Do you consider Oral & Maxillofacial Surgeons doctors? (Is shadowing ok?)

[Sam1276]

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Asking for a friend - but I'm also a little confused by this - Nobody I know seems to know anything about them

are oral & maxillofacial surgeons actually doctors? Or are they just dentists? As in - is it okay for me to shadow one to boost my hours? Or would medical schools not want that?

My friend says they're dentists - but apparently they do some crazy f****** procedures - Double jaw osteotomies, trauma, re-constructive facial surgery, plastics, etc.

...but they're dentists... right? Whats the deal?


Edit - googled this again and went to the AAMC website - "Oral & Maxillofacial surgery" isn't even listed as specialty. Yet, you scroll down the google results, and you see things like the plastics department at Duke really being named the "Department of Plastics, Maxillofacial, and Oral Surgery", along with a ton of other hospitals. Anyone here know something about why this is?

 

[deleted407021]

These guys may be either physicians or dentists. Some are both, i.e. they are MD/DMD or DO/DDS etc. This is my understanding.

You should be shadowing physicians, so check the credentials of the people you're interested in.

 

[Sam1276]

These guys may be either physicians or dentists. Some are both, i.e. they are MD/DMD or DO/DDS etc. This is my understanding.

You should be shadowing physicians, so check the credentials of the people you're interested in.

Wait - sorry I'm still a little confused - so if the field is open to both physicians or dentists - why does it matter what the credentials are of the oral surgeon I shadow?

Its kinda like you're saying - your anesthesiologist could be either a DO or an MD, but if I want to go to an MD school I should shadow the MD Anesthesiologist, not the DO.
But in reality - the degree of the anesthesiologist shadowed doesn't really matter - an anesthesiologist is an anesthesiologist.

So basically - why does it matter what the degree/credentials are of the oral surgeon is that I shadow? They could be an MD or a DMD, but the job is still the same though.
Are med schools really going to care about the difference...?

 

[deleted407021]

Wait - sorry I'm still a little confused - so if the field is open to both physicians or dentists - why does it matter what the credentials are of the oral surgeon I shadow?

Its kinda like you're saying - your anesthesiologist could be either a DO or an MD, but if I want to go to an MD school I should shadow an MD Anesthesiologist, not a DO.
But in reality - the degree of the anesthesiologist I shadow doesn't really matter - an anesthesiologist is an anesthesiologist.

So why does it matter what the degree/credentials are of the oral surgeon is that I shadow? They could be an MD or a DMD, but the job is still the same though

DO/MD are both physicians. The reason I recommended you look to make certain they're a physician is in case you want a letter from them, you'd want it to be from a physician. Additionally, you might get a better experience that's pertinent to your career interests of you shadowed someone who went to medical school.

 

[bc65]

The reason I recommended you look to make certain they're a physician is in case you want a letter from them, you'd want it to be from a physician.

Letters from doctors you shadow are useless. In fact they are annoying.

OP, you should shadow the oral surgeon. It's a fascinating and complex field that overlaps extensively, almost completely, with plastic surgery and ENT / Head and Neck surgery.

In fact, you should also shadow dentists, and even nurses and PA s if you can. It will be very educational for you, and will give you an appreciation for what other members of the health care team are doing. You won't have an opportunity to do it later, and after you do that, you will be one of the few applicants who will be able to answer the question, "why medicine and not a PA or a nurse" based on experience and not your imagination.

Wait - sorry I'm still a little confused - so if the field is open to both physicians or dentists - why does it matter what the credentials are of the oral surgeon I shadow?

Of course your reasoning is absolutely correct. It doesn't matter. Shadowing an oral surgeon is fine.

 

[deleted407021]

@bc65 , thanks for clarifying.

However, while the point about physician letters is true, that doesn't necessarily apply to all schools. Many DO schools and a handful of MD programs require letters from MDs/DOs.

The point about shadowing other health professions is spot on and I definitely agree.

 

[bc65]

However, while the point about physician letters is true, that doesn't necessarily apply to all schools. Many DO schools and a handful of MD programs require letters from MDs/DOs.

Then I stand corrected. For those schools that want an MD or DO letter, by all means send one. But most MD schools don't want them, because the letter writer is either your personal doctor, and therefore can't be objective, or they just met you for a day, in which case they know nothing about you other than the fact that you held it together for the 6 hours you spent with them. They are unable to comment on your honesty, integrity, work ethic, intelligence, or academic achievements or potential.

