4-year Vs. 6-year Oral Surgery Programs

[JavadiCavity]

I was talking with a student the other day about oral surgery programs and I asked him if he knew how the 4-year programs differed from the 6-year programs--aside from an MD.

Can an oral surgeon from a 6-year program do more than an oral surgeon from a 4-year program? Any information would be great!

 

[ajmacgregor]

Aside from the MD, there are few differences between the two types of programs.

4-year residents typically spend 30-36 months on the OMFS service (the remaining 12 - 18 months are spent on Anesthesia, Medicine, ENT, Plastics, General Surgery, ER, etc.: it varies from program to program).

6-year residents typically spend 30-33 months on the OMFS service (sometimes the med school years include some OMFS rotations - be sure to include these when looking at programs). A friend of mine in a six-year program had the following schedule:

Intern Year: 12 Months OMFS
MS3: 12 Months Medical School
MS4: 8 Months Medical School, 4 Months of Anesthesia at Resident Level
General Surgery: 12 Months, split between Cardiac, Trauma and Plastics
Junior Resident Year (12 Months): 9 Months OMFS, 3 Months ENT
Senior Resident Year (12 Months): 12 Months OMFS
Total OMFS Time: 33 months OMFS

So, as you can see, there is little difference between the total time on OMFS between these two types of programs (granted that there are some 4-year programs that may spend much more time on OMFS than some 6-year programs, but the difference is only a few months for most programs).

As far as scope of practice is concerned, AAOMS maintains that there is absolutely no difference in the scope of practice between 4-year and 6-year guys. There have been studies that have shown that 6-year guys tend to have a wider scope of practice, but the authors of the study went out of their way to point out that the difference is NOT related to 4-year guys being denied privileges, but rather that 6-year guys are more likely to seek out privileges to do expanded scope procedures. However, no matter what type of program you go to, always remember that YOU ARE A DENTIST FIRST (AND A PHYSICIAN SECOND - if 6-yr).

Having spoken to numerous residents and faculty (both 4- and 6-year), there is some consensus that, regardless of what AAOMS says, there is a perceived difference in the public/medical community between single/dual-degree guys. Most people I've talked to attribute this to the fact that AAOMS hasn't done a good job educating the public about OMFS and what OMFS are trained to do. Let me be very clear - I'm not claiming that there is a difference between 4- vs. 6-year trained surgeons, but that some people, through their own ignorance, think there is and that the professional organization has not been effective at dispelling these ignorant beliefs.

My personal opinion is that you should do a 6-year program if you have the time and energy. I think that having the MD may also open up more options to you outside mainstream OMFS (head/neck oncology, cosmetics, craniofacial), but even in these areas you'll still have to constantly prove your worth to related specialists (ENT, Plastics, G. Surg). Also, if you intend on pursuing an academic career, an MD can be valuable in the hospital setting.

 

[JavadiCavity]

ajmacgregor,

That was an excellent post. Thanks for the response!

 

[ISU_Steve]

How many six year OMS programs are out there?

And why would you need to remember that you are "a dentist first and a physician second" (other than the obvious chronological factors)? Is this some kind of pride issue (that's what it sounds like), and why would it even matter? I know two OMS practitioners who have their MD and list it first- of course they both do nothing that I would classify as anything but remotely as "dentistry" in their practices as they specialize in facial reconstructive and head and neck surgery, so I guess I don't blame them. It's just like I list my EMT-I credential first when I'm working on an ambulance, and my CRT credential first when I'm working in the ICU- list the most pertinent thing first (my opinion, I could be wrong).

I wouldn't presume to tell them that they need to remember "they are dentists first and physicians second." I think they know where their boundaries lie, they don't cross them and they have the respect of the rest of hospital staff for doing what they do and being damn good at it.

 

[ajmacgregor]

How many six year OMS programs are out there?

I wouldn't presume to tell them that they need to remember "they are dentists first and physicians second." I think they know where their boundaries lie, they don't cross them and they have the respect of the rest of hospital staff for doing what they do and being damn good at it.

True, true. I just wrote this because it seems that sometimes people are interested in OMFS because they want to get an MD and that some OMFS I've interacted with forget that they are dentists, and that the MD degree is ancillary to their training.

