Has the sentiment between 4-year and 6-year OMFS residencies changed in recent years?

[jiggapigga2]

---

Members do not see this ad.

What are these things? Are you referring to fellowship programs?

High volume clinical practice in a particular field that would be considered outside the traditional scope of oms.

A result of which could lead to a fellowship program.

 

[DentistScientist]

High volume clinical practice in a particular field that would be considered outside the traditional scope of oms.

A result of which could lead to a fellowship program.

I see. Thank you. I hope those are also closely related to research. Several innovations in neurosurgery involve using engineered CMV viruses to destroy brain tumor or synthetic neural implants.


Sent from my iPhone using SDN mobile

 

[W19]

Many MDs do not see you as their equivalent regardless. There will always be those who say that taking the 6 year track is a shortcut to the MD since many programs will grant the degree after around 24 months. Lots of physicians still view OMS’s as dentists first and foremost unfortunately. Also, some of the most prominent academicians are single degree holders: Drs. Dodson, Troulis, Le to name a few.

Virtually all MD won't see it that way... I am actually impressed that dental students go thru the pain of taking step1/2/3 to get that extra degree that according to many in this thread provides very little extra benefit. However, the penis measuring contest is everywhere... I am sure some OMFS see themselves as better than general dentists.

 

[0rgansm]

Virtually all MD won't see it that way... I am actually impressed that dental students go thru the pain of taking step1/2/3 to get that extra degree that according to many in this thread provides very little extra benefit. However, the penis measuring contest is everywhere... I am sure some OMFS see themselves as better than general dentists.

I mean, they are above general dentists in terms of education. Especially if they get an MD.

 

[Big Time Hoosier]

I mean, they are above general dentists in terms of education. Especially if they get an MD.

It’s true. That MD puts them at parity to Caribbean MD grads.

Big Hoss

 

[0rgansm]

It’s true. That MD puts them at parity to Caribbean MD grads.

Big Hoss

Lol a general dentists medical education is above Caribbean MD’s

 

[vellnueve]

Virtually all MD won't see it that way... I am actually impressed that dental students go thru the pain of taking step1/2/3 to get that extra degree that according to many in this thread provides very little extra benefit. However, the penis measuring contest is everywhere... I am sure some OMFS see themselves as better than general dentists.

Probably because, unlike in medicine where the PCP refers out things to specialists, theres a segment of the general dentist population who attempt the procedure and screw it up first, before sending it to the specialist.

 

[Likkriue]

Lol a general dentists medical education is above Caribbean MD’s

Well Caribbean MDs still have to take and pass step exams to get licensed in the US. General dentists don’t take anything close to that before cutting into people. Unless you consider nbde exams that literally have questions “what is the shape of the insicor?” As actual questions “better medical education”.

I would agree with dentists having a better dental education but we are nowhere near any MD in terms of medical education.

 

[W19]

Lol a general dentists medical education is above Caribbean MD’s

From what I have seen so far, most people (except academia) don't care where you attended med school once you attain attending status.

 

[LebronManning]

Lol a general dentists medical education is above Caribbean MD’s

Carribean MDs that actually become US physicians are actually very talented because they had to jump through hoops and get the highest USMLE scores to get residencies lol. I wouldn't recommend them or attend them but have the highest regard for any MD in this country regardless of where they trained due to the stringent US medical licensing requirements and competition for residencies.

 

[schmoob]

Lol a general dentists medical education is above Caribbean MD’s

No its not

 

[C.elegans]

If anything, I would say that he 6yr OMFS guys are taking the longer and harder route to the MD.
Attending Dental school and maintaining Top 10% status in a pool of highly motivated students that have already gone through the premed/predental weeding out process + Taking the CBSE vs. Doing undergrad and taking the MCAT
Pretty obvious which one is easier. Most MDs I know are very surprised that OMFS ppl do additional school for the medical degree and give them the respect they deserve for the dual degree status.

 

[surfline]

If anything, I would say that he 6yr OMFS guys are taking the longer and harder route to the MD.
Attending Dental school and maintaining Top 10% status in a pool of highly motivated students that have already gone through the premed/predental weeding out process + Taking the CBSE vs. Doing undergrad and taking the MCAT
Pretty obvious which one is easier. Most MDs I know are very surprised that OMFS ppl do additional school for the medical degree and give them the respect they deserve for the dual degree status.

Well, if they were to take the MCAT they would have to maintain top percentile status in a pool of highly motivated students that have already gone through the premed/predental weeding out process + take Step 1 for a career similar to OMFS (ENT, plastics, whateversurgerysubspecialty). Even then, most medical specialties off the ROAD just do not compare to the lifestyle found in OMFS.

But yeah, if your primary goal is to get an MD, medical school is hell of a lot easier to get into than matching into a 6-yr OMFS program. BUT, if your primary goal is to obtain an MD and live a great lifestyle, taking those additional 2 years to snag the MD title isn't a bad route.

 

[GimmeTheScalpel]

Well, if they were to take the MCAT they would have to maintain top percentile status in a pool of highly motivated students that have already gone through the premed/predental weeding out process + take Step 1 for a career similar to OMFS (ENT, plastics, whateversurgerysubspecialty). Even then, most medical specialties off the ROAD just do not compare to the lifestyle found in OMFS.

But yeah, if your primary goal is to get an MD, medical school is hell of a lot easier to get into than matching into a 6-yr OMFS program. BUT, if your primary goal is to obtain an MD and live a great lifestyle, taking those additional 2 years to snag the MD title isn't a bad route.

Not entirely accurate. You might want to start dental school first before chipping in your 2 cents about OMFS.

 

[LebronManning]

Not entirely accurate. You might want to start dental school first before chipping in your 2 cents about OMFS.

True, I LOLd when I read that persons post. Soon to be medical student that works in an ED and OMFS is almost as busy as an MD surgical service like ENT

 

[ProspectivePostPreDent]

Well Caribbean MDs still have to take and pass step exams to get licensed in the US. General dentists don’t take anything close to that before cutting into people. Unless you consider nbde exams that literally have questions “what is the shape of the insicor?” As actual questions “better medical education”.

