Country Club OMFS Programs

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senpai

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Are there any out there? I've kind of come to the conclusion that for myself I want a program that trains well in implants, 3rds, GA, and some orthognathic surgery, and benign pathology but that doesn't kill you during residency. I've heard UCLA is one, but very competitive to get into. Any suggestions. Thanks!
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On another note, does anyone know a job I can get that I don't have to work very hard or very long, have an easy life, and get rich quick? I would like to apply to only jobs that fit this description. Thanks.

I smell a weird fishy smell.
 
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senpai said:
Are there any out there? I've kind of come to the conclusion that for myself I want a program that trains well in implants, 3rds, GA, and some orthognathic surgery, and benign pathology but that doesn't kill you during residency. I've heard UCLA is one, but very competitive to get into. Any suggestions. Thanks!
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.
 
GreatOMFSHope said:
On another note, does anyone know a job I can get that I don't have to work very hard or very long, have an easy life, and get rich quick? I would like to apply to only jobs that fit this description. Thanks.

I smell a weird fishy smell.
Click to expand...


Honestly, there is nothing wrong with looking for a program that fits your long term goals. Would you rather have your third molars out by someone who trained at Jacksonville or someone who trained at Gainesville? I know my preference.

IMO most applicants would be best served in a well-balanced broad scope program, of which there seems to be very few. Attending a balanced program keeps you well trained in the core of our specialty while providing the necessary background to pursue fellowship or tailor your practice to those things you find interesting (which may be different than you expected when you applied 6 years prior).
 
Absolutely true on the 3rds comment servitup.

My issue is that he wanted a program that "doesn't kill you during residency". We all get killed during residency and I don't know if I'm comfortable with someone looking for the "easiest" route out there. I would love to find a program that only does teeth and titanium from 8-5 Mon-Thurs because I realize that is what I'll be doing more than likely. Realistically, you have to get beat down a bit before you reach that "pot of gold".

After just getting off of the interview trail, I can say there are programs out there that you can get there at 8 and leave at 430. For me, the training that came with that wasn't sufficient. If I'm going to invest 4-6 more years of my life, I want to make sure I work for it and be damn good at it.

But at the end of the day, mediocre training=OMFS. Unbelievable training=OMFS.
 
GreatOMFSHope said:
On another note, does anyone know a job I can get that I don't have to work very hard or very long, have an easy life, and get rich quick? I would like to apply to only jobs that fit this description. Thanks.

I smell a weird fishy smell.
Click to expand...
I smell someone who is efficient and knows their long term goals of being an oral surgeon?
 
flapaTron said:
you sure about that? i thought BU took most of the trauma for the greater boston area....
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I know they don't do oncology, which is a lot of work, little TMJ, very few orthognathic, and no craniofacial. The info is from a graduate 3 years ago. I have no idea about trauma though.
 
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GreatOMFSHope said:
Is this a question? No. The OP ambitions are to do largely bread and butter procedures and you call him out for taking the easiest route to do procedures that an oral surgeon provides, neglecting the maxiollofacial trauma and whatnot- because this does not bring him the Benjamins. I'm so confused.

Do you smell what The Rock is cooking? Yes
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eat-live-scorpion.jpg
 
monreal said:
I know they don't do oncology, which is a lot of work, little TMJ, very few orthognathic, and no craniofacial. The info is from a graduate 3 years ago. I have no idea about trauma though.
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Gary "Country Club vs. Knife and Gun Club" Ruska here,

GR applauds the OP for being very direct about his interests as a future OMFS. Whether or not most applicants are willing to admit it, they aspire to the same goals...or at least end up at the same place at the end of 4-6 years of training...

There is a significant discordance between what one learns in training and what the reality of practice entails. People often quote the 80-20/20-80 rule, which is as follows:

80% of what you do during residency will ultimately entail 20% of what you do in private practice and 20% of your residency procedures will make up 80% of your practice.

Why is this? GR is reminded of a film in which Cuba Gooding Jr. shouts at a leprechaun: "Show me the money!!!"

While one can anticipate this type of practice, such a strategy is, in many ways, shortsighted. You only THINK you know what you want to do 4-6 years from now, but you don't KNOW what you want to do and don't KNOW what you will LIKE to do.