 

[bc65]

you see things like the plastics department at Duke really being named the "Department of Plastics, Maxillofacial, and Oral Surgery", along with a ton of other hospitals. Anyone here know something about why this is?

For a couple of reasons.

As I noted, OMF surgeons operate on upper and lower jaw fractures, and do jaw reconstructions. So do plastic surgeons ( and some ENTs as well ). So the most logical department for OMF to be part of would be plastic surgery. Also, the path that OMF surgeons take is to go to dental school, and then do a 3 (?) year OMF residency and become oral surgeon ( aka OMF surgeons). However, in some schools, particularly the more competitive and academic ones, the OMF residents will do the last two years of medical school immediately after dental school, get an MD degree, and then do their OMF residency. When they finish, they are MD/DMD OMF surgeons. At that point, the ones most interested in an academic career might go on to do a plastic surgery residency for 6 more years, and then become plastic surgeons specializing in facial reconstruction.

In actual practice, most plastic surgeons don't want to deal with jaw fractures for a lot of reasons, and are more than happy to refer to oral surgeons. However, most oral surgeons don't want to deal with them either, as they prefer to pull wisdom teeth and do dental implants. So those who actually treat mandible and maxillary fractures tend to be motivated, and have the respect of those who do, regardless of their original degree or specialty. In practice most jaw fractures can be treated pretty easily, but I'm talking about the complex and difficult ones here.

The most complex deformities might also involve cranio-facial plastic surgeons as well, another reason that oral surgery would be part of the plastic surgery department. But again, we are only talking about academic practices. Most of the cases those specialties deal with are straightforward and can be done in their office. I suspect that most oral surgeons rarely use the O.R. for more than just sedation/anesthesia for difficult or fragile patients while pulling wisdom teeth.

EDIT: In order to be accepted to some ( or all?) oral surgery residencies, dental students need to take the Step 1 exam, in addition to their equivalent dental exam.

You may also notice some plastic surgery departments that are headed by plastic surgeons with MD/ DMD degrees. Those are all probably oral surgeons. In other cases they might be dentists who applied to medical school directly, did their two clinical years of med school, and went on to be plastic surgeons.

 

[AnatomyGrey12]

Just thought I'd point out that OMF is a specialty strictly available for dentists. As was mentioned above some of the more academic residencies will grant the MD degree so the graduates will have both. But to get into an OMF residency one must first go through dental school. They are not open to medical graduates.

I suggest go ahead and shadow because it is a cool experience either way, but know that if they don't have the MD then on your app you won't be able to list it as physician shadowing.

 

[LizzyM]

It is also useful to have that shadowing experience in your back pocket to help answer the "what if..." interview question that asks what you'd consider as a career in MD or DO were closed off to you.

 

[allantois]

OMFS is one of the FACS recognized specialties. The majority of them just do dental procedures though. But because they trained alongside ENTs and Plastic Surgeons, they are well qualified to speak of your qualifications for a healthcare profession.

 

[doktorinprogres]

For a couple of reasons.

As I noted, OMF surgeons operate on upper and lower jaw fractures, and do jaw reconstructions. So do plastic surgeons ( and some ENTs as well ). So the most logical department for OMF to be part of would be plastic surgery. Also, the path that OMF surgeons take is to go to dental school, and then do a 3 (?) year OMF residency and become oral surgeon ( aka OMF surgeons). However, in some schools, particularly the more competitive and academic ones, the OMF residents will do the last two years of medical school immediately after dental school, get an MD degree, and then do their OMF residency. When they finish, they are MD/DMD OMF surgeons. At that point, the ones most interested in an academic career might go on to do a plastic surgery residency for 6 more years, and then become plastic surgeons specializing in facial reconstruction.

In actual practice, most plastic surgeons don't want to deal with jaw fractures for a lot of reasons, and are more than happy to refer to oral surgeons. However, most oral surgeons don't want to deal with them either, as they prefer to pull wisdom teeth and do dental implants. So those who actually treat mandible and maxillary fractures tend to be motivated, and have the respect of those who do, regardless of their original degree or specialty. In practice most jaw fractures can be treated pretty easily, but I'm talking about the complex and difficult ones here.

The most complex deformities might also involve cranio-facial plastic surgeons as well, another reason that oral surgery would be part of the plastic surgery department. But again, we are only talking about academic practices. Most of the cases those specialties deal with are straightforward and can be done in their office. I suspect that most oral surgeons rarely use the O.R. for more than just sedation/anesthesia for difficult or fragile patients while pulling wisdom teeth.

