My OMFS Externship Journey

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Yah-E

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Tomorrow I will be on my way to my month-long OMFS Externship with Louisiana State University, School of Dentistry, Health Science Center (LSUHSC) in New Orleans, LA. I will be driving from South Florida to NO, the drive is forecast to be a 15+ hour drive. My official dates of participation is from Monday, June 7th through Sunday, July 4th.

Although I was initially placed in the on-call room at the hospital for the entire month as my "home" during my externship, I have gotten a dorm room literately right across the street from the hospital where I will be at most of the time. The hospital and the dorm building is connected by a Skyway. I was very fortunate to find such dorm room available and now I can be close to the hospital and I don't have to worry about getting my stuff stolen if I were to be living in the on-call room.

With my own dorm room, I now can bring my desktop computer (also serves to be my TV since I have a TV tuner installed in my desktop) and actually get rest if I do actually get to rest for the month. The dorm room will cost me $480 for the month and that includes all utilities, high-speed internet, an assigned garage parking space, and basic cable TV. The dorm is called Stanislaus Hall and it is BRAND NEW! No one has ever lived in it yet and it was just recently remodelled and opened. This dormatory is for medical students and residents. For more info and pictures, visit:

http://www.is.lsuhsc.edu/reshall/stanislaus.htm

Now from what I know, I will be at the hospitals, but I'm not sure if I will get to be going to the dental school/building at all, but I hope to. The dental school building is actually 20 or so blocks north of the hospital that I will be externing at and where I live. The hospitals that I will be extern at are CHARITY HOSPITAL AND UNIVERSITY HOSPITAL. I know Charity is right in downtown connected to my dorm building, but not sure where University hospital is located.

I applied to this externship back in October 2003 (Fall semester of my 2nd year) and was accepted/offered the opportunity in the same month. I looked at 3 other externships which are the following, but only applied to one (LSU in NO):

UCLA
Michigan
Baylor

I will be missing 3 weeks of scheduled clinic days at Nova which will be excused, but hopefully this will not come back and hunt me since these are very first weeks of my clinical days and my "graduation requirement clock" is ticking! Obviously the more clinic days I have the more I'll get to work on my patients and the more grad. requirements I will get done! I guess these month-long externships will require sacrafices! For my LSU externship application requirements, visit:

http://www.pbhs.com/omsnet/block/dept/1mth/index.html

Although I've visited University of Minnesota OMFS for two consecutive spring breaks the last two years which I call them "mini-externships", this month-long externship will be my first OFFICIAL one. I really don't know what to expect, but a lot of hard work and fun learning more about the praticing scope of OMFS. I will be checking in with the Chief Resident on Sunday when I arrive and I start at 7 AM at Charity with morning rounds on Monday.

As usuall, I plan to share my experiences with you all, but we'll just have to wait to see what an OMFS externship is all about when you participate in a month long journey. I probably won't get my internet connected in my dorm room until mid week next week so.....

Alright peeps, I'm about to embark on another chapter in my book of dental school experiences. 👍
 
Good luck Yah-E!! Please tell us about it when you get there.
 
I heard from somewhere that LSU was ranked by residents as the #2 program in the nation this past year. Yah-E you are awesome to secure a OMFS extern spot there. I look forward to hearing all about it.
 
By the way Andy, is there a quick and concise way to find out which schools offer externships and in what specialties? I'm interested in doing some externships, but short of accessing every single school website (and probably missing some possibilities due to lame/oudated websites) I don't know how to research programs.

Any advice?
 
Alright, after close to 10 hours of driving and 600 miles later, I decided to call it a night. I'm now spending the night in Pensacola, FL which is the very western city in the Florida's pan-handle. I'm about 3 hours away from New Orleans which I will drive tomorrow. A bird flew and hit my windshield today, I felt bad, but there was nothing I could do.

I'm staying in Ramada Inn and they have wireless internet access, how nice huh? So I'm just relaxing and watching TV. I was looking at an atlas and figured out that the UNIVERSITY HOSPITAL that I will be externing at, in addition to CHARITY HOSPITAL, belongs to Tulane University.

G:

I don't believe that there is a list of what schools offer what externships? I know for fact that Ortho and Pedo has externships out there because I knwo people that have done them and obviously OMFS. Endo, Perio, and Prostho, I'm not sure. If you're interested in certain type of externship at a certain school? It's best to contact them to see if they have anything available.

Standford:

I, too, have heard nothing, but positives about LSU NO OMFS residency so I'm excited to experience it first hand. I don't think that most OMFS externships are competitive to secure a spot. I know UCLA is very competitive or at least requires A LOT from their externship applicants. I believe that LSU NO externship applicaiton is fare, it does require some stuff, but not as stringent as UCLA's application. Michigan's externship is not stringent either, but it's pain in the @ss! They want 4 letters of recommendation! Come on, it's an externship for crying out loud!

Alright, time to go to bed, another long day tomorrow! Signing off from good 'o Ramada Inn!
 
Andy,

If i knew you were breaking up your trip, i would have offered you to stay the night at my house in near-by Tallahassee. Anyways, the door is open and be safe with the rest of your drive!
 
Ladies and Gents, Boys & girls:

My externship thus far is shaping up to be a quite exciting adventure! Here's the scoop. I finally arrived at New Orleans on Sunday (June 6th) at around 3 PM. Couldn't find the right people to check into my dorm room so I got in contact with one of the Chief Resident here and he gave me the contact info to a current 1st year who was on call on Sunday. After gotten in contact with the 1st year on-call resident, I proceeded to go to the hospital, Charity to meet up with the on-call resident. So Sunday after I arrived at New Orleans, I hung out at the hospital and the on-call room until about 10 PM. I didn't do much, but set around in the Resident's Lounge watching TV and chatted with the 1st year resident about life in the on-call room.

So Monday (June 7th) was my first official day of my externship. I showed up at around 6:45 AM for a 7 AM OMFS department conference. At this weekly conference, I met two 4th-year residents, one 3rd-year resident, and three faculty members (one in which is the Residency Director and the other one the Department Chairman). In this conference, two case presentations were given (one by a 3rd-year and the other one by the 4th-year) and it took about two hours. Each case presenter was quizzed and asked questions about the case (what they call "getting pimped") by the faculty members. This conference reminded me of the "Grand Rounds" that I have previously experienced at Univ. of MN OMFS externships. It was pretty cool, I learned a lot and it was pretty intense for those residents that presented a case.

