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OMFS single degree vs. dual degree question

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Rube

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Just from a financial standpoint, does a DDS, MD OS make more money per procedure than a DDS OS? I'm just wondering what the financial return on investment is for the investment in med school tuition one pays? Thanks.
 

Columbia07

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From the little I do understand about OMFS (naive D1), an OS w/o a medical degree has the same earning potential as an OS w/ a medical degree and vice versa. Both are capable of doing the same procedures, and from what I understand both should charge approx. the same amount of money for the same procedure, given they are in a comparable location (demographically and economically speaking).

So, in the end, the M.D. degree gives you a better handle on medical conditions (obviously), but will not automatically warrant you a higher income. I hope that helps, and someone correct me if I'm wrong.
 

armorshell

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I think the biggest advantages in getting the MD lie in the perception of others. It makes it easier for you to get hospital privaleges, and makes an impression on patients and referring doctors.

It definitely doesn't give you any direct financial benefit, such as letting you charge more for your procedures.

I believe it will also definitely get you a more varied and broad-base knowledge of various medical conditions, but the administration here seems to have the opinion that many programs sacrifice some training in OMFS/anesthesia to get that. However, I myself haven't done any investigation into that and have no idea besides what I've been told.
 

Jediwendell

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It definitely doesn't give you any direct financial benefit, such as letting you charge more for your procedures.


This is 100% not true. Dual degree OMS guys earn at least 50% more than their single degree counterparts. And dual degree Orthodontists earn about 75% more than their single degree counterparts.
 

aphistis

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This is 100% not true. Dual degree OMS guys earn at least 50% more than their single degree counterparts. And dual degree Orthodontists earn about 75% more than their single degree counterparts.
Only if their dental degree is a DDS, though. If they're a DMD, they have to accept what the HMO pays them.
 

toofache32

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Financially, you will do worse with an MD. It takes 2 extra years and requires payment of 2-3 years of tuition. Not only have you lost those 2 years of earning potential by delaying your entry into private practice, but you have also doubled your debt.

Reimbursment is based on what procedure you do, not what degree you have. So there is no difference in actual income (based on degrees).
 

toofache32

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This is 100% not true. Dual degree OMS guys earn at least 50% more than their single degree counterparts. And dual degree Orthodontists earn about 75% more than their single degree counterparts.

I won't question you on this one. :p
 

armorshell

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Only if their dental degree is a DDS, though. If they're a DMD, they have to accept what the HMO pays them.

I don't understand? Same number of letters after the name = same amount of money right? :confused:

Wht is diference btw DDS DMD plz?????//
 

armorshell

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Financially, you will do worse with an MD. It takes 2 extra years and requires payment of 2-3 years of tuition. Not only have you lost those 2 years of earning potential by delaying your entry into private practice, but you have also doubled your debt.

Not to mention the interest on the loans you already have gets to cook for 2 more years.
 

Squished Rat

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I do think it is harder to have much success in the cosmetic arena without an MD if that interests you at all. Same goes for cancer and big craniofacial stuff as well, in my opinion. In reality though, I think there isn't much, if any difference in scope. It is the procedures you learn during residency that you'll do in practice, not anything you learned in medical school. That being said, I still feel like there are more broad scoped dual degree programs out there than there are 4 yr programs. I am saying this generally, not specifically. There are some broad scope 4 yr programs as well (jacksonville comes to mind although I am not sure they still have a 4 yr spot, knoxville as well, carle from my impressions of esclavo), but my impression on the interview trail has been there are more dual degree programs doing things like cosmetics or cancer.

I think the bottom line is no one program does everything well. You have to decide what you want to be exposed to and where you want to live during residency.

It also depends where you want to practice. The hospital in the town I am from as some crazy by-laws that only allow MD's to be on the face team. SO it also depends where you want to live. I personally feel like the MD leaves a few more doors open to you after residency. Then again, as I am making up my rank list, I still keep flip-flopping back and forth between the 4 and 6 yr spots i interviewed at.:cool:
 

servitup

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4 year is a better deal financially but it may affect your ability to practice the way you want to practice.
 

OMFSeh

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Whether you are single or dual degree OMFS makes no difference in terms of what you charge per procedure. I am a single degree OMFS and my partner is dual degree and we charge the same for everything.

Having said that, there are of course advantages and disadvantages for choosing to do dual degree.

Dual degree advantages: Better if you want to do cosmetics, cancer + reconstruction and craniofacial. Some patients might be more impressed with your MD, (my patients do not care btw).

