OMFS after 4 years

[Lock_Jaw]

Hello all.

I've started considering a new path after a couple years practicing dentistry. During school always worked hard, got decent grades yada-yada. Probably graduated around top 25% of my class, don't remember off the top of my head, but around 3.7gpa is my guess, but I do have an official transcript sitting at home. Around 26th/112 or so. Anyway, didn't have my mind set on any particular specialty, nor did I think I'd want to go back to school. Fast forward to now, all I enjoy is OS. I worked for 3 years for the state in corrections and became quite independent and capable. Now, I'm working there only 1 day a week and the other 4 in a Medicaid clinic. I've become quite bored of dentistry and would like a change.

Having been away from school for a few years, the idea of having to take the CBSE is a bit daunting. Furthermore, in applying, I am so far removed from schools at this point, I'd say I don't have any connections to any OMFS faculty in academia for rec. letters.
-Would this pose an issue since I've been practicing, or more so a thing when you're a student?
-Do programs ever show preference to those that have been in practice?
-Would my background in work (prison/medi) provide an appealing side of things to programs?
-There's 2 6 year programs in my state, I'm not opposed to doing either if it gets me where to go, I'd imagine they are less desirable to many people due to length so competition is slightly lower to getting in?

Sorry for being naive, I wasn't one who ever obsessed over the application process like some did during school.

Any advise or direction of course is welcomed.

Thanks!

p.s. does PGY years - if employed by a non-profit hospital or program count towards PSLF? Just curious as I'm 4/10 years in at this point.

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[stealyoface]

You can match but you’ll need a good cbse. As far as programs showing preference to those who have been in practice, it’s kinda the opposite. To most programs it seems working in practice is a negative. You may have to do a non cat year to eventually match but who knows you may match without. For your letters of rec you need to get at least 3 from surgeons. I would reach out to your chair at your dental school and see if they have any suggestions. You can also try to set up externships with programs and if you impress you can try to get letters from them. Your background can help with topics of discussion for interviews but you will have to sell them that you’re committed to omfs and won’t leave your program from private practice money

 

[Gladiator2020]

Why practicing as a general dentist is considered negative? I personally know few OS who practiced for few years and then went back to residency. I believe it is a solid patient experience and excellent way to show leadership as well as boost your hand skills and bedside manner.

 

[Boat on the Chesapeake]

Why practicing as a general dentist is considered negative? I personally know few OS who practiced for few years and then went back to residency. I believe it is a solid patient experience and excellent way to show leadership as well as boost your hand skills and bedside manner.

Not an OS, but there are a few downsides:
1. OS residency is much more medicine/hospital based, and has less overlap with general dentistry than pedo, endo, perio does. Plus, even if you’re really good at extractions and implants that’s not the hard part of OS residency.
2. You’re used to having a life and income as a GP and that makes it harder to coach and work crazy hours. Fresh out of dental school you’re not used to the good life yet and will follow orders.

 

[mangler]

You will most likely need to do a non-cat year with your background in general dentistry. You have to prove you know what you're getting into. CBSE is daunting, residency is even more so.

 

[Thehighwind87]

Not an OS, but there are a few downsides:
1. OS residency is much more medicine/hospital based, and has less overlap with general dentistry than pedo, endo, perio does. Plus, even if you’re really good at extractions and implants that’s not the hard part of OS residency.
2. You’re used to having a life and income as a GP and that makes it harder to coach and work crazy hours. Fresh out of dental school you’re not used to the good life yet and will follow orders.

I second number 2.

If someone PAID me today to go back to residency- I wouldn’t do it for any amount of money- even with the promise of omfs salary.

The thought of having to do 80 hour rotations and getting barked at by an attending ….yeah NO WAY. I work 36 hours a week 4 days a week and of those 36 hours, it’s probably like 18 hours of “dental work” and the other 18 is hygiene checks with YouTube sprinkled in between.

That plus I have a family and kids to raise and spending 80 hours on rotation while missing out of kids growing up is a no go.

If you are in it for the money- I highly recommend reconsidering. Successful GP can easily pull in 1 mil bread butter practice on 50-60% overhead which is a solid income. With some good investing on that $$$- you can make even more.

One could argue that the lost opportunity cost of going back to school for 4-6 years and then having to work 1-3 years to build up your omfs salary- you would be further ahead as a GP income wise.

If you love OMFS that much- take CE and incorporate it into your practice instead. Regardless before you pull the trigger try the route of getting hobbies outside dentistry. Whenever I see a post saying I can’t see myself doing anything but x y z I wonder what they do in their free time. The best thing of dentistry is that you get to work 4 days and then get to do what you enjoy afterwards with all the free time you have. Fishing skiing raising kids etc. But I guess there are people out there that live breath and sleep about dentistry.

