crazy_sherm

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Got this message from one of the deans at school. I know nothing about the program, just passing the info along.


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Stony Brook University Medical Center will be starting a two year residency in dental anesthesiology this July. Following our application and interview process, we accepted three outstanding applicants for the program. Unfortunately, one of our prospective residents will be unable to start this July.

If you know of any graduating students or graduates who may be interested in this two year dental anesthesia residency program please have them contact the program director at: [email protected]. If you have any questions regarding this program please contact the Program Director (Ralph Epstein, DDS) at his E-mail address or by phone at 516-459-5134.

Thank you for your assistance

Steve London



Steven D. London, DDS, PhD
Associate Dean for Academic Affairs
Professor of Oral Biology & Pathology
Stony Brook University
School of Dental Medicine
150 Rockland Hall
Stony Brook, New York 11794-8700
Phone: (631) 632-8901
Fax: (631) 632-9105
E-mail: [email protected]


****************************************************************************************
 

GoGatorsDMD

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Question:

Why does a dentist need to do 2 years to be able to put people to sleep, but I can do 4 months of anesthesia training in OMFS and be qualified to do so?
 

AGAPE4U

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And I can do IV-Sedation legally with only 60 hours of training!!! Anyone can push drugs, but it take many cases before one can do it safely and handle the complications. The Anesthesia training programs includes a full year with the medical anesthesia residents, that is more training than you will get as an OMFS.
 

54807

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Question:

Why does a dentist need to do 2 years to be able to put people to sleep, but I can do 4 months of anesthesia training in OMFS and be qualified to do so?
I don't have an answer to why OMFS is only 4 months beyond the continued "practicing" of sedations throughout the latter years of residency.

But aren't medical anesthesiology residencies 2 or 3 years? Could that be a factor in it? Justifying the validity of the dental anesthesiologist? I wonder if that's actually needed...whats wrong with using MD anesthesiologists or Nurse anesthetists? Just keeping it in the family?
 

Dr.Millisevert

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And I can do IV-Sedation legally with only 60 hours of training!!! Anyone can push drugs, but it take many cases before one can do it safely and handle the complications. The Anesthesia training programs includes a full year with the medical anesthesia residents, that is more training than you will get as an OMFS.
Agreed. I think it is good that CODA is accrediting and standardising anesth training programs for dentists. :thumbup:
 

Dr.Millisevert

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I don't have an answer to why OMFS is only 4 months beyond the continued "practicing" of sedations throughout the latter years of residency.
Most OMFS may use IV sedation during office procedures.. but I don't know many who do GA and also do their own procedures (even though they may have a GA cert).

2-year Anesth residencies train dentists to use GA safe and effectively and they may actually use GA on a more regular basis in conjunction with other dental professionals. I think CODA standardising anesth training programs for dentists is a good thing. :thumbup:

Justifying the validity of the dental anesthesiologist? I wonder if that's actually needed...whats wrong with using MD anesthesiologists or Nurse anesthetists? Just keeping it in the family?
Nothing is wrong with that.. however having high quality anesth training programs for dentists provides those with an interest in the area the opportunity to train and become licensed anaesthesia providers. Some dentists or dental specialists 'may' enjoy employing a dental anesth over nurses or MD anesth because they might be easy to work with (common background) and have a greater understanding of the procedures we are doing. :thumbup:
 

54807

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I think CODA standardising anesth training programs for dentists is a good thing. :thumbup:QUOTE]

I like that comment alot. I guess all it could take is a couple negligent and/or unfortunate circumstances by general dentists to sorrow the public's opinion of dental supervised sedations.

Think this will drive up the costs? More training always commands higher fees. Even nurse anesthetists fees can be higher than fees charged by OS in private practice. I bet the DDS/DMD anesthesiologist fees will be steep.

more training is always good but i bet we'll start to price certain income levels out of the ability to receive care that requires sedation. or maybe we're all just a bunch of pansies who can't tolerate slight discomfort and we're creating a profession that has no true need! :laugh:
 

54807

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I am surprised to hear that. I have worked as an assistant to 6 different OMFS (4 in one practice, 2 in another) and all of them did their own IV general anesthesia and procedures. Only when they did a BSSO in-office (poor patient, hospital fees would've been unmanageable) did they not do their own anesthesia; for that they hired an anesthesiologist from the hospital. But for every other surgery done in the practice (not in the hospital) they do their own anesthesia and procedures.

