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.
