Ask an OMFS resident anything
Started by armorshell
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Was the satisfaction of getting the M.D. the main reason for you choosing a 6 year program? How exactly does the 6 year program work: first 2 years of med school and then 4 years of surgery or is it all meshed together? While still early in your studies, what is your plan upon graduation (private practice, hospital, etc.)? Lastly, is Gary Ruska your hero, have you ever met him, or plan on meeting him? 
Thanks for doing this,
Jon
Thanks for doing this,
Jon
Lastly, is Gary Ruska your hero, have you ever met him, or plan on meeting him?
Gary Ruska aka Bob Dole is everyone's hero!
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Gary "The Master" Ruska is everyone's hero
I love that guy... he sometimes posts some of the most sarsastic comments, but none the less, VERY knowledgable when it comes to OMFS. I think hes been an OMF-surgeon for a very long time.
Oh, and he only refers to himself in 3rd person, what a character
Oh, and he only refers to himself in 3rd person, what a character
.
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I'm heading to UoP, where I believe you went armorshell. My dad is an OMFS and I am really interested in it but concerned about debt. I was just wondering what your advice would be. I also wondered what advice you have on the 4yr vs 6yr MD programs. I have heard quite a bit from oral surgeons, saying they don't think that the MD matters...but they are from a different generation ha ha What do you think about it? THANKS!!
Wow, what a lucky situation to be born into (in light of your interest in dentistry and all). What has it been like having a father in OMFS? What are his thoughts on the field and you going into it? I guess he isn't spoiling you too much if you're concerned about debt. 🙂
You should get him on SDN, I bet he has a wealth of experience to share!
ha ha well, my dad is about a decade behind when it comes to technology, so would have a hard time imagining him on here. My dad has owned a practice in Las Vegas for over 20 years. I worked there in the summer when I was 15. That's pretty much when I decided that I wanted to go to dental school. Oh, and ya, I will be paying for school with loans. ha ha no trust funds here!
holy **** !!!
I just found this:
http://career.ucsf.edu/dent/samples/res/OS.pdf
The first question has some VERY interesting answers when it comes to the work-life style of an OMFS resident
http://career.ucsf.edu/dent/samples/res/OS.pdf
The first question has some VERY interesting answers when it comes to the work-life style of an OMFS resident
Awesome link-up dw
Very interesting Q&A, thank you for posting!
One panelist stated he slept about 4 hours per night during the intern year...The work schedule is highly demanding, ~17 hours a day with extra work after-hours, plus
research.
Jesus, is this the norm? It sounds worse than "medical" residency hours, or at least it doesn't sound like the hours are regulated at all as they supposedly are for "medical" residents?
A dual degree is not required to practice OS in the US, but is
required in most of the world.
What does "most of the world" even mean here? Is it the top 10 1st world countries or something??? I mean, I can't even think of 10 countries where dentists finish dental school with a doctorate at all (normally). Does this imply dual doctorate, or any two degrees?
At Harvard, an applicant was asked,
Who is the most evil man in the world, and why? At Massachusetts General Hospital, a panelist was asked about the
clotting cascade and to interpret a radiograph.
I'd love to see the responses+explanations given for this first question and how it affected the interviewee. The second case is pretty normal for a dental school graduate to do, right? Do dental schools cover radiographs/CT for the entire body, or just head/neck?
I wonder how/why exactly they state that UCSF specifically is a supportive, "women-friendly" residency, are the others women-unfriendly? 🙂
It's hard to prognosticate about a specialty that is fighting scope of practice battles on every front. In our lifetimes, the everyday practice of oral surgery has the potential to change in everything from implants, pre-prosth surgery, anesthesia administration, and things like cosmetics.
However, I don't expect changes will be ridiculously drastic. Implants are shifting towards being placed by the GP in many cases (and the implant companies are trying to make this happen as much as possible). But the same situation happened with root canals and endodontics is still a thriving specialty. There will always be implants a generalist won't be inclined to place because of treatment planning issues or plain surgical difficulty.
Then again, you have centers like Clear Choice opening up who only employ OMFS as their surgical providers, so who knows?
Not at all. I'm in medical school right now, and trust me, I'd much rather be with my 4 year brothers and sister slicking teeth, sticking implants and cutting trauma then reading about the poop chute. However, I thought it would be valuable to get the MD, both as a career move (IMO, the specialty is moving in the direction of having all training programs become dual degree) and as an educational supplement to my training.