Dual degree disadvantages: Two years of medical school (includes two years of medical school tuition and living expenses, two years of not working at your maximum income potential, and two extra years of interest payments on your loans).

Another thing to consider is how your referral base may view your MD, which could go either way.

Now for the two years of not working at your maximum income potential, the assumptions in this case are that both people retire at the same age and that they have a similar ramping up of their income at the beginning. I remember doing the opportunity cost calculation before and it came to around half a million dollars.

Finally, I think triple degree orthodontists make the most! :)
 

scalpel2008

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contrary to popular belief, MD doesn't always mean More Dough, but DDS always means Don't Do $hit
 
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tarheelnation

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as i have been through the process of interviewing and applying, i understand the pro's and con's of the single degree track and the dual degree track but my final question to all the residents and practitioners is the following.

Has anyone had second thoughts about pursuing one track and then wishing you went down the other? mainly, any 4 year guys regret not going down the 6.

every resident i have spoken with always has been completely happy with their decision and the 4yr guys say do the 4 while the 6yr guys say do the 6. in the end the decision will be made by match assuming I do match.
 

SororityOMFS

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Just from a financial standpoint, does a DDS, MD OS make more money per procedure than a DDS OS? I'm just wondering what the financial return on investment is for the investment in med school tuition one pays? Thanks.

There are some silly rules where an MD OMFS can make more. For example...you get called in to fix someone's face. Some hospitals pay you less than the plastics they might call in. I think this primarily goes for those people who are not insured and the bill is being picked up by some state or federal program. So instead of being paid $25 for the full recon you only get $19.50.

Then some states have an occasional rule where the DDS can't bill at the same rate as the DDS/MD for their anesthesia fees. Again this isn't private practice and limited to patients who are under some form of federal/state aid.

These are hardly reasons to pursue the MD but a real issue that is out there. I would guess these differences in pay will go away but you never know.

It IS however an example of MDs being considered more important/valued/skilled from an insurance/law standpoint. I think there were states or still are states that try and limit single degree folks. I would also think this feeling will go away as time goes on....i hope at least.

These are just some random things I've read over the past year.
 
S

Sunny_1225

from what I can tell,

Those with MD's can go onto do fellowships such as facial cosmetic surgery.
Also, people may not be comfortable seeing you for facial cosmetics if you don't have an MD. There is just too much BS to deal with from the medical community (plastic Sxs) if you don't have an MD.

This is the only financial why I would think anyone would get the MD.

But really, is this a financial advantage?

I definetely don't really think doing facial cosmetics would pay more than teeth and titanium.

In the end, whether you are an MD DDS, or just a DDS, one thing is ALWAYS certain.

you are at the mercy of general dentists who will refer you their patients. This is business.

just go golfing - this is a lot more important than the nonsense MD/ or DDS MD discussion.
 
S

Sunny_1225

OH since were on topic,

How much more difficult is it to get into the 4 year program vs. the dual degree.

I've heard many tell me that the MD route is easier, and the 4 year route is more competitive for admission.

However, I ununfortunately haven't heard of anything more specific...

4 yr program all the way!
 
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servitup

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I would say 4 yr's right now are slightly more competitive than 6's as a general rule. That said, the best programs are very competitive regardless and the crappy ones aren't as competitive. If your scores and grades are crappy and you have no experience, you can't go to a good 6 yr program. the difference in the end is pretty small. a marginal applicant can get into a 4 yr program, just not the good ones most likely. same goes for 6 yr people.
 

SoCalDent

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I am merely a predent, however my father is a OMFS who went to UW for his residency. He does regret not getting his MD.
Aparently there is some discrepency (at least in California) when it comes to facial cosmetics. For example if someone is in an accident and needs their face repaired, my father can be called into the hospital to do so. However if someone asks him to reconstruct their face in the same fashion ELECTIVELY he cannot by law (I think the governor is changing this).

I don't know of other situations but I assume there are some. I am very interested in OMFS as well and my father insists that a 6 year program is well worth it.

As far as making more money I am almost positive that it doesn't make a difference: I shadowed an Oral Surgeon just yesterday (not my dad) who does not have an MD who pulled in $31,000 yesterday :eek:(before overhead/taxes etc). It was the most unbelievable day I have ever seen.
 
B

Battlesign

Ultimately, how much you make is dependant upon how much you want to work for it and what procedures that you do.

