MD Option OMFS Programs

[Spaceman Spif]

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Just to mix it up a bit, I am wondering which 4 year OMFS programs have MD Option programs. Here is what I have so far:

VCU
Thomas Jefferson
UT-Memphis
Miami (Jackson Memorial)
St. Joseph's (NJ)
Louisville (4 year)
Westchester (NY)

Any others?

 

[The Anhedonia]

A word about MD-optional programs:

From what I understand, 4-yr programs that have an optional MD work by having you take 2 years of med school after residency. However, I think that you are not eligible for a medical license becuase you don't actually complete any PGY training (i.e. general surgery) as part of the 'optional' component. The whole reason 6-yr programs include the 1-yr (or 2 yrs as per state requirements in MA and PA) is to make you ellible for sit for USMLE Step 3. so ultimately, it makes the whole endeavor kinda useless..

Correct me if my understanding is wrong. 😕

 

[cyrano]

Are you sure that Louisville has a four year program? On their website I can only find information regarding the six year program.

 

[UCSFx2017]

A word about MD-optional programs:

From what I understand, 4-yr programs that have an optional MD work by having you take 2 years of med school after residency. However, I think that you are not eligible for a medical license becuase you don't actually complete any PGY training (i.e. general surgery) as part of the 'optional' component. The whole reason 6-yr programs include the 1-yr (or 2 yrs as per state requirements in MA and PA) is to make you ellible for sit for USMLE Step 3. so ultimately, it makes the whole endeavor kinda useless..

Correct me if my understanding is wrong. 😕

Are you sure they need the PGY designation in order to sit for Step 3? It seems like PGY is an arbitrary term for a pay-scale.

http://www.fsmb.org/usmle_apply.html
http://www.fsmb.org/step3/039_er.html
http://www.fsmb.org/step3/022_er.html

I think you might be right. In the application for the license of practicing medicine without restriction, they ask you to put at which hospital you completed your PGY-1 and PGY-2. It would be silly if you can sit for Step 3 but can't obtain a license.

http://www.portal.state.pa.us/porta...cine/12512/licensure_information/599413#forms

 

[CMistry]

A word about MD-optional programs:

From what I understand, 4-yr programs that have an optional MD work by having you take 2 years of med school after residency. However, I think that you are not eligible for a medical license becuase you don't actually complete any PGY training (i.e. general surgery) as part of the 'optional' component. The whole reason 6-yr programs include the 1-yr (or 2 yrs as per state requirements in MA and PA) is to make you ellible for sit for USMLE Step 3. so ultimately, it makes the whole endeavor kinda useless..

Correct me if my understanding is wrong. 😕

This is correct. A few states will allow you to take Step 3 without PGY-1 training, but licensing will require it anyways. So in reality the M.D.-option is actually 3 years after completing a 4-yr OMFS program. My understanding is that at some of the programs you can moonlight simultaneous to the med school training, and at others you will be away from OMFS the entire 3 years. Another thing to note is that some programs do med school years 2&3, while others do 3&4 and require you to pass Step 1 prior to admission (not easy for someone 7 years out of basic sciences!).

 

[Spaceman Spif]

This is correct. A few states will allow you to take Step 3 without PGY-1 training, but licensing will require it anyways. So in reality the M.D.-option is actually 3 years after completing a 4-yr OMFS program. My understanding is that at some of the programs you can moonlight simultaneous to the med school training, and at others you will be away from OMFS the entire 3 years. Another thing to note is that some programs do med school years 2&3, while others do 3&4 and require you to pass Step 1 prior to admission (not easy for someone 7 years out of basic sciences!).

Interesting. Unless you can moonlight during one if those years, it may not be worth it....

 

[IHO]

to further muddy the waters, some MD optional 4 yr programs the med school requires you to take the MCAT...unbelievably painful hurdle to jump through at that point in your training. although the MD option is theoretically possible, it doesn't seem very practical.

