Dentist going back for OMFS - looking for advice

[BlindTiger]

Hey guys, I am just looking for some advice on applying to 6-year programs this upcoming cycle.

I graduated in 2019 with a 3.81 GPA, ranked 30th, and CBSE score 78. I have been practicing full time in an emergency dental office since graduation. I've seen a lot of dentoalveolar trauma, infections, and I've done a lot of extractions. During dental school, I spent a lot of time with OS and I did 1 externship. I was originally going to apply in dental school, but I because of family issues I had to go to work.

What should I do over the next several months before I apply? I'm looking into externships, but I'm not sure which schools will allow a dentist to extern. Can I do externships over the summer and add them to my application?

How many schools should I apply to?

I appreciate any advice.

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[BlindTiger]

Why didn’t you apply then? Why not an intern year?

I took the CBSE in August 2020, and I didn't want to apply without a score. I have an obligation to work one more year, so thats why I didn't submit an application for internship. I'll definitely do one if I don't get in

 

[yappy]

Do a bunch of externships. Parkland, Rutgers, UNC I think are open. Do as many as you can one week at a time. You need to show passion towards the field. Stats are great. But they are just that, stats...

It's ironic that he/she must do all this. He/she is practicing dentistry and knows infinitely more about OMS and dentistry than D4s that are applying, especially in recent years when they have done almost nothing clinically.

 

[Ivy.ch]

It's ironic that he/she must do all this. He/she is practicing dentistry and knows infinitely more about OMS and dentistry than D4s that are applying, especially in recent years when they have done almost nothing clinically.

Exactly, he/she knows the good life. Might have forgotten what it’s like to be dumped on.

 

[Masterus]

Externships will show you more OMFS than private practice dentistry and dental school, however, not many places will take a non-student due to liability issues.

You should go ahead and apply and see if you get in. If not, your only bet is a noncat year. Decide on if you want 4 or 6 year and then apply broadly if not to every program.

COVID will have worked in your favor this current cycle because no one was doing externships, but I can see they will question you why OMFS now and why you didn't apply right away etc. They want you to know what your getting yourself into as well.

 

[C.elegans]

It's ironic that he/she must do all this. He/she is practicing dentistry and knows infinitely more about OMS and dentistry than D4s that are applying, especially in recent years when they have done almost nothing clinically.

Highly doubt OP knows "infinitely more" about OMFS than applying D4s. Does he/she know more about dentistry? absolutely. But not OMFS. In fact, I would say D4s who have been gunning for OMFS since day 1 actually know much more about the field and what it is like to be a resident because they have probably been on multiple externships taking call and handling scut work. Clinical faculty in dental school with 30-40 years of experience are often just as clueless about OMFS because their interactions with OMFS are often limited to them making referrals for management of impacted wisdom teeth, implants, suspicious lesions in the mouth, and massive odontogenic infections.

 

[yappy]

Highly doubt OP knows "infinitely more" about OMFS than applying D4s. Does he/she know more about dentistry? absolutely. But not OMFS. In fact, I would say D4s who have been gunning for OMFS since day 1 actually know much more about the field and what it is like to be a resident because they have probably been on multiple externships taking call and handling scut work. Clinical faculty in dental school with 30-40 years of experience are often just as clueless about OMFS because their interactions with OMFS are often limited to them making referrals for management of impacted wisdom teeth, implants, suspicious lesions in the mouth, and massive odontogenic infections.

All rhetorical: As a D4 how many single unit ext, graft, and implants did you do? How many all on 4 cases did you plan and complete? How many impacted wisdom teeth did you removed without tons of hand holding? How many local anesthetics have you done? etc. etc. Dentists with a year or more experience will have done what approximates "infinitely more" of these than a D4. D4s cannot do these cases, or have not done them, because they don't know how to.
I've been on externships job shadowing and I cannot say they amount to much. OP has great numbers and presumably lots of experience, I hope for their sake they don't have to do a 1 year internship while D4s are matching who barely know how to manage a simple extraction. It seems silly doesn't it?

 

[C.elegans]

All rhetorical: As a D4 how many single unit ext, graft, and implants did you do? How many all on 4 cases did you plan and complete? How many impacted wisdom teeth did you removed without tons of hand holding? How many local anesthetics have you done? etc. etc. Dentists with a year or more experience will have done what approximates "infinitely more" of these than a D4. D4s cannot do these cases, or have not done them, because they don't know how to.
I've been on externships job shadowing and I cannot say they amount to much. OP has great numbers and presumably lots of experience, I hope for their sake they don't have to do a 1 year internship while D4s are matching who barely know how to manage a simple extraction.

With all due respect, I do not think you know what you are talking about. First of all, how many impacted wizzies, implants, and all-on-4 cases does a dentist 1 or 2 years out of school complete? Not many, if any at all, is the answer. Oh and did I mention that implants and dentoalveolar surgery just makes up two of the multiple core disciplines of OMFS? I kindly recommend that you give "Atlas of Oral and Maxillofacial Surgery" by Kademani and Tiwana a read if you want to know what the full scope of OMFS entails.