After the Monday Conference, I was invited to the annual 2-day deep sea fishing trip with the LSUHSC OMFS department. With the Dept Chair's permission, I agreed to attend the annual festivities. The cost was $100 and that covered amazing food, drinks, round trip car ride, boating fee, and all the fish we can catch and keep. At around 11 AM, I left the Charity Hospital with a 4th-year resident in preparation of our fishing trip. At around 3 PM, 4 residents (one 4th-year, two 3rd-year, and one Chief) and I rode in the same car and drove 2.5 hours to our fishing/camping destination.

At this fishing/camping site, the following people were present:

me, the extern
3 Chief Residents
1 5th-year Resident
1 4th-year Resident
4 3rd-year Residents
1 2nd-year Resident
1 1st-year Resident
1 incoming 1st-year Resident (River13 of SDN)
2 faculty members (one is the Residency Director)
4 LSU OMFS alumni (one is LSU Dental school Pre-doctoral oral surgery course director)

On Monday night, we ate steaks, potatoes, drinked, talked, and played basketball! It was a really cool opportunity to meet everyone in the department and see them outside the academia environment. I learned old LSU OMFS stories from alumni, I drinked with them, played cards with them until late into the night and interacted with all the residents. It was this night where River13 (SDN) and I met!

Tuesday morning, we all got up around 5:45 AM and went fishing. We boarded our fishing boat at around 7 AM and drove the boat out 30 miles or so into the Gulf of Mexico (2.5 hours of boat ride out into sea). We fished from 9:30 AM until about 3:30 PM and came back to shore about 5:30 PM. We caught a lot of fish with a 80 lbs yellow fin Tuna! I, personally didn't catch much, but again, it was cool just hanging out with everyone. I also got boat sick and puked once, but be sure to ask how many times River13 puked? 😀

To end the trip, we all got home around 9:30 PM Tuesday night and I had to check in at the hospital at 8 AM. The trip was amazing and what a great way to start an externship! Wednesday, I got to do a whole lot of things. Some highlights are:

I learned how to wire mandible fractures (I did two patients)
I extracted posterior teeth (6 molars and premolars)

There were a ton of other things, but I was at the hospital from 8 AM to 5 PM. There is another extern here from LSU dental. He's doing a 2-week externship and him and I went to eat after our long day Wednesday. Today, Thursday, I extracted more teeth (6 molars) and assisted an implant sedation case. Tonight, I'm on call with a 3rd-year resident and that leads me to now where I'm in the Resident Lounge typing to you guys. I will be spending the night here tonight. More later....peace y'all...
 
Wow, I want to try an externship sometime...sounds great!
 
This externship sound exciting, but it also sounds like lots of work...I think that's why I will pass on OMFS and stick with general dentistry! :laugh:

Good luck Yah.
 
Other than experience, what does an externship do for you? Does it help your chances for matching into a specialty?
 
Bickle, for sure, ESPECIALLY if you extern at schools you are interested in (which is part of the point). Notice that the residency director was on Andy's fishing trip--huge bonus!

Andy, I'm jealous!
 
Sup y'all:

Tonight on call, the 3rd-year resident and I were beeped 4 times, only twice we had to go down to the "Accident Room". Once for post-operative swelling of the face and second time for a consult on a abnormal growth of the palate (which my 3rd-year resident believes it's lymphoma or salivary gland minor tumor). He ordered a CT and we'll see that particular patient on Monday morning. Two other calls were minor calls.

My resident just went to bed upstairs in the on-call room and he'll come and get me if he get beeped. I, on the other hand, will be quizzed on and have to study all the facial muscle with all their insertion and origin! Faculty and resident here will quiz and question you on just about everything in relation to OMFS. Just today, I was asked about anesthesia techniques, type of sutures and their usage, and pathophysiology of an abcess formation.

--------------------------

About how will an externship or will an externship help you in the OMFS application process. OF COURSE, only "IF" you leave a positive impression! Thus far, everyone seems to like me! 👍 I can't believe my first week is coming to an end already! Advantages of an externship:

1) get to know the program/residency/faculty/residents/city
2) get to know more about OMFS scope of practice
3) confirm your desire to specialize in OMFS
4) experiencing something that you may not have gotten to experience if you didn't do an externship (for me like deep sea fishing)
5) for the program/residency/faculty/residents to get to know you

What I thought was cool about that fishing trip was that not only the Residency Director gotten to know me on a social level, but also I've gotten to see how social he is. To share a beer or two or three with the Residency Director two nights in a row, to me, is something pretty damn cool! In addition, all four 3rd-year residents have asked me on separate occasions that:

"Andy, do you know that if you get in here, we'll be your Chief Residents?"

Of course this means nothing as far as getting into LSU OMFS, but it's just nice that all residents include me in things and events! I mean it, EVERY single one of them are cool! LSU OMFS is such a relaxed, friendly, easy going environment with a lot of OMFS practice exposure. Alright....I should be reviewing facial muscles right now! Good night....I'll write more later..

Oh just so you all know, I've been here at Charity since 7:45 AM this morning and I won't get home tomorrow (Friday) until in the afternoon. I guess I'm required to be on call every third night. It's funny, the other extern from LSU dental, they don't ask him to be on call at all, but then again, this extern doesn't really care to match here at LSU OMFS so he doesn't do everything that I do (go to fishing trip, eat lunch with OMFS dept, stick around longer after hours, go on-call, etc.), he's even missed a day of externship unexcused! I'm not saying that I'm doing everything right, but if one wishes to place a positive impression onto a residency, you should try to do as much as you can! Just my opinion!
 
Hey Andy,

I appreciate you sharing your experience with all of us. Keep up the good work. I still remember reading your posts back in the day when you were struggling to get into dental school. Now look at what you have accomplished. You did well on the boards. You have maintained a good GPA, and NOW you are hob-nobbin with oral surgeons!! You are an inspiration to us all 👍

Good luck to ya.

-critter
 
Wow.. sounds exciting, Andy.

Thanks for sharing and hope to hear more stories soon. 🙂
 
Wow, that sounds really exciting. Have fun. 🙂
 
Andy,

This sounds way too cool.