An amusing story from my past....I was interviewing at a 4 yr program <honestly cannot recall which one> that had stated on their website they offered an MD option. During the panel interview, talk came around to the MD degree in OMS...I launched into my well prepared (and by that point well rehersed) speech about how the MD degree was an important component of the training, but it wasn't necessary, but it added depth, but you could be the best surgeon ever without it, but it might provide more flexibility, blahblahblah, and that I was only looking at 6 yr programs and 4 yr programs with MD option, which I would be absolutely commited to taking. When I was finished talking, there were lots of exchanged glances around the table, then the chairman informed me they stopped the MD option 2 years ago. a Long AWKWARD silence followed. Then they asked me about my favorite movie and the interview wrapped up pretty quick.

 

[Spaceman Spif]

to further muddy the waters, some MD optional 4 yr programs the med school requires you to take the MCAT...unbelievably painful hurdle to jump through at that point in your training. although the MD option is theoretically possible, it doesn't seem very practical.

An amusing story from my past....I was interviewing at a 4 yr program <honestly cannot recall which one> that had stated on their website they offered an MD option. During the panel interview, talk came around to the MD degree in OMS...I launched into my well prepared (and by that point well rehersed) speech about how the MD degree was an important component of the training, but it wasn't necessary, but it added depth, but you could be the best surgeon ever without it, but it might provide more flexibility, blahblahblah, and that I was only looking at 6 yr programs and 4 yr programs with MD option, which I would be absolutely commited to taking. When I was finished talking, there were lots of exchanged glances around the table, then the chairman informed me they stopped the MD option 2 years ago. a Long AWKWARD silence followed. Then they asked me about my favorite movie and the interview wrapped up pretty quick.

I can wholeheartedly assure you I am NOT taking the MCAT.

Why do some programs say 6 years instead of 7? And if you don't do that extra year of general surgery, does that mean you can't sit for the Step 3 AND can't legally put MD behind your name?

 

[IHO]

I can wholeheartedly assure you I am NOT taking the MCAT.

Why do some programs say 6 years instead of 7? And if you don't do that extra year of general surgery, does that mean you can't sit for the Step 3 AND can't legally put MD behind your name?

great ? and somewhat controversial. Technically it is considered somewhat unethical (because it is misleading to the general public) to advertise yourself as an MD if you are not licensed to practice medicine. The official AAOMS stance on the issue ( unless it has recently changed) is that you should have a state license to advertise yourself with MD credentials. I would be interested to hear opinions from others on this subject.

All states require a minimum of a 12 month preliminary year (aka intern year or PGY1) in medicine or surgery to get licensed; some require 24 months. All MD-integrated 6 year programs will provide you credit for a PGY1 prelim general surgery year. This does not mean you do a full 12 months of GS, because you are allowed electives; your electives will be in oral surgery and/or anesthesia. Most programs will have you doing around 6 months of general surgery. A few OMS programs provide you credit for 24months of General surgery. If the state you are applying too for a medical license requires 24 months of medicine or surgery , you may be able to get your 5th year of oral surgery to count. This situation did not apply to me, so I may be off on some of the details.

 

[osteotomy01]

A question for residents, do you know of any residents who went to a 4yr program that didn't have the 2yr MD option (+1yr gen surg) but was able to work out an arrangement with another school/program for such a route. I know there are a couple PDs that have done so, mainly through fellowships in H&N...is that the only possible way?

 

[CMistry]

A question for residents, do you know of any residents who went to a 4yr program that didn't have the 2yr MD option (+1yr gen surg) but was able to work out an arrangement with another school/program for such a route. I know there are a couple PDs that have done so, mainly through fellowships in H&N...is that the only possible way?

It has been done in the past (without the H&N fellowship), but I'm sure it's on a case-by-case basis. Now that there are more and more 6-yr programs I do not think this happens very often if at all.

 

[Contach]

During my interview at Banner in 2012, this is what they said:
- when the program first started (4 or so years ago), they were working on making the program offer the MD option to its residents. The very first resident who was accepted, ended up leaving during his residency because they couldn't bring that work to fruition.
- one of the current residents looked through my information package at the meet and greet the night before to make sure the program wasn't falsely/inadvertently advertising the MD option.
- so for the foreseeable future - it will be a 4 year program.

 

[Regmata]

A question for residents, do you know of any residents who went to a 4yr program that didn't have the 2yr MD option (+1yr gen surg) but was able to work out an arrangement with another school/program for such a route. I know there are a couple PDs that have done so, mainly through fellowships in H&N...is that the only possible way?