Second, you could have pulled 100 impacted wisdom teeth as a dentist but that doesn't make you any more prepared to be a good OMFS resident than a D4. A monkey can be taught to do surgery and that is what residency is for. A dentist with years of experience is just as clueless as a D4 on what it is like to function as a surgical resident in a hospital. I would have as my junior a fresh dental school grad who is teachable and mentally prepared for the rigors of residency over an arrogant dentist any day.

 

[yappy]

With all due respect, I do not think you know what you are talking about. First of all, how many impacted wizzies, implants, and all-on-4 cases does a dentist 1 or 2 years out of school complete? Not many, if any at all, is the answer. Oh and did I mention that implants and dentoalveolar surgery just makes up two of the multiple core disciplines of OMFS?

Second, you could have pulled 100 impacted wisdom teeth as a dentist but that doesn't make you any more prepared to be a good OMFS resident than a D4. A monkey can be taught to do surgery and that is what residency is for. A dentist with years of experience is just as clueless as a D4 on what it is like to function as a surgical resident in a hospital. I would have as my junior a fresh dental school grad who is teachable and mentally prepared for the rigors of residency over an arrogant dentist any day.

At the DSO I work at GP 1-2 years out of dental school are being mentored by in house specialists in doing implants, all on 4, and impacted wisdom teeth. I think the false dichotomy between an arrogant dentist and a teachable D4 is not accurate. I think you're confused. Imagine for a moment that all dentists were at one time D4s. Everything the D4 has done, including reading Fonseca / Peterson, scoring well on the CBSE, etc. the GP with a few years of experience has also done. The only difference is that the GP with a few years of experience has continued to grow as a provider and has a ton more clinical experience. Why you cannot accept that is baffling to me.

 

[C.elegans]

At the DSO I work at GP 1-2 years out of dental school are being mentored by in house specialists in doing implants, all on 4, and impacted wisdom teeth. I think the false dichotomy between an arrogant dentist and a teachable D4 is not accurate. I think you're confused. Imagine for a moment that all dentists were at one time D4s. Everything the D4 has done, including reading Fonseca / Peterson, scoring well on the CBSE, etc. the GP with a few years of experience has also done. The only difference is that the GP with a few years of experience has continued to grow as a provider and has a ton more clinical experience. That is the reality. Why you cannot accept that is baffling to me.

Not sure if it is a false dichotomy when you seem to be overconfident of your abilities and "knowledge" of OMFS based on the fact that you have some experience doing dentoalveolar surgery in private practice. And no I'm not confused because the fact is that D4s who did multiple externships, have good numbers, and have a passion for OMFS more often than not match straight out of dental school. Most dentists that I have seen who decide to go back realized they want to pursue OMFS during the time they worked as dentists. This means they likely never went on an externship, didn't spend time with their home department in school, or have OMFS research. Because this is reality, it is understandable that PDs want proof that a dentist has the passion, humility, and work ethic to join the team and excel as an intern. PDs prefer teachable residents, not people who think they know all about OMFS based on dentoalveolar experience in private practice.

And FYI, this isn't isolated to OMFS. In medicine, FMGs who are fully trained physicians in their respective countries are often expected to complete one or more prelim years before matching to a categorical spot in the US. This is because PDs want to see if FMGs can integrate into the care team in the US and function as a good resident. PDs just don't care if the FMG has done a thousand appendectomies before because they will be re-taught during residency anyways (and having done 1000 appendectomies is not a predictor of becoming a good general surgeon, nor does it begin to scratch the surface of the full scope of general surgery)

 

[GimmeTheScalpel]

@yappy why do you assume that the GP with several years of experience is equal in academic talent to the D4 entering residency? I think my friend/colleague @C.elegans makes a great point about the fact that it’s not just about sheer volume of a subset of the specialty someone might get exposed to in private practice. I said this in a different thread. Other surgical specialties look at the academic talent of their candidates and their performance in medical school. Lots of factors come into play. Residency encompasses way more than what someone does in PP. Not sure PP prepares that person for managing oncology patients, or making precise osteotomies in orthognathic surgery, or reducing and plating a mandibular fx, or accessing the TMJ via endaural approach, or resecting an ameloblastoma. It’s a pretty broad specialty. Regardless, it’s a moot argument and I think we should all be respectful and focus on our own practices/specialty.

 

[Masterus]

A big part of residency and oral and maxillofacial surgery is being in the operating room. That is not something a general dentist does. You really only get that exposure shadowing as a dental student or on externships. Anyone can handle standing in the clinic- that's what dentists do.

"Everything the D4 has done, including reading Fonseca / Peterson, scoring well on the CBSE, etc. the GP with a few years of experience has also done."

To be honest, I don't know any D4s or general dentist that read Fonseca and Peterson, let alone understand what they're reading. Doing well on the CBSE is related to medical knowledge and not being a general dentist and most of it is not covered in dental school or real life (lots of molecular bio, histopathology, pathophysiology etc.). It is something you have to prepare A LOT for and a lot of dental students do not do well on this exam. General