I think that about half the programs in the country are MD-integrated programs (mostly 6-years). There's also a few that are MD-optional.

 

[ISU_Steve]

Thanks for the answers. I really do appreciate it.

 

[rahmed]

Aside from the MD, there are few differences between the two types of programs.

4-year residents typically spend 30-36 months on the OMFS service (the remaining 12 - 18 months are spent on Anesthesia, Medicine, ENT, Plastics, General Surgery, ER, etc.: it varies from program to program).

6-year residents typically spend 30-33 months on the OMFS service (sometimes the med school years include some OMFS rotations - be sure to include these when looking at programs). A friend of mine in a six-year program had the following schedule:

Intern Year: 12 Months OMFS
MS3: 12 Months Medical School
MS4: 8 Months Medical School, 4 Months of Anesthesia at Resident Level
General Surgery: 12 Months, split between Cardiac, Trauma and Plastics
Junior Resident Year (12 Months): 9 Months OMFS, 3 Months ENT
Senior Resident Year (12 Months): 12 Months OMFS
Total OMFS Time: 33 months OMFS

So, as you can see, there is little difference between the total time on OMFS between these two types of programs (granted that there are some 4-year programs that may spend much more time on OMFS than some 6-year programs, but the difference is only a few months for most programs).........

Hi ajmacgregor

Thanks for posting a clear prespective and scope regarding 4 yr vs 6 yr program. Being an Oral Surgeon (trained in UK) currently seeking retraining path in US it is quite helpful to me. For certain personal reasons and also the reasons sited by you in your posting now I am more convinced to get into a 4 year program. Of course by now I have learnt that they are the most difficult ones to get in!

rahmed

 

[HumbledDDS]

simple question:

which programs are more competitive (harder to get into)? 4-year ones for 6-year ones?

 

[ajmacgregor]

simple question:

which programs are more competitive (harder to get into)? 4-year ones for 6-year ones?

This is a difficult question to answer, because each program type is hard to get into, but for different reasons...

4-year programs are "harder" to get into because they draw from a larger pool of applicants, so the probability of matching a spot is lower than for 6-year programs.

6-year programs are "harder" to get into because they have more stringent entrance requirements, which are often dictated by the associated MD programs.

I'd say that, on the whole, it's quite difficult to match into OMFS. Both 4-year and 6-year programs will be a tough match.

 

[HumbledDDS]

... for your reply

This is a difficult question to answer, because each program type is hard to get into, but for different reasons...

4-year programs are "harder" to get into because they draw from a larger pool of applicants, so the probability of matching a spot is lower than for 6-year programs.

6-year programs are "harder" to get into because they have more stringent entrance requirements, which are often dictated by the associated MD programs.

I'd say that, on the whole, it's quite difficult to match into OMFS. Both 4-year and 6-year programs will be a tough match.

 

[toofache32]

...And why would you need to remember that you are "a dentist first and a physician second" (other than the obvious chronological factors)? Is this some kind of pride issue (that's what it sounds like), and why would it even matter? I know two OMS practitioners who have their MD and list it first- of course they both do nothing that I would classify as anything but remotely as "dentistry" in their practices as they specialize in facial reconstructive and head and neck surgery, so I guess I don't blame them...

I disagree. You ARE dentists first for one good reason: OMS is an ADA accredited specialty (not medical) and the MD is definately peripheral to the training. Here's another way to look at it: a regular MD is not equipped to do any of the bread-and-butter OMS procedures. They haven't even heard of most of the diagnoses we give. Either way you look at it, OMS is a dental specialty.

This "facial reconstructive surgery" you speak of is what OMS is all about. If you don't classify that within dentistry, you need to educate yourself on the actual definition of dentistry and OMS. Try this for starters:
http://www.aaoms.org/omsdefined.cfm

The dual-degree OMS's that I know who list their MD first are very ego-driven. Given a choice, I will list my DDS instead of my MD because it is the core of what I will practice. Not to mention I had to work a lot harder to get my DDS than my MD.

 

[adamlc18]

simple question:

which programs are more competitive (harder to get into)? 4-year ones for 6-year ones?

Although I am in no postion to say which type of program is harder to get into, I noticed that all the unmatched spots (5) from last year were for dual degree programs.