 

[parkinglottoilet]

6 year does not mean less competitive, the average 6 year resident CBSE score is ~10+ points higher than a 4 year matched applicant

 

[carabelliscusp]

I second number 2.

If someone PAID me today to go back to residency- I wouldn’t do it for any amount of money- even with the promise of omfs salary.

The thought of having to do 80 hour rotations and getting barked at by an attending ….yeah NO WAY. I work 36 hours a week 4 days a week and of those 36 hours, it’s probably like 18 hours of “dental work” and the other 18 is hygiene checks with YouTube sprinkled in between.

That plus I have a family and kids to raise and spending 80 hours on rotation while missing out of kids growing up is a no go.

If you are in it for the money- I highly recommend reconsidering. Successful GP can easily pull in 1 mil bread butter practice on 50-60% overhead which is a solid income. With some good investing on that $$$- you can make even more.

One could argue that the lost opportunity cost of going back to school for 4-6 years and then having to work 1-3 years to build up your omfs salary- you would be further ahead as a GP income wise.

If you love OMFS that much- take CE and incorporate it into your practice instead. Regardless before you pull the trigger try the route of getting hobbies outside dentistry. Whenever I see a post saying I can’t see myself doing anything but x y z I wonder what they do in their free time. The best thing of dentistry is that you get to work 4 days and then get to do what you enjoy afterwards with all the free time you have. Fishing skiing raising kids etc. But I guess there are people out there that live breath and sleep about dentistry.

If the money thing is true then why are incomes so much higher for OMFS?

 

[yappy]

Why practicing as a general dentist is considered negative? I personally know few OS who practiced for few years and then went back to residency. I believe it is a solid patient experience and excellent way to show leadership as well as boost your hand skills and bedside manner.

It's funny. I once saw a resident on service struggle with local anesthetics and basic instrumentation. These are things that are second nature to anyone who has practiced. I also don't agree that being fresh out of dental school means that you will be more academically oriented. The domain of knowledge from dental school does not equal what you will learn in residency.

You have to realize that most people saying this stuff are still in training, repeating what other people further down the training pipeline have told them. They only know their own path and have not practiced general dentistry. OS in academia is dominated by surgeons who don't practice the way most other surgeons will practice (dental alveolar) in settings that most OMS surgeons don't practice in, which further skews their perspective. However, it's their game so you have to play it...

@Lock-jaw The advice that was offered to me by a program director when I asked him the same question you did was to get at least a 65 (old scoring) on the CBCE, preferably higher. He also said that I will need to do a non-cat year or more. My plan for letters was to shadow private practice OMS for the non-cat and then use the non-cat OMS for residency.

I decided that OMS is a great career, but it was not for me. If it's for you, I say go for it!
You said that you're working in Medicaid offices and prisons. Have you considered changing jobs to do a broader range of procedures or to work with different patient populations?

 

[Thehighwind87]

If the money thing is true then why are incomes so much higher for OMFS?

Of course money is in general higher for speciality. No doubt about it especially If you work for someone as w2 employee.


But if you own your own business- then the income disparity becomes less obvious.

Go on your local broker website and you can see 1 million dollar general practice 50-60% overhead for sale… and you can see some specialty clinics for sale that make 700-800k on 50-60% overhead- guess who is making more? The GP.

Now in general fees are higher for specialty so if you have in theory a well run booming speciality practice- you in general will make more, but a good GP practice can easily do just as well as a “good” specialty practice.

In addition- one can argue that the time the GP has in less schooling and less debt accumulation with reinvested compounding stock returns can come out ahead. 6-10 years of 300-400k income compounded while someone is still in speciality school accumulating debt and that specialist has to continue building a practice afterwards and building a reputation before the big bucks come in…. Amounts to a steep hill to climb.

It’s just the law of numbers. If someone has been compounding a large principle for 5-10 years. Then the compounding interest just works for you and those that start later have a harder time catching up. If you have a 1 mil principle then do the math on the average return sp500 11% that’s an additional 110k compounding yearly.

Just looked at my local broker- GP practice collecting 1.7 mil- on 60% overhead- you can do the math on that.

 

[Ivy.ch]

Agree with a comment above. This week, we rounded at 05:30 every day, and didn’t finish in clinic stuff until 20:30 each night, not to mention we’re on call through the night about q3-4. And we’re not even one of the hardcore programs.

I don’t think my chief has seen his baby girl awake for several days.

I never had a life, so it’s fine. But to come from a cushy life making money and spending time with family, I’d make sure you really think about it and make sure you are willing to make sacrifices from other areas of life

 

[Gladiator2020]

It is a big sacrifice and worth it for those who love OMS. Not sure if this will make you feel better but my work is 1:30 away from where I live; I come an hour earlier to prepare for the day and leave an hour later to finish what I need to finish before I leave. So it is very similar to your schedule. Good luck to everyone!