EDIT: In order to be accepted to some ( or all?) oral surgery residencies, dental students need to take the Step 1 exam, in addition to their equivalent dental exam.

You may also notice some plastic surgery departments that are headed by plastic surgeons with MD/ DMD degrees. Those are all probably oral surgeons. In other cases they might be dentists who applied to medical school directly, did their two clinical years of med school, and went on to be plastic surgeons.

Mostly did justice, just thought I'd clear up a few things

There are two paths to OMFS after dental school, a 4 yr or 6 yr residency (except Case offers a 5yr). For the 6 year option residents most generally complete PGY1 followed by 2 years of MS3 and MS4 and then continue onwards. The 6 year option thus grants an MD degree. 4 year option does not but scope and pay does not differ.

In order to be accepted into either program applicants have to take the NBME CBSE. Those in a 6 yr program take Step 1 during their first year there.

edit: apparently I'm mistaken and its MS 2 and 3
edit2: apparently which years of MS varies as a quick check showed Louisville and Shreveport do MS 3 and 4

 

[bc65]

Mostly did justice, just thought I'd clear up a few things

There are two paths to OMFS after dental school, a 4 yr or 6 yr residency (except Case offers a 5yr). For the 6 year option residents most generally complete PGY1 followed by 2 years of MS3 and MS4 and then continue onwards. The 6 year option thus grants an MD degree. 4 year option does not but scope and pay does not differ.

In order to be accepted into either program applicants have to take the NBME CBSE. Those in a 6 yr program take Step 1 during their first year there.

Thanks for the clarifications. However, my understanding was that any dental student interested in oral surgery would take the USMLE step 1 exam after the second year of school, because that's when the material is fresh, and because many programs want to see that you can pass it before they would consider you. While some programs won't require it, you generally won't know in advance which type of program you'll get acccepted to.

Also, when you refer to an internship preceding MS3 and 4, are you referring to a dental internship? I don't see how a surgical internship could precede MS3 and 4.

 

[redferrari]

My school thought it was okay to have one interview me... Hahaha I'm sure it's fine they're just as much of a physician as any other surgeon in my eyes.

 

[allantois]

Thanks for the clarifications. However, my understanding was that any dental student interested in oral surgery would take the USMLE step 1 exam after the second year of school, because that's when the material is fresh, and because many programs want to see that you can pass it before they would consider you. While some programs won't require it, you generally won't know in advance which type of program you'll get acccepted to.

Also, when you refer to an internship preceding MS3 and 4, are you referring to a dental internship? I don't see how a surgical internship could precede MS3 and 4.

Second year of dental school isn't really like second year of medical school (at least at the majority of schools), so that's why OMFS residencies require applicants to take CBSE, not the actual Step 1. It goes like this:

year 1: PGY-1 OMS
year 2: MS2 and Step 1
year 3: MS3
years 4-6: PGY 2-4 OMS

OMS residency in itself sort of counts for MS4. Cut out med school part completely for 4 year residencies (which is what they all really are - they just insert med school in between at 6 year programs). People at 4 year programs never take any of the Steps.

Although, I should say there are variations: residents at UMiami can do MD part after their residency, while Harvard doesn't actually have MS2 but instead have MS4 (so they tend to select residents from dental schools with med heavy curriculums), and Case Western is a 5 year program.

 

[bc65]

Second year of dental school isn't really like second year of medical school (at least at the majority of schools), so that's why OMFS residencies require applicants to take CBSE, not the actual Step 1. It goes like this:

year 1: PGY-1 OMS
year 2: MS2 and Step 1
year 3: MS3
years 4-6: PGY 2-4 OMS

OMS residency in itself sort of counts for MS4. Cut out med school part completely for 4 year residencies (which is what they all really are - they just insert med school in between at 6 year programs). People at 4 year programs never take any of the Steps.

I thought I heard otherwise, but it looks like I misunderstood. Thanks for the corrections and explanation.

 

[Biden_white]

Thanks for the clarifications. However, my understanding was that any dental student interested in oral surgery would take the USMLE step 1 exam after the second year of school, because that's when the material is fresh, and because many programs want to see that you can pass it before they would consider you. While some programs won't require it, you generally won't know in advance which type of program you'll get acccepted to.

Also, when you refer to an internship preceding MS3 and 4, are you referring to a dental internship? I don't see how a surgical internship could precede MS3 and 4.