Do some OMFS have another surgeon or nurse anesthetist or MD anesthesiologist in the room? I would think that would be extremely expensive.
maybe the term GA is used to loosely. I've always been told that OS in private practice sedate to the point where pt is fully intact interms of respiratory and cardiovascular. The hospital based, and true, GA takes it one step further requiring mechanical ventilation and sometimes chemical aulteration of CVS rates and rhythems.

This is probably a real dumbed down answer but hey....the wikipedia article quassi backs it up!

Isn't that the reason why surgeons can do sedations and not GA? Are we mixing terms up here?
 

Yahtzee

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How many DA residencies are there currently?
 

54807

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How many DA residencies are there currently?
That's it. Ive had enough of you. You think you can come on here with your sarcastic comments.......No more endo-typodont for you.......

Dr. N mentioned 2 off the top of his head...
 

armorshell

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more training is always good but i bet we'll start to price certain income levels out of the ability to receive care that requires sedation. or maybe we're all just a bunch of pansies who can't tolerate slight discomfort and we're creating a profession that has no true need! :laugh:
In europe there is no such thing as anesthesia. You just clench your fist angrily and quickly down a pint of bitter ale and that is enough for even the smallest children.
 

Yahtzee

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Wow. You guys are great. Really. Thank you, from the bottom of my heart.
 

Bifid Uvula

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Question:

Why does a dentist need to do 2 years to be able to put people to sleep, but I can do 4 months of anesthesia training in OMFS and be qualified to do so?
The OMFS rotates for 4-6 months of general anesthesia as an "anesthesia resident" but then spends close to another 2.5-3 years providing IV Sedation, IV General Anestheia and General Anesthesia.

They also rotate at the resident level for:
2 Months- Internal Medicine
1 Month- Emergency Medicine
6 Months to 1 Year- General Surgery
1 Month- Otolaryngology
1 Month- Plastic Reconstructive Surgery

That's why....
 

ItsGavinC

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I don't have an answer to why OMFS is only 4 months beyond the continued "practicing" of sedations throughout the latter years of residency.

But aren't medical anesthesiology residencies 2 or 3 years? Could that be a factor in it? Justifying the validity of the dental anesthesiologist?
That is 100% a factor in validating the position. Anesthesiologists do an intern year, followed by 3 years of clinical anesthesiology.
 

ItsGavinC

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maybe the term GA is used to loosely. I've always been told that OS in private practice sedate to the point where pt is fully intact interms of respiratory and cardiovascular. The hospital based, and true, GA takes it one step further requiring mechanical ventilation and sometimes chemical aulteration of CVS rates and rhythems.

This is probably a real dumbed down answer but hey....the wikipedia article quassi backs it up!

Isn't that the reason why surgeons can do sedations and not GA? Are we mixing terms up here?
There comes a point where you cannot differentiate between deep sedation and general anesthesia. Indeed, what may set out as a deep sedation may actually be general anesthesia. I suppose you could hook a BIS monitor up to them if you are looking for an actual number.

That being said, if you are shooting for a mild sedation it shouldn't be difficult to stay away from removing the patient's protective reflexes. But stuff happens, so you better know how to handle it the patient ends up deeper than you desired.
 

buck-E

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maybe the term GA is used to loosely. I've always been told that OS in private practice sedate to the point where pt is fully intact interms of respiratory and cardiovascular. The hospital based, and true, GA takes it one step further requiring mechanical ventilation and sometimes chemical aulteration of CVS rates and rhythems.

This is probably a real dumbed down answer but hey....the wikipedia article quassi backs it up!