Part of the problem is that you typically will need not only the 2 years of medical school, but also at least 1 year of general surgery in order to get your medical license. Unless there is a way to count your fellowship training as the year requirement, but I have never heard of this being a possibility.

 

[CranioFacial]

Fella that left was a great guy. Wasn't really for the reasons of it being a 6yr or not though. There are no plans in place for an option at this time. The program is growing pretty well though.

 

[deleted913442]

Wanted to revive this thread - anyone know how true this is with regards to the MD optional 4yr programs? is it technically 7 yrs to get the medical license?

 

[_balzac_]

Does it really worth it to get the MD? I love Medicine, I really do. But, from a very pragmatic point of view, doesn't make sense. Consumes more time, money, you earn less on those years, and your debt (most likely) will rise. For what?, another degree to do exactly the same thing that others can do in 4 years? I know its make it a bit easier to secure fellowships and teaching positions, but honestly, I wouldn't waste time in making my life more complicated than necessary.

 

[Life of Pablo]

But, from a very pragmatic point of view

I think it's fair to say people don't get the MD because it's pragmatic, so if you look at it from that POV, you'd never understand. Each person has their own reasoning for wanting to get it. I'm with you though, the cons outweigh the pros in my eyes.

 

[deleted1047421]

Does it really worth it to get the MD? I love Medicine, I really do. But, from a very pragmatic point of view, doesn't make sense. Consumes more time, money, you earn less on those years, and your debt (most likely) will rise. For what?, another degree to do exactly the same thing that others can do in 4 years? I know its make it a bit easier to secure fellowships and teaching positions, but honestly, I wouldn't waste time in making my life more complicated than necessary.

Sometimes people don't have a choice. They match where they match.
Everyone should feel absolutely blessed whether or not they get into a 6 yr or 4 yr. They are the luckiest sobs alive.
There are great advantages to having an MD. There are outstanding advantages to getting into a solid 4 year.

 

[Charcot-Marie-Tooth]

Sometimes people don't have a choice. They match where they match.
Everyone should feel absolutely blessed whether or not they get into a 6 yr or 4 yr. They are the luckiest sobs alive.
There are great advantages to having an MD. There are outstanding advantages to getting into a solid 4 year.

Well, you match where you applied/interviewed/ranked... So yeah, you do have a choice of whether you match a 4 or 6 year program

 

[deleted913442]

Does it really worth it to get the MD? I love Medicine, I really do. But, from a very pragmatic point of view, doesn't make sense. Consumes more time, money, you earn less on those years, and your debt (most likely) will rise. For what?, another degree to do exactly the same thing that others can do in 4 years? I know its make it a bit easier to secure fellowships and teaching positions, but honestly, I wouldn't waste time in making my life more complicated than necessary.

Personally, I am undecided b/w 4 or 6yr, but you never really know what might happen in the future. Maybe 1 day an MD can hold up more weight with regards to future restrictions. @OMSDoc said that assistants of 6yr docs can do more than the assistants of a 4yr doc, which could help with patient volume (state-dependent). It's obvious that OMFS wont be able to do their own anesthesia at some point in our lifetime - maybe an MD guy can hire a CRNA while a 4yr has to hire a Dental Anesthesiologist (again not sure/doubt this would happen but you never know)?

Also the reason I wanted to revive this thread is because maybe during mine (or anyones 4yr part of an MD optional route) you could fall in love with cancer or craniofacial abnormalities or plastics. The MD option gives you the opportunity to get the MD and have a better shot with those fellowships.

I am NOT discrediting 4yr docs and understand that 4yr docs are just as well-trained, if not better, than most 6yr docs. I am just merely just playing the devils advocate here.

 

[deleted1047421]

Personally, I am undecided b/w 4 or 6yr, but you never really know what might happen in the future. Maybe 1 day an MD can hold up more weight with regards to future restrictions. @OMSDoc said that assistants of 6yr docs can do more than the assistants of a 4yr doc, which could help with patient volume (state-dependent). It's obvious that OMFS wont be able to do their own anesthesia at some point in our lifetime - maybe an MD guy can hire a CRNA while a 4yr has to hire a Dental Anesthesiologist (again not sure/doubt this would happen but you never know)?

