MD OMFS - The Future?

[ajmacgregor]

What do y'all think about the future of the 6-year MD OMFS programs?

Specifically - do you think more programs will move to the 6-year model, or will more programs move back to a 4-year + MD optional model?

-AjM

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[Jediwendell]

What do y'all think about the future of the 6-year MD OMFS programs?

Specifically - do you think more programs will move to the 6-year model, or will more programs move back to a 4-year + MD optional model?

-AjM

I think you will continue to see both.

 

[north2southOMFS]

I 2nd that notion.

I don't think it will change at all.

 

[Cranial]

i hope i dont get flamed for saying this, but i get the feeling that in the US, we'll have a dicotomy btw duel trained and non-duel trained surgeons. We'll have oral surgeons (single degree guys), and maxillofacial surgeons (duel degree guys)...sort of like Europe

 

[KY2007]

I couldn't disagree with you more. 6 year programs don't have any advantage over the scope or type of surgeries that you can perform. It sounds like you are trying to say that all 4 year oms can do is shuck teeth. Not true. The M.D. may give you more insight in how to deal with a medically compromised patient, but it doesn't make you a more skilled surgeon.

 

[Cranial]

I couldn't disagree with you more. 6 year programs don't have any advantage over the scope or type of surgeries that you can perform. It sounds like you are trying to say that all 4 year oms can do is shuck teeth. Not true. The M.D. may give you more insight in how to deal with a medically compromised patient, but it doesn't make you a more skilled surgeon.

dont get me wrong, i dont think it has anthing to do with scope of practice during training. Let me clarify: it would be more by choice of the surgeon. Those interested in more scope will gravitate more towards the 6-yr programs, while those not won't (just because it means more yrs, and they want to get out there and practise private and make a living doing the bread and butter procedures)

thats all.

 

[ItsGavinC]

I follow what cranial is saying: not that there IS a gap in training, but that practitioners may begin (or do) to perceive that there is a gap in training or difference in scope.

 

[Battlesign]

I don't think that it will change much. The only turf battles that we as future OMFSers will face are the ones that go on in our own heads. The scope of practice that is defined by the AAOMS is equal for all trained OMFS, 4 or 6. At the same time it may be easier to do certain procedures with an MD. No one will argue that some of the best surgeons in the US are single degree. No one will argue that some of the finest surgeons in the US are dual degree.
Ultimately your scope of practice will be dictated by you

 

[Cranial]

there is no question that there are a good number of very strong single-degree programs. also, there is no question that some of our guru omfs guys are single degree surgeons, but those were from the older generation(s). I have the feeling that as far as the future is concerned, we'll see more 6-yr guys go into academcis and less 4-yr guys doing the same.

Remember that one of the benfits of getting that MD is academics, and most applicants know that--i think. thus, those not interested in academics (ie those not interested in pursuing wide scoped surgery) are most likely to stick to 4-yr programs. i think will see more of that. its just behavioral and nothing more. its a matter of attitude.

 

[Battlesign]

there is no question that there are a good number of very strong single-degree programs. also, there is no question that some of our guru omfs guys are single degree surgeons, but those were from the older generation(s). I have the feeling that as far as the future is concerned, we'll see more 6-yr guys go into academcis and less 4-yr guys doing the same.

Remember that one of the benfits of getting that MD is academics, and most applicants know that--i think. thus, those not interested in academics (ie those not interested in pursuing wide scoped surgery) are most likely to stick to 4-yr programs. i think will see more of that. its just behavioral and nothing more. its a matter of attitude.

I agree that those that want to go into academics will want to get an MD. That still by no means implies that only those that get their MD and go into academics and work at a university hospital will be the only OMFS that have a large scope of practice. I know plenty of DDS or DMD/MD molar rollers. I also know plenty of DMD or DDS full scope guys/gals.
In the end what does 2 extra years of med school do for an OMFS. OMFS don't practice medicine they're surgeons.
Don't get me wrong, I'm going to be a dual. That is what I want for where I want to do in my life.
I just don't think that there will be much change in the way things in the real world concerning OMFS go.

 

[Jediwendell]

I couldn't disagree with you more. 6 year programs don't have any advantage over the scope or type of surgeries that you can perform. It sounds like you are trying to say that all 4 year oms can do is shuck teeth. Not true. The M.D. may give you more insight in how to deal with a medically compromised patient, but it doesn't make you a more skilled surgeon.