You're forgetting that oral surgery residents are already doctors - they're licensed dentists with full prescribing rights, etc. You don't need an MD to do a surgical internship - a DMD is the exact equivalent in this situation (Oral/ Maxillofacial Surgery)

So typically, during a 4 year or 6 year residency, the PGY-1 is spent on OMFS service, the 2nd and 3rd year in medical school (although many residents may be on call during this time).

4 year programs don't award an MD, but the scope of practice is the exact same (so they're more competitive as a result). These programs skip the med school years, and the residents spend all 4 years doing OMFS. The MD for the most part, doesn't really add much, unless you want to be a faculty member somewhere

 

[allantois]

I thought I heard otherwise, but it looks like I misunderstood. Thanks for the corrections and explanation.

I think you are a plastic surgeon? If you trained with OMFS's, they probably didn't even take CBSE when applying. OMS residencies only started requiring it in 2012 after NBDE (dental equivalent of USMLE), eliminated numerical scores and became a P/F exam.

 

[Mad Jack]

Dentists are doctors. They are not physicians. OMFS surgeons without an MD are surgeons, but not physicians. OMFS surgeons with MDs are surgeons and physicians.

 

[allantois]

Dentists are doctors. They are not physicians. OMFS surgeons without an MD are surgeons, but not physicians. OMFS surgeons with MDs are surgeons and physicians.

Don't forget podiatrists who are also surgeons, but not physicians 😀

 

[musicplease]

Dentists are doctors and surgeons
Physicians are doctors
Oral Surgeons DMD are dentists, doctors, and surgeons
Oral Surgeons DMD/MD are dentists, doctors, surgeons, physicians
Physician Surgeons are doctors, surgeons, physicians
Physicians without surgical specialty (example family practice) are doctors and physcians

 

[allantois]

I wouldn't get too excited about becoming an OMFS if you are in med school already. Their high incomes are maintained from the type of procedures they do in private practice, that is wisdom teeth extractions and implant placements. Due to financial pressures that newly graduating dentists face, more and more of them are now taking care of what previously used to be referred to specialists. I think a big push for OMS's to obtain MD degrees stems from the fact, that they will soon have to look into expanding their practices beyond dentoalveolar surgery.

 

[Mad Jack]

Which is pretty much just semantics - Nobody cares about the exact phrasing. In much of world, OMFS is a medical specialty, in others, it's dental. Really, for the patient, it doesn't actually matter. The fact that there's an official route to get an MD for the field speaks volumes about capability and importance. Word on the street is, the AAMC came very close to making Oral Surgery an official specialty, but didn't due to internal politics.

If you're a single-degree OMFS working at a hospital, most people don't know, or care what degree you have when you're preforming facial surgery on a trauma patient at 4am (~40% of all facial trauma is handled by OMFS, another 40% by plastics, and ~20% by ENT).

(Also, for those of you who don't know, the average salary of an Oral & Maxillofacial Surgeon is ~$400,000... regardless of degree. Yes, you read that right )



Podiatry is a dying field lmao

Whether or not you have the MD can matter a lot when it comes to patient management in some states. Your treatment options that you can offer without having a physician involved are limited. For instance, an OMFS surgeon without an MD can't primarily oversee their patient if they need to be in the ICU for whatever reason post-op in many states. That's not just semantics- that's losing control over your patient.

 

[bc65]

If you trained with OMFS's, they probably didn't even take CBSE when applying. OMS residencies only started requiring it in 2012 after NBDE (dental equivalent of USMLE), eliminated numerical scores and became a P/F exam.

That explains part of my confusion. Thanks for that.

Actually I was basing most of my information on a conversation I had last year with an oral surgeon and his rotating dental resident. As the oral surgeon was older, as I am, and the resident wasn't an OMF resident, probably a lot of misinformation was passed around and misunderstood, mostly on my end. When they were talking about taking the board exam, perhaps they were referring to the CBSE, or perhaps they were describing how things used to be.

Also, for those of you who don't know, the average salary of an Oral & Maxillofacial Surgeon is ~$420,000. Yes, you read that right

But from what I hear, it's very competitive, although my source told me orthodontics is even more competitive and better paid. It was my understanding that going to dental school and planning on being an oral surgeon is just as likely to be as disappointing as going to medical school determined to be a dermatologist or orthopod.

 

[Mad Jack]

why on earth would you not allow a surgeon to follow his patient - on an account of 2 letters after his name; never mind that he probably has more training than a lot of physicians.