I would agree with dentists having a better dental education but we are nowhere near any MD in terms of medical education.

Obviously med students have gone through a more painful battery of tests by the time they're practicing, but I don't think cherry picking is very fair, either. I don't know if you've literally seen that incisor question, but I have seen a number of step 1 questions which require little more than some undergrad concept (eg Hardy Weinberg) to solve.

You can make any test look trivial that way, at least until you get into the actual braniac turf (theoretical physics, etc).

 

[W19]

Obviously med students have gone through a more painful battery of tests by the time they're practicing, but I don't think cherry picking is very fair, either. I don't know if you've literally seen that incisor question, but I have seen a number of step 1 questions which require little more than some undergrad concept (eg Hardy Weinberg) to solve.

You can make any test look trivial that way, at least until you get into the actual braniac turf (theoretical physics, etc).

Hardy-Weinberg is not an difficult concept, but I would not compare it with a question that says: 'What is.....' To be fair, there is a handful questions on step1 that are straight recall as well.

I am not sure why continue arguing MD/DO vs. DDS/DMD difficulty... The system as it is now produce good physicians and dentists.

 

[ProspectivePostPreDent]

Hardy-Weinberg is not an difficult concept, but I would not compare it with a question that says: 'What is.....' To be fair, there is a handful questions on step1 that are straight recall as well.

I am not sure why continue arguing MD/DO vs. DDS/DMD difficulty... The system as it is now produce good physicians and dentists.

Agreed on all counts. Just the first example that came to mind.

 

[caffeine jitters]

Why are there 4, 5, and 6-year programs in the first place? I feel like oral surgery would be more unified as a specialty if everyone went through the same training and earned the same credentials, whether they be certificate or MD.

Just spitballing; obviously, I'm young and ignorant to healthcare professions as a whole.

 

[GimmeTheScalpel]

Why are there 4, 5, and 6-year programs in the first place? I feel like oral surgery would be more unified as a specialty if everyone went through the same training and earned the same credentials, whether they be certificate or MD.

Just spitballing; obviously, I'm young and ignorant to healthcare professions as a whole.

CODA mandates 30 months OMS service (4 year and 6 year) for accreditation and almost all programs abide by it. You can’t squeeze in an MD within a 4 year time span and certificate program candidates do not need an extra 24 months of OMS to practice. That’s why the difference in length of time is what it is.

 

[Likkriue]

Obviously med students have gone through a more painful battery of tests by the time they're practicing, but I don't think cherry picking is very fair, either. I don't know if you've literally seen that incisor question, but I have seen a number of step 1 questions which require little more than some undergrad concept (eg Hardy Weinberg) to solve.

You can make any test look trivial that way, at least until you get into the actual braniac turf (theoretical physics, etc).

The NBDE is a farce ever since making it pass/pail.

 

[surfline]

Not entirely accurate. You might want to start dental school first before chipping in your 2 cents about OMFS.

I was referring to lifestyle outside of residency — not many medical specialties compare to OMFS in terms of freedom of practice, compensation, and work-life balance.

If you disagree, please drop some knowledge on me.

 

[ProspectivePostPreDent]

The NBDE is a farce ever since making it pass/pail.

Okay. Doesn't matter to me either way. But "farce" is a great example of the dramatic word choice that always pops up with these comparative threads for whatever reason. It's glorified biology. A ****load of biology. Nobody's winning fields medals here.

 

[Likkriue]

Okay. Doesn't matter to me either way. But "farce" is a great example of the dramatic word choice that always pops up with these comparative threads for whatever reason. It's glorified biology. A ****load of biology. Nobody's winning fields medals here.

It doesn’t matter to you we have to pay for exams that are so insufficient that programs decided to come out with another exam to try to distinguish students from each other? Oh and of course the ADAT itself has its issues.

 

[W19]

It doesn’t matter to you we have to pay for exams that are so insufficient that programs decided to come out with another exam to try to distinguish students from each other? Oh and of course the ADAT itself has its issues.

Well, we have step2 CS for med school that cost $2000 for the exam itself and logistics... The whole med school education needs complete overhaul. I don't know if things are the same for dentistry...

 

[C.elegans]

Well, if they were to take the MCAT they would have to maintain top percentile status in a pool of highly motivated students that have already gone through the premed/predental weeding out process + take Step 1 for a career similar to OMFS (ENT, plastics, whateversurgerysubspecialty). Even then, most medical specialties off the ROAD just do not compare to the lifestyle found in OMFS.

But yeah, if your primary goal is to get an MD, medical school is hell of a lot easier to get into than matching into a 6-yr OMFS program. BUT, if your primary goal is to obtain an MD and live a great lifestyle, taking those additional 2 years to snag the MD title isn't a bad route.

Studying in your own time for an exam which is essentially a condensed version of Step 1 (an exam that the entire first two years of med school is designed to prepare students for) while simultaneously maintaining top grades in dental school (note that most dental schools have letter grades unlike med schools that are mostly pass/fail) and keeping up with all the preclinical+clinical requirements of dental school AND taking the NBDE part 1,2, CDCA licensure exams, sounds just as, if not more, difficult than med students who try matching into ENT, plastics and etc. Speaking of lifestyle, that just depends on how you practice later on. Academic OMFS suffer just as much as other academic surgeons, while the ones in private practice have better lifestyle like the plastic surgeons in private practice.

 

[UncUndergrad1]

some serious butthurt inferiority complex 4-year guys on this thread

 

[UncUndergrad1]

as far as how much medical students work or how difficult med school is, I worked in 60 hours a week during the 2nd year of medical school and 30 hours a week during the clerkships. Med school is not hard.