I hope to practice full scope OMS when I finish, and for that I believe an MD will be quite beneficial in hospital politics, marketing and the like. Additionally, should I choose to pursue a fellowship after I finish, an MD is all but required for most programs.
As an educational supplement, I've found my medical school training, having a comprehensive understanding of the human system makes it easier to understand why we do what we do. I don't know that it will necessarily change my future practice or that this isn't something you could achieve in a 4 year course, just having a formalized medical curriculum made more sense to me for the type of OMFS I hope to practice.
Depends on the program. At UTSW, med school is up front for 25 months then the rest is residency training.
At this point in my training, I'm about 70/30 full scope private practice (potentially in a hospital setting) vs. academic OMS. I still need to do a lot more research, but I could definitely see myself in academics if I could secure the right position. 6 months ago if you had asked me I would have said 100/0 to that question though, but I've been lucky to be exposed to some cademic OMS superstars at my program who've been enlightening me about that career path.
Lastly, is Gary Ruska your hero, have you ever met him, or plan on meeting him?
It is my life's goal to meet Gary "Shuck Norris" Ruska
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Nope. Anecdotally it's generally lumped into the "weak" pile, but I really know nothing.
Sounds about right, probably averages out to be about 16-17 hours a day. Less on some nights, more on call nights. Before I started med school I would be up for 36 hours straight if I had a call night that coincided with a week night with a few bad traumas. It's not that bad if you love what you're doing and you still find time to carve out a semblance of a life outside of the hospital.
But yeah, OMS residencies don't monitor hours like medical residencies. In general, OMS doesn't represent a large majority of the residents that CODA covers and it's somehow not become a major issue on their radar.
In several European countries (UK and France come to mind), OMS is dual degree only (Medical/dental degrees, not necessarily doctorates, but the nature of a doctorate degree differs between the US/UK systems. Technically speaking, a DDS is a bachelors degree in dentistry) specialty.
Yeah, I got asked a few pimp questions on interviews. Generally it seems like they're trying to see how you respond more than if you get it right or not.
Some people in OMFS have a more active preference that women not be included in their programs, generally revolving around the issue of maternity leave. Some OMFS programs are so small a resident going on maternity leave could handicap the entire service until they got back. Generally, these places tend to exclude women (The few that actually apply, there's about a 10:1 ratio) from their interviews, which I think is unfortunate. Personally, I'd welcome a female co-resident as long as she pulled her fair share.
Yes, thank you! You're truly a generous person to give some of your free time to this community. (36 hours straight... you're a machine!) 🙂
That's not a particularly impressive statistic, given what some at many programs out there manage. Programs with 1 or 2 residents sometimes spend marathon sessions of days or weeks living entirely out of the hospital. That being said, there are also programs out there where you have a more normal workday and much more compartmentalized "late night call" requirements.
I would hardly call a program that allows its residents to train in one of the greatest general surgery programs in the world as "weak". Even if a full scope OMFS training program isn't based within their curriculum, there would be numerous opportunities to gain the desired exposure at a place like MGH. But I get your point I think (...too much didactics vs. operating, etc.)
Gary "Accreditation Station" Ruska here,
Being an OMS faculty is interesting in that one gets to serve on committees and review other programs and really get a sense of comparing the inner workings, content, curriculum and surgical experience across programs.
GR's experience in this regard has been an eye-opener. Programs, on the inside, are not a different as one would suspect. In addition, much of the banter regarding program quality on this board comes from dental students and residents who are relatively early on in their training. While such input is valuable, it does, at times, miss the mark.
GR was fortunate (or unfortunate, based on the paperwork involved) to have visited a number of programs over the past few years, MGH included. This is a program that, historically, has gotten a relatively bad rap, similar to the way the affiliated dental school often gets a bad rap.
GR would say that MGH is at least average for most qualities of a program and certainly above average in many significant areas. The main criticism of MGH is that interns don't do much cutting, aside from wizzies, trauma, and the occasional implant. However, this seems to be the culture of MGH in general, a very hierarchical system, rather than an OMS-specific attribute. That being said, the intern year does appear to have a stronger didactic component that most other programs and a significant amount of "knowledge" assessment (i.e. pimping) appears to happen to the interns during conferences.