You know, you are right, but not entirely. It depends on if you want to do things in a hospital. Getting priviledges for cosmetics, craniofacial and other types of in hospital procedures that aren't traditional OMS is a lot easier if you have the MD. Scope of training in a four year program might be good, but the hospitals call the shots on who does what. I have seen four year guys doing neurosurgery for pete's sake. BUT..........If you want to do cosmetics in your office, you should be fine. Cleft lip and palate generally you have to have priviledges at a hospital and it can get pretty tough. Cancer is absolutely out in some places if you aren't an ENT. So, in some places, yes, there are two types of oral surgeons. Actually, the distinction is more that there are a few OMS types (MD and not) that really do full scope in private practice, and generally they are MD trained. Most OMS guys seem to sit in their office, shuck thirds, place implants and dabble in cosmetics. Some get more adventurous and do breasts. I know some people up in the Northeast and in California that really have trouble because they don't have an MD and want to do certain procedures. Oh, and just my two cents, I don't think that the MD really helped me to understand sick patients that much better. It justs helps you figure out when and how to consult that much sooner.

 

[Battlesign]

You know, you are right, but not entirely. It depends on if you want to do things in a hospital. Getting priviledges for cosmetics, craniofacial and other types of in hospital procedures that aren't traditional OMS is a lot easier if you have the MD. Scope of training in a four year program might be good, but the hospitals call the shots on who does what. I have seen four year guys doing neurosurgery for pete's sake. BUT..........If you want to do cosmetics in your office, you should be fine. Cleft lip and palate generally you have to have priviledges at a hospital and it can get pretty tough. Cancer is absolutely out in some places if you aren't an ENT. So, in some places, yes, there are two types of oral surgeons. Actually, the distinction is more that there are a few OMS types (MD and not) that really do full scope in private practice, and generally they are MD trained. Most OMS guys seem to sit in their office, shuck thirds, place implants and dabble in cosmetics. Some get more adventurous and do breasts. I know some people up in the Northeast and in California that really have trouble because they don't have an MD and want to do certain procedures. Oh, and just my two cents, I don't think that the MD really helped me to understand sick patients that much better. It justs helps you figure out when and how to consult that much sooner.

I always like your view. I agree wholeheartedly with your comments.

 

[KY2007]

There are just as many 4 year guys going into academics as there are 6 year. There is a shortage of dental facaulty out there because most people don't want to take the cut in pay. If you want to go into academics you most certainly do not need a M.D. The real benefit may be in the eyes of your patients although many may not know that you are not a physician in the first place.

 

[omfsapplicant]

There are just as many 4 year guys going into academics as there are 6 year. There is a shortage of dental facaulty out there because most people don't want to take the cut in pay. If you want to go into academics you most certainly do not need a M.D. The real benefit may be in the eyes of your patients although many may not know that you are not a physician in the first place.

A licensed md/dmd omfs is both a physicain and a dentist. md/do=physician dmd/dds]= dentist. Residency=specialty. For the record, integrated programs are more competitve (gpa, dental boards ect.) than 4 year programs, this was published a couple of years ago in jomfs.

 

[toofache32]

For the record, integrated programs are more competitve (gpa, dental boards ect.) than 4 year programs, this was published a couple of years ago in jomfs.

You have to be careful basing this statement merely on the scores of the applicants. These are self-selective applicant pools. I think most people apply to either 4- or 6-year programs, and few people apply/interview at both. But this is only my anecdotal observation.

The higher gpa/board scores for 6-year programs is likely due to mandated cut-off levels, and does not address the "applicant to available position" ratio. A higher cut-off for grades will actually decrease the application pool, in theory, while the number of positions available remains the same.

In reality, I don't think there is a way to know the answer to this. I'm not even sure why it matters.

 

[omfsapplicant]

You have to be careful basing this statement merely on the scores of the applicants. These are self-selective applicant pools. I think most people apply to either 4- or 6-year programs, and few people apply/interview at both. But this is only my anecdotal observation.

The higher gpa/board scores for 6-year programs is likely due to mandated cut-off levels, and does not address the "applicant to available position" ratio. A higher cut-off for grades will actually decrease the application pool, in theory, while the number of positions available remains the same.