A dentist isn't qualified to operate a ventilator, to manage fulminant sepsis, etc. Again, this isn't semantics. Without the additional training, a dentist simply isn't as qualified as a physician to manage patients in certain settings. Being able to do a reconstruction on a patient that you send to the PACU and gets extubated thirty minutes later is a lot different than managing a patient that develops aspiration pneumonia, that suffers sepsis secondary to their operation, etc. If you think that that is "semantics" I think you really need to re-evaluate where you're coming from lol.

 

[Mad Jack]

No you don't quite understand - not just a dentist - a Dentist who has completed 4-6 extra years of training to become an Oral Surgeon. You're comparing a General Dentist with a specialist that has FAR more extra training. Don't confound the 2 because they're both commonly referred to as "dentists" lmao

Would a family doctor be able to manage the above? Because thats essentially what a general dentist is.

Family physicians are not only allowed to work in ICUs, but many work as hospitalists that regularly treat their own patients in intensive care in open ICU settings. During medical school and residency, we spend quite a few months in the ICU and doing general inpatient medicine and surgery regardless of specialty, so pretty much anyone in IM/FM/surgery/OB/peds/neuro can work an ICU if needed (though the type of ICU differs depending on the credentials- IM/FM you'll see in MICUs, OB you'll see in PICUs, etc). OMFS residencies do not spend a great deal of time focusing on intensive care or general internal medicine- most give you two rotations in IM and one month of ICU, on top of zero weeks of both in dental school. They also generally barely crack four months of general surgery, and lack the entire undergraduate medical curriculum that builds the foundation for managing patients across a broad spectrum of settings.

OMFS MDs, on the other hand, undergo the full medical school clinical curriculum, allowing them to catch up on what they miss, in addition to eight full months of general surgery acting as physician residents in the ICU and OR. Those extra years of training give them *gasp* the skill and qualifications to provide full-spectrum care because they've spent enough time learning both medicine and surgery to be competent enough to manage their own patients from beginning to end if they so choose.

That's the reason that OMFS dentists without MDs only gain the following extra privileges in my state:

(1) Diagnose, evaluate, prevent or treat by surgical or other means, injuries, deformities, diseases or conditions of the hard and soft tissues of the oral and maxillofacial area, or its adjacent or associated structures; and (2) perform any of the following procedures, provided the dentist has been granted hospital privileges to perform such procedures: (A) Surgical treatment of sleep apnea involving the jaws; (B) salivary gland surgery; (C) the harvesting of donor tissue; (D) frontal and orbital surgery and nasoethmoidal procedures to the extent that such surgery or procedures are associated with trauma.

while MD OMFS dentists have a full scope of practice- they're physicians, and dentists.

 

[bc65]

You're forgetting that oral surgery residents are already doctors - they're licensed dentists with full prescribing rights, etc. You don't need an MD to do a surgical internship - a DMD is the exact equivalent in this situation (Oral/ Maxillofacial Surgery)

When someone referred to a surgical internship year, I assumed that they were referring to a general surgery preliminary year, which I would have thought requires an MD. A surgical intern would be taking care of general surgery patients. I would be surprised to find that a dental graduate who never rotated in a hospital as a student would be managing general surgery patients, but perhaps I'm wrong. Is that the case, or by surgery internship are you referring to an oral surgery internship?

I was thinking of the path to an MD. If someone is doing an oral surgery residency, but never finished medical school, then I would have thought that whatever internship or residency that they do will not count towards the MD license unless they have an MD degree. But I'm now assuming that what's happening is that the PG1 year is a distinct oral surgery internship year. Then, after going back and finishing medical school, the next subsequent year of OMF, which would be the 4th year of the OMF program, might then count as the medical internship year for MD licensing purposes.

@allantois, Is that correct?

You're comparing a General Dentist with a specialist that has FAR more extra training. Don't confound the 2 because they're both commonly referred to as "dentists" lmao

Would a family doctor be able to manage the above? Because thats essentially what a general dentist is.

More training doesn't matter if the training isn't appropriate to the problem. Medical students learn body system functions in depth in their second year, and spend two years doing clinical rotations. Dental students don't get that experience. Perhaps some OMF residents do, but I wouldn't assume that's always the case.

In my hospital, most physicians are no longer accredited to manage ICU patients without specialized and appropriate training. The fact that an oral surgeon wouldn't get approved for direct ICU patient management is not unique to OMF. For example, most ophthalmologists wouldn't have ICU privileges either.

I think there was another situation too in California where a plastic surgeon sued an Oral & Maxilofacial Surgeon for preforming a rhinoplasty. The Oral Surgeon basically just said "if I'm on call in a hospital, and a patient comes in from a car crash, I am required to preform a rhinoplasty/put their face back together. But I'm not allowed to do it in my private practice?"