I think that my Howard Hughes Program at the NIH ends fairly early (end of May)... which gives me almost an entire month before I have to return to UCSF to do my 3rd year. Maybe I can do an externship then... should be a blast.

You the man.
 
Well, I just got back from my first week of externship, well, really only 3.5 days of actual oral surgery stuff (the rest was fishing/camping). Now, the first time sleeping in the oncall room wasn't that bad, the bed was actually really nice to sleep on. I plan on to be oncall again for Sunday night with a 1st-year resident (not the incoming 1st-years, they don't start until July). It is so nice to come back to my dorm room where I can get buck @ss naked and relax! I've been gone since 7:40 AM on Thursday and getting back now at 2:45 PM on Friday (30+ hours). Fridays, the hospital dental clinic only opens until NOON! How sweet huh? But people usually stick around to chat and stuff. I stayed behind and was quizzed by a faculty. He's super nice!

Today, I extracted 14 teeth total plus fishing out about 6 roots (some with help from residents and some without). On one patient I was extracting #4 (right upper 2nd premolar), 40% of the clinical crown was detroyed by decay, after some elevation, I used a #150 forceps and eventually snapped the crown off and fractured the tooth at root trunk. I was like "****", I'm in trouble now....it took me another 30 minutes to fish those roots out with help from a resident! Also, I saw two patients who had mandible fractures and their mouths were wired shut with wires, they decided to remove them on their own. Ordered another set of panorex and evaluated their bone healing and rewired them shut. One was only wired for two weeks and the other one was only wired for 3 days after their mouths were wired shut the first time. Another patient I treated today had a lower left mandible swelling due to a tooth infection. I extracted #18 (lower left 2nd molar), by sectioning the roots to mesial and distal root halves (crown was destoryed by decay). I'm starting to get really good at giving local anesthetics and writing up charts (SOAP). The LSU dental extern is finished with his externship and a new one from Louisville should arrive this weekend.

Another cool thing I found out this morning when the 3rd-year resident and I were hanging out. He told me that residents will usually tell the Residency Director what they think of each and every externs and the Residency Director will go directly to the residents to see how each and every externs did! I guess it makes sense because I haven't seen the Residency Director since the fishing trip. He's always at the dental school building which is about 20 blocks or so northeast of the hospital where I'm at all the time. If an extern does not want to come to the residency that (s)he externed at, then it's still important to place a positive impression for letters of recommendation possibilities when the extern apply for residencies.

Alright peeps, I'm going to take a sh1t, shower, and nap and actually get some real good rest!

(out of 5 👍 possible)
Week one = 👍 👍 👍 👍 👍
 
1) Tulane Medical and LSU Medical Schools are right next to each other, both which are right next to Charity Hospital

2) Charity Hospital is the only Level 1 trauma medical center in south Louisiana, Mississippi, and Alabama.

3) Xavier University is about 5 minutes away

4) Tulane Hospital, Charity Hospital, University Hospital (LSU), and VA Hospital are all within three block radius. [correction: in a earlier post, I said University Hospital belongs to Tulane, that is incorrect, they're two separate hospitals]

5) LSU OMFS has currently

3 6th-year residents (Chiefs)
4 5th-year residents
4 4th-year residents
4 3rd-year residents - by the end of this year, these residents have the MD degree
3 2nd-year residents
3 1st-year residents
4 incoming 1st-year residents
3 incoming interns (1 year) - I believe these people didn't Match during matching process when they applied (OMFS internships are getting more popular for OMFS applicants who didn't match during matching process, I would go into an OMFS internship before a GPR if you wish to get into an OMFS residency if you didn't match). This year is the first time that LSU OMFS accepted OMFS interns. OMFS internships spots are far and few between, but more and more residencies are creating these internship spots. [POINT OF CLARIFICATION: faculty and residents call 1st-year residents "interns", then you have actual interns that are interns. It's all symantics, it's like a "redshirt" for sports, I guess.]

6) July of each year is when each OMFS classes move up to the next rank (1st-year become 2nd-year and so on) because that's when the new "interns" start!

7) LSU OMFS currently only has one female resident, but one more is coming in starting July, total of two female residents out of twenty something residents.

8) Those residents that I've gotten to know really well have all done an externship here prior during their pre-doctoral years. Not all classes have LSU dental graduates.

9) Case presentations are given every Monday morning and Tuesday night conferences, latter being much more formal. These conferences usually require all residents and department faculty to be present, but some don't show up for whatever reason (certain rotation, medical school, etc.). At these conferences, the resident case presenter will get quized left and right by faculties. As the residents would tell me, "get ready to bend over"! Externs are not required to do a case presentation, but it will look really good if you do one told by the residents. The last extern that did a case presentation, he is now a 1st-year resident (will be a 2nd-year this July). A 4th-year resident want me to do a case or a subject and I'm seriously considering doing one to learn and getting involved. Plus it will look good! I know I will get trimpled with questions, but it's expected! I'll keep y'all up-to-date on this one.

10) being on-call = you are sleeping at the hospital and are not sleeping at home and get beeped then you go to the hospital. on-call residents are usually underclassmen meaning 1st-, 2nd-, and 3rd-year residents. These are not rules, but pretty much what they live by, 4th-, 5th-year, and Chieves are not on-call out of respect and senority. Chieves are usually "2nd-call".

11) LSU OMFS have "face-calls" (any trauma to the craniofacial region) once every 3 nights between Plastics and ENTs

12) LSU OMFS residents rotates through, Plastics, Anesthesiology, Neuro, Orthopedics, Gen. Surgery, ERs (see below), Radiology and others that I can't remember right now

13) Charity Hospital ERs:
MER (Medical Emergency Room) - really sick patients
Accident Room
Fast Track - all easy stuff