In reality, I don't think there is a way to know the answer to this. I'm not even sure why it matters.

mandatory cut-offs and applicants self-selecting are two ways which make the 6-yr program more competitive.

 

[aphistis]

You have to be careful basing this statement merely on the scores of the applicants. These are self-selective applicant pools. I think most people apply to either 4- or 6-year programs, and few people apply/interview at both. But this is only my anecdotal observation.

The higher gpa/board scores for 6-year programs is likely due to mandated cut-off levels, and does not address the "applicant to available position" ratio. A higher cut-off for grades will actually decrease the application pool, in theory, while the number of positions available remains the same.

In reality, I don't think there is a way to know the answer to this. I'm not even sure why it matters.

The biggest reason I've come up with is that it must make certain, uh, omfs applicants, fixated on 6-year programs, feel better about the size of their boy parts.

 

[omfsapplicant]

The biggest reason I've come up with is that it must make certain, uh, omfs applicants, fixated on 6-year programs, feel better about the size of their boy parts.

though i should take the advice of your by-line....I am not nor have ever implied that 4 yr programs are inferior. Nor am I making judgement on idividual surgeons. I am only doing something which is rare on this site, stating facts and trying to site them.

 

[toofache32]

... feel better about the size of their boy parts.

...you mean adam's apple?

 

[aphistis]

...you mean adam's apple?

Of course.

...wait...are you saying there are others?

 

[omfsapplicant]

Of course.

...wait...are you saying there are others?

HEMaphitisRoDITE

 

[KY2007]

A licensed md/dmd omfs is both a physicain and a dentist. md/do=physician dmd/dds]= dentist. Residency=specialty. For the record, integrated programs are more competitve (gpa, dental boards ect.) than 4 year programs, this was published a couple of years ago in jomfs.

Don't want to crush the ego, but M.D. or not OMSers are still dentists. Still not sure why you quoted me. Also, I know that oms chairs may want 6 year programs to be more competitive and that 6 year programs want higher board scores on average. However, last year all 5 programs that didn't match someone were 6 year programs. In my book this makes 4 year programs more competitive.

 

[toofache32]

Don't want to crush the ego, but M.D. or not OMSers are still dentists. Still not sure why you quoted me. Also, I know that oms chairs may want 6 year programs to be more competitive and that 6 year programs want higher board scores on average. However, last year all 5 programs that didn't match someone were 6 year programs. In my book this makes 4 year programs more competitive.

Good point.

 

[omfsapplicant]

ky2007, I quoted you because you said pt won't know omfs aren't physicians. I never said omfs weren't dentists. You need to reread both posts.

The reason those programs didn't match was that the pool of good applicatios was spread too thin for the top programs. They all interview the same pool. Many of the applicants weren't acceptable to interivew. The lower tier programs aren't faced with the same problem. Let me know if you don't follow this. Sometimes you have to dig deeper.

 

[Jediwendell]

Don't want to crush the ego, but M.D. or not OMSers are still dentists. Still not sure why you quoted me. Also, I know that oms chairs may want 6 year programs to be more competitive and that 6 year programs want higher board scores on average. However, last year all 5 programs that didn't match someone were 6 year programs. In my book this makes 4 year programs more competitive.

Competitiveness here is kindof off topic. You still have to consider that in order to get interviews at most MD residencies you have to have a board of 90. Now you and I both know people that are in MD residencies that didn't have a 90. I would think that 4 years would be more competitive because they have more total applicants for both the reasons of attractiveness of 2 less years and the board score issue. Also, "competitiveness" is a little different than "difficult to get into". It eventually shakes out similar, I guess, but while you have to be very competitive in grades and board scores to get interviews at MD programs, they still might not be as competitive to get a spot in once you get the grades and scores you need. Dunno if that makes sense.

 

[omfsapplicant]

I don't think this statement could be farther off--I follow what cranial is saying: not that there IS a gap in training, but that practitioners may begin (or do) to perceive that there is a gap in training or difference in scope., ITsglavin.---No practitioner believes there is a gap in training. The fact is that intergrated surgeons end-up in the OR with more privileges than the 4 yr guys. This is most likely because dmd/mds choose to be in the or more often.