Also the reason I wanted to revive this thread is because maybe during mine (or anyones 4yr part of an MD optional route) you could fall in love with cancer or craniofacial abnormalities or plastics. The MD option gives you the opportunity to get the MD and have a better shot with those fellowships.

I am NOT discrediting 4yr docs and understand that 4yr docs are just as well-trained, if not better, than most 6yr docs. I am just merely just playing the devils advocate here.

The assistants do the exact same thing and can't do more/less based on single vs dual degree oral surgeons.

4 year OMFS can contract/hire CRNAs, just like dual degree oral surgeons.
But most oral surgeons whether single or dual degree don't do that. They administer their anesthesia by themselves.

Dual degree OMFSs can work with PAs which single degree OMFS cannot. I've heard that Kaiser has a preference for dual degree surgeons because they can work with PAs.

Licenses to operate OMFS and anesthesia permits are administered by a dental board. Any restrictions will likely fall on both single and dual degree.

 

[deleted1047421]

Well, you match where you applied/interviewed/ranked... So yeah, you do have a choice of whether you match a 4 or 6 year program

Yes there will be applicants who only apply to dual degree. There will be applicants that only apply to single degree programs. You are correct that for those applicants they have already decided and they have control on the matter.

But many applicants will apply to both. In those cases you can have applicants that want to go to a 6 year program, but ended up in a single degree program, and vice versa. At that point the decision is taken out of their hands when they submit their rank list. A lot of applicants will interview everywhere, rank every program, in hopes of just getting in. Remember this is a highly competitive specialty to match into.

Here is an example: Programs who have both single degree and dual degree options in the same institution. You have the option to apply to single, dual or both. Most applicants will apply to both hoping they will get a spot.

 

[deleted913442]

The assistants do the exact same thing and can't do more/less based on single vs dual degree oral surgeons.

4 year OMFS can contract/hire CRNAs, just like dual degree oral surgeons.
But most oral surgeons whether single or dual degree don't do that. They administer their anesthesia by themselves.

Dual degree OMFSs can work with PAs which single degree OMFS cannot. I've heard that Kaiser has a preference for dual degree surgeons because they can work with PAs.

Licenses to operate OMFS and anesthesia permits are administered by a dental board. Any restrictions will likely fall on both single and dual degree.

Makes sense! With regards to the assistant comment, OMSDoc mentioned that in another post (and he's a well-established 4yr doc), so I was just re-iterating it. I personally have no clue.

What if a 6yr OMFS guy is practicing under a medical license as opposed to their dental license? How would an anesthesia change affect them? Also, how would that affect them accepting insurances? Any advantage to practicing under your medical license?

 

[deleted913442]

Yes there will be applicants who only apply to dual degree. There will be applicants that only apply to single degree programs. You are correct that for those applicants they have already decided and they have control on the matter.

But many applicants will apply to both. In those cases you can have applicants that want to go to a 6 year program, but ended up in a single degree program, and vice versa. At that point the decision is taken out of their hands when they submit their rank list. A lot of applicants will interview everywhere, rank every program, in hopes of just getting in. Remember this is a highly competitive specialty to match into.

Here is an example: Programs who have both single degree and dual degree options in the same institution. You have the option to apply to single, dual or both. Most applicants will apply to both hoping they will get a spot.

Do you think applying to both the single and dual looks bad, though? I am very interested in Jefferson's program and they have both, but I have heard that it looks bad to apply to both and should just commit to one. Can you or anyone confirm this? I know Jefferson has the 4yr MD option, so maybe that is an outlier as you could say that you want 6yr and will do the 2yrs MD after 4yr residency and can apply to both.

 

[DDSER1]

Do you think applying to both the single and dual looks bad, though? I am very interested in Jefferson's program and they have both, but I have heard that it looks bad to apply to both and should just commit to one. Can you or anyone confirm this? I know Jefferson has the 4yr MD option, so maybe that is an outlier as you could say that you want 6yr and will do the 2yrs MD after 4yr residency and can apply to both.