14) OMSSAT - is an evaluation/assessment examination taken by OMFS residents every year in their OMFS training/residency (4Xs in a 4-year program and also 4Xs in a 6-year porgram). It is compared within all OMFS residents across the country. In a way it assesses how well the residency trains their residents. I guess the first one is taken in the 1st year of the OMFS residency and majority of the residents gets killed on it because 1st-year OMFS residents does not know much about oral surgery. In certain instances some OMFS residencies their 1st-years seem to do quite well on their first OMSSAT, it is known that particular residency teaches their residents the OMSSAT covered materials and/or has old OMSSAT exams (majority of the OMFS residencies does not have access to the old OMSSAT exams). I've been told that some OMFS residencies that do well in the OMSSAT exams may lack in clinical exposure and they have all the time to prepare for the OMSSAT exam (the academics). It is questionable that how can a 1st-year OMFS resident at one residency do better or get the same score and know more about oral surgery than a 4th-year OMFS resident at another residency on the OMSSAT?! OMSSAT used to be called OMSSITE. Started this year, ABOMS is releasing OMSSAT exams with answer explanations to all residencies so no particular residency has any advantages

15) The LSU dental student (4th year) extern who just finished his two-week externship and I went to this restaurant/bar the other night after our day at the hospital call The Dock, we had all you can eat crawfish (they look like mini-lobsters) for $9.99. We each had about 9 lbs of crawfish. That was some good sh1t!! Happy hour special, two-for-one on domestic brew-ha-has. A nice meal for a cheap price

16) If any of you plan to do an externship here at LSU OMFS Charity Hospital, I strongly suggest you live where I live right now in Stanislaus Hall. It is literately right across the street to the hospital and you get FREE cable TV, highspeed internet, outdoor onsite parking spot, and today I found out that I get FREE LAUNDRY also in brand new full size washers and dryers!! Everything in this dorm is brand spanking new and only cost about $480/month with a $250 refundable security deposite. You can sleep in the oncall room at the hospital for free, but you'll be bored there if you're not oncall. I'm the first extern that lives in Stanislaus Hall during my externship. Externs usually stay with their friends/family here in New Orleans, they're from here (they go to dental school here at LSU), or they stay in the oncall room.

17) LSU OMFS oncall room is on the 15th floor in the Charity hospital. OMFS has its own oncall room and shares it with no one. It is two rooms connected with a door in between that is never closed. There are a total of 6 single beds where housekeeping comes in everyday to change sheets. There is a bathroom in the oncall room, clean overall, but the shower is nasty. There are no TVs or internet connection to keep you entertained. I think is just fine if you were oncall and you sleep there, but if you stay there for the whole month, you may get bored. On the 14th floor in the hospital, there is a Resident's Loundge where there is a pool table, computers with internet connection and a TV where you can kill time if you decide to stay in the oncall room during your externship here

18) In my experience here so far, having a car is really helpful where I'm not trapped here in my dorm all the time. Living in a dorm, you'll need things like toilet paper, foood, little things.....if you don't have a car, it may be inconvenient for you to get your daily essentials.

19) Food - this is one area where I'm currently spending a lot of money on my own. The hospital has a cafeteria in the basement that you can eat at or you can dine at the restaurant in the downtown vicinity. The externship will not and does not cover your meals. But during your day at the hospital during your externship, the residents will try to feed you by using these green hospital meal tickets that they also use for themselves. These green meal tickets are worth $5.50 and only certain residents are permitted to pick them up from hospital business office. These meal tickets are limited to certain amount for each hospital departments. This past week, in the beginning I spend a lot of money on food for all 3 meals of the day, but at the end of the week, I'm starting to finally getting some meal tickets. So far, my lunches are covered by these meal tickets. Breakfast and dinner I'm on my own. Since my cooking utensils and apparatus is limited, I'm forced to dine out quite a bit. Just today I went grocery shopping for some non-perishable items that I can keep aroun to eat. That's one thing, if you plan to be doing an externship at a place where you're not staying with your family or friends or you're not originally from, plan to spend a lot of money for food especially if you're there for the month!

20) My dorm building is so new that they don't have the plumbing all right yet. I have no cold water in my shower, so I take an extremely HOT shower daily. It's not fun. The dorm people said that the water issue will be fixed by next week.....we'll see!

Alright peeps, that's it for now....lot of info huh? 😀
 
21) All the 1st-year residents are currently studying for the USMLE Step I which they will take on Saturday, June 19th. They get one week to study for the exam where they are free of their OMFS duties. They all will start medical school 3rd-year curriculum in August if they pass the USMLE Step I. A passing score is around mid-180s. From all the OMFS residents that I interacted with, they've all have said that USMLE Step I is a KILLER! By far the most challenging exam they've ever taken. You get two chances, if the second time you retake it and you still don't pass, then you're booted out of the LSU OMFS program. On individual basis, one may come back and complete the 4-year program and finish the OMFS portion of the training, but no MD degree. But it is at the discretion of the program director. At LSU OMFS, the program director STRONGLY believes that if an OMFS applicant earned a 90 on NBDE Part 1, his/her chances of passing the USMLE Step 1 are better than an OMFS applicant who didn't get a 90 on NBDE Part 1. That is why it is strongly encouraged by this department that this residency accept applicants with a 90 or higher average on NBDE Part 1 board scores.

22) LSU medical school also conducts an interview with the OMFS applicants when they come for an interview. This is when your undergraduate grades will be looked at and asked (if asked). LSU OMFS interview is a two-day event and the second day is where the LSU medical school will interview you.
 
Andy,
I'm wondering how important undergrad grades are in your case since you had to recover from them and it was so long ago.

You're a tremendous resource Andy.
 
Oh, I'm sure it will come back and hurt me in my applications to 6-year OMFS residencies.....but hopefully the medical schools and OMFS residencies will over look my undergaduate grades and see how I improved over the years.

Be honest with you, I probably will have better chances at a 4-year OMFS residency than at a 6-year! At the end of my LSU OMFS externship, I plan to sit down with the Residency Director and discuss my application outlook and I plan to ask that very specific question in regards to my undergraduate transcript! I'll keep y'all updated.

When I asked this very question to a 3rd-year resident, he said that high dental school grades and NBDE Part 1 scores will usually take some of the "bad blow" of undergrad grades away, but exactly is it enough, we don't know. It's all individual basis!

Like I mentioned earlier, it is the medical schools that will care mostly in these 6-year OMFS programs. Now some 6-year OMFS programs will have separate medical school interviews like LSU, but some 6-year OMFS programs don't have a separate medical school interviews (medical schools will accept whom ever the OMFS program selects).

I've seen stranger things happen, I'm sure y'all will read what happens to me next year when I apply. I guess I'll cross that bridge when I get there, right?!

😎
 
It doesn't sound right to hold something that you did wrong against you a while back when you have do well since then. If anything don't you think they'll look at your dental school grades like a "postbacc" grades?
 