Some people HATE taking out teeth. Others HATE doing model surgery and dealing with FLKs (and their parents). Some LOVE opening up a neck or operating for 10 hours at a time. OMFS is a big tent and it takes all types.

So, in the face of uncertainty, what is one to do? The poster above had it right on when they suggested that you go wherever you will get the most balanced training and EXPOSURE to niche areas. You don't need to do a bunch of neck dissections every week for 6 years to know whether you love or hate it. You just need to do enough to know whether you want to spend more time learning how to do it well.

There are primary areas of focus in residency. All residents should be EXCEPTIONAL at these:

1. Dentoalveolar Surgery
2. Implant Surgery
3. Bone Grafting
4. Benign intraoral pathology
5. Orthognathic Surgery
6. Maxillofacial Trauma
7. Temporomandibular Joint Disorders
8. Ambulatory Anesthesia

This is where the public will depend on OMFS practitioners and you owe it to them (they, to some extent, pay your resident salary) to learn these things well.

Secondary areas of focus are areas where the clinical volume is diluted by the presence of other specialties and, generally, require further training:

1. Facial Esthetic Surgery
2. Head/Neck Oncology
3. Craniofacial Surgery

For these areas, find a program that will provide you with enough exposure to decide whether you can dedicate your life to this niche area.

Additionally, in the context of a long training pathway (i.e. 4-6 years), programs can change faculty and thus change focus. One only needs to look at NYU 5-7 years ago compared to now. Someone above mentioned that BU doesn't do cancer. See what happens over the next 1-2 years now that Salama is there. Same with UWash and Jas Dillon. See how much cancer UCSF will do over the next 2 years, now that Schmidt is gone. See what happens at Buffalo in the next 2-3 years if Dierks' fellow decides to go back there...

There is a MAJOR push in the specialty to expand head and neck oncologic practice. Academic programs are aware of this. Just look at the academic postings in the AAOMS Classifieds. At least two programs specifically are soliciting applications for faculty with "advanced training in head and neck oncology."

Don't count on your program staying the same over the next 4-6 years. Change is coming.

Finally, be very cautious about chasing the money tree. Medical reimbursement is a ever changing landscape and it is almost certain that reimbursement levels for dentoalveolar surgery and the like will not remain at their present levels. You'd be much better off doing what you like and making a reasonable income than doing something you're not terribly excited about just for the money, only to realize that some MBA or bureaucrat has decided that your services are not as valuable as your predecessors. Another argument for broad training - it allows you to adapt to the changing landscape. If you don't learn how to do core OMFS procedures during residency, you're unlikely to learn them in private practice.
 
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what's the salary...starting vs xxx yrs experience that these guys, oncology only guys are making?...how do they structure/supplement their practice?
 
drgoro said:
what's the salary...starting vs xxx yrs experience that these guys, oncology only guys are making?...how do they structure/supplement their practice?
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1) Can't answer salary

2) From my understanding the structure is usually a multi team approach at a center (hospital, cancer center, etc.) that treats cancer as opposed to a private practice that relies on referral for 3rds and implants.

Many patients would come from the private practice realm when a PP OMS gets a biopsy back as something he does not care to do (ie. GP refers weird lesion to OMS, OMS performs bx, returns as SSC or osteosarcoma, etc. and it is referred to local cancer center where an OMS is on staff)

I would assume that if the OMS wishes he could have a private practice where these patients could follow up where he could also perform other OMS procedures like 3rds implants trauma, etc. I would also imagine that this would have to be a group practice otherwise the OMS would be very busy doing H&N resections/recons, rounding on the patients, and taking care of onc f/u's and private practice aspects...this is probably the reason many oncology guys are at residencies where they can use the residents as labor (in a good way).
 
gary_ruska said:
Gary "Country Club vs. Knife and Gun Club" Ruska here,

GR applauds the OP for being very direct about his interests as a future OMFS. Whether or not most applicants are willing to admit it, they aspire to the same goals...or at least end up at the same place at the end of 4-6 years of training...

There is a significant discordance between what one learns in training and what the reality of practice entails. People often quote the 80-20/20-80 rule, which is as follows:

80% of what you do during residency will ultimately entail 20% of what you do in private practice and 20% of your residency procedures will make up 80% of your practice.

