OMFS post-call day

[zdoq]

Is post-call day a thing for OMFS residencies? Not much info on this on program websites. I know it’s required for the gen surg portion of the residency because of ACGME, but does OMFS service take this rule on as well at any institutions?

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[OMFSLife123]

It depends on the program and how call is set up. Vast majority of programs do not have post-call.

 

[deleted923283]

I only know of one program which has post-call.

It’s part of what we do. Our teams are not big enough to give someone a day off after a night on call.

 

[Captain Underplants]

Most OMFS resodencies don't have postcall, but that's also because msot programs are not in-house call, but instead home call.

 

[Tootyfruity]

Post call is working more tired than usual. Maybe you see a patient or two less in the day.

 

[SilkyJ]

Depends on the size of the program, but most won’t have post-call days because most programs don’t take in-house call, and take home-call instead. We try to be conscious of people’s hours and send PGY1s home early if they got brutalized the night before. The vast majority of call nights in our program are busy, but not busy enough to warrant a post-call day off routinely.

OMFS is often in a grey area since we don’t generally fall under ACGME jurisdiction. At our program we voluntarily try our best to adhere to their rules, but it’s tough when you have a small service. CODA has no regulation on duty hours, so it’s ultimately at the discretion of the hospital and the program itself if they want to have duty hour restrictions.

 

[deleted1047421]

Most OMFS resodencies don't have postcall, but that's also because msot programs are not in-house call, but instead home call.

Where are you getting this information that most omfs programs are not taking in house call?

Most programs I know of are taking in house call. But then again the programs I’m familiar with are all good programs primarily based out of a level 1 trauma center with a high volume caseload.

Even if they allowed you to take call from home, it would be pointless as you’d be there anyways.

 

[Captain Underplants]

Where are you getting this information that most omfs programs are not taking in house call?

Most programs I know of are taking in house call. But then again the programs I’m familiar with are all good programs primarily based out of a level 1 trauma center with a high volume caseload.

Even if they allowed you to take call from home, it would be pointless as you’d be there anyways.

Personal experience. I am chief resident at a Level 1 trauma hospital in a busy program and we take home call. From all the programs I interviewed at (15) I'd say 70% were level 1 trauma centers and none took in-house call. I think you're forgetting that alot of programs share call with ENT/Plastics so they're not necessiraly on trauma call every day of the month.

Sure there may be days you end up spending all night at the hospital (even if you're on puss call) but those are maybe 1 out of every 7 or 8 trauma calls if that in my experience.

 

[deleted1047421]

Personal experience. I am chief resident at a Level 1 trauma hospital in a busy program and we take home call. From all the programs I interviewed at (15) I'd say 70% were level 1 trauma centers and none took in-house call. I think you're forgetting that alot of programs share call with ENT/Plastics so they're not necessiraly on trauma call every day of the month.

Sure there may be days you end up spending all night at the hospital (even if you're on puss call) but those are maybe 1 out of every 7 or 8 trauma calls if that in my experience.

Where I trained plastics took no facial trauma call and ent took <15 percent of facial trauma. There are a number of programs where omfs does take the majority of facial trauma call, if not all.

On top of that with all the other elective surgery in house patients (orthognathic etc), and having to pre round etc. I certainly didn’t see any point in taking call from home.

This was the same for a lot of my colleagues in other programs.

Perhaps I just didn’t know the same people you know and didn’t interview at the programs you interviewed at.

 

[desertrat12]

My program has 2 Level 1 traumas. I take 2-3 facial trauma calls per week and a solo tooth night thrown in usually once a week (call is q2-q3). It’s pretty common I’ll make it home, at least for a few hours, on a tooth call night. I’ve never made it home on a trauma night. This seems very common/the norm for my buddies in other programs.

 

[zdoq]

Does having home call compared to in-house call make a significant difference in your quality of life as a resident?

 

[bergus95]

Does having home call compared to in-house call make a significant difference in your quality of life as a resident?

Huge. Also having a GPR program would have made a big difference in hindsight

 

[desertrat12]

Huge. Also having a GPR program would have made a big difference in hindsight

I totally agree a gpr would make a significant difference for the better…I’ve lost count how many splints I’ve placed this year

 

[zdoq]

Great insight, thank you. Any other aspects to look for in a program to improve quality of life as a resident? Really appreciate your opinions.

 

[OMFSLife123]

Great insight, thank you. Any other aspects to look for in a program to improve quality of life as a resident? Really appreciate your opinions.

The residents. Make sure they all genuinely get along and that you see yourself being friends with them. It doesn't matter how "easy" of an experience it is, if you don't like your coresidents it is going to be a miserable 4+ years.

 

[nade0016]

I have an issue with someone looking for less call. So you want an easier residency and less call experience. Go do Ortho.

 

[deleted1047421]

I have an issue with someone looking for less call. So you want an easier residency and less call experience. Go do Ortho.

Nade0016 Couldn’t have said it better.