If you want an MD in order to know medicine and better treat/manage your patients as a whole, get an MD. If you don't, then don't, you can refer and consult as needed. Orthopedics essentially does 0 medical mgmt, so don't feel bad. It's not ****ing rocket surgery. Do what you want. If you don't know what you want, step back and re-evaluate bc you're driving blind.

 

[GimmeTheScalpel]

I was referring to lifestyle outside of residency — not many medical specialties compare to OMFS in terms of freedom of practice, compensation, and work-life balance.

If you disagree, please drop some knowledge on me.

There are many specialties and sub specialties of medicine that you can build a private practice for. Derm, cards, sleep med, plastic surgery, ophtho, orthopedics, rheumatology, peds, family med, etc etc

 

[jiggapigga2]

Why are there 4, 5, and 6-year programs in the first place? I feel like oral surgery would be more unified as a specialty if everyone went through the same training and earned the same credentials, whether they be certificate or MD.

Just spitballing; obviously, I'm young and ignorant to healthcare professions as a whole.

Not all OMFS are made equal.
Just like not all General surgeons are made equal.

Yes. an OMFS across the board should have the fundamentals down - which would be dentoalveolar, trauma, orthognathics, non vascularized bone grafting, etc..
but just like any other medical specialties, you get sub specialties.

Think of it like this.. You can have a general surgeon - who does appys, laps , and other rando general stuff. ; but then you have general surgeons who invest their time into gaining additional training in vascular, thoracic, transplant, whatever it may be.. Yes they are general surgeons; probably take the general surgery boards, but they also have additional training that sets them apart. and also additional certifications....

ENT is the same way.. you can have ENT - basic - general stuff - but if the said ENT want to enhance their skills, or knowledge - they do a sub specialization - ears, skull base, head and neck, cosmetics

For OMS - it's similar.
you have OMS - base - and then for those who want to know a touch more to manage patients, feel comfortable about co-morbidities, etcs, then you get the OMS + MD
if you want to do/learn more, then u do fellowship in craniofacial, cosmetics, head and neck.. whatever.

Again, there will always be tiers; based on the fundamental skills as defined as an OMS.

In Europe, OMS wo MD's are actually thought of as Oral Surgeons - teeth and titanium , and trauma.. i think. -
whereas, the OMS w MD's are referred to as Maxillofacial - and they essentially do what oral surgeons do, and more -(trauma, pathology, hospital based stuff)
They view each other as separate entities.


Here in the USA - it has not got to that point, but likely one day it will.
.

 

[UncUndergrad1]

lol no, we will not see a split between oral surgery and maxillofacial in the US

How exactly would that play out? We send a memo to all the 4 year programs and tell them they're just Oral Surgeon's now and they need to stop anything else? There is simply no realistic way to back integrate that split. I expect the current model will persist for decades, until eventually the medical system itself changes and dictates how we change -- more likely you'd see the dissolution of 4 year programs, the expansion of GPRs, and 6 year programs becoming 5 year surgical residencies (assuming medical school curriculum shortens further and General Surgery requirements also shorten). Even that is a stretch, but my only lean towards that is changing legislation threatening 4 years, anesthesia threatening non-MD providers, etc. But I still think even this scenario is unlikely. The current model works just fine, it's simply a matter of choice and there's room for both tracks.

And before someone says it, no we won't see GPRs become Oral Surgeons. We already have super dentist and **** calling themselves Oral Surgeons, but those residencies will continue to cover general practice. I'm simply implying that they will continue to move aggressively into exodontia, implants, and IV sedation (until they kill enough people and likely cause the legislation ban hammer that hurts us all). But they're still general dentist.

Again, all of this is pure speculation. The current model will exist for DECADES. This exercise in thought should have 0 influence on choice of path.

 

[caffeine jitters]

Not all OMFS are made equal.
Just like not all General surgeons are made equal.

Yes. an OMFS across the board should have the fundamentals down - which would be dentoalveolar, trauma, orthognathics, non vascularized bone grafting, etc..
but just like any other medical specialties, you get sub specialties.

Think of it like this.. You can have a general surgeon - who does appys, laps , and other rando general stuff. ; but then you have general surgeons who invest their time into gaining additional training in vascular, thoracic, transplant, whatever it may be.. Yes they are general surgeons; probably take the general surgery boards, but they also have additional training that sets them apart. and also additional certifications....

ENT is the same way.. you can have ENT - basic - general stuff - but if the said ENT want to enhance their skills, or knowledge - they do a sub specialization - ears, skull base, head and neck, cosmetics

For OMS - it's similar.
you have OMS - base - and then for those who want to know a touch more to manage patients, feel comfortable about co-morbidities, etcs, then you get the OMS + MD
if you want to do/learn more, then u do fellowship in craniofacial, cosmetics, head and neck.. whatever.

Again, there will always be tiers; based on the fundamental skills as defined as an OMS.

In Europe, OMS wo MD's are actually thought of as Oral Surgeons - teeth and titanium , and trauma.. i think. -
whereas, the OMS w MD's are referred to as Maxillofacial - and they essentially do what oral surgeons do, and more -(trauma, pathology, hospital based stuff)
They view each other as separate entities.


Here in the USA - it has not got to that point, but likely one day it will.
.

But see, the specialties you listed grant the same degrees. It’s the fellowships these surgeons pursue after residency that give them more training, if they want it.

Why isn’t it like this with OMFS? Why wouldn’t the residencies all grant the same degrees? If an OMFS wanted more training after the residency, they could apply for a fellowship against “equally qualified” applicants. It’s no longer DDS/DMD, MD vs. DDS/DMD. It’s single degree folks vs. single degree folks; or, if dual degree residencies were the norm, it would be dual degree folks vs. dual degree folks.

The problem I have with the current model is that some people say 6-year programs help when it comes time to apply for a fellowship or an academic position. What if someone is 4-year trained and didn’t realize they wanted to pursue a competitive subspecialty or academia until they were half way through with their single degree residency program?