No, you're kind of making this up. What did happen is that the OMF lobbyists got a law passed that allowed oral surgeons to do cosmetic surgery in California. Now, I can tell you that many ENT's and plastic surgeons don't do rhinoplasties because it's a rather specialized procedure, as is all cosmetic surgery. While I'm reluctant to condemn an entire profession for the faults of a few, the fact that some oral surgeons would think that their training prepared them to do cosmetic procedures such as rhinoplasties and facelifts is very disappointing and worrisome.

Reducing a nasal fracture is a very different procedure than doing an elective rhinoplasty. The fact that someone would think to compare the two demonstrates a lack of understanding of both procedures.

What the law allows is not the same as prudent practice. My MD license allows me to do brain surgery and heart transplants, but I have no training in either. But hey, go to an oral surgeon for your facelift or rhinoplasty. Let me know how that works out for you.

 

[fancymylotus]

Dentists are doctors. They are not physicians. OMFS surgeons without an MD are surgeons, but not physicians. OMFS surgeons with MDs are surgeons and physicians.

I dont think any of us are parading around calling ourselves physicians, but thanks for the clarifications!!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

[allantois]

@CMistry @armorshell @Sublimazing

When someone referred to a surgical internship year, I assumed that they were referring to a general surgery preliminary year, which I would have thought requires an MD. A surgical intern would be taking care of general surgery patients. I would be surprised to find that a dental graduate who never rotated in a hospital as a student would be managing general surgery patients, but perhaps I'm wrong. Is that the case, or by surgery internship are you referring to an oral surgery internship?

I was thinking of the path to an MD. If someone is doing an oral surgery residency, but never finished medical school, then I would have thought that whatever internship or residency that they do will not count towards the MD license unless they have an MD degree. But I'm now assuming that what's happening is that the PG1 year is a distinct oral surgery internship year. Then, after going back and finishing medical school, the next subsequent year of OMF, which would be the 4th year of the OMF program, might then count as the medical internship year for MD licensing purposes.

@allantois, Is that correct?

 

[Mad Jack]

I dont think any of us are parading around calling ourselves physicians, but thanks for the clarifications!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Well clearly this guy

No you don't quite understand - not just a dentist - a Dentist who has completed 4-6 extra years of training to become an Oral Surgeon. You're comparing a General Dentist with a specialist that has FAR more extra training. Don't confound the 2 because they're both commonly referred to as "dentists" lmao.

It's sort of like if you see someone's name, and it has MD after it, you have no way of knowing what "type" of physician they are, or how well qualified they are. Would a family doctor be able to manage the above? Because thats essentially what a general dentist is.

And for the record - Oral Surgeons are in fact, qualified to do all the things you mentioned. Which is why in many parts of the world they are dual qualified (MD-DMD). Single degree OMFS exists in the US because of 1) The way medical school is structured in the United States (starting after college vs. High school), and 2) Many people acknowledged that you don't really "learn" anything 3rd and 4th year in medical school. Most of your knowledge base comes from residency (where you rotate through relevant fields, like anesthesia anyway)

EDIT - I realize this the pre-allo forum, and most people here haven't even started medical school yet. So it seems a bit weird to you guys to learn about a field that is "essentially" a physician, yet "technically not" (In your heads). I assure you this is really all just semantics -

Go to the Oral Surgery/Plastic Department/ED at your local hospital and ask to shadow an oral surgeon. All Level 1,2,3 trauma centers are required by law to have Oral & Maxillofacial Surgeons on staff in the ED, for obvious reasons. Shadow them for a day, come back, and tell me what you think 😉

thinks that non-MD OMFS surgeons are physicians qualified to practice a full scope of medicine, rather than dentistry, surgery, and uncomplicated postoperative care as their license allows.

And I was just saying, semantically, what is true 😛 I never implied any dentist thinks they're a physician, but you guys are definitely doctors of the sort that help people 😀

 

[armorshell]

A dentist isn't qualified to operate a ventilator, to manage fulminant sepsis, etc. Again, this isn't semantics. Without the additional training, a dentist simply isn't as qualified as a physician to manage patients in certain settings. Being able to do a reconstruction on a patient that you send to the PACU and gets extubated thirty minutes later is a lot different than managing a patient that develops aspiration pneumonia, that suffers sepsis secondary to their operation, etc. If you think that that is "semantics" I think you really need to re-evaluate where you're coming from lol.