Doing a single degree residency or a dual residency will prepare you both to do routine OMFS stuff. However, the dual surgeon will always have more training anyway that you look at it.

Not doing a dual training program is usually motivated by a financial decision. This is the only reason to do a single degree track.

There are a lot more options if you have both degrees.

One of the residents in my program was at the AAOMS meeting and attended an associate preparation meeting for new surgeons and those surgeons that were looking to add a new surgeon to their practice. The guy giving the presentation, single degree, said that dual surgeons receive a higher initial contract arrangement. I can’t recall the amount, but it seems like it was around 50 K more per year.

I also disagree with the statement that the single degree scope will get better with time. I think that it will narrow with time.

Our specialty is really not expanding like it should. More new surgeons need to get out there and practice full scope surgery and not be limited to teeth and titanium. Recently, there was an article in the plastic surgery journal about orthognathic surgery for the next generation. I hope that the next generation for orthognathic surgeons is not plastic surgeons. We are losing ground and need to spend less time fighting about who makes more and start contributing to our specialty. We need to be doing more orthognathic surgery, more cosmetics, more cancer, more reconstruction, more clefts and more hospital based surgery. Sure these don’t pay as well as teeth and titanium, but our presence needs to be seen in every hospital in the US.

Every new surgeon should finish OMFS training and establish a full scope practice.
 

Columbia07

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Ultimately, how much you make is dependant upon how much you want to work for it and what procedures that you do.

Doing a single degree residency or a dual residency will prepare you both to do routine OMFS stuff. However, the dual surgeon will always have more training anyway that you look at it.

Not doing a dual training program is usually motivated by a financial decision. This is the only reason to do a single degree track.

There are a lot more options if you have both degrees.
One of the residents in my program was at the AAOMS meeting and attended an associate preparation meeting for new surgeons and those surgeons that were looking to add a new surgeon to their practice. The guy giving the presentation, single degree, said that dual surgeons receive a higher initial contract arrangement. I can't recall the amount, but it seems like it was around 50 K more per year.

I also disagree with the statement that the single degree scope will get better with time. I think that it will narrow with time.

Our specialty is really not expanding like it should. More new surgeons need to get out there and practice full scope surgery and not be limited to teeth and titanium. Recently, there was an article in the plastic surgery journal about orthognathic surgery for the next generation. I hope that the next generation for orthognathic surgeons is not plastic surgeons. We are losing ground and need to spend less time fighting about who makes more and start contributing to our specialty. We need to be doing more orthognathic surgery, more cosmetics, more cancer, more reconstruction, more clefts and more hospital based surgery. Sure these don't pay as well as teeth and titanium, but our presence needs to be seen in every hospital in the US.

Every new surgeon should finish OMFS training and establish a full scope practice.

This reminds of a series of articles I recently read in the Journal of Oral and Maxillofacial Surgery. The articles talked about the future of OMFS. Interestingly, it seems quite a few programs are worried that future OMFS' are going to go straight into private practice and limit themselves to 3rd's and titanium instead of taking on positions in hospitals and teaching centers to carry on the rich tradition of broad scope OMFS. The articles addressed the fact that programs need to ensure that they are picking residents that will go on to complete fellowships in plastics, oncology, etc and not just complete their residency and go into private practice. Interestingly, a lot of these fellowships go unmatched now, which is really going to limit the field of OMFS in the future. It also talked about the decline in applicants to OMFS, which I was not aware of.

Journal of Oral and Maxillofacial Surgery: (all of these editorials are free)

Volume 65, Issue 2, Pages 161-366
Training the Future: Protecting the Scope and Diversity of Oral and Maxillofacial Surgery
Leon A. Assael
pages 161-162

Volume 65, Issue 3, Pages 367-594
Recruiting the Future: Who Will Our Specialty Be?
Leon A. Assael
pages 367-368

Volume 65, Issue 4, Pages 595-822
Invest the Future: Capitalizing Infrastructure for the Future of Oral and Maxillofacial Surgery
Leon A. Assael
pages 595-596

Volume 65, Issue 5, Pages 823-1062
Ally the Future: Building Relationships That Build the Future of Oral and Maxillofacial Surgery
Leon A. Assael
pages 823-824

Volume 64, Issue 12, Pages 1711-1866
Controversies: Debating the Future of Our Specialty
Leon A. Assael
pages 1711-1712
 
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armorshell

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Thanks for posting these Columbia, should make for some good reading with what's left of my break.