Why is this? GR is reminded of a film in which Cuba Gooding Jr. shouts at a leprechaun: "Show me the money!!!"

While one can anticipate this type of practice, such a strategy is, in many ways, shortsighted. You only THINK you know what you want to do 4-6 years from now, but you don't KNOW what you want to do and don't KNOW what you will LIKE to do.

Some people HATE taking out teeth. Others HATE doing model surgery and dealing with FLKs (and their parents). Some LOVE opening up a neck or operating for 10 hours at a time. OMFS is a big tent and it takes all types.

So, in the face of uncertainty, what is one to do? The poster above had it right on when they suggested that you go wherever you will get the most balanced training and EXPOSURE to niche areas. You don't need to do a bunch of neck dissections every week for 6 years to know whether you love or hate it. You just need to do enough to know whether you want to spend more time learning how to do it well.

There are primary areas of focus in residency. All residents should be EXCEPTIONAL at these:

1. Dentoalveolar Surgery
2. Implant Surgery
3. Bone Grafting
4. Benign intraoral pathology
5. Orthognathic Surgery
6. Maxillofacial Trauma
7. Temporomandibular Joint Disorders
8. Ambulatory Anesthesia

This is where the public will depend on OMFS practitioners and you owe it to them (they, to some extent, pay your resident salary) to learn these things well.

Secondary areas of focus are areas where the clinical volume is diluted by the presence of other specialties and, generally, require further training:

1. Facial Esthetic Surgery
2. Head/Neck Oncology
3. Craniofacial Surgery

For these areas, find a program that will provide you with enough exposure to decide whether you can dedicate your life to this niche area.

Additionally, in the context of a long training pathway (i.e. 4-6 years), programs can change faculty and thus change focus. One only needs to look at NYU 5-7 years ago compared to now. Someone above mentioned that BU doesn't do cancer. See what happens over the next 1-2 years now that Salama is there. Same with UWash and Jas Dillon. See how much cancer UCSF will do over the next 2 years, now that Schmidt is gone. See what happens at Buffalo in the next 2-3 years if Dierks' fellow decides to go back there...

There is a MAJOR push in the specialty to expand head and neck oncologic practice. Academic programs are aware of this. Just look at the academic postings in the AAOMS Classifieds. At least two programs specifically are soliciting applications for faculty with "advanced training in head and neck oncology."

Don't count on your program staying the same over the next 4-6 years. Change is coming.

Finally, be very cautious about chasing the money tree. Medical reimbursement is a ever changing landscape and it is almost certain that reimbursement levels for dentoalveolar surgery and the like will not remain at their present levels. You'd be much better off doing what you like and making a reasonable income than doing something you're not terribly excited about just for the money, only to realize that some MBA or bureaucrat has decided that your services are not as valuable as your predecessors. Another argument for broad training - it allows you to adapt to the changing landscape. If you don't learn how to do core OMFS procedures during residency, you're unlikely to learn them in private practice.
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When will GR begin weekly fireside chats?
 
GTFOOMICT said:
When will GR begin weekly fireside chats?
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He is like the online demigod.

For all we know he is 600 lbs, hairy, and types these posts in his underwear...and he is not even a doctor 😀

I know! Blasphemy!

Nevertheless, I wouldn't be opposed to a weekly "GR's thoughts".

All in favor?
 
gary_ruska said:
*snip*
There are primary areas of focus in residency. All residents should be EXCEPTIONAL at these:

1. Dentoalveolar Surgery
2. Implant Surgery
3. Bone Grafting
4. Benign intraoral pathology
5. Orthognathic Surgery
6. Maxillofacial Trauma
7. Temporomandibular Joint Disorders
8. Ambulatory Anesthesia

*snip*
Click to expand...

Thanks for posting this GR, and FWIW I absolutely agree. These are the core of our specialty, and what 95% of us will end up doing.
 