Isn't that the reason why surgeons can do sedations and not GA? Are we mixing terms up here?
Minimal Sedation (Anxiolysis) is a drug-induced state during which patients respond normally to verbal commands.
Although cognitive function and coordination may be impaired, ventilatory and cardiovascular functions are unaffected.
Moderate Sedation/Analgesia (Conscious Sedation) is a drug-induced depression of consciousness during which patients
respond purposefully** to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are
required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.
Deep Sedation/Analgesia is a drug-induced depression of consciousness during which patients cannot be easily aroused but
respond purposefully** following repeated or painful stimulation. The ability to maintain ventilatory function independently
may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be
inadequate. Cardiovascular function is usually maintained.
General Anesthesia is a drug-induced loss of consciousness during which patients are not arousable, even by painful
stimulation. The ability to maintain ventilatory function independently is often impaired. Patients frequently require
assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous
ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.

The above is taken from the AAOMS parameters of care for anesthesia. It is a spectrum which is difficult to define exactly what level a patient is at. Every surgeon has their own desired level of sedation for their patients. I prefer mine to be on the deep side (not responsive to voice and pain)and ofter wander into GA as apnea for short periods is common. I don't intubate my patients but I know of oral surgeons who routinely do this in their office. I cannot think of a drug that we use for "IV sedation" that does not alter respiratory or cardiovascular status.

It also depends on the state and what you are licensed to do. In most states as stated by someone else oral surgeons have a general anesthesia license. Without a GA license some states legislate sedations to a single drug or a single dose depending on the type of license you have.
 

54807

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Without a GA license some states legislate sedations to a single drug or a single dose depending on the type of license you have.
Is this not a reason in itself to pursue a 6year over a 4year?

I can't imagine if all of a sudden a state came down on my practice saying "no more sedation for you!". I would think the MDers would pull out their diploma and claim they're sedating under their med license.

Is this a legit worry?

*****

I do hear the AAOMS is loaded with cash from member fees so I'd assume they'd step in to protect the members...but you never know.
 

servitup

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Is this not a reason in itself to pursue a 6year over a 4year?

I can't imagine if all of a sudden a state came down on my practice saying "no more sedation for you!". I would think the MDers would pull out their diploma and claim they're sedating under their med license.

Is this a legit worry?

*****

I do hear the AAOMS is loaded with cash from member fees so I'd assume they'd step in to protect the members...but you never know.
I think protection from political unrest IS a good reason to get the MD. That said, if single-degreers are ever told they can't do GA, then it will probably screw dual-degreers too. Your ability to do GA would then rest on your liability insurance provider's willingness to cover you for it which would be unlikely in that scenario. So, in this case, the MD won't help IMO but it could in others.
 

Bifid Uvula

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Your GA Permit comes under your Dental License... not your Med License.
 

servitup

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Yes but your med license basically let you do anything you want to do as long as your liability carrier will cover you.
 

Dr.Millisevert

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I think protection from political unrest IS a good reason to get the MD. .
agreed.

That said, if single-degreers are ever told they can't do GA, then it will probably screw dual-degreers too. Your ability to do GA would then rest on your liability insurance provider's willingness to cover you for it which would be unlikely in that scenario. So, in this case, the MD won't help IMO but it could in others.
I don't know any dental anesth who are out trying to take over GA provision in all hospitals.

Honestly, with the CRNA issues in the US... Dental Anesthesia is the least of the MD Anesth worries. I wouldn't worry too much. :thumbup:
 

blaska999

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Stony Brook University Medical Center will be starting a two year residency in dental anesthesiology this July. Following our application and interview process, we accepted three outstanding applicants for the program. Unfortunately, one of our prospective residents will be unable to start this July.

Has the spot already been filled? If not, are there a lot of applicants already?
 
OP
crazy_sherm

crazy_sherm

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Has the spot already been filled? If not, are there a lot of applicants already?
As stated in my post:

1) I know nothing about the program, I'm just passing the information along
2) If you have questions, contact the director. His contact info is in the post.

Good luck!