Doing a foreign perio residency?

[Utdarsenal]

I know this sounds a little crazy.. but please hear me out. I'm seeking advice on doing a foreign residency.

Gonna shoot some facts about myself here
-I'm a new dentist in the U.S. and am debt free (trying to keep it that way). 28 years old and have already been working for almost 3 years.
-My wife is from a foreign country (where my family is also from/I also spent some years there). We're thinking about retiring there when we're older.

Now.. I love periodontics/implantology and would like to become an "expert" in implants. I've spoken to several periodontists and a few have told me they don't think it's necessary to do a 3 year residency just to learn implants. I've really been looking into specializing here in the U.S. but, this would set me back 3 years and possibly hundreds of thousands of dollars in debt, as well. This is what worries me most..

So... I've come to a crossroad. Doing a perio/implant residency abroad in the foreign country my wife is from. It's only 2 years and a fraction of the cost of a residency in the states. I can be a GP/implantologist and i'd also have a foreign license I could use when I feel it's time to retire.

Obviously I wouldn't be able to consider myself a specialist in the states, but, it'd give me a huge stepping stone and I'd compare it to an intense 2-year GPR focused on advanced surgical procedures.

Thoughts?

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[periopocket]

I would say go for it -> alternative DSOs/Multi-specialty practices or practices with everything under one roof are the future.
Pros: You would be an expert at perio/implant cases and could tackle most cases without even thinking of referring
Cons: You wouldn't be able to get specialty rates via insurance companies, but the fact of the matter, is many are going FFS and setting their own fees anywase.

 

[P7898]

Agreed above.

 

[bracketbuster68]

While I'm sure you can receive a quality education outside the US, some foreign programs may not have the same standard of care as US practice. This could potentially lead you to liability and unwanted headaches if you practice in the states. That being said, I'm not sure how you determine the quality of a foreign program. Surely there are good and bad programs.

 

[BritDentist]

It would massively depend on the country you were studying and the university in that country I would imagine but otherwise theres nothing wrong studying implants abroad

 

[AONLINE]

What are you guys' opinions on doing implant CE courses on live-patients in 3rd world countries?

 

[P7898]

What are you guys' opinions on doing implant CE courses on live-patients in 3rd world countries?

live is always better

 

[Combine33]

Keep the referrals coming, everyone. I appreciate it. At the end of the day, if you want to learn implants, you can do it that way, or an AEGD that teaches it, or even those live patient things. But if you want to master a topic, and be the end of the line to your patients and the community, you need to do a CODA accredited OMFS or Perio res. Thats it.

 

[katthenomad]

Keep the referrals coming, everyone. I appreciate it. At the end of the day, if you want to learn implants, you can do it that way, or an AEGD that teaches it, or even those live patient things. But if you want to master a topic, and be the end of the line to your patients and the community, you need to do a CODA accredited OMFS or Perio res. Thats it.

THIS. 100%. Also, it's not a big issue if GPs are doing specialty procedures as long as they can defend their own work. Because when it comes down to the wire, they will be held to the same standards as specialists.

 

[deleted721052]

Because when it comes down to the wire, they will be held to the same standards as specialists.

i totally agree that if you do a procedure as a GP you should be confortable with the whole treatment and possible complications. However, at least in canada, if something bad happens, you will be held to the standard of a GP if you end up in court. A good, diligent GP, but still not specialist level. The patient expect the same tho, that i agree.

 

[Utdarsenal]

Meh.. there are a lot of GP's who are great implantologists and even organize course's and all..

I don't think it's very difficult to practice within standard of care placing implants if you follow the necessary, basic guidelines and don't attempt things outside of your limits.. (basically, if you don't know how to recover from a failure.. you probably shouldn't be doing it). Even specialists have debates about whether to place a 6mm implant vs a 10 mm implant in order to avoid having to do a sinus lift.

Would any dentists here be against the idea of hiring a GP labelling himself as an "implantologist" to place implants at your office/focus on surgery if he provided good work?

 

[P7898]

Meh.. there are a lot of GP's who are great implantologists and even organize course's and all..

I don't think it's very difficult to practice within standard of care placing implants if you follow the necessary, basic guidelines and don't attempt things outside of your limits.. (basically, if you don't know how to recover from a failure.. you probably shouldn't be doing it). Even specialists have debates about whether to place a 6mm implant vs a 10 mm implant in order to avoid having to do a sinus lift.

Would any dentists here be against the idea of hiring a GP labelling himself as an "implantologist" to place implants at your office/focus on surgery if he provided good work?

My quarrel with this is the specialist is the standard of care. So I’d rather hire someone who is the standard of care than someone who is not (OMS or Perio). Just me personally because it will be my license on the line since it is my practice when the individual inevitably messes up and you have to refer to a specialist or worse. Then you could charge a specialist fee. Because the patient is getting the top notch care.

 

[GoDental101]

My quarrel with this is the specialist is the standard of care. So I’d rather hire someone who is the standard of care than someone who is not (OMS or Perio). Just me personally because it will be my license on the line since it is my practice when the individual inevitably messes up and you have to refer to a specialist or worse. Then you could charge a specialist fee. Because the patient is getting the top notch care.

The specialist isn't necessarily the standard of care, both GPs and specialists are held to the same standards of care. It's just as possible for a specialist to not meet a standard of care as it is for a GP.

 

[P7898]

The specialist isn't necessarily the standard of care, both GPs and specialists are held to the same standards of care. It's just as possible for a specialist to not meet a standard of care as it is for a GP.

Right, but in terms of going to court, it will help you out. I mean I know of 2 cases were GPs went to court. I do not know when two specialists went to court for implants other than someone dying from an OS in a hospital but that was a freak post op infection not from implants.

I would just rather be safe than sorry. Plus, a specialists on average will be better than a GP that places implants. Just how it is. They spend 3+ years full time studying and doing those related procedures. In addition if it were me, I would prefer specialists work, so why would I change that for my patients? It would just make me feel safer. Everyone is entitled to their own opinion and roles - it is the best part about our profession. We can do anything we want.

 

[2TH MVR]

it is the best part about our profession. We can do anything we want.

As long as the interests of the patients are placed before your own.

 

[P7898]

As long as the interests of the patients are placed before your own.

Exactly. Always best interests of the patient first and foremost. Never forget why you all are in this profession. Quality of care, empathy, and compassion should come first.