Also in for a GR weekly fireside chat. Which would be intensely frightening since one stray spark could set him aflame since I'm pretty sure he eats dynamite and sweats kerosene.
 
that sounds oddly similar to a Texan that I know... GR.... or should I say Chuck?? 😱
 
I disagree; Case is very well rounded. They are somewhat light on trauma though.
 
servitup said:
Honestly, there is nothing wrong with looking for a program that fits your long term goals. Would you rather have your third molars out by someone who trained at Jacksonville or someone who trained at Gainesville? I know my preference.
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Yeah! Wait - what are you driving at here?
 
Yahtzee said:
Yeah! Wait - what are you driving at here?
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Some places do a lot more core oral surgery than others during residency. It is up to the individual to decide if that matters to them or not. Would you rather have someone who trained in Gainesville or Jacksonville remove your tongue cancer? I know my preference. 😀
 
servitup said:
Some places do a lot more core oral surgery than others during residency. It is up to the individual to decide if that matters to them or not. Would you rather have someone who trained in Gainesville or Jacksonville remove your tongue cancer? I know my preference. 😀
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Neither
 
fellowship trained head and neck surgeon and microvascular surgeon team. Definitely not from MIAMI, especially with Marx concepts.
 
servitup said:
Some places do a lot more core oral surgery than others during residency. It is up to the individual to decide if that matters to them or not. Would you rather have someone who trained in Gainesville or Jacksonville remove your tongue cancer? I know my preference. 😀
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Don't worry - I'm not that sensitive. Just a little (poorly executed) humor.
 
Yahtzee said:
Don't worry - I'm not that sensitive. Just a little (poorly executed) humor.
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Hey Yahtzee - how you doing buddy? I fixed it for ya!
-----
Some places see a lot more Asian people than others during residency. It is up to the individual to decide if that matters to them or not. Would you rather have someone who trained in Gainesville or Jacksonville tell two Asian classmates apart? I know my preference. :laugh:
 
crazy_sherm said:
Hey Yahtzee - how you doing buddy? I fixed it for ya!
-----
Some places see a lot more Asian people than others during residency. It is up to the individual to decide if that matters to them or not. Would you rather have someone who trained in Gainesville or Jacksonville tell two Asian classmates apart? I know my preference. :laugh:
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This thread is just getting weird now lol Thanks to everyone for the informative comments, except for GreatOMFSHo, you are no longer invited to my birthday party
 
senpai said:
This thread is just getting weird now lol Thanks to everyone for the informative comments, except for GreatOMFSHo, you are no longer invited to my birthday party
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Your birthday party probably would suck anyway. You'd play pin the tail on the donkey with no blindfold because you wouldn't want to work hard for it.
 
Knife and gun vs. cancer vs. "country club (read: Perio)", 0 or 7 fellowships, dual or single degree, male (preferable though😀) or female...in the end the patient just doesn't want paresthesia and the GP wants to be able to restore your implant(s).
 
and no elevator tip in the orbit..lol

Personally know of 1 guy that did 2 fellowship, and planning a 3rd
 
recovering OMFS said:
The BS that he preaches, pec flap(workhorse of reconstruction), PRP and HBO ....etc all voodoo.
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Wow, you speak like you are some sort of authority in OMFS/head and neck surgery... Are you a dental student, an OMFS resident, an OMFS Oncology Fellow, or an OMFS Grad?

I find it very intriguing that someone in their young career has already developed such a strong opinion about one of the most important and influential american oral and maxillofacial surgeons in the last 35 years.
(Brings back memories when that one douchebag extern was talking smack about Ghali Ghali from LSU).

He's not just some dude off the street to accuse him of preaching. He's a world authority in maxillofacial oncology and reconstruction. And like it or not, he's been doing it longer and better than most out there. There's no denying it. That's not to say that there aren't other ways to do things and that there aren't other wonderful and well-respected surgeons in our specialty. But you gotta give the man credit for revolutionizing our specialty in the fields of oncology and reconstruction. To deny that is completely and utterly ignorant.

The pectoralis major myocutaneous flap IS the workhorse flap of maxillofacial reconstruction. It is the most predictable myocutaneous flap and has been used probably more than any other flap since 1979 when Aryian introduced the flap. It is versatile and easy flap to harvest, with a predictable blood supply and a skin-paddle that is highly successful. Marx published his improved technique for developing the flap in great detail in the journal so that other surgeons would benefit from it and apply it in their reconstructive practice. There are plenty of flaps that can be used. Each flap has its place and its indication. Its not like its the only flap he uses either. He also uses the Temporalis, Trapezius, Latissimus Dorsi, Supraclavicular, SCM, and Platysma Flaps... If his patient needs a microvascular ALT, Radial Forearm, Rectus Abdominus flap as part of the reconstruction they get one too.