Yah,

While you are there, do you mind asking them if the GRE is required or not? I'm still not sure if I am willing to take that stupid test just for their program. Thanks man.
 
Doggy Dog:

I did ask that! It's funny because according to the PASS application requirements, LSU OMFS at New Orleans is one of two OMFS residencies in the entire US that requires the GRE scores, I, too saw that, but when I asked a 3rd-year resident, he laughed and said "no"!

Then again, it may be a new requirement since that 3rd-year resident had gone through the application process, but from his reactions, he was shocked! I will ask the Residency Director or more recent residents tomorrow after our Monday morning conference.

Also, if River13, you're reading this, did you submit a GRE score report when you applied? The 3rd-year resident told me that the PASS application instructions often has misprinted info on there. "Be catious" the resident added and he recommends that you call the program directly and find out yourself exactly what is required in the application process. I will get to the bottom of this GRE crap! I don't want to take another exam either if I don't have to!
 
You don't need the GRE. I never took it for any of my interviews...its when the progam requires a masters degree that you have to take it.

'This year is the first time that LSU OMFS accepted OMFS interns' - that's not quite right. I know one from this year that interviewed w/ me.

BTW, I never externed at LSU.

Oh, and I barfed 13+ times in 3 sessions on the boat 😱
 
I wondered why the PASS stated that LSU OMFS requires the GRE then? That goes to show that be careful with what you read during application times. River13, that's funny that an intern interview you? I was talking to all the residents and they all said that the Chieves do and sometimes a 5th year will also do interviews. I know all the current residents, not all externed here at LSU, but I know many have.

After talking to the Residency Director today, I guess he wants to set up an "exit interview" with me. Sounds interesting and I'm looking forward to that! Today, I've done the following:

1) wired another mandible
2) extracted 4 teeth (3rds and premolars)
3) first IND (incision and draining an abscess)
4) Morning conference (3 cases)
5) got quizzed on "why do you get headaches in Meningitis?" (30 minute session)
6) TMJ consult

Mondays are recall & reevaluation days, it was busy but not horribly insane. Last Wednesday was CRAZY! Tonight I'll be on call with a 3rd-year resident and tongiht is "face call" night. Everything to the face, trauma, etc., OMFS will be beeped. It should be a fun night. Tomorrow, Tuesday, morning is OR at 7 AM, we have a hip graft reconstruction of the mandible at 7 AM. Since I'll be at the hospital already from tonight, I'll be in the OR watching! The Chief will be performing the surgery (he's only got one week left).

When all the new residents (River13) come in in the beginning of July, this Chief will be done and a whole new team of residents will be in the Charity dental clinic. Alright, I'm going to eat and then go back to the hospital for the rest of the night.

Peace! 👍

Alright guys, I barfed once....River barfed god knows how many times, but it was in 4 SESSIONS!! Not 3!! 😀 But he made up by catching more fish than I did!
 
For clarification, the intern interviewed WITH me, he didn't interview me. He'll be starting at Houston in 2 weeks.

Caught WAY more fish...
 
Tuesday, June 15th:

Last night I did "call" with a 3rd-year resident and with another extern who just arrived late Monday afternoon. He is from University of Kentucky and NOT Louisville as mentioned previously. The 3 of us did Pre-op rounds and rounds for patients we had previously operated on. Around 2:30 AM, we received our first "call" and it was a guy got bunched in the face and broke his mandible. So there I was, 3 AM wiring a mandible! 👍 It was a "face call" Monday night.

We didn't sleep from then on and started our Tuesday morning rounds at 6:45 AM and went to the Operating Room (OR) at around 7:15 AM. Tuesdays are OR days. We had three OR cases this Tuesday and they were all mandible fractures. The first case took about 3 hours for a bilateral mand Fx. I scrubed in and assisted and operated on the case. After all the OR cases were finished at around 3 PM, I went back down to the dental clinic and treated more patients and extracted some teeth. At 5 PM we had our weekly Tuesday conference and that lasted until about 7:30 PM. At this conference all the Chiefs presented what they've learned in the last 6 years because that was their last conference and last week there before they officially complete the program. This Friday night is the Chiefs' Departing/graduating banquet which the entire department will be there including the externs. Needless to say, working on all day Monday, oncall Monday night and working all day Tuesday contiously (> 48 hours in a row), I passed out when I got home Tuesday night at around 8:30 PM!

Oh how can I forget, 5 of us went to a bar before the Tuesday night "goodbye" conference started. It was:

2 externs
1 Chief
1 5th-year
1 4th-year

Alcohol didn't help my tiredness. The the Tuesday night conference, I also met the BIG BIG DOG at LSU OMFS department and a few more residents. I'm confident to say that I've just about met everyone in the OMFS department here at LSU (like 30 some people). At any rate, there are lots to share which I'll share over the weekend when I have some time, but now I have to get my Wednesday started, I need to go to the hospital now.

more later....
 
Hey Andy,

Could you go into a little detail about the patient base that you are seeing. Like, what type of people are you dealing with, how old, personality, etc?? I?m sure you get your share of ?class? patients, and their stories would make this even more informative.
 
Due to patients confidentiality, I won't mention any names, but patients at Charity Hospital here are usually people on state funded insurance or poor people. About 90% of patients are African American and 40% of that are inmates. I don't have any special "easy" patients because I'm an extern, I do everything from extraction, wiring mandible fractures, incising & drain oral & maxillofacial abscesses, cancer screening, and work on OR cases.

Most patients for extractions are poor oral hygiene patients where the teeth to be extracted are grossly carious, 50% of the time the clinical crown snaps right off with your fingers and you'll have to go "fishing" for the root(s). A lot of the time, there will be no crowns and there's just this one root tip I'll have to get it out. Like today, I had this patient, 43 y/o aaf complaining of lower left jaw pain due to gross carious teeth #20 & #21. Both clinical crowns are gone with only lingual cusps left with root(s). Anesthetized with left IAN, some mental block and go in with a small straight elevator loose those bad boys!