I heard from a friend who’s a resident at a program that offers both options that if you apply to both they throw out your application. So you gotta decide beforehand to be safe.

 

[deleted913442]

I heard from a friend who’s a resident at a program that offers both options that if you apply to both they throw out your application. So you gotta decide beforehand to be safe.

I could totally see that. I wonder if they'd do the same at Jeff since technically the 4yr has the MD route and you could be committed to that.. hmm guess I just need to ask around.

 

[shulk]

The programs with both tracks love to ask why you do or don't want the MD during interviews. And of course, there are probably dual and single degree interviewers in the room. Fun times! Applying to both tracks at these places is dangerous. There are 'safe' answers for either pathway to give in the interview, but if you are applying to both you can't really use those justifications.

 

[deleted1047421]

Do you think applying to both the single and dual looks bad, though? I am very interested in Jefferson's program and they have both, but I have heard that it looks bad to apply to both and should just commit to one. Can you or anyone confirm this? I know Jefferson has the 4yr MD option, so maybe that is an outlier as you could say that you want 6yr and will do the 2yrs MD after 4yr residency and can apply to both.

I can't comment on that since I did not attend a program that offered both tracks.
What I can tell you is that I've been through the process myself. When I was a resident I went through countless applications, and interviewed many candidates. Our department would never discriminate against an applicant just because they were applying to the opposite track. That would be ridiculous. Many of the applicants that interviewed with us were applying to both tracks. We would hand select the best applicants based on the obvious factors (academic strength, willingness to learn, work ethic, humbleness). Candidates would be eliminated (on interview day), if they were rude, arrogant, awkward, etc. Being a resident is tough and you will work up to 130 hours a week. All this talk about 80 hours is simply untrue and you will understand this when you match. Underreporting of your hours will happen from the start.

On a side note, way back when I was an applicant myself I did interview at a program that offered both tracks. At the end of the interview the chairman told all the applicants that they were encouraged to apply to both tracks to increase their chances and that there was no harm in doing so. I remember his words clearly: "if you came to the interview today thinking you wanted a specific track and changed your mind or you are now open to the opposite track we encourage you to apply to both".

Obviously oral surgeons and residents from across the aisle will be biased as towards the track they chose. They is fine and that is life. But at the end of the day when they graduate no one really discusses this anymore.

 

[deleted1047421]

The programs with both tracks love to ask why you do or don't want the MD during interviews. And of course, there are probably dual and single degree interviewers in the room. Fun times! Applying to both tracks at these places is dangerous. There are 'safe' answers for either pathway to give in the interview, but if you are applying to both you can't really use those justifications.

Applicants typically place a heavy importance on which track they want to go to - which is a good thing.
However, applicants should focus more on the quality of education.
There will be high quality programs, regardless of whether or not the program is 4 or 6 years.

What do I mean by quality of education?
1) quality of attendings
2) case load
3) hospital politics
4) quality of anesthesia rotation


1) Quality of attendings:
Choose a program with good attendings. All of them have a career in education, but not all of them are equally devoted to teaching.

We are all dentists that have gone to dental school. Every dental school has certain faculty that most students try to avoid. Why? because they are plain difficult to work with. There are OMFS attendings across the country, in both dual and single degree programs that can behave the same way. (In fact they exist across all surgical specialties in health care).
Here is an example: orthognathic surgery.
Many orthodontist and dentist believe that orthognathic surgery should be a basic skill set for oral surgeons. I would agree. But sadly there are some residents that graduate that don't feel comfortable doing orthognathic surgery. This is why fellowships exist.
So why don't they feel comfortable? A lot has to do with how they are being taught by their attendings.

Here is a good example:
Attending stands at the head of the table and retracts. Allow two chief residents to operate the case fully. The attending is patient and tells the residents to take their time, no matter how long the case will last. Time is not as important than teaching the right technique. Residents are fully involved in the treatment planning and do the entire workup themselves. They even contact the orthodontists and show them the model surgery etc.