 

[ProspectivePostPreDent]

It doesn’t matter to you we have to pay for exams that are so insufficient that programs decided to come out with another exam to try to distinguish students from each other? Oh and of course the ADAT itself has its issues.

I'm just saying the back and forth stuff doesn't matter to me. I agree with you in principal on the test, but as dental students, I think we have much bigger bones to pick when it comes to price gouging.

 

[UncUndergrad1]

But see, the specialties you listed grant the same degrees. It’s the fellowships these surgeons pursue after residency that give them more training, if they want it.

Why isn’t it like this with OMFS? Why wouldn’t the residencies all grant the same degrees? If an OMFS wanted more training after the residency, they could apply for a fellowship against “equally qualified” applicants. It’s no longer DDS/DMD, MD vs. DDS/DMD. It’s single degree folks vs. single degree folks; or, if dual degree residencies were the norm, it would be dual degree folks vs. dual degree folks.

The problem I have with the current model is that some people say 6-year programs help when it comes time to apply for a fellowship or an academic position. What if someone is 4-year trained and didn’t realize they wanted to pursue a competitive subspecialty or academia until they were half way through with their single degree residency program?

Then they can apply and try, or they can go to medical school after. Both have been done and are done today.

The world does not have to hold your hand and hedge your decisions for you.

 

[jiggapigga2]

But see, the specialties you listed grant the same degrees. It’s the fellowships these surgeons pursue after residency that give them more training, if they want it.

Why isn’t it like this with OMFS? Why wouldn’t the residencies all grant the same degrees? If an OMFS wanted more training after the residency, they could apply for a fellowship against “equally qualified” applicants. It’s no longer DDS/DMD, MD vs. DDS/DMD. It’s single degree folks vs. single degree folks; or, if dual degree residencies were the norm, it would be dual degree folks vs. dual degree folks.

The problem I have with the current model is that some people say 6-year programs help when it comes time to apply for a fellowship or an academic position. What if someone is 4-year trained and didn’t realize they wanted to pursue a competitive subspecialty or academia until they were half way through with their single degree residency program?

Then the 4 year will have to accept the potential barriers' that they will face or pony up and do the additional training.
Not sure why there is a sense of entitlement to reap the same opportunities as someone who has put in more "time"

 

[osteotomy01]

Not all OMFS are made equal.
Just like not all General surgeons are made equal.

Yes. an OMFS across the board should have the fundamentals down - which would be dentoalveolar, trauma, orthognathics, non vascularized bone grafting, etc..
but just like any other medical specialties, you get sub specialties.

Think of it like this.. You can have a general surgeon - who does appys, laps , and other rando general stuff. ; but then you have general surgeons who invest their time into gaining additional training in vascular, thoracic, transplant, whatever it may be.. Yes they are general surgeons; probably take the general surgery boards, but they also have additional training that sets them apart. and also additional certifications....

ENT is the same way.. you can have ENT - basic - general stuff - but if the said ENT want to enhance their skills, or knowledge - they do a sub specialization - ears, skull base, head and neck, cosmetics

For OMS - it's similar.
you have OMS - base - and then for those who want to know a touch more to manage patients, feel comfortable about co-morbidities, etcs, then you get the OMS + MD
if you want to do/learn more, then u do fellowship in craniofacial, cosmetics, head and neck.. whatever.

Again, there will always be tiers; based on the fundamental skills as defined as an OMS.

In Europe, OMS wo MD's are actually thought of as Oral Surgeons - teeth and titanium , and trauma.. i think. -
whereas, the OMS w MD's are referred to as Maxillofacial - and they essentially do what oral surgeons do, and more -(trauma, pathology, hospital based stuff)
They view each other as separate entities.


Here in the USA - it has not got to that point, but likely one day it will.
.

Having been out in practice for a short time I can say MD or not, I have seen it up to the individual on what scope they wish to practice. I have seen MD OMFS refuse to treat a simple H&N infection that requires OR, referring out anything needing OR, and doing nothing other than dentoalveolar. On the flip side I see single degree OMFS doing TMJR, panfacials, bimax, etc.

 

[FullyRelaxed]

Having been out in practice for a short time I can say MD or not, I have seen it up to the individual on what scope they wish to practice. I have seen MD OMFS refuse to treat a simple H&N infection that requires OR, referring out anything needing OR, and doing nothing other than dentoalveolar. On the flip side I see single degree OMFS doing TMJR, panfacials, bimax, etc.

He was talking about the barriers 4 year guys face when going for fellowships, getting priviledges, and getting referrals.

When it comes to limited scope or “expanded scope” then where you trained matters way more than 4y vs 6y...but the 4 year guys can potentially have obstacles with Full Scope stuff (vaults, free flaps, full body cosmetics).

 

[Mordecai]

The UK and Australian drift into requiring that OMS specialists have both dental and medical qualifications was a result of pressure from medical surgical specialists. The argument was that oral surgeons were exceeding their scope in treating complex medical patients or managing airways, performing flaps and treating cancer. This argument was deemed as having some merit by the medical fields and administrators. The result was that OMS training has drifted from a 3-4 year post dental training pathway to a 6 year training pathway more in line with what the Royal Colleges expect from surgical trainees (Internship year, Surgical Resident year, 4 year OMS training).Older specialists were grandfathered in, and by and large since the mid 80's -90's all trainees had to obtain an MD. Has this made the specialty better? The jury is out. Certainly in the UK, OMS has the reputation for being big surgeons and "head cutters", but this has been to the detriment of the dentoalveolar "oral surgery" component. A new specialty of "oral surgeon" has emerged and is now taking more and more of the the dentoalveolar and titanium work from the OMS specialists. The same is starting to occur in Australia. Specialists who have spent almost 2 decades (medical school/dental school/internship/general surgical residency) training are watching in horror as their lucrative private clinic work is scooped up by single degree DDS "oral surgeons" with a 2-3yr postgrad added on to dental school.

 

[TravelingPharmD14]

Can someone please explain to me the scope of practice of a DDS/MD and what the MD title actually allows them to do?

