Has anybody done a 4 year program and done an optional 2 years of medical school at the end of the program? I’m just curious about getting more info on this. Would you already be a board certified oral surgeon and be able to practice part time during those med school years? I have heard there is technically a 3rd year that is a general surgery requirement but I’m not sure of any detail on that. If anybody has any info they can share, I would appreciate it.
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4 + 2 yr OMFS programs
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Yes there are guys that have done 4 year programs and then gone back to medical school later down the line.
Cincinnati has an optional 2 years to obtain your MD after completing 4 years of OMFS residency
Do the 6 year. There's probably 3 people in the history of OMFS that did the MD afterwards.
First, to use your MD, you need to have at least 1 year post grad to practice as an MD, which makes it a 3 year committent.
I did a 6-year program, and after 4 years I'm like.. ANOTHER 2 YEARS?? I'm graduating after the kids in the dental school I gave CBSE study material to.
Money is lucrative. 500k starting salaries after your OMFS certificate and you want to do 3 more years of this?
First, to use your MD, you need to have at least 1 year post grad to practice as an MD, which makes it a 3 year committent.
I did a 6-year program, and after 4 years I'm like.. ANOTHER 2 YEARS?? I'm graduating after the kids in the dental school I gave CBSE study material to.
Money is lucrative. 500k starting salaries after your OMFS certificate and you want to do 3 more years of this?
Eduardo D. Rodriguez, MD, DDS
Dr. Eduardo DeJesus Rodriguez is a plastic surgeon at NYU Langone specializing in reconstructive and cosmetic surgery. Learn more.
nyulangone.org
One of the 3 guys that did it.
I believe Carlson and Schlieve also went back and did MD
InterestingEduardo D. Rodriguez, MD, DDS
Dr. Eduardo DeJesus Rodriguez is a plastic surgeon at NYU Langone specializing in reconstructive and cosmetic surgery. Learn more.
One of the 3 guys that did it.
AnotherEduardo D. Rodriguez, MD, DDS
Dr. Eduardo DeJesus Rodriguez is a plastic surgeon at NYU Langone specializing in reconstructive and cosmetic surgery. Learn more.
One of the 3 guys that did it.
I can't imagine Carlson taking primary general surgery intern call, getting yelled at by 27year olds, after being an OMFS PD.
Yeah seriously lol I don’t remember the details. I think he did a sabbatical and probably just did 3rd and 4th year rotations. He did another sabbatical later and moved to Boston to do a masters in education too.
Karlis of NYU also did MD/general surgery after completing dental school and OMFS residency. It's rarer these days to have graduates go back for MD after graduating since 98% graduates go into PP. I always wonder if these people moonlighted (or even allowed to) during med school/general surgery lol.
That’s kinda what I was getting at. What does moonlighting look like as a resident vs as a board certified oral surgeon going back to complete med school.
Would be wildly more lucrative, but you are also adding an additional year at least to do the gen surg/acgme time. I think the reality is there aren't many places that have a 2 year deal post graduating and if you want to go back you are more than likely going to have to do 4 years.
I saw that VCU is offering an MD option after completion of residency. I'm not sure if this is new or not, I don't recall hearing about it when I interviewed there in 2019.
oralsurgery.vcu.edu
On a side note, UAB recently published in JOMS about the reverse track of MD's applying to and completing an OMFS residency including dental school.
Curriculum - Oral and Maxillofacial Surgery - Virginia Commonwealth University
On a side note, UAB recently published in JOMS about the reverse track of MD's applying to and completing an OMFS residency including dental school.
Not worth it, it's actually 3 years total if you actually want to be a licensed physician, because you need to complete a year of general surgery intership. It would also likely be a full 12 months of general surgery to meet ACGME standards, which is a lot compared to most OMFS programs. If you even remotely think you want an MD just do a 6-year program and don't waste your time with that MD optional stuff.
Some 6 year programs don’t offer enough ACGME time as it is to receive a medical license. There are states that are raising their requirements. Hopefully exceptions are carved out for OMS to count their residency time as ACGME, but the problem is ACGME vs CODA accreditation. OMS programs are accredited by CODA.
From what I hear, there are very few states that don't have an separate individual pathway for OMFS to obtain MD license. These states want oral surgeons to come there.
Im glad because they absolutely should be able to get licensed. I still don’t know what the MD license tangibly does for an OMS though. Owning a med spa or practicing internationally were the only things I could come up with.
I believe an MD is required to supervise APPs in most non-academic settings. Someone mentioned that awhile back on here. Billing possibility differences. Hospital bylaws application and credentialing. Some academic omfs programs only hire MDs. Overall respect. How much this matters? Idk, but there are some differences. When future restrictions are placed on omfs, namely IV sedation privileges being taken away at some point, will they be implemented against all omfs, or single degree first then later down the road dual degree? Who knows. Idt there’s any huge reason to get your MD, just enough small ones that make it worth it for half the people. Plus two years of med school is fun - you’ll never get the college life again after this. To each their own
Also someone higher up than me please correct anything I’m saying wrong. I’m talking out of my butt
Hilarious if you think they would only give sedation privileges to people who went to a 6 yr program. Someone drank the MD kool aid
Chill dude, we can be professional. As my post states, it's just a possibility, not some strong held prediction. Easier for opponents to play dominoes and start with stripping GPs of their weekend course sedation privileges, then move to single degree os, then dual degree os than it is to strip everyone of their sedations all at once. Again, just a possibility, even if small. I didn't drink the MD kool aid and sacrifice a large opportunity cost off of this food-for-thought idea.
Also let's not overlook the medical training itself. Having that knowledge would be nice in life. Again, to each their own. Not saying it's worth it to everyone
-The MD doesn’t affect credentialing for the OMS scope. It makes zero difference of what you can and can’t do. A case log does. A fellowship does.