Here is a bad example:
Attending acts as a bully. Nothing is ever good enough for him/her. Makes the resident stand on the opposite side, while they cut from their dominant side. The attending always cuts more than their half, and really only allows the resident to operate because of difficult access. There is plenty of yelling and the resident is in a high stress environment.
There are plenty of reasons why they would behave this way. It could be because they don't trust the resident (surgery has high liability and they want to minimize their legal risk). Perhaps this is how they were taught. Sometimes they just want to do it themselves because they want to go home as early as possible. Occasionally you may see a junior attending who is just treating their role as a "fellowship", to learn as much as he/she can and then to get out into private practice (their focus was never to teach to begin with), while still getting paid an attending salary.

Again high quality attendings exist in both tracks (the opposite is also true).

2) case load
Gotta have the numbers. Satisfying the requirements to graduate is simple (these numbers are very low). To be proficient and comfortable you need to go to a high volume program. As residents your job is to learn the fundamental skills of full scope surgery (trauma, TMJ, orthognathics, implants, recon, implants etc). You better go to a high volume program that actually allows you to operate and focus on the basic core.

3)
Hospital politics.
Easiest example: trauma. How is it split among OMFS, ENT, and PRS?
Good example: One or both (ent or plastics) is out of the picture.
Bad example: ENT and PRS take the majority.
This is like your crown and bridge, your drill and fill of OMFS. You better know this properly. Choose a program obviously where you are primarily based out of level 1 trauma center, and OMFS takes the vast majority of the trauma call and leaves the competing specialties with crumbs.
Again the good programs are both single and dual degree.

4) Anesthesia rotation.
This is extremely important that you go to a program that your department has a strong and positive relationship with the anesthesia department.
I won't give any bad examples here, only good ones.
Good ones:
Anesthesia attendings are totally hands off and resident runs the entire case by themselves. There was an attending who told me one time: "you could intubate just as fast and good if not better than my own anesthesia residents". This is a critical part of your training.

I can go on and on (implants. TMJ (joint replacements), etc. I could write a story on all of these. But by now you are all tired of reading from me.

Point is: choose a program that is strong that will give you the best bang for your buck. These programs are both single and dual degree. That should be the focus.

 

[deleted913442]

Applicants typically place a heavy importance on which track they want to go to - which is a good thing.
However, applicants should focus more on the quality of education.
There will be high quality programs, regardless of whether or not the program is 4 or 6 years.

What do I mean by quality of education?
1) quality of attendings
2) case load
3) hospital politics
4) quality of anesthesia rotation


1) Quality of attendings:
Choose a program with good attendings. All of them have a career in education, but not all of them are equally devoted to teaching.

We are all dentists that have gone to dental school. Every dental school has certain faculty that most students try to avoid. Why? because they are plain difficult to work with. There are OMFS attendings across the country, in both dual and single degree programs that can behave the same way. (In fact they exist across all surgical specialties in health care).
Here is an example: orthognathic surgery.
Many orthodontist and dentist believe that orthognathic surgery should be a basic skill set for oral surgeons. I would agree. But sadly there are some residents that graduate that don't feel comfortable doing orthognathic surgery. This is why fellowships exist.
So why don't they feel comfortable? A lot has to do with how they are being taught by their attendings.

Here is a good example:
Attending stands at the head of the table and retracts. Allow two chief residents to operate the case fully. The attending is patient and tells the residents to take their time, no matter how long the case will last. Time is not as important than teaching the right technique. Residents are fully involved in the treatment planning and do the entire workup themselves. They even contact the orthodontists and show them the model surgery etc.

Here is a bad example:
Attending acts as a bully. Nothing is ever good enough for him/her. Makes the resident stand on the opposite side, while they cut from their dominant side. The attending always cuts more than their half, and really only allows the resident to operate because of difficult access. There is plenty of yelling and the resident is in a high stress environment.
There are plenty of reasons why they would behave this way. It could be because they don't trust the resident (surgery has high liability and they want to minimize their legal risk). Perhaps this is how they were taught. Sometimes they just want to do it themselves because they want to go home as early as possible. Occasionally you may see a junior attending who is just treating their role as a "fellowship", to learn as much as he/she can and then to get out into private practice (their focus was never to teach to begin with), while still getting paid an attending salary.

Again high quality attendings exist in both tracks (the opposite is also true).