 

[Anonymomfs]

Can someone please explain to me the scope of practice of a DDS/MD and what the MD title actually allows them to do?

Sure.
The scope of practice of a DDS (or DMD)/MD:
The same as a DDS (or DMD)

What the MD title actually allows them to do:
1. Puts a nice badge on you that tells the world "I was once capable of getting into and through medical school." Forgive me if I sound sarcastic, but this is actually kind of a big deal.
2. Marketing. This applies to both academics and private practice. It makes you more hirable. Even if an academic department hiring you is knowledgeable about the tangible value of combined programs vs. single degree, the academic institution will be happier and more inclined to hire an MD, thus making the process easier for the department. While most dentists don't care if you have single vs. dual degree training for referrals, many family members and friends purposely sought MD-trained OMS's to put their kids to sleep.

I don't think I could explain it better than Armorshell did a few years ago. I copy/pasted his reply below.

"UCSF is, by no means, stating that single degree OMFS are inferior practitioners. But dual degree surgeons have tangible benefits from their additional training and MD degree. If you only want to operate out of your dental office, then a single degree program would be best for you. If you want to practice predominately in a hospital setting and you want parity with the physicians, then the dualdegree is the better choice.

Remember that Harvard pioneered the concept of a MD-DDS oral surgeon. If there were no tangible benefits, Harvard's pilot program would have disappeared. Today nearly 50% of all OMFS residency program are dual degree.

Don't be myopic.

Tangibility I can agree with, but what about significance? For the majority of practicing OMFS, what are the benefits and drawbacks of 6 year programs vs. 4 year programs? Lets examine:

Tangible Benefits:

1. MD degree and licensure. Really, that's the only tangible benefit. Lets unpack what exactly this means though in the new subsection, tangible sub-benefits(!):
a. Availability of post-certificate fellowship training.
b. Additional job security. Say during the repeat penis reduction surgery I'm scheduled to have in April, the CRNA accidentally gives me an accidental intra-arterial dose of Phenergan and my right arm falls off. In addition to my fat disability policy kicking in and the giant settlement from the hospital, I can live out me dream of going back to residency (and becoming a radiologist)!
c. Minor job preferences. There are a few job postings I've seen requesting dual-degree applicants only. Very few.
d. MD portability. No regional licensing with an MD so it may be easier to move if you can practice solely under that degree. YMMV.
e. Formal general surgery year. I hear this one sometimes, bandied about with something along the lines of "It makes you a better overall surgeon." Sure, maybe in the grand scheme of things if we could quantify every single stitch and stick-tie, yes. However, I imagine the magnitude of that effect is incredibly small, and the number of lap appendectomies you need to do to make you 1% better at doing an arthroscopic disc repositioning is likely more than you'd get if you did 5 full years of formal general surgery residency. In terms of inpatient management, I would tend to agree that more general surgery is better. But by how much? How many dual-degree surgeons spent the majority of their general surgery time on high-yield inpatient management services like SICU or trauma as opposed to bottom-of-the-honey-bucket rotations they stuck you into so a categorical resident wouldn't have to do it?


Intangible benefits (?):

1. Prestige. Your mom will tell all her friends about your double doctor degrees. Your Tinder profile is on lock (YMMV). Every physician will still think of you as a dentist, even the SICU intern you're calling report to because you just did a frontal craniotomy. Your general dentist colleagues will call you to ask what the dose of various antibiotics are, and try to get you to prescribe them their cholesterol medicine across state lines.
2. Academics. I don't really buy this one. It certainly seems like there's a disparity in single vs. dual degree surgeons going into academics, but I'd be a lot more likely to ascribe that to a conscious decision on the part of the graduating residents before I would the people hiring them. Simply, you don't actively make the choice to go for the more rapid route of training (which is by all means equivalent) without holding several opinions which would makes academic OMS an unpalatable career choice. Certainly wouldn't be a salary difference between the two (save if someone was fellowship trained), and remember, the majority of OMS academicians are currently single degree surgeons.
3. Insurance billing. "You can bill medical OR dental insurance, whichever pays more!" I've seen that here several times, and I may have even blindly repeated it too. Single degree surgeons can also do this.
4. Eventual conversion to a single training pathway. I personally think this will eventually happen. The number of dual degree surgeons entering academics grossly outweighs the number of single degree surgeons, and programs are converting to dual degree on a yearly basis with few to none going in the reverse direction. When or how (or if?) it will go down is difficult to ascertain
5. Top of the heap. This could go under prestige, but some people can[t live with being seen as having taken an "inferior" track. If there's a longer option that carries more titles and prestige, they will value it higher.

Tangible Drawbacks:

1. Opportunity cost. You're giving up two years of your average lifetime salary or delaying retirement by two years. Worse if you take advantage of your ability to do a fellowship (MORS are all 2 years now, craniofacial moving in that direction). Generally, fellowship training in OMS is associated with a decrease in expected salary due to moving away from high-paying, low-complication bread and butter OMS procedures.

2. Actual cost. Most places you have to pay med school tuition, and of course eat, drink and Netflix and chill(YMMV). That means more loans and more cost. Don't forget thousands in fees to sit the medical licensing exams, and doubling your yearly cost for licensure. Plus two years of additional interest on all those loans you took out for dental school.

3. MD portability. Hope you didn't want to practice in Pennsylvania or Nevada, two states famous for denying medical licenses to OMS for not completing the required number of years of ACGME accredited residency. Not a problem for all programs, but for many.


Lets now examine the straight dollar value of the benefits versus the drawbacks amortized over a 40 year career. I'm going to use very general ranges to simplify things Since intangible benefits by necessity have no intrinsic value, their valuation is solely dependent on the individual evaluating them. We'll address that later.

Tangible benefit dollar value - 1-2 x 10^5

I think this is pretty generous. I could pay some more monthly premiums and wipe out the benefit of being able to follow my dream of becoming a medical radiologist after my iatrogenic amputation. Maybe I can get a slightly better job, or one in a slightly more ideal area, etc...