 

[tx oms]

I couldn't disagree with you more. 6 year programs don't have any advantage over the scope or type of surgeries that you can perform.

This part of your statement is NUTS!

 

[aphistis]

HEMaphitisRoDITE

You managed to screw up both my username and the word you attempted to embed it within. Not just anyone can fit two misspellings into a single word that was made-up to begin with.

 

[omfsapplicant]

You managed to screw up both my username and the word you attempted to embed it within. Not just anyone can fit two misspellings into a single word that was made-up to begin with.

Spelling aside, I thought it was pretty clever.

 

[aphistis]

Spelling aside, I thought it was pretty clever.

Good ideas are a dime a dozen, friend. It's the execution that counts.

 

[OzDDS]

I don't think this statement could be farther off--I follow what cranial is saying: not that there IS a gap in training, but that practitioners may begin (or do) to perceive that there is a gap in training or difference in scope., ITsglavin.---No practitioner believes there is a gap in training. The fact is that intergrated surgeons end-up in the OR with more privileges than the 4 yr guys. This is most likely because dmd/mds choose to be in the or more often.

The problem is.. most 4 year grads are better surgeons because they get more surgical training. 4 years of surgery vs. aprox. 3 years surg and 3 years med rotations. Depending on what program you go to. Something to think about.

 

[omfsres]

The problem is.. most 4 year grads are better surgeons because they get more surgical training. 4 years of surgery vs. aprox. 3 years surg and 3 years med rotations. Depending on what program you go to. Something to think about.

Not really. Even four year programs spend several months off service. 4 -6 months anesthesia, medicine, gen surgery, etc. so they probably get between 30 to 40 months. I'm at a six year program with 17 months of medical school and we spend 43-44 months on oral surgery. I don't know any 4 year program that has that much time on oral surgery. Most 6 year programs that only have MSIII and MSIV will have equal to or more months of oral surgery when compared to 4 year programs.

 

[Jediwendell]

most 4 year grads are better surgeons because they get more surgical training.

Pretty broad statement covering a lot of folks. Don't believe it. A six year guy's three and a half years of OMS are just as good as a four year guy's. Some faculty at four year progams will try and sell you on this, and it is a crap idea. The surgery amount and type is totally program dependent, not length of program dependent.

 

[OzDDS]

Not really. Even four year programs spend several months off service. 4 -6 months anesthesia, medicine, gen surgery, etc. so they probably get between 30 to 40 months. I'm at a six year program with 17 months of medical school and we spend 43-44 months on oral surgery. I don't know any 4 year program that has that much time on oral surgery. Most 6 year programs that only have MSIII and MSIV will have equal to or more months of oral surgery when compared to 4 year programs.

So what programs only do last two years of med.. I thought some made you do the last three years of med. What 5-year MD programs.. (Case, UIC?) Or I have even heard of a couple that were for year programs and then had an option at the "end" of the 4 year program to do a 2-year MD. any insite or advice?

 

[KY2007]

This part of your statement is NUTS!

In what way. Cosmetic, trauma, orthognathic? Certainly not preposthetic or 3rds. If you say cosmetic I won't believe you because there are plenty of 4 year guys out there that do that. Trauma is based on what you have done in the past and how much faith the hospital has in you. Orthognathic, have you heard of Dr. Joseph Van Sickles? Now don't get me wrong I am not trying to bash 6 year programs because I am going to apply to some too. All I know is everyone that has a M.D. says you should get one and everyone without one says you don't need it. Sounds kinda biased to me. I believe that all of the programs are capable of producing great surgeons. What you choose to do with your life after you finish your residency is up to you.

 

[USC2003]

I don't really believe the argument that 6 yr programs are more competitve based on requirements. Most people that were in my year of applicants and those applicants that I see applying to the 4 yr program where I attend certainly meet the minimum requirements of the med schools at the 6 yr spots. Most applicants I know already have a 90 or better on part I and as long as your undergrad gpa is above a 3.0 you shouldn't have any problems meeting these requirements. My undergrad gpa was 3.3 and I received interviews at all the 6 yr programs I applied to, Parkland, USC, UCLA, Houston, Louisville, Columbia, LIJ, NYU.