2) case load
Gotta have the numbers. Satisfying the requirements to graduate is simple (these numbers are very low). To be proficient and comfortable you need to go to a high volume program. As residents your job is to learn the fundamental skills of full scope surgery (trauma, TMJ, orthognathics, implants, recon, implants etc). You better go to a high volume program that actually allows you to operate and focus on the basic core.

3)
Hospital politics.
Easiest example: trauma. How is it split among OMFS, ENT, and PRS?
Good example: One or both (ent or plastics) is out of the picture.
Bad example: ENT and PRS take the majority.
This is like your crown and bridge, your drill and fill of OMFS. You better know this properly. Choose a program obviously where you are primarily based out of level 1 trauma center, and OMFS takes the vast majority of the trauma call and leaves the competing specialties with crumbs.
Again the good programs are both single and dual degree.

4) Anesthesia rotation.
This is extremely important that you go to a program that your department has a strong and positive relationship with the anesthesia department.
I won't give any bad examples here, only good ones.
Good ones:
Anesthesia attendings are totally hands off and resident runs the entire case by themselves. There was an attending who told me one time: "you could intubate just as fast and good if not better than my own anesthesia residents". This is a critical part of your training.

I can go on and on (implants. TMJ (joint replacements), etc. I could write a story on all of these. But by now you are all tired of reading from me.

Point is: choose a program that is strong that will give you the best bang for your buck. These programs are both single and dual degree. That should be the focus.

This is great, thank you so much. 2 questions:

1) How are you supposed to find out the quality of attendings and exact case loads? Is this all word of mouth? Every OMFS program website says the same thing I feel and never give any numbers.

2) Wouldn't that be a good reason to explain to a PD why you're applying to both of their 4 and 6yr paths? I know the one person said they would "trash the app", but how is it bad to say "hey your program is my number 1. I want the 6yr but am willing to do the 4yr as long as I can train at this program. I will be applying to both and ranking the 6 as my number 1". If I was a PD, I would be ok with that. But I'm not, so idk maybe they do trash the apps.. Theres a few programs I want to apply to and would be willing to go either route as long as I get the same training at that exact program, even if I do match 4 or 6.

 

[super frank]

I could totally see that. I wonder if they'd do the same at Jeff since technically the 4yr has the MD route and you could be committed to that.. hmm guess I just need to ask around.

Extern at Jeff and find out.

 

[avangusva]

Applicants typically place a heavy importance on which track they want to go to - which is a good thing.
However, applicants should focus more on the quality of education.
There will be high quality programs, regardless of whether or not the program is 4 or 6 years.

What do I mean by quality of education?
1) quality of attendings
2) case load
3) hospital politics
4) quality of anesthesia rotation


1) Quality of attendings:
Choose a program with good attendings. All of them have a career in education, but not all of them are equally devoted to teaching.

We are all dentists that have gone to dental school. Every dental school has certain faculty that most students try to avoid. Why? because they are plain difficult to work with. There are OMFS attendings across the country, in both dual and single degree programs that can behave the same way. (In fact they exist across all surgical specialties in health care).
Here is an example: orthognathic surgery.
Many orthodontist and dentist believe that orthognathic surgery should be a basic skill set for oral surgeons. I would agree. But sadly there are some residents that graduate that don't feel comfortable doing orthognathic surgery. This is why fellowships exist.
So why don't they feel comfortable? A lot has to do with how they are being taught by their attendings.

Here is a good example:
Attending stands at the head of the table and retracts. Allow two chief residents to operate the case fully. The attending is patient and tells the residents to take their time, no matter how long the case will last. Time is not as important than teaching the right technique. Residents are fully involved in the treatment planning and do the entire workup themselves. They even contact the orthodontists and show them the model surgery etc.

Here is a bad example:
Attending acts as a bully. Nothing is ever good enough for him/her. Makes the resident stand on the opposite side, while they cut from their dominant side. The attending always cuts more than their half, and really only allows the resident to operate because of difficult access. There is plenty of yelling and the resident is in a high stress environment.
There are plenty of reasons why they would behave this way. It could be because they don't trust the resident (surgery has high liability and they want to minimize their legal risk). Perhaps this is how they were taught. Sometimes they just want to do it themselves because they want to go home as early as possible. Occasionally you may see a junior attending who is just treating their role as a "fellowship", to learn as much as he/she can and then to get out into private practice (their focus was never to teach to begin with), while still getting paid an attending salary.