Tangible drawback dollar value- 1-2 x 10^7

No way to get around this. The cost of lost income is huge, even if you're a lifetime academic. The real cost is not insignificant either, especially if you end up at your USC/NYU-type private medical schools with wildly spiraling out of control costs.

So we can see, it's at least a million dollar decision.

So what does this mean? The individual needs to evaluate whether the intangible (or low-value tangible in my eyes) benefits outweigh the costs in their personal calculation. I think we benefit from having multiple pathways so people can evaluate these various factors and move along an educational pathway appropriate for them, their world view and their values.

You yourself indicated that, in your view, it's most appropriate for a single degree oral surgeon to stay in their office all day and shuck wizzies, and a dual-degree surgeon to spend their time in the hospital. You even mentioned 50% of graduates are in dual degree programs. But 50% of graduates don't work in a primary hospital setting. Not even 50% of dual degree graduates work in hospital settings. I'd wager not even 20% of dual-degree graduates go into a primary hospital or academic practice. That being the case, who's the one who's really myopic? (It's still the OP)

TL;DR:
-Real dollar cost vs. benefit is hands down non-existent for dual degree training over single degree training, need to rely on personal valuation of numerous intangible benefits which by definition only apply to the individual.
-Probably a significant relative difference in the number of full time hospital based practitioners between the two tracks, but the absolute difference is likely minimal compared to the number going into clinic-based cashola private practice."

 

[TravelingPharmD14]

Sure.
The scope of practice of a DDS (or DMD)/MD:
The same as a DDS (or DMD)

What the MD title actually allows them to do:
1. Puts a nice badge on you that tells the world "I was once capable of getting into and through medical school." Forgive me if I sound sarcastic, but this is actually kind of a big deal.
2. Marketing. This applies to both academics and private practice. It makes you more hirable. Even if an academic department hiring you is knowledgeable about the tangible value of combined programs vs. single degree, the academic institution will be happier and more inclined to hire an MD, thus making the process easier for the department. While most dentists don't care if you have single vs. dual degree training for referrals, many family members and friends purposely sought MD-trained OMS's to put their kids to sleep.

I don't think I could explain it better than Armorshell did a few years ago. I copy/pasted his reply below.

"UCSF is, by no means, stating that single degree OMFS are inferior practitioners. But dual degree surgeons have tangible benefits from their additional training and MD degree. If you only want to operate out of your dental office, then a single degree program would be best for you. If you want to practice predominately in a hospital setting and you want parity with the physicians, then the dualdegree is the better choice.

Remember that Harvard pioneered the concept of a MD-DDS oral surgeon. If there were no tangible benefits, Harvard's pilot program would have disappeared. Today nearly 50% of all OMFS residency program are dual degree.

Don't be myopic.

Tangibility I can agree with, but what about significance? For the majority of practicing OMFS, what are the benefits and drawbacks of 6 year programs vs. 4 year programs? Lets examine:

Tangible Benefits:

1. MD degree and licensure. Really, that's the only tangible benefit. Lets unpack what exactly this means though in the new subsection, tangible sub-benefits(!):
a. Availability of post-certificate fellowship training.
b. Additional job security. Say during the repeat penis reduction surgery I'm scheduled to have in April, the CRNA accidentally gives me an accidental intra-arterial dose of Phenergan and my right arm falls off. In addition to my fat disability policy kicking in and the giant settlement from the hospital, I can live out me dream of going back to residency (and becoming a radiologist)!
c. Minor job preferences. There are a few job postings I've seen requesting dual-degree applicants only. Very few.
d. MD portability. No regional licensing with an MD so it may be easier to move if you can practice solely under that degree. YMMV.
e. Formal general surgery year. I hear this one sometimes, bandied about with something along the lines of "It makes you a better overall surgeon." Sure, maybe in the grand scheme of things if we could quantify every single stitch and stick-tie, yes. However, I imagine the magnitude of that effect is incredibly small, and the number of lap appendectomies you need to do to make you 1% better at doing an arthroscopic disc repositioning is likely more than you'd get if you did 5 full years of formal general surgery residency. In terms of inpatient management, I would tend to agree that more general surgery is better. But by how much? How many dual-degree surgeons spent the majority of their general surgery time on high-yield inpatient management services like SICU or trauma as opposed to bottom-of-the-honey-bucket rotations they stuck you into so a categorical resident wouldn't have to do it?


Intangible benefits (?):

1. Prestige. Your mom will tell all her friends about your double doctor degrees. Your Tinder profile is on lock (YMMV). Every physician will still think of you as a dentist, even the SICU intern you're calling report to because you just did a frontal craniotomy. Your general dentist colleagues will call you to ask what the dose of various antibiotics are, and try to get you to prescribe them their cholesterol medicine across state lines.
2. Academics. I don't really buy this one. It certainly seems like there's a disparity in single vs. dual degree surgeons going into academics, but I'd be a lot more likely to ascribe that to a conscious decision on the part of the graduating residents before I would the people hiring them. Simply, you don't actively make the choice to go for the more rapid route of training (which is by all means equivalent) without holding several opinions which would makes academic OMS an unpalatable career choice. Certainly wouldn't be a salary difference between the two (save if someone was fellowship trained), and remember, the majority of OMS academicians are currently single degree surgeons.
3. Insurance billing. "You can bill medical OR dental insurance, whichever pays more!" I've seen that here several times, and I may have even blindly repeated it too. Single degree surgeons can also do this.
4. Eventual conversion to a single training pathway. I personally think this will eventually happen. The number of dual degree surgeons entering academics grossly outweighs the number of single degree surgeons, and programs are converting to dual degree on a yearly basis with few to none going in the reverse direction. When or how (or if?) it will go down is difficult to ascertain
5. Top of the heap. This could go under prestige, but some people can[t live with being seen as having taken an "inferior" track. If there's a longer option that carries more titles and prestige, they will value it higher.

