Dental Anesthesiology Residency. Thoughts?

[mersault]

Hey Everyone,
I was speaking with a friend of mine who's in dental school. he mentioned these dental anesthesiology residencies: http://www.adsahome.org/resident.html

I looked at the UPitt program and they teach them epidurals and spinals. They train them in the general ORs for orthopedic cases even. they also have one month of ICU.

in the mission statement it says: " At the conclusion of the program, the dentist will be proficient in providing all levels of anesthesia services for ambulatory patients undergoing a variety of medical and dental procedures."

my question is, that prior to these residencies, who was providing the type of anesthesia these patients need? I doubt it was the general dentists cause why would you then need to even make such programs in the first place if their skills sufficed. And if it was anesthesiologists who were providing the anesthesia/pain management, then wtf?

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[W222]

A complete joke and a scary trend, people who should not be doing something they are not effectively trained in and expanding the scope of their practice. We do peds dental cases with this one dentist who thinks they are trained in this area. She almost killed a kid a few months back while doing a case in her office under what she called "mac". Heard that when the code team arrived they had to run PALS/ACLS on the kid. Also know of one instance where a dentist used some heavy meds on a young adult and killed them with an anoxic brain injury. This dentist still practices and has the biggest ego in the world.

 

[JonnyG]

At my programs, the oral surgeons spend four months training with us and they will generally do ASA 1/II in their office. One does the anesthesia while another works. They bring us the rest. Nothing better then seeing you have a case for two teeth to be extracted in the OR and then reading the consult saying pt for heart transplant next week.

It maybe the exception to have a good working relationship with the oral surgeons but they tend to respect what we do alot more than other services.

 

[GTFOOMICT]

I'll offer up some 1-3 sentence answers.

General Dentist w IV Sedation Training - This is traditionally a weekend or several weekend course where single drug is used. (Not that single makes it safe, it just makes it safer in their mind)

Dental Anesthesiologist - This is traditionally a 2-3+ year residency post DDS that attempts to mirror your traditional MD anesthesia residency with the goals of providing true anesthesia care in the private dental office for dental cases. Was developed to increase the level of care in the dental community. This will not go away and they are receiving tremendous support at their institutions. Learn anesthesia from an anesthesiologist, not a weekend dental CME.

Oral/Maxillofacial Surgeon - Traditionally, as part of the 4 year residency a 4, soon to be 6, month resident rotation with anesthesia with the goal of providing sedation in private practices for small procedures in anxious patients when they finish up residency.

Medical Anesthesiologist - You know the training. 🙂 Dentists in general do not like many of the groups they work with. When the MDs jump ship for bigger/better/more interesting gigs, the dentist is left starting over in terms of meeting someone they trust and getting the MD 'certified' for dental office sedation/anesthesia based upon state dental laws.


I'm not defending or shooting these down nor implying a hierarchy of care, just offering up some definitions although it has been discussed many times.

 

[mersault]

thanks for all the info.
I really don't know what to think. on the one hand there's a shortage of anesthesia providers, so I guess training all these people is good on a humane level. on the other hand, I can't help but think we're training our own competition.

I'll offer up some 1-3 sentence answers.

General Dentist w IV Sedation Training - This is traditionally a weekend or several weekend course where single drug is used. (Not that single makes it safe, it just makes it safer in their mind)

Dental Anesthesiologist - This is traditionally a 2-3+ year residency post DDS that attempts to mirror your traditional MD anesthesia residency with the goals of providing true anesthesia care in the private dental office for dental cases. Was developed to increase the level of care in the dental community. This will not go away and they are receiving tremendous support at their institutions. Learn anesthesia from an anesthesiologist, not a weekend dental CME.

Oral/Maxillofacial Surgeon - Traditionally, as part of the 4 year residency a 4, soon to be 6, month resident rotation with anesthesia with the goal of providing sedation in private practices for small procedures in anxious patients when they finish up residency.

Medical Anesthesiologist - You know the training. 🙂 Dentists in general do not like many of the groups they work with. When the MDs jump ship for bigger/better/more interesting gigs, the dentist is left starting over in terms of meeting someone they trust and getting the MD 'certified' for dental office sedation/anesthesia based upon state dental laws.


I'm not defending or shooting these down nor implying a hierarchy of care, just offering up some definitions although it has been discussed many times.

 

[RxBoy]

It maybe the exception to have a good working relationship with the oral surgeons but they tend to respect what we do alot more than other services.

I agree... I find both OMF and ENT surgeons the only specialist who really respect our tube and scope of practice. Maybe thoracic surgeons too, but its just because they want that lung deflated.