-As far as sedation, states grant the ability to sedate under a dental license and not the medical license. And it has nothing to do with the degree, it’s the single operator anesthetist model that the medical community does not like.
In California, there actually is a not-insignificant caveat to this. While the scope of 4 vs 6 years is the same, the single degree surgeons cannot perform elective facial cosmetic surgeries without obtaining a special permit to do so. Including anything that’s aesthetic only and not for functional reasons (I.e cosmetic Botox, filler, aesthetic scar revision etc.).
I believe it to be a relatively rigorous application process and was given even stricter requirements just last year. This permit is through the dental board by a 5 member committee. Something like 3 OMFS and 1 PRS and 1 ENT.
The MDs are allowed to without a permit. (As well as NPs /PAs/ RNs supervised)
So the scope remains, just an extra hurdle to jump and keep renewing.
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There's a prs and an ent in the dental board?
I want to see proof for that. An NP doing it but a board certified OMS unable to right off the bat? No way lol that just sounds completely unserious
If practicing fellowship scope is even in your thoughts, you should pursue an MD. I think there is a huge misconception among applicants and residents. Fellowships are in general not very competitive to obtain which is why a 4 year and 6 year program does not matter and there are 4 year people that do them. But what people do not tell you is that you can do the fellowship as a 4 year, but obtaining a GOOD job afterwards is near impossible. For jobs for head and neck, a lot of them you have to interview with the ENT chair and so OMFS programs wouldn't even dare trying to bring a 4 year in front of them. The best jobs are the private hospital jobs for fellowship jobs and those mostly will not hire a 4 year - they can't have a PA or NP which is needed to generate production (These people are breaking 7 figures). Also, it's a disadvantage in the hospital not to have a PA or NP that the hospital pays for. Furthermore, look at the number of 4 year vs 6 year practitioners doing head and neck or cleft/cranio. It's pretty much 6 year dominated - almost 90%+. Yes, there's a handful for 4 years doing it. Cosmetics is hard as a 4 year. There's unicorns doing it but it's mostly MD dominated. Also look at the fellowship directors, there's a reason why everyone is a 6 year and at the job they're at. (They're good jobs because they have a fellow doing their scutwork)
Why can’t a 4 year have a NP or PA? I thought private practice OMS can have them
Federal rules basically state PAs must work under MD/DO. Only dual degree OMS can have them. They're not independent practitioners in most states and require MD/DO supervision. The PA can also bill for a second surgeon fee in your OR as well as see consults and clinic patients and drive up the number of procedures you do and generate more RVUs while keeping your own clinic volume maximized in a hospital setting. The idea of a PA is fairly new to OMFS. This is actually a major area most people practicing or residents/applicants do not discuss nor do they know is a major advantage to the MD especially if you are trying to build out a major surgery practice as the PA can see tons of followups and new patients and load your schedule up with surgical patients and consults. They can also round on your inpatients etc. It can also work in private practice. The Carolina's practice is employing PAs right now to see TMJ and other consults for them in private practice. Tons of head and neck surgeons are employing PAs. In private practice models, PAs can generate you direct money. Let's say PA bills 300k a year, you pay 140k, overhead is 40k and net 120k. Then you take home 40-50% of that. This is how private practice MD practices work in plastic surgery, ENT, etc. They hire these PAs to generate income.
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If someone is doing orthognathic surgery on me I’m meeting the surgeon. There’s no way I’m settling with only talking to a PA.
I'm also not too familiar with the PA's role for seeing OMFS patients. Definitely not for a new orthognathic consult. They could definitely see facial trauma call and schedule for the OR, and postops. I can see it for academic OMFS. For elective surgeries (orthognathic, TMJ, cosmetics), maybe they could see follow ups but a lot of these are just way out of the realm for a PA or NP. Maybe I just am not seeing the full use of PAs and NPs though, it is an interesting concept
No, but there must be one ENT and one PRS on this committee.
Currently both the required ENT and PRS committee members are held by dual board accreditation in OMS+PRS/OMS+ENT.
The dental board is the licensing body that issues an Elective Facial Cosmetic Surgery Permit, following recommendation by the appointed EFCS Credentialing Committee after a closed session review of the application.
They upload meeting notes and provide easy ways for public to attend virtually actually.
Technically a RN can give Botox for stand alone esthetic procedures (forehead wrinkles), if under on-site physician supervision. While a board certified OMS, with no active Medical License, cannot until having obtained the EFCS Permit.
Medical Board of California
The Medical Board of California licenses and disciplines doctors, handles complaints against physicians and offers public-record information.
www.mbc.ca.gov
My prior message mentioned LVN. That was a corrected error, they are prohibited. The actual laws are not easy to find for the independent administration by NPs.
The laws for elective cosmetics for dentistry is easy to find.
Provision of Botox solely for cosmetic purposes is outside the scope of dental practice in California - CDA
CDA reminds dentists that the California Dental Practice Act permits the use of Botox only when used as part of a comprehensive dental treatment plan and for one of the purposes defined in section 1625 of the state’s Business and Professions Code.
Even more complicated is that California recently upheld a bill to prevent anyone without MD/DO to refer to themselves as “doctor” or “Dr.” . It looks like this was decided on a case specific to Nurse Practitioners started in 2023 and upheld a few months ago in 2025. It looks like somewhere in between a carve out for dental specialists was proposed but not included. The new limit of federal loans would be a major reason to avoid the six year route while this new law would make that option a serious consideration, not just in California. Ironically, I got my MD even though I applied to my program ranking the four year position #1 and Six year #2, which I matched into, and the rest of the list was essentially four year spots.
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