PRP... Like everything else has its place in the reconstructive armamentarium. Were/Have bone grafts successful before PRP? Yes. Are bone grafts successful with PRP? Yes. Can they fail with or without PRP? Yes. Do you need PRP on a 30 year old patient undergoing a posterior iliac crest cortico-cancellous reconstruction of the mandible after an ameloblastoma resection? No! Is it indicated in a 60 year old patient with an ORN resection having an identical defect in the mandible. Absolutely!

HBO... Just how many osteo-radionecrosis patients have you treated???? Marx has treated over 3000 ORN Cases. Patients come to him from all over the USA and from around the world to have their ORN treated. He has the only prospective randomized trial credited to him showing the benefits of HBO. What people often underestimate is the fact that ORN patients are the hardest to reconstruct and have the most reconstructive complications... its not just dead bone, its the surrounding tissue that is also radiation damaged. HBO doesn't work for every patient. But it helps level the playing field for the surgeon. If you take a critical look at the literature, study after study after study supports the use of HBO.

What else is Voodoo???
His research in BMAC (Bone Marrow Aspirate Concentrate and Stem-Cells)? Pretty amazing stuff to be able to suck out some "stem-cells" from the hip and apply them to a bone graft for some pretty amazing results.

His research in rhBMP-2? We are literally reconstructing entire mandibles from angle to angle with just rhBMP-2 and ALLOGENEIC BONE. The stock of bone, the shape/size/height/width he achieves is superior to what you can get out of a Fibula.

What about Bisphosphonates???? I doubt there is anybody else that has treated more Bisphosphonate Osteonecrosis than him. The line of patients with dead bone in the jaws is a testament to him... even more so when they come back for follow-up and they no longer are in pain, their fistulas have been treated, their infections have resolved and they have returned to a relative state of normalcy/form/function.

What about the Tent-Pole procedure? That has literally revolutionized our ability to reconstruct the severely resorbed (atrophic) mandible.

So when you've treated thousands of SCCa patients and done thousands of neck dissections, when you've treated thousands of benign cysts and tumors, when you've treated thousands of ORN Cases and Hundreds of Bisphosphonate patients, and when you've done thousands of major bone grafts or raised thousands of flaps and treated thousands of patients that have failed attempt after attempt at reconstruction by other well respected OMFS/ENTs/Plastic Surgeons then you may have a little room to stand on your soap-box and preach to us a little.
 
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Bifid Uvula said:
Wow, you speak like you are some sort of authority in OMFS/head and neck surgery... Are you a dental student, an OMFS resident, an OMFS Oncology Fellow, or an OMFS Grad?

I find it very intriguing that someone in their young career has already developed such a strong opinion about one of the most important and influential american oral and maxillofacial surgeons in the last 35 years.
(Brings back memories when that one douchebag extern was talking smack about Ghali Ghali from LSU).

He's not just some dude off the street to accuse him of preaching. He's a world authority in maxillofacial oncology and reconstruction. And like it or not, he's been doing it longer and better than most out there. There's no denying it. That's not to say that there aren't other ways to do things and that there aren't other wonderful and well-respected surgeons in our specialty. But you gotta give the man credit for revolutionizing our specialty in the fields of oncology and reconstruction. To deny that is completely and utterly ignorant.

The pectoralis major myocutaneous flap IS the workhorse flap of maxillofacial reconstruction. It is the most predictable myocutaneous flap and has been used probably more than any other flap since 1979 when Aryian introduced the flap. It is versatile and easy flap to harvest, with a predictable blood supply and a skin-paddle that is highly successful. Marx published his improved technique for developing the flap in great detail in the journal so that other surgeons would benefit from it and apply it in their reconstructive practice. There are plenty of flaps that can be used. Each flap has its place and its indication. Its not like its the only flap he uses either. He also uses the Temporalis, Trapezius, Latissimus Dorsi, Supraclavicular, SCM, and Platysma Flaps... If his patient needs a microvascular ALT, Radial Forearm, Rectus Abdominus flap as part of the reconstruction they get one too.