 

[ItsGavinC]

Although I am in no postion to say which type of program is harder to get into, I noticed that all the unmatched spots (5) from last year were for dual degree programs.

Which is difficult to decipher without knowing exactly how many applicants applied to each program, and whether or not each program was single or dual-degree.

Good stuff though.

 

[ItsGavinC]

I disagree. You ARE dentists first for one good reason: OMS is an ADA accredited specialty (not medical) and the MD is definately peripheral to the training. Here's another way to look at it: a regular MD is not equipped to do any of the bread-and-butter OMS procedures. They haven't even heard of most of the diagnoses we give. Either way you look at it, OMS is a dental specialty.

Bingo. OMS are *always* dentists and sometimes physicians. There isn't any way around that.

 

[ISU_Steve]

Yes I see where you are coming from, but there are MD surgeons who do facial reconstructive surgery. So to say that it's strictly within the domain of a dental specialist is being a bit short-sighted. Granted if it was my face, I'd want someone who was trained as an OMS treating me rather than some guy from plastics (don't get me wrong I know a few reconstructive surgeons who are amazing, but I would just feel more comfortable being treated by someone who is an OMS), but then again if the DDS is the "important" part of a OMS's credentials then why even give them the MD degree if it's just basically fluff or filler? Pardon me if I'm misinterpreting what you're saying, but that seems to be the gist of what you are trying to get across.

Personally I do think listing the MD first is a bit pretentious, I've always figured you list your credentials in the order you recieve them unless you recieve something of higher standing (say a DDS vs. an MS). But of course, I'm planning on listing my RRT credential (which I'm testing for now) after my DDS or DMD even though it has nothing to do with what I will be doing so my opinion may be a little bit skewed. I guess it's all a matter of what you consider most important to you.

 

[toofache32]

Yes I see where you are coming from, but there are MD surgeons who do facial reconstructive surgery. So to say that it's strictly within the domain of a dental specialist is being a bit short-sighted.

I didn't mean to imply facial reconstruction was only done by a DDS. I guess I was challenging the assumption that many people have (not you, BTW) that a dental degree only makes you an enamel carpenter. Interestingly, "Facial reconstruction" was initially done by dentists on WWI soldiers and then plastics soon got in on the game. ENTonly got involved during the last 20 years or so.

As an aside...Does anyone remember the old commercial from a few years ago about the dental school lecture where the prof says, "today we're going to talk about.....MOLARS!" and the class erupted with cheers? I have several friends who think that's what dental school really is.

... but then again if the DDS is the "important" part of a OMS's credentials then why even give them the MD degree if it's just basically fluff or filler? Pardon me if I'm misinterpreting what you're saying, but that seems to be the gist of what you are trying to get across.

Everyone has their own reasons for getting the MD. For me, it's because I want to go into academics and 2 more letters after your name helps, even though it's definately not required. And 2 laid-back years isn't a bad deal for an MD. My OMS program just hired their first dual-degree attending this year, so you definately don't have to have it for academics.

Some people argue that an MD makes the turf battle for cosmetic surgery easier, but you will still have to fight even with the MD. It's kind of funny to me because I didn't learn a damn thing about "cosmetic surgery" in med school, and most cosmetic procedures are much less invasive and demanding than our routine trauma or orthognathic cases.

 

[rrc]

Keep on preaching to the choir!!!

 

[gryffindor]

As an aside...Does anyone remember the old commercial from a few years ago about the dental school lecture where the prof says, "today we're going to talk about.....MOLARS!" and the class erupted with cheers? I have several friends who think that's what dental school really is.

Hehe... That was a Trident commercial in the late 1990s. I still laugh when I think of that commercial. Too bad there wasn't a single day in dental school that felt like that class in the commercial did.

 

[UltraTooth]

There is a reason why the number of dual-degree OMFS programs are increasing. For just two more years of training, your practice possibilities skyrocket. Don't think choosing one program over another is merely a matter of what procedures you will learn. Medical centers are ruled by MDs and the DDS-only Oral Surgeons will never gain the advantages of their DDS-MD counterparts.

 

[thewingman]

^^^^ FALSE! You can do the same exact thing and gain privileges at the hospital as a single degree surgeon. The possibilities are exactly the same. When you start stepping on the turf of ent or plastics, even with your MD, you will still just be a dentist.