The majority of significant operative experience is in the 4th, 5th and 6th years. The 4th year is general surgery, during which the residents do cut quite a bit on plastics and the general surgical services (not necessarily directly relevant, but operative experience nonetheless). The 5th years spent time on plastics and ENT, where they definitely do a lot of cutting on head and neck cases. The remainder of their 5th year time, they are cutting trauma, implant and ambulatory cases. The 6th year is split - the chiefs spend 4 months cutting 1:1 with Kaban/Dodson (the latter operates more than one would expect) and doing a significant volume of orthognathic surgery/pediatric maxillofacial, 4 months on the craniofacial service at Boston Children's with Mulliken/Padwa/Meara (a rotation that, GR suspects, few outside the system know about or have exposure to and thus have no insight on) and 4 months on the MGH private service, doing custom joints, pathology, orthognathics and pretty much everything that falls under standard OMS practice (i.e. everything except malignant path and esthetics).
Trauma exposure is certainly adequate and the chiefs definitely knew their stuff and how to cut mandibles, midface, orbits, frontal bone and panfacials. Not a lot of knife and gun club stuff, so few major soft tissue recons.
For those interested in 6 year paths, MGH has, arguably, one of the better med school models, as the residents only do the 3rd and part of the 4th year of medical school (4 months of the 4th year is the anesthesia time). This is, of course, balanced by the hefty price tag for HMS.
GR was definitely pleasantly surprised with their scope, given the pervasive "anecdotal" evidence. Albeit limited with regard to esthetic surgery and oncology, it is otherwise comparable to most of the excellent programs. The dentoalveolar and implant experience is very good, as is the orthognathic/TMJ/craniofacial.
Of note, they have three attendings at MGH who are under the age of 40, all dual-degree guys who are excellent surgeons and will likely continue to improve the program in the years to come.
A note to applicants, particularly those for 6-year programs. The sentence above should not be taken lightly. Many of you will see a wave of turnover in faculty over the next 5-10 years. Please keep this in mind when looking at programs, as some big names will be heading to the Social Security office soon.
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Nice! We'll have to get this copied over the OMS threads so it doesn't get lost.
To be fair, as I said above, I don't know anything about MGH. I was just passing on the anecdotal information that was so passed on to me. The best kind of evidence is the kind you share with friends!
Gary "armor shells are like rubber and others are glue" Ruska here,
Given the abundance of people who spout off on the board about topics as though they were experts without qualifying their statements, GR believes that armorshell should be commended for clearly stating a) that this was anecdotal evidence and b) that he was, by no means, an expert.
To his detractors - ease up.
Also - MGH general surgical training is not what it used to be. There are many places which will train you to be a better general surgeon. MGH will train you to be a good surgeon and an excellent fellowship candidate. Ask around.
Finally, to all applicants and future residents - JOMS has, over the past 5 years, done profiles on OMS residencies. These can usually be found as the first article after the editorial. The articles are generally well-written and give a history of the program as well as the contemporary scope of practice and training model. Though somewhat biased (they are written by the PD and Chairmen of the programs), they are good reads if you want to learn more about a program's history.
The February 2011 issue highlights an oft-neglected but excellent program - Highland.
Some other programs that have been profiled in the past:
Highland (2/2011)
VCU (11/2010)
UPenn (5/2009)
Pitt (10/2008)
UMDNJ (9/2008)
OSU (7/2006)
Parkland (4/2006)
UCSF (3/2006)
MGH (8/2005)
There may be others - feel free to add if you know of any that GR has forgotten!
The only unfortunate thing about those articles is that while they give a general overview, they can't account for major changes that have happened in the recent past. Three of those programs (including Highland even) have experienced major faculty changes since the publication of those articles, with new program directors at Parkland, UCSF and a new assistant program director at Highland.
Unfortunately even program websites, what should be the fastest and most up to date method, aren't ideal. Our program website doesn't reflect our change in program director yet, and as far as I can tell I'm not yet a resident there.
Unfortunately even program websites, what should be the fastest and most up to date method, aren't ideal. Our program website doesn't reflect our change in program director yet, and as far as I can tell I'm not yet a resident there.
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what do you think are the best 5 programs for full scope OMS right now? are they all dual degree? OR what programs impressed you the most?
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Best is a fairly subjective term. There are probably 20 or so programs out there that would be classified as "full scope", and what makes each one of those the "best" kind of depends on who you talk to. You're going to have to figure that out for yourself, and I'd recommend surfing websites, talking to people, going on externships as much as possible. Figure out what you want to do.