PRP... Like everything else has its place in the reconstructive armamentarium. Were/Have bone grafts successful before PRP? Yes. Are bone grafts successful with PRP? Yes. Can they fail with or without PRP? Yes. Do you need PRP on a 30 year old patient undergoing a posterior iliac crest cortico-cancellous reconstruction of the mandible after an ameloblastoma resection? No! Is it indicated in a 60 year old patient with an ORN resection having an identical defect in the mandible. Absolutely!

HBO... Just how many osteo-radionecrosis patients have you treated???? Marx has treated over 3000 ORN Cases. Patients come to him from all over the USA and from around the world to have their ORN treated. He has the only prospective randomized trial credited to him showing the benefits of HBO. What people often underestimate is the fact that ORN patients are the hardest to reconstruct and have the most reconstructive complications... its not just dead bone, its the surrounding tissue that is also radiation damaged. HBO doesn't work for every patient. But it helps level the playing field for the surgeon. If you take a critical look at the literature, study after study after study supports the use of HBO.

What else is Voodoo???
His research in BMAC (Bone Marrow Aspirate Concentrate and Stem-Cells)? Pretty amazing stuff to be able to suck out some "stem-cells" from the hip and apply them to a bone graft for some pretty amazing results.

His research in rhBMP-2? We are literally reconstructing entire mandibles from angle to angle with just rhBMP-2 and ALLOGENEIC BONE. The stock of bone, the shape/size/height/width he achieves is superior to what you can get out of a Fibula.

What about Bisphosphonates???? I doubt there is anybody else that has treated more Bisphosphonate Osteonecrosis than him. The line of patients with dead bone in the jaws is a testament to him... even more so when they come back for follow-up and they no longer are in pain, their fistulas have been treated, their infections have resolved and they have returned to a relative state of normalcy/form/function.

What about the Tent-Pole procedure? That has literally revolutionized our ability to reconstruct the severely resorbed (atrophic) mandible.

So when you've treated thousands of SCCa patients and done thousands of neck dissections, when you've treated thousands of benign cysts and tumors, when you've treated thousands of ORN Cases and Hundreds of Bisphosphonate patients, and when you've done thousands of major bone grafts or raised thousands of flaps and treated thousands of patients that have failed attempt after attempt at reconstruction by other well respected OMFS/ENTs/Plastic Surgeons then you may have a little room to stand on your soap-box and preach to us a little.
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I'm a maxillofacial and head and neck surgeon who has been in practice for a long time, long enough to tell you that you drunk the Marx unproven coolaid, my guess you are a resident who saw him lectured and got impressed with his cool cases.

1. Pec flap, used to be the workhorse of recon, nowadays it is a Salvage only flap. Better update your knowledge in max recon.
2. HBO, definitely Voodoo esp. For ORN, the proof is in the pudding, nobody could replicate MARX HBO results, anywhere in the world, so the so-called MArx protocol is questionable, by the way it is not approved by most insurances for lack of evidence.
3.PRP i don't have to say much, Marketing Gimmick.
4.Bisphosphonates, he just reinvented the wheel, nothing new; Dr Ruggerio did the majority of the original work, so far no magic bullet, I don't know what he added. CTX another unproven voodoo.

By the way, if you didn't take your boards yet, I'm assuming probably not, from your over impressed wow response, don't quote Marx on the boards, you will fail. just an advice!!!
 
GreatOMFSHope said:
Your birthday party probably would suck anyway. You'd play pin the tail on the donkey with no blindfold because you wouldn't want to work hard for it.
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Interesting how much more critical an individual who isn't an OMFS in the real world, hasn't gone through residency, nor even entered residency for that matter can be compared to those who actually have some credibility that have posted, i.e. servitup, Gary Ruska, etc. Earn some credibility and if you still have the impulse to always be **** measuring, well...atleast you'll have something to show for it...And good luck trying to get referrals from GP's with that charming personality...
 
recovering OMFS said:
1. Pec flap, used to be the workhorse of recon, nowadays it is a Salvage only flap. Better update your knowledge in max recon.
2. HBO, definitely Voodoo esp. For ORN, the proof is in the pudding, nobody could replicate MARX HBO results, anywhere in the world, so the so-called MArx protocol is questionable, by the way it is not approved by most insurances for lack of evidence.
3.PRP i don't have to say much, Marketing Gimmick.
4.Bisphosphonates, he just reinvented the wheel, nothing new; Dr Ruggerio did the majority of the original work, so far no magic bullet, I don't know what he added. CTX another unproven voodoo.