Although I highly doubt it, I hope for the sake of the patient OMFS don't ever try to anesthetize their facial/mandibular fractures. I can see those cases getting ugly quick. I think these are up there as some of the toughest airway cases for anesthesiologists.

 

[ASA6]

I find this a little scary. I rotate at a hospital with a program. To put things in perspective, they are supposed to take call, but they don't, because most of the arts dings don't trust them/ don't want to work with them for the emergencies that come in at night. in terms of competition, there are only like 19 residents currently training in the country. So I wouldn't be to concerned. It is a little bit of a financial scam though. They are also able to supervise crna's during anesthesia for dental procedures. So many of these dental anesthesiologists are practicing dentistry, while th crna provides the anesthetic, and the dentist gets to bill for both.

 

[Ething]

I find this a little scary. I rotate at a hospital with a program. To put things in perspective, they are supposed to take call, but they don't, because most of the arts dings don't trust them/ don't want to work with them for the emergencies that come in at night. in terms of competition, there are only like 19 residents currently training in the country. So I wouldn't be to concerned. It is a little bit of a financial scam though. They are also able to supervise crna's during anesthesia for dental procedures. So many of these dental anesthesiologists are practicing dentistry, while th crna provides the anesthetic, and the dentist gets to bill for both.

Dont know which program you are at but we do take call and are there as much, if not more than the MD anesthesiology residents. Our anesthesia years are identical...we take the same classes as the MDs and 9 out of 10 of our attendings are MDs....that is who we are learning from. Please point out to me what exactly we are doing different than MDs during those 2 yrs of anesthesia training? We dont do cardiac and spinals bec we will not be doing that in our careers. That is all.

 

[Ething]

Oh...and it is more competitive than that. about 80 -90 pple applied last yr for 25 spots. Also, after having met some of these MD kids from the med schools in the islands...if I were an attending, I would trust a dentist any day over some of these guys....

 

[TenaciousGirl]

For whatever it's worth, I know that Aphistis did an anes residency after he graduated from dental school. You might want to PM him since he's someone who went down that road. Goodluck.

 

[DRJ37]

Our anesthesia years are identical...we take the same classes as the MDs and 9 out of 10 of our attendings are MDs....that is who we are learning from. Please point out to me what exactly we are doing different than MDs during those 2 yrs of anesthesia training?

This argument sounds strangely familiar...

 

[sevoflurane]

Oh...and it is more competitive than that. about 80 -90 pple applied last yr for 25 spots. Also, after having met some of these MD kids from the med schools in the islands...if I were an attending, I would trust a dentist any day over some of these guys....

🤣🤣🤣

😆😆😆

Your ignorance is so dang laughable.....

You can't make blanket statements like this. Unless it's true. Just saying dude.

 

[chocomorsel]

Dont know which program you are at but we do take call and are there as much, if not more than the MD anesthesiology residents. Our anesthesia years are identical...we take the same classes as the MDs and 9 out of 10 of our attendings are MDs....that is who we are learning from. Please point out to me what exactly we are doing different than MDs during those 2 yrs of anesthesia training? We dont do cardiac and spinals bec we will not be doing that in our careers. That is all.

Please explain to me what the residency entails. I am not aware. And anesthesiology residency is 3 years + intern year. Are you doing just 2 years or is there an intern year in there after dental school? Also, when you are doing your residency, are you also doing dentistry or just concentrating on anesthesia alone? When you take call, how does it work with the other MD/DO residents as far as call responsibility? Just interested.

 

[Coastie]

Dont know which program you are at but we do take call and are there as much, if not more than the MD anesthesiology residents. Our anesthesia years are identical...we take the same classes as the MDs and 9 out of 10 of our attendings are MDs....that is who we are learning from. Please point out to me what exactly we are doing different than MDs during those 2 yrs of anesthesia training? We dont do cardiac and spinals bec we will not be doing that in our careers. That is all.

2 years?

You mean, you're practicing medicine at a consultant level after two years of "Dental residency" and 4 years of DENTAL school?


I'm with Sevo. Thanks for the laugh, buddy!

 

[nycitygas]

I rotate at a hospital where they have dental residents, and they seem to spent two years learning how to chart and place IVs (the attendings never let them sit in a room by themselves as least from what i saw). Any interesting procedures will go to the MD resident.
Why you would pass up a >150k starting salary to become a scut money for two years is beyond me.

 

[ASA6]

Oh...and it is more competitive than that. about 80 -90 pple applied last yr for 25 spots. Also, after having met some of these MD kids from the med schools in the islands...if I were an attending, I would trust a dentist any day over some of these guys....