Again high quality attendings exist in both tracks (the opposite is also true).

2) case load
Gotta have the numbers. Satisfying the requirements to graduate is simple (these numbers are very low). To be proficient and comfortable you need to go to a high volume program. As residents your job is to learn the fundamental skills of full scope surgery (trauma, TMJ, orthognathics, implants, recon, implants etc). You better go to a high volume program that actually allows you to operate and focus on the basic core.

3)
Hospital politics.
Easiest example: trauma. How is it split among OMFS, ENT, and PRS?
Good example: One or both (ent or plastics) is out of the picture.
Bad example: ENT and PRS take the majority.
This is like your crown and bridge, your drill and fill of OMFS. You better know this properly. Choose a program obviously where you are primarily based out of level 1 trauma center, and OMFS takes the vast majority of the trauma call and leaves the competing specialties with crumbs.
Again the good programs are both single and dual degree.

4) Anesthesia rotation.
This is extremely important that you go to a program that your department has a strong and positive relationship with the anesthesia department.
I won't give any bad examples here, only good ones.
Good ones:
Anesthesia attendings are totally hands off and resident runs the entire case by themselves. There was an attending who told me one time: "you could intubate just as fast and good if not better than my own anesthesia residents". This is a critical part of your training.

I can go on and on (implants. TMJ (joint replacements), etc. I could write a story on all of these. But by now you are all tired of reading from me.

Point is: choose a program that is strong that will give you the best bang for your buck. These programs are both single and dual degree. That should be the focus.

This guy OMFS's

This is a really good breakdown of some of the behind-the-scenes that is so hard to grasp at any interview or reading any program overview on SDN. Which is super unfortunate. The only way to know for sure is to extern at a program, and even then, it's hit or miss.

I think of all of these points, which are in the same order of importance that I'd agree with, the 1st is the easiest to see during externship. Some residents will be frank with their pros-cons during interviews. I personally am very honest about our program and what we do well and not so well. Unfortunately, I don't think this is the case everywhere and I really feel bad when I hear of people ending up spending 4-6 years of their lives miserable. Although in reality its such a short period of time and before you know it, it's gone.

 

[deleted972255]

Does anyone know-for the OMFS-MD option programs like VCU and NYMC, are you required to finish the MD immediately after the 4 year certificate? Or can you come back at a later point to finish it?

 

[parkinglottoilet]

Almost no one ever does it. It takes minimum 3 years for all those places because 2 years of med school and one year of general surgery. Sometimes the med school doesn't even line up with your graduation so it would be graduating in June and then having to wait to matriculate to medical school in march of the next year so it really becomes 4 years. If you want the MD do an integrated program IMO- it will make life easier and the road shorter

 

[deleted972255]

Almost no one ever does it. It takes minimum 3 years for all those places because 2 years of med school and one year of general surgery. Sometimes the med school doesn't even line up with your graduation so it would be graduating in June and then having to wait to matriculate to medical school in march of the next year so it really becomes 4 years. If you want the MD do an integrated program IMO- it will make life easier and the road shorter

But technically speaking, if say you have familial obligations and need to earn for a few years before doing the med school, that's allowed? Meaning you can come back a few years later?
I would like to do a 6yr, but I have a sick relative who could use some help with significant medical expenses.

 

[Sublimazing]

But technically speaking, if say you have familial obligations and need to earn for a few years before doing the med school, that's allowed? Meaning you can come back a few years later?
I would like to do a 6yr, but I have a sick relative who could use some help with significant medical expenses.

I would contact those programs. We used to allow omfs 4yr grads to come to our medical school...but that ended.

I also think you’d have to REALLY REALLY think about the importance of going back to school when you’re leaving $1.5 million + on the table.

 

[parkinglottoilet]

But technically speaking, if say you have familial obligations and need to earn for a few years before doing the med school, that's allowed? Meaning you can come back a few years later?
I would like to do a 6yr, but I have a sick relative who could use some help with significant medical expenses.

Yes that is definitely allowed. You can go back to school at any time as far as I know