Since I've been here, I'm confident that I've extracted over 70 teeth already! No joke! I've extracted just about every single type of tooth in the mouth since I've been here! I see about 6-8 patients a day on average when I'm in the clinic and I just go from one operatory to the next! Writing up the chart and H&P takes the longest, but after that, anesthetize and go at it! Spend about 20-30 minutes per patient and the most I've extracted at one time was 7 maxillary teeth all at one appointment. I've done a lot of 3rds, but no bony impactions obviously.

Tomorrow, I'll be going into the OR again at 7 AM and do morning rounds at 6:45 AM. Tonight, I just got back from working out with a 1st-year resident (soon to be 2nd-year resident in July), we did chest today. Man feels good to get back into the gym! At any rate, tonight that exact 1st-year resident and I and the extern are going to go get some drinks and smoke some cigars. That 1st-year resident is actually oncall tonight too, but he's all good.

Today in clinic, I wired two mandible fractures, both bilateral fractures. Extracted 5 teeth, treated one alveolar osseoitis (dry socket), and bunch of evaluations/recalls. Ladies and Gents, I'm having a blast! Alright shower time! Oh, one other thing, I met a very cute medical intern today in the ER, very, very cute! A little southern Brunette! 😍
 
This afternoon when I did rounds, a 1st-year resident and I and the other extern went checked up on this 11 y/o hispanic girl. Two days ago, she was involved in a car accident where she was thrown out of the vehicle. Luckily, she only fractured her mandible and some laceration on her face, but she also has lacerations all over her little body and suffered some internal organ damage and bleeding. She is stabled now, but here's the story...

She was brought in to Charity as an emergency two days ago, her father, mother and two sibling were all involved in the accident and were treated somewhere else. She doesn't speak English, only Spanish (which I don't speak) and she's here at New Orleans all by herself. LSU OMFS gone into the OR and plated her mandible and fixed/stabled her mandible fractures and then we proceeded to wire her jaw shut. So I've been following up on her while we do rounds starting in Surgical Intensive Care to Pediatrics.

Just this afternoon, we went to check up on this little girl who's all by herself and we need to release her metal wires that locked her jaw together and exchange elastic bands on her (her jaws are plated so we can do this, usually you wire the jaws together for minimal 6-weeks). She was more alert now and she was so scared. No parents, no family with her in the room. Myself and the resident was standing right next to her next to her bed. So as the resident proceeded to remove her metal wires and change to elastic bands, she raised her left arm and opened her hand to me! I didn't know what to do or what she wanted (language barrier), so I said, "you wanted to hold my hand?" and stook my hand out (not knowing if she understood me or not)! She knotted her head up and down and I held her hand the entire time while the resident exchanged the jaw apparatus.

I felt her hand squeezing tightly to mine everytime the resident opened her mouth. She had tears rolling down her little beautiful face, but she was so brave and her grasp absolutely touched me. She is such a beautiful little girl and I know she will recover fully and successfully. We, OMFS, have discharged her from our duties, but I think I will continue to check up on her during her stay here in New Orleans. Both of her parents are seriously injured as well from what I've heard, but this little girl's extended family have been contacted!

Oral surgery is a great thing and this is why I enjoy and love OMFS that much more! Buckle up people and especially your young children!
 
Hey andy, first of all great job with this journal. Second, I am really happy you are having a good time.

Can you please shed some light on 4yr vs 6yr program. I have talked to some people (residents and attendings) and come up with some comments I posted on another thread which I am going to paste here. But I was wondering if you could add some more to it.

The MD does not really do anything special for you if you are going to do bread and butter OMS work (as almost all OMS's do). Some people say that as an MD you get hospital rights easier... I dont see how this is true. As one of my MD OMFS instructors told me: Hospital rights are based on your status as BE/BC by the AAOMS and that is granted to anyone who successfully completes a residency MD or not.

There are a lot of guys who do fellowships like Plastics, Craniofacial, Head and Neck (oncology), etc... for these I imagine you have a better shot of matching into if you have the MD. Its up to each individual. My 4th year friends who just graduated said that this year the 4yr programs were a lot more competitive. If you notice, a lot of programs upto 2001 would give their residents stipends all through the 6 years and deduct the med school tuition in the MSIII and MSIV years... that seems to have stopped. Now you are responible for all your expenses during the med school years. Also, NYU seems to have changed their 6yr to 4yr.... so maybe the trend is changing since a lot of students are opting for the 4yr programs.

Keep in mind, if anyone does want to go into PRS after the OMFS residency, they still have to go back and complete two more years of GS before they are eligible to do a PRS residency, so it becomes 6+2+2 = 10 yrs
 
Yah-E said:
Around 2:30 AM, we received our first "call" and it was a guy got bunched in the face and broke his mandible. So there I was, 3 AM wiring a mandible! 👍 It was a "face call" Monday night.

And this is precisely why I opted to do my GPR at a hospital that has a 6-yr OMS program in the same clinic with us. Any broken faces at 3 am, I am calling the OMS resident. Maybe I'll stick around and suction for him/her, only b/c I'm a nice person.

Yah-E, your cute story sounds like great applicant essay material.
 
AMMD:

You're absolutely right on a lot of things you've mentioned. Since I'm externing at a 6-year program, everyone here is pretty much "pro" MD and they can rub shoulders with all the MDs giving them "****". I've, too, been told by residents that if you wish to do "bread and butter", do the 4 year program. The MD program has its own advantages and disadvantages, I'm actually finding these "advantages and disadvantages" myself as I go through my externship! I believe that gaining "respect" plays a huge part of it amongest the MD counterparts, but I know there are plenty more. We can sit here and talk about why MD and why not MD all day, which I don't wish to do. I'm simply keeping my options open, I don't know exactly if I will go for the MD or not.

G:

You're right, it's the left side and not right as I have typed earlier! What can I say, I was tired and I don't know my teeth numbers yet. Oh yeah, never forget the ladies! Especially cute ones!

Griffin:

Essay idea? Perhaps, but for now, I just want that little girl to get better!

Alright peeps, night night time and then Morning Rounds at 6:45 AM.
 
Is there stipend for OMS externship programs?
 
Hey Yah, can you shed some light on years 2 and 3 and what their schedule is like.
 
This thread is really awesome! YAh-E, Thanks for sharing your amazing experience with all of us.
 