 

[Jediwendell]

In what way. Cosmetic, trauma, orthognathic? Certainly not preposthetic or 3rds. If you say cosmetic I won't believe you because there are plenty of 4 year guys out there that do that. Trauma is based on what you have done in the past and how much faith the hospital has in you. Orthognathic, have you heard of Dr. Joseph Van Sickles? Now don't get me wrong I am not trying to bash 6 year programs because I am going to apply to some too. All I know is everyone that has a M.D. says you should get one and everyone without one says you don't need it. Sounds kinda biased to me. I believe that all of the programs are capable of producing great surgeons. What you choose to do with your life after you finish your residency is up to you.

You are still missing one large point. In order to do a lot of things after you get out, you still have to get priveledges in a hospital. You even mention it in your statement, "how much faith the hospital has in you." It sometimes can be a really big issue. If they think you are going to get in there and start muscling in on the burgeoning cosmetic practice of the already established plastic surgeon and ENT, you are really going to have issues without an MD. Sure, you can do little cosmetic procedures in your office, but if you do a full face lift with submental lipo, it might be nice to have a place to put the patient for the evening so their pain is well controlled and somebody is monitoring them so their face doesn't slough. Why don't you go as Don Maxx over with Nicol and Morrow how well his cosmetic practice is going. Last I heard he was doing mostly traditional, but that may have changed, and he is a four year guy with a cosmetic one year fellowship. You are right that trauma can be done very easily by four years, but you generally don't get paid for trauma, so if you want to do it, bully for you. The bottom line is that six year guys will have an easier time getting priveledges at private hopsitals and surgery centers, and you can't use JVS or Rich Haug as examples because they work for an institution and have HUMONGOUS names. Even academicians can have trouble getting priveledges, just ask John Holmes who used to be at UAB. He was cancer fellowship trained and couldn't do any at UAB because they wouldn't give him the priveledges he needed.

 

[Jediwendell]

I don't really believe the argument that 6 yr programs are more competitve based on requirements. Most people that were in my year of applicants and those applicants that I see applying to the 4 yr program where I attend certainly meet the minimum requirements of the med schools at the 6 yr spots. Most applicants I know already have a 90 or better on part I and as long as your undergrad gpa is above a 3.0 you shouldn't have any problems meeting these requirements. My undergrad gpa was 3.3 and I received interviews at all the 6 yr programs I applied to, Parkland, USC, UCLA, Houston, Louisville, Columbia, LIJ, NYU.

The biggest issue with the 6 years is that the medical schools generally require them to have a part I cutoff of 90. If the person doesn't have a 90, it goes to a review committee. That is their way of determining who can pass Step I. This is they way I think about it. Suppose you have a pool of 800 people, and they are applying for 100 total spots of which 55 are six year. (The actual ratio is 103 6 year programs to 92 4 year, but this is a good approximation. If you take that 800 and assume that they have a pretty normal distribution curve for board scores, only about 100 at most will have above 90. Might not a little low in a real applicant pool, but above 90 is 91.2 percentile according to the back of my score card, so we will go with that number as a rough approximation. So, if you look at the number of applicants for each spot you get 14 to 1 ratio for the 4 year spots, and a 2 to 1 application ratio for the 6 year spots. So, the four years are more competitive, but in reality only about 15% of the total pool was even able to apply for the six year spots. So the six year spots are still very difficult to get into overall. If you are lucky enough to get above 90 on boards, you can most likely get a six year spot. I think that in the current dental atmosphere, less and less of the very qualified students are looking to OMS. Most have seen the lifestyle and are choosing ortho, endo and even pedo over OMS. So you see less people with 90 plus on their boards applying for OMS, particularly the six year OMS. Six years is a long time when you are comparing a two year pedo, ortho or endo residency. Hell, you could be a neurosurgeon after 4 years of school and six years of residency.

 

[KY2007]

Jediwendell I believe that it will be hard to set up a true cosmetic practice with or without the M.D. Who is going to be your referral base. Other physicians are going to send these procedures to plastic surgeons. Even a lot of general dentists don't know the full scope of oral and maxillofacial surgery. Most of the referrals will probably come from the people that you have worked on. I don't want to sound shady but advertising might be the only way.