 

[dratc]

Many have said it better than me, residency is definitely a slog. You will almost certainly regret your decision, probably many times. Doesn’t necessarily mean it’s the wrong choice, just be sure you have a good enough reasons to persevere, otherwise doubts will be crushing.

 

[Teeth and Titanite]

I never had a life, so it’s fine.

If it weren't for this, I would struggle to keep grinding. Can't sacrifice what you don't have haha.

 

[Thehighwind87]

Agree with a comment above. This week, we rounded at 05:30 every day, and didn’t finish in clinic stuff until 20:30 each night, not to mention we’re on call through the night about q3-4. And we’re not even one of the hardcore programs.

I don’t think my chief has seen his baby girl awake for several days.

I never had a life, so it’s fine. But to come from a cushy life making money and spending time with family, I’d make sure you really think about it and make sure you are willing to make sacrifices from other areas of life

Dam, no wonder my OMFS that I refer to says residency was one of the hardest things he went through- while trying to juggle raising a toddler. 5:30 AM to 8:30 PM while being on call? Actually looking at those times- you don't even get to see your kids mine wakes up at 7 and sleeps at 7:30. Yeah....no thanks.

That's not for everyone. He is doing very well for himself today though but hes also 40+ with lots of experience a built up practice.

 

[stealyoface]

Dam, no wonder my OMFS that I refer to says residency was one of the hardest things he went through- while trying to juggle raising a toddler. 5:30 AM to 8:30 PM while being on call? Actually looking at those times- you don't even get to see your kids mine wakes up at 7 and sleeps at 7:30. Yeah....no thanks.

That's not for everyone. He is doing very well for himself today though but hes also 40+ with lots of experience a built up practice.

And the best part is after that shift and being up all night doing consults, you get the privilege of working a full day of ORs the next day

 

[Peon.]

You never know until you apply. Score well and you'll get noticed. How you present your application is important, that being said being odds are you will have to complete a non-cat year to match. I'd say your experience background is great but only scratches the surface of OMFS scope. I'd also be more open to matching outside of your state.

 

[George Lincoln]

Hello all.

I've started considering a new path after a couple years practicing dentistry. During school always worked hard, got decent grades yada-yada. Probably graduated around top 25% of my class, don't remember off the top of my head, but around 3.7gpa is my guess, but I do have an official transcript sitting at home. Around 26th/112 or so. Anyway, didn't have my mind set on any particular specialty, nor did I think I'd want to go back to school. Fast forward to now, all I enjoy is OS. I worked for 3 years for the state in corrections and became quite independent and capable. Now, I'm working there only 1 day a week and the other 4 in a Medicaid clinic. I've become quite bored of dentistry and would like a change.

Having been away from school for a few years, the idea of having to take the CBSE is a bit daunting. Furthermore, in applying, I am so far removed from schools at this point, I'd say I don't have any connections to any OMFS faculty in academia for rec. letters.
-Would this pose an issue since I've been practicing, or more so a thing when you're a student?
-Do programs ever show preference to those that have been in practice?
-Would my background in work (prison/medi) provide an appealing side of things to programs?
-There's 2 6 year programs in my state, I'm not opposed to doing either if it gets me where to go, I'd imagine they are less desirable to many people due to length so competition is slightly lower to getting in?

Sorry for being naive, I wasn't one who ever obsessed over the application process like some did during school.

Any advise or direction of course is welcomed.

Thanks!

p.s. does PGY years - if employed by a non-profit hospital or program count towards PSLF? Just curious as I'm 4/10 years in at this point.

Good afternoon,
As a former Program Director, OMS Private Practice and Father, I'd tell you it's America, do what you want to do. If this is what you want to pursue, then prepare for the CBSE and do well to make you competitive with other applicants. Class rank was always a problem because there has been such grade inflation and the CBSE becomes the "acid test". Yes I see the other comments and it is a lot of commitment to pursue a career as an Oral & Maxillofacial Surgeon. I trained when there were no restrictions on hours and yes it was brutal, sometimes coming in on a Friday morning and leaving on Monday night, but I don't regret the decision. No one mentioned litigation, but premiums are higher for OMS because of that and it takes a certain demeanor to handle the personal accusation of law suits. I had one partner who refused to go to court and just settled the suits, this unfortunately raised our rates.
So ultimately your life's course is up to you. If you want to pursue this then I've laid the path out for you. If you are happy and satisfied in General Practice that's also great. I am friends with many general practitioners who are happy with their choice and also very wealthy; so money should not be a consideration.
All the best.