Sup Y'all:

Since the staff has to do ACLS today, Charity Dental Clinic is closed and only accepts emergency visits. There were two OR cases this morning:

1) hip graft (from anterior iliac crest) to reconstruct the mandible
2) 5 dental implants in the mandible

I'm now holding down the dental clinic taking all emergency visits while the 2 4th-residents guide me. Today for emergency, I treated a dry socket patient and placed an eugenol wound dressing and irrigated the surgical site. Second patient, it was a 12 y/o aam, cute little boy who plays football (def. lineman), he had a lingual mass by tooth #26. The mass has increased in size over the last year. I excised it and send it to pathology. I taught the little boy how to read a panorex radiograph (stimulate his medical interest/drive). I'll be on call tonight, it's another "face call" night.

OMFS externships are not funded, you will not get a stipend. But some dental schools will give you some money for externships. The last extern from LSU dental, he told me that he received $750 from his dental school. Now, is it true or not, I'm not sure. Ask your own dental schools if they have such funds, but OMFS residencies will not pay for anything during your externship participation.

About the Year 2 and 3 curriculum, I don't have all the details.
 
You should re-title this thread "Learning to play God II" by Yah-E ....

Do you ever question giving up some of the benefits associated with being a general dentist (lifestyle, etc?) in order to pursue OMFS? Seems like there is a big tradeoff? just to become a surgeon 🙂
 
Zurik5, I ask myself this eeeevvveeeerrrryyyy day. Yah-E's post is helping me figure it out.

Thanks Andy
 
Years 2 and 3 of the program consist of years 3 and 4 of medical school.

Year 3 of medical school consists of core rotations in Surgery, ob-gyn, medicine, pediatrics, and psych, with a few smaller rotations thrown in depending on the particular school. You are usually required to rotate on the oral surgery service during the vacation month that most sudents get. No not your winter vacation, you get that one

Year 4 in medical school has a wide variety of schedules depending on the school and student. Most med students take their electives during this year in addition to a few months of required rotations. As an omfs your elective schedule is limited and insted you rotate on the omfs service

Typical schedule might look like this

3rd year Surgery 2 months
ob-gyn 2 months
medicine 2 months
pediatrics 2months
psych 6 weeks
Ent 1 week
Ortho 1 week
Urology 1 week
ophto 1week
neuro/ neurosurgery 2 weeks
Omfs 1 month

My classmates get the month that I'm doing omfs off.

My fourth year begins July 1

Looks like my schedule will be as follows

5-7 months of Omfs depending if I choose to work or slack and take a month vacation, and an elective. They are flexible on this but I have to do at least 5 months on service

1 month as a med student in the ER, easy because I've already done 2 as an intern

1 month working with a private practice general surgeon

1 month in the MICU

1 month doing some other thing that the school hasn't exactly defined yet, although I'm fully prepared to bend over for this one.

1 month of in June before beginning general surgery internship


By the way, it will be funny when you return to dental school and try to extract a tooth with the speed and ease that they let you in an externship.
Damn dental school profs are so conservative. Drove me nuts
 
Thanks Bitters, that's very helpfull. What about your day to day schedule. Hours at school during PGY2/3 compared to PGY1 and all the rest for that matter. I'm trying to find some good news to break to the wife, if it exists.
 
Thursday night I was oncall with a 3rd-year resident and this night was a "face night". We first got a call about this 25 y/o guy present in the Accident Room with right angle mandible swelling pain, indurated, 7 cm, localized, and patient unable to open greater than 20 mm. The swelling gradually increased in size in the last 15 days. Patient took Penicillin, didn't work, changed to Clinda po, puked it up and now he's here. Order a CT scan 3mm slices, vertical from mandible up to thr orbit. Later the swelling was diagnosed as submandibular abscess odontogenic origin, abcess was in the submandibular space.

Patient was brought to OR at 8 PM for immediate I & D (incision & draining) because we didn't want the abscess continued on into the lateral laryngeal space compromising the airway. I scrubbed in and act as the second surgeon. I & D was done by a 5th-year resident who was "2nd-call" and I removed teeth #30, 31 & 32 and closed the patient. The drainage site was left open with two rubber hose sutured to the incision site for draining over night.

Once that was done, we, OMFSs were consulted on a GSW (gun shot wound) patient who was shot in the abdomen and in the face. After a thorough maxillofacial examination, we diagnosed that a bullet entered the the face just below the left lower lip, travelled superior-posteriorly and exited in the front of the left tragus and right through the back of the ear. The 3rd-year resident sutured the exit wounds of the ear and we plan on checking up on this patient this morning (Friday) during morning rounds. The tympanic membrane seem to be intact and no CT scans were ordered. No apparent/obvious intraoral perforations from the bullet.

By this time, it was already midnight. I went up to the resident's lounge and watch Celebrety Poker on Bravo while the oncall resident went upstairs to the oncall room to get a shut-eye. I finally went up to the oncall room around 1 AM Friday to sleep. At 3 AM we got another call from the Accident Room downstairs.

This patient was smoking cocaine and got f-up! Apparently he fell and hit his face on a fence. This was a face laceration case. This patient had a 6-inch laceration from the philtrum of his lip (crossed the midline) all the away across his right face along the midface and zygomatic arch. Another 2-inch laceration on his chin and another 1-inch diameter piece of skin hanging off of a 2 mm intact skin on his forehead. The resident allow me to do this entire case all by myself. I first anesthetized the patient by giving him a right extraoral infraorbital block, I also gave him two ASA blocks intraorally, and some local infiltration on his forehead just inferior to the wound to block the V1 coming up from the superior orbital foramen innervating the forehead. The lacerations were ranged from 3 mm to 8 mm deep, the deepest along the inferior border of the nose. I used a 4-0 Vicro to suture the subcutaneous tissues of the laceration and a 5-0 prolene to suture the superficial skin because I wanted to see him back. I used simple interrupted suturing technique and when all said and done, this patient recieved 28 stitches from me. Took me two hours. I approximated the wounds so nicely that a medical school ER faculty said that I did a wonderful job, but this is not plastic surgery! 😀 I can't believe that I sewed someone's face back together for the first time!

When that was done, it's already 5:30 AM and almost time for morning rounds! During the morning rounds, we went to check up on the GSW patient who we just sutured up the night before. During our physical examination, when asked to smile, wrinkled forehead, frown, close eye lids, only one side of the facial muscles moved. This poor patient's left CN VII was severed. We checked up on 5 patients total during our morning rounds.