 

[USC2003]

Jediwendell,

I am not talking about the average Jo when considering OMFS applicants. Serious applicants are those that have done well on their part I. Thus my statement that the majority of applicants that I have seen have a 90 or better on their part I's. There will always be people who apply to a specialty who are not competitive to begin with. So I still believe that those who apply to OMFS who are competitive to begin with will not have a problem meeting the requirments of a 6 yr program.

 

[KY2007]

Not to mention that everyone is assuming that you MUST get a 90 or above to get into a 6 year program. I was talking to one of the attendings at my school who used to be an attending at one of the 6 year programs in Texas and he said that they sometimes accepted people with board scores as low as 87.

 

[omfsapplicant]

I don't really believe the argument that 6 yr programs are more competitve based on requirements. Most people that were in my year of applicants and those applicants that I see applying to the 4 yr program where I attend certainly meet the minimum requirements of the med schools at the 6 yr spots. Most applicants I know already have a 90 or better on part I and as long as your undergrad gpa is above a 3.0 you shouldn't have any problems meeting these requirements. My undergrad gpa was 3.3 and I received interviews at all the 6 yr programs I applied to, Parkland, USC, UCLA, Houston, Louisville, Columbia, LIJ, NYU.

You don't believe? This anecdotal comment sure no purpose but to confuse the issue. The fact is that overall, 6 yr programs are more competitive, no matter how you twist it. I think omfs should applaud the integrated programs for advancing the specialty. To answer another question, the md option is a bad idea, because there is no way to get licensed. I you are not licensed, you should not advetise the degree.

 

[InMyCrossHairs]

Here is what I dont understand. It seems that there are so many OMFS applicants and hopefuls who really want to do plastics, facial reconstruction, cleft lip/palate and cancer, but, they do not seem to understand that the majority of those cases are going to the traditional route MD's (ENT's and Plastics) Why if this is the scope of practice you want to be in, and you know there are going to be turf wars down the road, why not just go straight to medical school and not Dental School. I am not questioning the ability of Oral Surgeons, I am confidant they have the technical skill to be superior to their med counterparts, but traditional MD's are very protective of these procedures and in the majority of cases are going to be kept in their "cirlce of trust."

I know someone is going to reply with a statement to the effect of I know Dr SOandSo and he is a OMS and does tons of.... Good for Dr SOandSO, he is typically the exception and not the norm. I just think that once many of these OMFS applicants are accepted and then finish their residency they may be both disappointed and perhaps jaded b/c they are not able to flourish in the subspecialty areas they would like to be excelling in.

 

[Jediwendell]

Here is what I dont understand. It seems that there are so many OMFS applicants and hopefuls who really want to do plastics, facial reconstruction, cleft lip/palate and cancer, but, they do not seem to understand that the majority of those cases are going to the traditional route MD's (ENT's and Plastics) Why if this is the scope of practice you want to be in, and you know there are going to be turf wars down the road, why not just go straight to medical school and not Dental School. I am not questioning the ability of Oral Surgeons, I am confidant they have the technical skill to be superior to their med counterparts, but traditional MD's are very protective of these procedures and in the majority of cases are going to be kept in their "cirlce of trust."

I know someone is going to reply with a statement to the effect of I know Dr SOandSo and he is a OMS and does tons of.... Good for Dr SOandSO, he is typically the exception and not the norm. I just think that once many of these OMFS applicants are accepted and then finish their residency they may be both disappointed and perhaps jaded b/c they are not able to flourish in the subspecialty areas they would like to be excelling in.

I agree one hundred percent. You shouldn't be going into OMS if you don't like doing wizzies, implants and pre-prosthetic surgery. That is going to be the majority of what you do.

 

[omfsapplicant]

Here is what I dont understand. It seems that there are so many OMFS applicants and hopefuls who really want to do plastics, facial reconstruction, cleft lip/palate and cancer, but, they do not seem to understand that the majority of those cases are going to the traditional route MD's (ENT's and Plastics) Why if this is the scope of practice you want to be in, and you know there are going to be turf wars down the road, why not just go straight to medical school and not Dental School. I am not questioning the ability of Oral Surgeons, I am confidant they have the technical skill to be superior to their med counterparts, but traditional MD's are very protective of these procedures and in the majority of cases are going to be kept in their "cirlce of trust."