By the way, if you didn't take your boards yet, I'm assuming probably not, from your over impressed wow response, don't quote Marx on the boards, you will fail. just an advice!!!
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bravo, you are now my new idol on the forum
 
recovering OMFS said:
I'm a maxillofacial and head and neck surgeon who has been in practice for a long time, long enough to tell you that you drunk the Marx unproven coolaid, my guess you are a resident who saw him lectured and got impressed with his cool cases.

1. Pec flap, used to be the workhorse of recon, nowadays it is a Salvage only flap. Better update your knowledge in max recon.
2. HBO, definitely Voodoo esp. For ORN, the proof is in the pudding, nobody could replicate MARX HBO results, anywhere in the world, so the so-called MArx protocol is questionable, by the way it is not approved by most insurances for lack of evidence.
3.PRP i don't have to say much, Marketing Gimmick.
4.Bisphosphonates, he just reinvented the wheel, nothing new; Dr Ruggerio did the majority of the original work, so far no magic bullet, I don't know what he added. CTX another unproven voodoo.

By the way, if you didn't take your boards yet, I'm assuming probably not, from your over impressed wow response, don't quote Marx on the boards, you will fail. just an advice!!!
Click to expand...

I used to believe a lot in Marx's theories and take what he says for granted until one of my attendings once told me: Marx did a great job in miseducating the OMFS residents in the country. I don't know if I agree with him, but if you look critically in the stuff he advocates, most of it is voodoo as described above. I still believe that he contributed a lot to our specialty but I take what he says with a grain of salt until it becomes backed up by a solid scientific evidence.
 
For the OP, keep in mind, when you get to general surgery it doesn't matter where you're at. You will get brutalized. 80hrs a week my ass!
 
drhobie7 said:
For the OP, keep in mind, when you get to general surgery it doesn't matter where you're at. You will get brutalized. 80hrs a week my ass!
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While we're on the topic perhaps you could share your experience in general surgery. Why is it so intense? Why such the long hours (on call alot?, etc.)? Do you personally get to operate that much? Is it really that beneficial to your training as an OMFS or just a formality for MD licensing?
 
senpai said:
While we're on the topic perhaps you could share your experience in general surgery. Why is it so intense? Why such the long hours (on call alot?, etc.)? Do you personally get to operate that much? Is it really that beneficial to your training as an OMFS or just a formality for MD licensing?
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The g surg experience varies month by month depending on the service you are on. The workload can be moderate to oppresive. A lot of the time it's a race to get your work done so you can sign out and leave at a reasonable hour. As the day goes on you get a pile of new work heaped on top of you. Count on spending 13-15 hours at the hospital during the week, 6-10 hrs on the weekends, and being on call 1-2 times a week. You do not go to the OR much as an intern. That's not your role. You are there to run the service perioperatively. You do get to operate some but you're not doing cases daily. You get to put in central lines and do other little bedside procedures. I feel g surg internship is beneficial to OMS training. How else are you going to learn how to take care of sick surgical patients? Generally, the patients we operate on in OMS are not critically ill. After being on the busiest liver transplant service in the country for a month and taking care of 70 of the sickest patients on the planet that threaten to die on you nightly, I can handle anything. G surg is about learning perioperative management of surgical patients. Every surgeon needs to be able to take care of patients pre and post surgery. Honestly, the term "country club" OMS program is an oxymoron. At least, that's my opinion at being at UCLA, supposedly THE country club program. Ha! Oh and BTW, I worked just as hard if not harder when I was an oral surgery intern before med school. I wasn't at the hospital as many total hours, but I was reading and doing presentations all night when I got home. There is no easy road to OMS.
 
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