picture for the majority of those who take that path.

It is very expensive. But in the end, getting an MD and all the privileges/rights/knowledge/respect is priceless.
 
It is one of the most expensive decisions you will ever make. It will cost you 2 years of your peak earnings as an opportunity cost to do a 6 year program for little gain in the vast majority of cases. That number could mean $1.5 million in lost income plus the costs you incur during medical school.... something to consider. Mostly a personal choice because objectively it makes no sense in the big picture for the majority of those who take that path.

Some 6 year residencies are GME funded - which means they pay for your tuition as well as giving you a stipend on top of that. You incur zero expenses.
 
Some 6 year residencies are GME funded - which means they pay for your tuition as well as giving you a stipend on top of that. You incur zero expenses.

Yes you do. No matter what 6 year program you do, even if you go to Mayo or Louisville and you get free med school and they pay you a stipend on top of it, that's still an entire two years you're investing that if you went to a 4 year program you would have been practicing as an oral surgeon. It's opportunity cost.
 
It is very expensive. But in the end, getting an MD and all the privileges/rights/knowledge/respect is priceless.


What priveleges and rights would a dual degree OS have that a single wouldnt?
 
What priveleges and rights would a dual degree OS have that a single wouldnt?


It's like shaving your pubes... Makes your d!ck look bigger. Or was it makes you look like a bigger d!ck? Hmm. I can't remember...
 
rochrome's question is right on. You get nothing more than a medical degree and the education that comes with it. Training not degree dictates scope of practice. Competence and professionalism get you respect. Like I said it is usually a personal decision because it may in fact result in less surgical experience due to the way many dual programs are structured.
 
No matter how many times we answer this question on this forum, give it 6-9 months and this same question will pop up again....here was my personal take/response 6 months ago:
"Dual degree surgeons can assure themselves and their patients that every educational measure was taken to be able to provide the best care possible; peace of mind knowing that no shortcuts or 'fast-tracks' were taken in order to accommodate personal desires or family obligations. Do a quick search of the American College of Surgeons and see how many single degree OMFSs are Fellows.
Single degree surgeons will always have an inferiority complex, wondering for the rest of their lives if such-and-such patient could have been better medically managed; wondering if they would be better doctors if they had taken the time to get a proper medical education; they will never know."
I will also respond to some of the other comments that have appeared on this particular thread:

"
....MD guys are probably better at managing there inpatients. I feel that is of little benefit to us as OMFS bc MOST of our patients are healthy and the one that aren't we can manage just fine. They trend is more guys/gals applying to single degree programs. Why put off making all that money for 2 extra years when there is not that much benefit...."
Actually, it is the sick patients that get referred to omfs; dentists can handle the healthy extractions fine, but its the 77 year old with emphysema, CAD, and renal failure that they refer to OMFS. Your knowledge of Medicine will impact this patient. And what is your obsession with money? Formal medical training is a once-in-a-lifetime oppurtunity, you can always go out and make money.

"....as a general guideline you will get more exposure to OMFS surgery on average in a single degree program...."

I submit that surgical exposure has NOTHING to do with the 4/6 year question, and EVERYTHING to do with the individual program you match to. There are no generalizations when it comes to surgical exposure.

"....It will cost you 2 years of your peak earnings as an opportunity cost to do a 6 year program for little gain in the vast majority of cases. That number could mean $1.5 million in lost income...."

First thing, this statement was made by someone who had 'attending' as their status, so don't you think you're inflating your income ability a little? Again, there is so much more to this than money. Don't make this decision based on money, there will be plenty of $ no matter which track you get into.
 
I must grin when I read this as I have seen this whole issue evolve since I was a resident 20 plus years ago. Everyone has made valid points but in the end it is a totally personal decision as most have pointed out in their rationale for and against the dual/single degree. Most OMFS's in private practice including the medically trained rarely take care of really sick patients by themselves, they get assistance from medical colleagues, at least the smart ones do. It is called sharing liability. We have several dual degree surgeons in our community and one on my faculty and that always holds true for good reason. Interestingly, all of the dual degree programs in our geographic region have non MD Department Chairs and program directors. That dicotomy makes it hard to rationalize that an MD is so critical.

I am not sure what was meant by inflating income ability because of attending status. Perhaps it is the impression that one cannot meet or exceed private practice income if you are in academics. In many places that is true and that is a problem...but not all are like that. The great thing about American programs is you have both options so you can exercise your personal choice. Neither is wrong.
 
Interestingly, all of the dual degree programs in our geographic region have non MD Department Chairs and program directors. That dicotomy makes it hard to rationalize that an MD is so critical.

Those who have practiced in academics long enough to become PD's and chairs completed residency before the MD became mainstream, for the most part. In 20 years, I submit that very, very few chairs and PD's will be single degree.

And regarding the "million dollar mistake," any OMFS will make enough money to retire at age 65 or sooner. The decision to retire should have much more to do with an OMFS's personal priorities than the money they make through their careers. It is silly to think all OMFS will practice to age X so therefore single degree guys get 2 extra years of practice (and of course those years are the fruitful ones at the end).

In the evolving politics of healthcare, I believe an MD will serve a young surgeon who plans to practice for 20-30 years from now with an array of options that will not be present for our single degree counterparts. Teeth, implants, and ambulatory anesthesia will likely not remain the cash cow they are now indefinitely. If you are willing to bet your career that they will, I say go for that four year spot. If not, take the best bargain in education worldwide and get a legit American MD in 2 years.
 
The MD is prob the most recognized and sought after degree with the most applicaion outside of the world of healthcare. With an MD you don't have to step into a hospital or clinical setting to make a living. Plenty of companies, organzations, consulting firms have job descriptions for individuals wth an MD than prob any other degree out there, even my paltry DDS.😀
 
Thank you yl4lif3 and faceguy; you said what many of us are thinking in regards to the pros of getting the MD.
 
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