I wanted a program where I would get trained in every aspect of oral surgery at least to competency level so I could evolve my skill set to mastery in the areas I end up enjoying. I also had some geographic restrictions which luckily didn't end up mattering. For me, the best places for what I wanted were Parkland, LLU, and Jacksonville. I also liked Louisville and Case Western, both are busy programs but for various reasons didn't make the top of my rank list. Though, that's not an exclusive list since I didn't interview at every full scope program out there, and a select few I applied to chose not to interview me.
All those are 6 years, but there are several 4 years which offer a full scope experience as well. Again, this isn't what I was looking for so I'm not the best resource, but Carle Clinic, Knoxville and Miami are some I've heard mentioned as good for that on this board.
Correct me if I'm wrong, which could be since I'm not an OS resident.
Despite the long hours, do you get chance to nap, doze here and there. My understanding is that there are a lot of waiting happening throughout the day... e.g. waiting for CT, waiting for attending, waiting for OR availability, waiting for lab results, and whatever. So 16 hour days is long, but not dense.
Despite the long hours, do you get chance to nap, doze here and there. My understanding is that there are a lot of waiting happening throughout the day... e.g. waiting for CT, waiting for attending, waiting for OR availability, waiting for lab results, and whatever. So 16 hour days is long, but not dense.
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Generally those 16 hours are pretty packed. Most of that is spent rounding on patients, clinical duties (Point and pull, biopsies, facial lesion clinic, pre-op H&P, post-ops), more rounding, conferences, etc... It's definitely manageable though. If you're on call though, all bets are off. Things go from manageable to "wild-haired intern sprinting through the hospital" in no time.
armor, is it hard to focus when you are so sleep deprived in that environment? do you find yourself making any mistakes/trippin up when you lose steam at the end of a 16 hr day or an on-call day?
16hr day, no way. After the end of a good call session I don't feel like I make overt mistakes but everything sure does seem to take longer for me to do.
armorshell, have you considered or would you, doing a blog with cases/pictures/radiographs/general residency experiences? I've been following one from one of the Army dentists here, and I think they can be an incredible source of information for us SDNers.
Seeing as I'm in medical school right now, I doubt any sort of blog I might do would be very interesting. Additionally, I'd be afraid of being crucified by the hospital for HIPAA.
Are there any non-traditional residents or any that are married with children? If there are, how are they handling it?
I think it's a couple of weeks a year but when you're in medical school you have piles of time off. Think undergrad amounts.
Yes and yes. Everyone seems to be doing fine and there's even been a few kids born during the residency.
Well, one of these days we'll have to welcome you to the doctor circle. I hope you pay attention to the med school lectures. M1 and M2 years are academic medicine, so clinical medicine will be a challenge without rotations and residency.
Answer's correct. Good job.
Yep. Learned that one in dental school.
Not sure what you mean "without rotations or residency." I do a full year of core rotations, 4 months of electives and sub-I, then 4 months of anesthesia and 10 months of gen surg.
The only thing all MD/OMFS programs have in common in the way they structure medical school years is they all require a full year of MS3 core rotations.
Well, it'd be stupid of me to ask about uncommon scenarios to a first year. I purposely chose the most important (arguably) scenario in modern medicine.
I dunno anything about OMFS. I have no interest in it, and there are lots of other surgical fields that are way cooler that I'd rather go into.
Q: where's the G-spot?
I thought you "sit next to Armorshell in class"?
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I'm doing 2nd year right now. Cool is subjective. For example, my mom says I'm cool. Subjective.
http://maps.google.com/maps?f=q&sou...nd+St,+Leicester+LE1+1RE,+United+Kingdom&z=16
Who's that? This TV guide sticker says Chanandler Bong, is that who you mean?
Armorshell,
This question is a little off topic but with the boards going p/f in 2012 I've heard prospective OMFS applicants will need to take Step 1 of the USMLE in order to gauge one's competitiveness. If this is true do you know if there is a specific time frame for the exam? Will it be at the same time as as NBDE Part I?
This question is a little off topic but with the boards going p/f in 2012 I've heard prospective OMFS applicants will need to take Step 1 of the USMLE in order to gauge one's competitiveness. If this is true do you know if there is a specific time frame for the exam? Will it be at the same time as as NBDE Part I?
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