2 years of advanced shadowing and list updating, and an additional 8 months of holding wires in the vascular OR and discharging colorectal patient also don't qualify you for that.

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[armorshell]

Family physicians are not only allowed to work in ICUs, but many work as hospitalists that regularly treat their own patients in intensive care in open ICU settings. During medical school and residency, we spend quite a few months in the ICU and doing general inpatient medicine and surgery regardless of specialty, so pretty much anyone in IM/FM/surgery/OB/peds/neuro can work an ICU if needed (though the type of ICU differs depending on the credentials- IM/FM you'll see in MICUs, OB you'll see in PICUs, etc). OMFS residencies do not spend a great deal of time focusing on intensive care or general internal medicine- most give you two rotations in IM and one month of ICU, on top of zero weeks of both in dental school. They also generally barely crack four months of general surgery, and lack the entire undergraduate medical curriculum that builds the foundation for managing patients across a broad spectrum of settings.

OMFS MDs, on the other hand, undergo the full medical school clinical curriculum, allowing them to catch up on what they miss, in addition to eight full months of general surgery acting as physician residents in the ICU and OR. Those extra years of training give them *gasp* the skill and qualifications to provide full-spectrum care because they've spent enough time learning both medicine and surgery to be competent enough to manage their own patients from beginning to end if they so choose.

That's the reason that OMFS dentists without MDs only gain the following extra privileges in my state:

(1) Diagnose, evaluate, prevent or treat by surgical or other means, injuries, deformities, diseases or conditions of the hard and soft tissues of the oral and maxillofacial area, or its adjacent or associated structures; and (2) perform any of the following procedures, provided the dentist has been granted hospital privileges to perform such procedures: (A) Surgical treatment of sleep apnea involving the jaws; (B) salivary gland surgery; (C) the harvesting of donor tissue; (D) frontal and orbital surgery and nasoethmoidal procedures to the extent that such surgery or procedures are associated with trauma.

while MD OMFS dentists have a full scope of practice- they're physicians, and dentists.

What state are you in? You'd be surprised what "hard and soft tissues of the oral and maxillofacial area" can mean.

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[Mad Jack]

2 years of advanced shadowing and list updating, and an additional 8 months of holding wires in the vascular OR and discharging colorectal patient also don't qualify you for that.

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Our MD OMFS guys were pretty involved at the cancer hospital, but I never saw a non-MD OMFS managing a patient outside the OR. And I lived in a state in the Northeast.

 

[armorshell]

Our MD OMFS guys were pretty involved at the cancer hospital, but I never saw a non-MD OMFS managing a patient outside the OR. And I lived in a state in the Northeast.

The particular vagaries of omfs practice at a handful of hospitals don't necessarily represent the national zeitgeist.

There's no difference in surgical training between MD and non-MD oral surgeons. Any difference in treatment of these specialists levied by local/state entities or hospitals is at best misunderstanding and at worst intentionally anti-competitive.

 

[Mad Jack]

The particular vagaries of omfs practice at a handful of hospitals don't necessarily represent the baobab the national zeitgeist.

There's no difference in surgical training between MD and non-MD oral surgeons. Any difference in treatment of these specialists levied by local/state entities or hospitals is at best misunderstanding and at worst intentionally anti-competitive.

While there is no difference in surgical training, there is a substantial difference in medical knowledge that they're forced to slog through. Finishing enough medical school prerequisites to get that MD counts for something.

 

[armorshell]

While there is no difference in surgical training, there is a substantial difference in medical knowledge that they're forced to slog through. Finishing enough medical school prerequisites to get that MD counts for something.

I'm well aware of the difference between the two tracks, and I'm intimately familiar with the additional knowledge gained. You picked an interesting word, slog. That makes me think you realize the majority of the extra years spent are mostly low yield and superfluous (they are).

Why then would one deserve any benefit over the other? As a prize for dealing with more bs?

 

[Mad Jack]

I'm well aware of the difference between the two tracks, and I'm intimately familiar with the additional knowledge gained. You picked an interesting word, slog. That makes me think you realize the majority of the extra years spent are mostly low yield and superfluous (they are).

Why then would one deserve any benefit over the other? As a prize for dealing with more bs?

Hey, dealing with it right now, I've got to say there's a lot of stuff that I'll no doubt forget down the road. But it's the broad base of knowledge and standardized internship that is the reason we get the whole "unlimited scope of practice" as physicians. The thinking is, we've got enough knowledge to know where to look for things we don't know, and to build upon a foundation to work in areas we might not have been fully prepared for right out of the gate (such as FM docs that work the ER or ICU).