Back when I was a resident, being on call was highly stressful.

The on call resident responded to facial trauma, infections, managed all in house patients, and had to take any other related omfs calls.

I would literally be running from the trauma bay （guaranteed multiple admissions for facial fractures), to the ER admitting large abscesses, and literally running my own clinic at night draining smaller facial abscesses/extracting infected teeth, doing closed reductions and extracting teeth for in house cardiac patients awaiting their surgery. We were so busy and stretched thin that leaving these patients for the next day just was not an option.
Also all the in house patients had be taken care of. I went to a high volume orthognathic program where we made sure all the orthognathic patients were properly managed (post op occlusion closely evaluated) and all attendings and chiefs were updated with a post op pano and ceph, while on call. We didn’t wait until the next day.
Eventually when I became chief I operated 130 orthognathic cases and did ORIF on a ton of trauma cases. What kept us going was that we knew one day our time would come and we would get to operate. It’s all worth it in the end.

Being on call will give you the skills and mental conditioning to be a highly productive oral surgeon when you are out in practice. Everything will feel like a cake walk.
The busier the program, the better it will be for you.

 

[zdoq]

I have an issue with someone looking for less call. So you want an easier residency and less call experience. Go do Ortho.

I don’t see why it’s problematic to want to know what aspects of a residency can make things a *little* easier. I’m not sure why home call, an in-house GPR program, or having co-residents you get along with means completely copping out. I initially asked about post-call because this is often discussed on the med side of residencies but not with OMFS specifically. Couldn’t find anything about it anywhere online so I posted here. Curiosity killed the cat I guess.

 

[rotichawal]

Coming from a program that has GPRs, I can attest to their value. Apart from not having to do splints and ellis fractures on top of all the other hundred things you have to do in a night, the GPRs are actually very helpful in triaging every rando who comes in with dental pain

 

[deleted1047421]

Coming from a program that has GPRs, I can attest to their value. Apart from not having to do splints and ellis fractures on top of all the other hundred things you have to do in a night, the GPRs are actually very helpful in triaging every rando who comes in with dental pain

Omfs Programs that don’t have gpr residencies have parameters set forth with the er.
The ER doesn’t call the omfs resident unless there is facial swelling and a facial abscess associated with the infected tooth/teeth.
Tooth pain, tooth fractures don’t make it to an omfs resident. Dentalalveolar fractures yes.

 

[rotichawal]

Omfs Programs that don’t have gpr residencies have parameters set forth with the er.
The ER doesn’t call the omfs resident unless there is facial swelling and a facial abscess associated with the infected tooth/teeth.
Tooth pain, tooth fractures don’t make it to an omfs resident. Dentalalveolar fractures yes.

Got it. Wonder where they send those people then

 

[deleted1047421]

Got it. Wonder where they send those people then

They just give them pain meds and antibiotics and send them to a general dentist. They tell the patient that they don’t have a general dentist on call, only omfs. In order to call the oral surgeon there must be facial swelling/facial abscess or facial skeletal trauma (fractures).

 

[desertrat12]

Omfs Programs that don’t have gpr residencies have parameters set forth with the er.
The ER doesn’t call the omfs resident unless there is facial swelling and a facial abscess associated with the infected tooth/teeth.
Tooth pain, tooth fractures don’t make it to an omfs resident. Dentalalveolar fractures yes.

I’m not sure how universal these parameters are…at least where I am at a large resident training hospital there are so many different services rotating through the ED, even if there are parameters they aren’t known by everyone. We’ll get consulted occasionally for the smallest things. Sometimes we can get it canceled over the phone. But many times they push pretty hard for us to just come lay eyes and give it our blessing to dc. Can be very annoying with actual calls are piling up.

 

[702]

Nade0016 Couldn’t have said it better.

Back when I was a resident, being on call was highly stressful.

The on call resident responded to facial trauma, infections, managed all in house patients, and had to take any other related omfs calls.

I would literally be running from the trauma bay （guaranteed multiple admissions for facial fractures), to the ER admitting large abscesses, and literally running my own clinic at night draining smaller facial abscesses/extracting infected teeth, doing closed reductions and extracting teeth for in house cardiac patients awaiting their surgery. We were so busy and stretched thin that leaving these patients for the next day just was not an option.
Also all the in house patients had be taken care of. I went to a high volume orthognathic program where we made sure all the orthognathic patients were properly managed (post op occlusion closely evaluated) and all attendings and chiefs were updated with a post op pano and ceph, while on call. We didn’t wait until the next day.
Eventually when I became chief I operated 130 orthognathic cases and did ORIF on a ton of trauma cases. What kept us going was that we knew one day our time would come and we would get to operate. It’s all worth it in the end.

Being on call will give you the skills and mental conditioning to be a highly productive oral surgeon when you are out in practice. Everything will feel like a cake walk.
The busier the program, the better it will be for you.

Case volume is great! Is it 130 cases or 130 jaws?