Tangible Drawbacks:

1. Opportunity cost. You're giving up two years of your average lifetime salary or delaying retirement by two years. Worse if you take advantage of your ability to do a fellowship (MORS are all 2 years now, craniofacial moving in that direction). Generally, fellowship training in OMS is associated with a decrease in expected salary due to moving away from high-paying, low-complication bread and butter OMS procedures.

2. Actual cost. Most places you have to pay med school tuition, and of course eat, drink and Netflix and chill(YMMV). That means more loans and more cost. Don't forget thousands in fees to sit the medical licensing exams, and doubling your yearly cost for licensure. Plus two years of additional interest on all those loans you took out for dental school.

3. MD portability. Hope you didn't want to practice in Pennsylvania or Nevada, two states famous for denying medical licenses to OMS for not completing the required number of years of ACGME accredited residency. Not a problem for all programs, but for many.


Lets now examine the straight dollar value of the benefits versus the drawbacks amortized over a 40 year career. I'm going to use very general ranges to simplify things Since intangible benefits by necessity have no intrinsic value, their valuation is solely dependent on the individual evaluating them. We'll address that later.

Tangible benefit dollar value - 1-2 x 10^5

I think this is pretty generous. I could pay some more monthly premiums and wipe out the benefit of being able to follow my dream of becoming a medical radiologist after my iatrogenic amputation. Maybe I can get a slightly better job, or one in a slightly more ideal area, etc...

Tangible drawback dollar value- 1-2 x 10^7

No way to get around this. The cost of lost income is huge, even if you're a lifetime academic. The real cost is not insignificant either, especially if you end up at your USC/NYU-type private medical schools with wildly spiraling out of control costs.

So we can see, it's at least a million dollar decision.

So what does this mean? The individual needs to evaluate whether the intangible (or low-value tangible in my eyes) benefits outweigh the costs in their personal calculation. I think we benefit from having multiple pathways so people can evaluate these various factors and move along an educational pathway appropriate for them, their world view and their values.

You yourself indicated that, in your view, it's most appropriate for a single degree oral surgeon to stay in their office all day and shuck wizzies, and a dual-degree surgeon to spend their time in the hospital. You even mentioned 50% of graduates are in dual degree programs. But 50% of graduates don't work in a primary hospital setting. Not even 50% of dual degree graduates work in hospital settings. I'd wager not even 20% of dual-degree graduates go into a primary hospital or academic practice. That being the case, who's the one who's really myopic? (It's still the OP)

TL;DR:
-Real dollar cost vs. benefit is hands down non-existent for dual degree training over single degree training, need to rely on personal valuation of numerous intangible benefits which by definition only apply to the individual.
-Probably a significant relative difference in the number of full time hospital based practitioners between the two tracks, but the absolute difference is likely minimal compared to the number going into clinic-based cashola private practice."

So I really appreciate that in depth response. It’s not too often that people actually take the time to explain something to another healthcare professional so that we can all learn something. If I could divulge a little information...I was asking because a DDS/MD is going around telling pharmacies he’s an MD and therefore calling in all sorts of stuff for his family that has nothing to do with OMFS. In my state, and many others, if an RX is for a family member it’s considered outside their scope of practice and is considered invalid. I’m wondering what kind of safeguards are in place to protect the public against being misleading like this. I see on the AAOMS Use of Doctoral Degrees section it says specifically not to confuse people by telling people you’re an MD, but not disclosing what you’re actually trained and qualified in. And under the Scope of Practice section it basically says they’re limited to oral maxillofacial surgery and medications associated with that practice. Other surgeries are permitted, but that the provider has to make it clear (again) what they’re trained in and I don’t think he does that. He does rhinoplastys and eye lifts and tauts himself as an MD without saying he’s not a plastic surgeon....anyway, thoughts? Thank you again.

 

[W19]

@TravelingPharmD14

If he has a MD degree, it's not misleading for him to tell people he is a physician... I dont know about your state law, an MD degree gives you unlimited scope of practice, but physicians also have to be careful in that they have to practice medicine in the scope they are comfortable in.

 

[Anonymomfs]

So I really appreciate that in depth response. It’s not too often that people actually take the time to explain something to another healthcare professional so that we can all learn something. If I could divulge a little information...I was asking because a DDS/MD is going around telling pharmacies he’s an MD and therefore calling in all sorts of stuff for his family that has nothing to do with OMFS. In my state, and many others, if an RX is for a family member it’s considered outside their scope of practice and is considered invalid. I’m wondering what kind of safeguards are in place to protect the public against being misleading like this. I see on the AAOMS Use of Doctoral Degrees section it says specifically not to confuse people by telling people you’re an MD, but not disclosing what you’re actually trained and qualified in. And under the Scope of Practice section it basically says they’re limited to oral maxillofacial surgery and medications associated with that practice. Other surgeries are permitted, but that the provider has to make it clear (again) what they’re trained in and I don’t think he does that. He does rhinoplastys and eye lifts and tauts himself as an MD without saying he’s not a plastic surgeon....anyway, thoughts? Thank you again.

Your concern is understandable, but in order for anyone to have an MD license in most states one must complete an intern year in an ACGME-accredited residency. All combined MD programs have this built in as the year of general surgery. If he is a licensed MD then it is within his rights to diagnose and prescribe medications appropriate for his diagnoses, although I imagine state boards may have various rules regarding family members. In my state he is legally clear. If anything goes wrong with these medications and these patients choose to pursue legal action, then his intern year may not look so great in civil court.

Think about his MD license as equivocal to my friends who graduated from medical school, completed an intern year in either internal medicine or general surgery, and now moonlight in Doc in a box urgent care centers. They prescribe everything from antibiotics to birth control to pain medication to blood pressure meds. The prescribing doctor that you describe, again, if he completed a full combined program, has essentially the same training and legal rights.