At 8 AM, clinic starts, but it's emergency only just like Thursday because our in-house staff has ACLS. I saw one emergency and it was this 29, y/o aam present with upper left jaw pain due to an old restoration falling out. It has been bothering him for the last month or so and he wanted that tooth extracted. After examining the panorex, we found that this patient has all of his 3rds in, teeth #3 and #15 have missing restorations and tooth #21 has PA radiolucency with missing clinical crown due to caries. At that point, I felt strongly that since our patient is still young, tooth #3 or #15 can be saved with general dentistry, possibly Endo, I referred the patient to general dentistry. I extracted #21 and recommended the patient to schedule for 3rds removal under light sedation. #16 was distal angulared and impacted.

Clinic closed at noon and I'm going to take a shower and a nap. Another week down and these 29-30 hour oncall nights are not only physical draining but it's also a lot of fun since I see so much crap and action! Tonight is graduation dinner at 7 PM, then the whole department is off to Bourbon Street!

Alright peeps..

2nd-week of externship receives another 👍 👍 👍 👍 👍
 
1. After talking with many residents and faculty members, it has been clarified that undergraduate grades will be looked at by the LSU medical school here in this particular 6-year MD OMFS program more than the dental school. I asked what about an applicant with crappy undergraduate grades. All my sources have said that if the OMFS residency (dental side) ranks you (have interests in you for a resident spot), they will negotiate your application with the medical school. All my sources have said that if the OMFS residency wants you, then the medical school will take you regardless of your crappy undergraduate GPA. It has also mentioned that a high NBDE Part 1 may compensates for a lower undergraduate GPA.

2. Once accepted to the LSU OMFS program, an out-of-state person attending the residency program will automatically receive in-state tuition for medical school, which is around $17K/year. Remember some OMFS residency out there will pay you a stipend during medical school, but LSU New Orleans is not one of them. Further, some OMFS residencies will pay for your medical school tuition, again, LSU New Orleans is not one of them.

3. LSU OMFS's residency curriculum only has about 1.5 years of medical school curriculum if you add them all together.

4. The two most respected OMFS residencies in the country (unofficial) are said to be: 9in the eyes of LSU OMFS residents)

LSU New Orleans (Charity Hospital)
Parkland Dallas (Soutwestern Hospital)

These two have the most clinical exposure and action in OMFS training.

5. Externships are used for:

- gain OMFS scope of practice exposure
- for faculty & residents to know you for application success purpose
- to increase your application success and competitiveness

People always say, "go do externships so you can see the program", this is true, BUT another effective tactic is, "go do externships at high respectable residencies to increase your application competitiveness" (not the name, but clinical exposure). For example, applicant A did two externships, one at LSU NO and the other at Parkland, applicant B did 1 externship at University of Minnesota. Both of these applicants wish to match at University of Minnesota. All other variables are constant. University of Minnesota OMFS residency receives 200 applications for their 4 seats/year. They see that applicant A is very deteremined and that (s)he has experienced externships at two prestigious OMFS residencies with strong clinical exposure and that applicant B is someone that they already know because (s)he was there for an externship. In this case, both of these applicants (A & B) may very well be ranked by the Univ. of MN OMFS program.

See what I'm saying? Of course, this is only an educated hypothesis, but in my opinion, I suggest you to do an externship either at a residency that you intent to apply to OR do one at a strong clinical exposure OMFS residency such as LSU or Parkland so it looks good.

6. When to do an OMFS externship?
I strongly suggest you do one in the summer between your 2nd and 3rd year of dental school. I have many residents and faculty told me that they think it's wonderful that I started so early instead of waiting until the summer between 3rd & 4th year. Of course all this depends on your dental school and what they allow and don't allow. I know it can be difficult to find time to do an externship, especially an one-month externship, but do one as early as possible. In this way, the next one you participate in, you'll be that much more efficient and effective as an extern.

7. How long should my externship be?
Again, I am a "pro" month-long externships if you can afford it. Everyone has different view on this, but for me, two weeks may or may not be enough to see what a program has to offer? A lot of the residents and faculty here at LSU are glad that I'm here for a month and I've created some strong bonds (educational and social) with many of residents and faculty already. Many of them strongly recommends 1 month. Two weeks, they don't feel like it's enough. They don't care if you want to leave early, but they will talk about you after you leave. I've heard many negative extern stories already. For example, if I had only arranged for a two-week externship, then I would be leaving LSU already. I learned a lot and sure I got to do a lot as well. Of course I got a good idea what this OMFS residency program is like, but I would have missed a Plastic Surgery day on next Friday! I was invited last night by a faculty at the graduation dinner to assist him on this upcoming Friday to do Plastic Surgery all day. This particular faculty member finished his OMFS residency here at LSU NO and gone on a 1-year Plastic Surgery Fellowship. Now he's back, hired to be on staff and all he does is plastics. If I were to be finished with my externship, I would've missed this great opportunity to assist and perform Liposuction, rhinoplasty, and other plastics procedures! Another example, the extern that left last week, who only did a 2-week externship, if he would've done a month-long externship, he would've gotten to attend the Graduation Banquet last night and met more residents and faculty under a celebratory/social environment to increase his chances! I personally met the LSU Medical School Admission Dean at the dinner banquet who works with the LSU OMFS residency program. We didn't talk business, but I did introduce myself and we shared a cocktail! See a month-long experience may provide many unexpected opportunities! Everyone has their own goals with these externships, I'm simply stating that the longer you have the more you can impress if you play your cards right.

8. Some future events that I'm looking forward to in the next two weeks:
- golfing outings with the whole department
- plastic surgery exposure
- exit interview with the residency director
- meet the incoming interns/residents (they start on July 1st in the dental clinic at Charity)

More later.....
 
Andy,

What do you do for food? Do you eat out all the time?
What did Nova pay for? Anything? Nothing?
 
This past week, I've been getting more hospital meal tickets from residents. Several times, the residents will pay for my lunches if we don't eat at the hospital cafeteria. Dinners is where I spend my own money for food. Externships can be expensive when it comes to food and living expenses.

Nova did not pay for a penny, but they are however insuring me for liability and malpractice insurance in case I screw up!
 
Ouch. That's rough. But at least you get to do all those procedures, and that's a pretty valuable thing. Sweet deal still.
 
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