I know someone is going to reply with a statement to the effect of I know Dr SOandSo and he is a OMS and does tons of.... Good for Dr SOandSO, he is typically the exception and not the norm. I just think that once many of these OMFS applicants are accepted and then finish their residency they may be both disappointed and perhaps jaded b/c they are not able to flourish in the subspecialty areas they would like to be excelling in.

A lot of plastic surgeons still object to ents/opthoplastics to dong plastic procedures. Ents are geting ce course on oral diseases, opthoplastics are doing breasts. No matter were you go in surgery there is a turf war.

Reconstructive surgery in the maxillofacial region is the realm of omf. The question is why not ent/plastics? In my experince ent is largely a medical speciality. And plastics is a lot of breasts. I personnally have no desire to persue facial plastics, nor run a medical practice.

 

[USC2003]

It really serves no purpose to argue over which is more compeitive 4 or 6yr programs. The point is that were all colleagues in the same profession and we should all be trying to better our profession. When it comes down to it whether you have an MD or not unfortunately you are seen as a dentist in the eyes of most (not all) of our medical colleagues. From personal experience and from talking to residents in various progams most of our medical colleagues are unaware of our full scope of practice. It is almost inevitable that you will be asked a dental related question or hear some joke while in residency whether you are in a 4 or 6yr program. This is why as residents as well as out in practice it is necessary for OMFS to be on top of their game. We have to work and know that much more to show our colleagues we belong. It just takes one bad resident or OMFS to allow someone else to say that we don't belong or shouldn't be performing certain procedures.

 

[OzDDS]

Here is what I dont understand. It seems that there are so many OMFS applicants and hopefuls who really want to do plastics, facial reconstruction, cleft lip/palate and cancer, but, they do not seem to understand that the majority of those cases are going to the traditional route MD's (ENT's and Plastics) Why if this is the scope of practice you want to be in, and you know there are going to be turf wars down the road, why not just go straight to medical school and not Dental School. I am not questioning the ability of Oral Surgeons, I am confidant they have the technical skill to be superior to their med counterparts, but traditional MD's are very protective of these procedures and in the majority of cases are going to be kept in their "cirlce of trust."

I know someone is going to reply with a statement to the effect of I know Dr SOandSo and he is a OMS and does tons of.... Good for Dr SOandSO, he is typically the exception and not the norm. I just think that once many of these OMFS applicants are accepted and then finish their residency they may be both disappointed and perhaps jaded b/c they are not able to flourish in the subspecialty areas they would like to be excelling in.

I think it is very much if not mostly in Oral Maxillofacial scope of practice to do craniofacial surgery. The funny thing is.. if you go to med school first and then do plastics. When you do your craniofacial fellowship.. YOU HAVE TO LEARN occlusion, orthognactics, dentofacial orthopedic theory, etc, etc, etc. THis is Dentistry!! I think by doing dental school and medical school and then oral and maxilofacial surgery you should be one of the BEST candidates for craniofacial work. More so even than a plastics guy because they have NO training in dental material.

craniofacial is head and neck reconstruction... I don't need to do 3 years of breast implants and lipsuctions and burn vascular surgery before I supspecialise in this area.. this should be more in the area of Maxillofacial and maybe ENT.

 

[mike3kgt]

unfortunately you are seen as a dentist

Unfortunately? I see this as a benefit, I love being "just a dentist" when:

1. On average, general dentistry (primary care) demands a salary higher on average than primary care in medicine.

2. Insurance does not dictate the scope of our fees, the way we run our practices, and who we see.

3. Your knowledge of the oral cavity far exceeds that contained by any other profession (except maybe for those that involve standing on street-corners). Occlusal harmony and TMD represent a significant problem, if I contain intimate knowledge of the TMJ as a resident, then imo, I contribute a significant amount to my residency.

Sorry to come out a seem like I'm blasting you, do not take it the wrong way, but I LOVE being called "just a dentist"

-Mike

 

[omfsapplicant]

It would greatly benefit the specialty if all programs were integrated.

 

[KY2007]

It would greatly benefit the specialty if all programs were integrated.

If your making a wish list why not ask that physicians and other doctors become more educated about what the training of OMS actually involves instead of saying that integration would benefit the specialty. Getting a M.D. doesn't make you a better surgeon. If you think that the only way to be a great surgeon is to have an M.D., why did you not go to medical school?