But they still went to medical school. You didnt. What if I did an orthodontics residency? Except instead of the normal 3 years, I did 2? But don't worry, I'd be learning from actual orthodontists. Would I think be as qualified as anyone else to practice orthodontics? Or any other dental specialty?

 

[muhali3]

But they still went to medical school. You didnt. What if I did an orthodontics residency? Except instead of the normal 3 years, I did 2? But don't worry, I'd be learning from actual orthodontists. Would I think be as qualified as anyone else to practice orthodontics? Or any other dental specialty?

well...arguably...aren't the first 2 years of dental school pretty much the same as medical school? And is M4 really necessary anyways? The only difference between medical school and dental school seems to be 3rd year. And dental students also begin practicing manual dental work starting in D1, iirc.

But yeah...these dental "anesthesiologists" seem more like CRNAs than anything else.

 

[Ething]

I rotate at a hospital where they have dental residents, and they seem to spent two years learning how to chart and place IVs (the attendings never let them sit in a room by themselves as least from what i saw). Any interesting procedures will go to the MD resident.
Why you would pass up a >150k starting salary to become a scut money for two years is beyond me.

i guess that's why starting salaries for dental anesthesiologists are around 300k....u need someone who can hit that iv and chart! no brains required! but what would i know, im just a dentist who has been intubating for a week (they let me! omg!!!!) we do the same exact rotations as the md residents and are treated the same. i know this because i am the one here. did you really convince yourself that we just place ivs and chart for two years??

 

[Ething]

But they still went to medical school. You didnt. What if I did an orthodontics residency? Except instead of the normal 3 years, I did 2? But don't worry, I'd be learning from actual orthodontists. Would I think be as qualified as anyone else to practice orthodontics? Or any other dental specialty?

correct. if you did 2 years you would be just as qualified as if you did 3. ill bet you wouldnt know the difference....and they do get the same certificate! who knew!! love it how i am the one bashed for not knowing what i am talking about. did you also know that some med schools and dental schools are combined for the first two years?

 

[Ething]

Please explain to me what the residency entails. I am not aware. And anesthesiology residency is 3 years + intern year. Are you doing just 2 years or is there an intern year in there after dental school? Also, when you are doing your residency, are you also doing dentistry or just concentrating on anesthesia alone? When you take call, how does it work with the other MD/DO residents as far as call responsibility? Just interested.

i was under the impression that md anesthesia was 1 yr internship, 2 yrs anesthesia, 1 yr fellowship. dental anesthesia next yr will be 1 yr internship, 2 yrs anesthesia. in private practice we will not be doing cardiac cases and in outpatient setting it is asa 1 and 2. we only do anesthesia and we do it in the OR on medical surgeries (asa 1 through 6)....occasionally on dental procedures on kids in the OR. call responsibility is the same here. before everyone claims that i dont know what im talking about...do some research on your own before speculating.

 

[Ething]

well...arguably...aren't the first 2 years of dental school pretty much the same as medical school? And is M4 really necessary anyways? The only difference between medical school and dental school seems to be 3rd year. And dental students also begin practicing manual dental work starting in D1, iirc.

But yeah...these dental "anesthesiologists" seem more like CRNAs than anything else.

interesting then that these dental "anesthesiologists" CRNA's can hire CRNAs of their own to work for them. Wow....who let that slip under the radar?????

 

[muhali3]

interesting then that these dental "anesthesiologists" CRNA's can hire CRNAs of their own to work for them. Wow....who let that slip under the radar?????

Are you trying to say that dental anesthesiologists are as qualified as MD anesthesiologists, just because they can hire CRNAs....? You go to dental school to become a dentist, not an anesthesiologist.

 

[okayplayer]

i was under the impression that md anesthesia was 1 yr internship, 2 yrs anesthesia, 1 yr fellowship. dental anesthesia next yr will be 1 yr internship, 2 yrs anesthesia.

I don't know why I'm bothering to respond, but you're wrong.

 

[Lightwand]

we only do anesthesia and we do it in the OR on medical surgeries (asa 1 through 6)....occasionally on dental procedures on kids in the OR.

I hate when I've got an ASA 6 who has to come down for a stat dental case.

I mean, come on. I know I'm taking the troll bait here, but you cannot honestly tell me that you think you're as qualified as a physician anesthesiologist after going to dental school and doing a two year residency.

 

[chocomorsel]

I hate when I've got an ASA 6 who has to come down for a stat dental case.

I mean, come on. I know I'm taking the troll bait here, but you cannot honestly tell me that you think you're as qualified as a physician anesthesiologist after going to dental school and doing a two year residency.