As far as rhinoplasties and blepharoplasties (eye lifts) go, we're trained in that too. While most of us, including myself, are all about the TNT (Teeth and titanium,) there are oral and maxillofacial surgeons who do facial cosmetic procedures on a regular basis.

Just to make things more confusing, there are many single-degree oral and maxillofacial surgeons who do these facial cosmetic procedures too. Like I said, there's no difference between the MD and non-MD counterparts.

I will add that although I have two doctorates, I am not planning on pursuing another. I am neither pharmacist nor a lawyer and your training probably equips you better than me for situations like this.

 

[TravelingPharmD14]

Next time you see that dentist, tell him exactly what's on your mind. How dare that dentist act like a real doctor? Who does he think he is...Going around prescribing meds, performing surgeries, and informing people about the degrees that he's earned? The nerve of these dentists! Acting like they're real doctors! Next time you see him, tell him to stay in his lane and go fill some teeth!

Didn’t say any of that. I was asking about his scope of practice per our state law.

 

[TravelingPharmD14]

Your concern is understandable, but in order for anyone to have an MD license in most states one must complete an intern year in an ACGME-accredited residency. All combined MD programs have this built in as the year of general surgery. If he is a licensed MD then it is within his rights to diagnose and prescribe medications appropriate for his diagnoses, although I imagine state boards may have various rules regarding family members. In my state he is legally clear. If anything goes wrong with these medications and these patients choose to pursue legal action, then his intern year may not look so great in civil court.

Think about his MD license as equivocal to my friends who graduated from medical school, completed an intern year in either internal medicine or general surgery, and now moonlight in Doc in a box urgent care centers. They prescribe everything from antibiotics to birth control to pain medication to blood pressure meds. The prescribing doctor that you describe, again, if he completed a full combined program, has essentially the same training and legal rights.

As far as rhinoplasties and blepharoplasties (eye lifts) go, we're trained in that too. While most of us, including myself, are all about the TNT (Teeth and titanium,) there are oral and maxillofacial surgeons who do facial cosmetic procedures on a regular basis.

Just to make things more confusing, there are many single-degree oral and maxillofacial surgeons who do these facial cosmetic procedures too. Like I said, there's no difference between the MD and non-MD counterparts.

I will add that although I have two doctorates, I am not planning on pursuing another. I am neither pharmacist nor a lawyer and your training probably equips you better than me for situations like this.

Thanks the clarification. It sounds like per his training and expertise I’m still okay to say he’s outside his scope with how our state law is set up. But he’s *very* upset I’d even question it so I wanted to get some advice from other people in the field to see if I was off base. I appreciate all the information.

 

[vellnueve]

So I really appreciate that in depth response. It’s not too often that people actually take the time to explain something to another healthcare professional so that we can all learn something. If I could divulge a little information...I was asking because a DDS/MD is going around telling pharmacies he’s an MD and therefore calling in all sorts of stuff for his family that has nothing to do with OMFS. In my state, and many others, if an RX is for a family member it’s considered outside their scope of practice and is considered invalid. I’m wondering what kind of safeguards are in place to protect the public against being misleading like this. I see on the AAOMS Use of Doctoral Degrees section it says specifically not to confuse people by telling people you’re an MD, but not disclosing what you’re actually trained and qualified in. And under the Scope of Practice section it basically says they’re limited to oral maxillofacial surgery and medications associated with that practice. Other surgeries are permitted, but that the provider has to make it clear (again) what they’re trained in and I don’t think he does that. He does rhinoplastys and eye lifts and tauts himself as an MD without saying he’s not a plastic surgeon....anyway, thoughts? Thank you again.

If he has training in the areas in which he's prescribing meds, why is it your place to question it?

The fact that it's for family members would be more concerning for me.

 

[TravelingPharmD14]

If he has training in the areas in which he's prescribing meds, why is it your place to question it?

The fact that it's for family members would be more concerning for me.

I was saying both were concerning that he doesn’t have training in family practice/dermatology and that the medications were for family. But I agree, the family part was the most concerning for me.

 

[DDSER1]

I was saying both were concerning that he doesn’t have training in family practice/dermatology and that the medications were for family. But I agree, the family part was the most concerning for me.

Just relax, don’t be a narc

 

[Anonymomfs]

Just relax, don’t be a narc

Ugh. Reading posts like this from first-year dental students (yeah, I looked at your post history) is really disheartening. You most likely have no idea what this person's job is like, what they're responsible for, and what kind of training they have to deal with it.

If you want to keep your prescribing power in the future, I suggest you start treating extra-disciplinary professionals with respect. There are MDs all over the country who are aching to take our prescribing power and anesthesia privileges away from us. To keep them, we must explain our training and abilities ad nauseum, patiently and again, respectfully. Ask any oral surgeon or oral surgery resident who has been through a general surgery, anesthesia, or medical school rotation. People will be questioning your scope for your entire life. Impatience and disrespect will get you nowhere and reflect poorly on the rest of us.

This thread has deviated from the original topic quite a bit, but if I may circle back around, this discussion has provided a prescient example of how an MD degree may or may not be useful.

 

[DDSER1]

Ugh. Reading posts like this from first-year dental students (yeah, I looked at your post history) is really disheartening. You most likely have no idea what this person's job is like, what they're responsible for, and what kind of training they have to deal with it.

If you want to keep your prescribing power in the future, I suggest you start treating extra-disciplinary professionals with respect. There are MDs all over the country who are aching to take our prescribing power and anesthesia privileges away from us. To keep them, we must explain our training and abilities ad nauseum, patiently and again, respectfully. Ask any oral surgeon or oral surgery resident who has been through a general surgery, anesthesia, or medical school rotation. People will be questioning your scope for your entire life. Impatience and disrespect will get you nowhere and reflect poorly on the rest of us.

This thread has deviated from the original topic quite a bit, but if I may circle back around, this discussion has provided a prescient example of how an MD degree may or may not be useful.

You’re right, my mistake. I’ll be better