Of course, the vast majority of OMFS MD holders do chiefly operative work- there's not a whole lot of money in post-op management, following patients on floors, etc when you can have the hospitalists or whomever else do it. But you do have both the right (and, arguably, a better foundation) and the license to provide more longitudinal management of patients up to the point of discharge if you so choose.

 

[Gem91]

On a kind of similar note, I remember shadowing an ENT at UT, and she introduced me to an anesthesiologist in the hallway. I looked him up later and noticed his bio had DDS and when I asked her later about it, she said she had no idea he went to dental school but he is a fine anesthesiologist. Apparently, he did an anesthesiology residency somewhere after dental school but doesn't have an MD or DO. Has anyone ever heard of such a thing?

 

[Advance]

On a kind of similar note, I remember shadowing an ENT at UT, and she introduced me to an anesthesiologist in the hallway. I looked him up later and noticed his bio had DDS and when I asked her later about it, she said she had no idea he went to dental school but he is a fine anesthesiologist. Apparently, he did an anesthesiology residency somewhere after dental school but doesn't have an MD or DO. Has anyone ever heard of such a thing?

Maybe he was a dental anesthesiologist?

 

[fancymylotus]

On a kind of similar note, I remember shadowing an ENT at UT, and she introduced me to an anesthesiologist in the hallway. I looked him up later and noticed his bio had DDS and when I asked her later about it, she said she had no idea he went to dental school but he is a fine anesthesiologist. Apparently, he did an anesthesiology residency somewhere after dental school but doesn't have an MD or DO. Has anyone ever heard of such a thing?

Yes. Our anesthesiologist is like this.


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[Gem91]

Yes. Our anesthesiologist is like this.


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Maybe so. He does OB and Neuro cases, too, but I think primarily works with ENTs. I just found it intriguing that an anesthesiologist doesn't/didn't necessarily have to go to medical school.

 

[Dr.p53]

Dentists are doctors and surgeons
Physicians are doctors
Oral Surgeons DMD are dentists, doctors, and surgeons
Oral Surgeons DMD/MD are dentists, doctors, surgeons, physicians
Physician Surgeons are doctors, surgeons, physicians
Physicians without surgical specialty (example family practice) are doctors and physcians

NOT all dentists are surgeons. Only Oral and Maxillofacial Surgeons are allowed to call themselves as surgeons in the Dental community.

 

[Jdp00921]

Asking for a friend - but I'm also a little confused by this - Nobody I know seems to know anything about them

are oral & maxillofacial surgeons actually doctors? Or are they just dentists? As in - is it okay for me to shadow one to boost my hours? Or would medical schools not want that?

My friend says they're dentists - but apparently they do some crazy f****** procedures - Double jaw osteotomies, trauma, re-constructive facial surgery, plastics, etc.

...but they're dentists... right? Whats the deal?


Edit - googled this again and went to the AAMC website - "Oral & Maxillofacial surgery" isn't even listed as specialty. Yet, you scroll down the google results, and you see things like the plastics department at Duke really being named the "Department of Plastics, Maxillofacial, and Oral Surgery", along with a ton of other hospitals. Anyone here know something about why this is?

As far as the above argument of dentist vs doctor, I have no information or opinion to offer - I just wanted to answer your question on whether or not it is okay to shadow an oral surgeon.

My first shadowing experience was actually an oral surgeon. It was at that time I was contemplating entering a post-bac program with the hopes of eventually applying to medical school. By coincidence, I was having a procedure done by an oral surgeon and asked if it was okay to shadow sometime - he was excited to have me. It was a really exciting experience and definitely worth the time! As a non-traditional student, however, I was asked about this specifically during one of my interviews! I was asked how, as a non-traditional, I knew that I wanted to pursue medicine and not dentistry or any other healthcare field (ie - nursing, etc). I never thought of this coming up but after the interview, I felt the question was completely fair as I was a non-traditional student who's first experience with medicine was technically a dental specialty. Overall, I explained that it just happened to be a coincidence and at the time, I simply wanted to see a day in the life of a doctor (I didn't care which type of doctor, dentist, etc) and they seemed to accept that as an answer (and of course, I did explain in more detail why I wanted to be a physician specifically).

Overall, I just wanted to make the point that it MAY come up in an interview, especially if you are a non-traditional like me. However, I would definitely take the opportunity to shadow an oral surgeon - it is a really cool field to observe and they do some pretty awesome procedures!

Good luck!