In his/her defense, if what he's saying is true about residency and call and equal treatment, he is pretty close to a real anesthesiologist, just shy of one year. Back in the 80's wasn't anesthesiology residency a total of 3 years? So he's pretty close.

What's with all the bashing here? My opinion is this is a colleague. And yes some medical schools are integrated with the dental schools the first two years. Their knowledge base is not a "CRNA" knowledge base.

 

[Ething]

Are you trying to say that dental anesthesiologists are as qualified as MD anesthesiologists, just because they can hire CRNAs....? You go to dental school to become a dentist, not an anesthesiologist.

No, I agree that MD's are more qualified. I agree that an internship year and fellowship year adds a lot. I am saying that dental anesthesiologists are more qualified than nurse anesthetists and not equal to them. We go to dental school to become dentists and then we do an anesthesiology residency to become dental anesthesiologists just like oral surgeons go to residency to become oral surgeons (so yes, we can go to dental school and wind up being anesthesiologists...there is no point in arguing this, it is not like I am making this field up). I am not planning on providing the same scope of anesthesia as MD anesthesiologists (ie cardiac, spinals etc) because I will not be working on certain patients undergoing certain surgeries. All I am saying is that we are very qualified to provide the anesthesia required for our patient population. The safety and track record of dental anesthesiology is out there.

 

[Ething]

I don't know why I'm bothering to respond, but you're wrong.

You're right, I am wrong. 3 yrs anesthesia residency.

 

[muhali3]

No, I agree that MD's are more qualified. I agree that an internship year and fellowship year adds a lot. I am saying that dental anesthesiologists are more qualified than nurse anesthetists and not equal to them. We go to dental school to become dentists and then we do an anesthesiology residency to become dental anesthesiologists just like oral surgeons go to residency to become oral surgeons (so yes, we can go to dental school and wind up being anesthesiologists...there is no point in arguing this, it is not like I am making this field up). I am not planning on providing the same scope of anesthesia as MD anesthesiologists (ie cardiac, spinals etc) because I will not be working on certain patients undergoing certain surgeries. All I am saying is that we are very qualified to provide the anesthesia required for our patient population. The safety and track record of dental anesthesiology is out there.

Ok...cool. I don't know enough about dental anesthesiology training to be able to compare it to anesthetist training. I thought you were saying that dental anesthesiologists are equivalent to MD anesthesiologists.

The way I see it, if you go to dental school, your primary function is as a dentist. You are specialized in the oral cavity. Any training beyond that is secondary.

Such as oral surgeons who do plastic surgery. They can do it, but it's not their specialty. Their scope and ability is much more limited than an MD plastic surgeon's, and they should be aware of that.

I think the same applies to dental anesthesiology. Dental anesthesiologists shouldn't be acting like they're as qualified as MD anesthesiologists. But it seems like you already agree with that, so cool.

 

[GreatOMFSHope]

Good thread for once. Appreciate the mutual respect going around. As a dentist doing an OMFS residency, we ABSOLUTELY understand that we are not trained as well as an anesthesiologist. At our program, when your 6 months are over, I'd like to hope that we are very similar to a CA-1 at that level as well, but again, we have no reason/desire/need to do the next level cases (cardiac, transplant, etc.). We will never do these in our practice of taking out whizzys on 16-21 year old ASA I-II patients in our office. We only get 6 months to learn as much anesthesia as possible and we do bust our ass trying to absorb as much as possible. We are highly respected and appreciated by the attendings at our program. We catch a little slack from the residents when they play the "dental" card, but our training after the basic sciences are completely different and I'm ok with that.

I agree with the above poster. As long as we stay within our respected training boundaries, we should be able to co-exist very well. I promise you that I will never try to do anesthesia on a transplant case if you guys promise never to take out some 3rd molars that could make me a boat payment.

And also, many oral surgeons do perform plastic surgery. There are many cosmetic fellowships in the US that will give you specialized training. Plastic surgery of the face only imo. I have heard some OMFS guys who do boob jobs, just because they can. Asking for trouble.

 

[FutrrENT]

I'll offer up some 1-3 sentence answers.

General Dentist w IV Sedation Training - This is traditionally a weekend or several weekend course where single drug is used. (Not that single makes it safe, it just makes it safer in their mind)

As I understand it, a general dentist cannot perform intravenous sedations unless they have had anesthesia training similar to that of an oral surgeon. There is such a thing as “oral sedation”, which is short training program (a few weekends, I’m guessing?), but IV sedation is a different animal. I know this because my own dentist provides oral sedation, but not IV sedation, and I asked him about this.