I agree with you as well; it seems such a waste to seek out such expanded scope training only to practice within a narrow portion of that scope. It seems to me like if all you want to do is take out 3rds and place implants you can get that training as a GP, and lets be honest here, the wizzie/sedation/insurance gravy train isn't going to last forever.
 

toofache32

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....Interestingly, a lot of these fellowships go unmatched now, which is really going to limit the field of OMFS in the future.

Really? Which article talks about this? Or which fellowships? There were almost 3x the usual number of applicants for oncology fellowships this past year.
 

Columbia07

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Really? Which article talks about this? Or which fellowships? There were almost 3x the usual number of applicants for oncology fellowships this past year.

It didn't name specific fellowships (bad on my part--I just named fellowships I could think of off the top of my head), but it did say that positions for prestigious fellowships are going unmatched. I'm sure you would be much more knowledgeable about fellowships than I would (if I remember correctly, you're doing an oncology fellowship at Michigan...?) Anyways, I was just highlighting points that were made in the articles. I have no idea as to the validity of these articles. By the way, it was in this issue of the Journal of Oral and Maxillofacial Surgery: (two paragraphs before the "Strategies" section)

Volume 65, Issue 2, Pages 161-366
Training the Future: Protecting the Scope and Diversity of Oral and Maxillofacial Surgery
Leon A. Assael
pages 161-162
 
S

Sunny_1225

99% of people I talk to who want to go into OMFS don't want to do major surgery. They all want to go into private practice and perform minor procedures.

So what does it matter, even if one gets the an MD, and 'better training'.

Personally, I don't have an inferiority complex, and don't need an MD to make myself feel better at the end of the day.

I sure as hell don't think having an MD, would impress a family dentist either.
 

brycethefatty

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99% of people I talk to who want to go into OMFS don't want to do major surgery. They all want to go into private practice and perform minor procedures.

So what does it matter, even if one gets the an MD, and 'better training'.

Personally, I don't have an inferiority complex, and don't need an MD to make myself feel better at the end of the day.

I sure as hell don't think having an MD, would impress a family dentist either.


What a shame, isn't it!
 

IcedOMFS

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Our specialty is really not expanding like it should. More new surgeons need to get out there and practice full scope surgery and not be limited to teeth and titanium. Recently, there was an article in the plastic surgery journal about orthognathic surgery for the next generation. I hope that the next generation for orthognathic surgeons is not plastic surgeons. We are losing ground and need to spend less time fighting about who makes more and start contributing to our specialty. We need to be doing more orthognathic surgery, more cosmetics, more cancer, more reconstruction, more clefts and more hospital based surgery. Sure these don’t pay as well as teeth and titanium, but our presence needs to be seen in every hospital in the US.

Every new surgeon should finish OMFS training and establish a full scope practice.

I totally agree with you. I think you should add trauma to your list... The management of maxillofacial trauma is an important historical backbone to the hospital presence of our specialty, and provides the basis for many of the forays into broader scope surgical areas, as well as justifying our presence in the hospital. There are far too many T&T guys out there who do not even take trauma call any more... It's embarassing.
 
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Bifid Uvula

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So True!

Everybody (OMFS, ENT, Plastics) needs to take a fair share of trauma call and be adequately compensated for their work.

We fought so hard and so long as a specialty to establish ourselves... as not only "legitimate surgeons", but to become the TRUE EXPERTS OF FACIAL TRAUMA SURGERY and FACIAL RECONSTRUCTIVE SURGERY.

Now we are at risk of losing that distinction- largely because of the attitudes in our specialty and having to deal with the attitudes of the Private ENT's and Plastics that avoid ANY facial trauma call like the plague.

We've dropped most orthognathic surgery in the "real world", Trauma is falling and before you know it... we are going to be MASSIVELY OVER-TRAINED PERIODONTISTS.

Cancer Sucks, Trauma Sucks... but we all need to take a little responsibility to give back to our community. If everybody took their fair share, we'd probably only have to be on-call for 1-3 days a month...
 
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north2southOMFS

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Personally, I don't have an inferiority complex, and don't need an MD to make myself feel better at the end of the day.

I do. I have a huge inferiority complex and lets face it....at the end of the day my MD makes me feel like the bulge in my pants is that much bigger....:laugh:

Ok seriously....I learned quite a bit in med school and think that the MD adds to your training immensely. I think it kinda does it indirectly though, and yes it has everything to do with others perception. For instance, i'm doing my GS/anesthsia year right now and during these rotation months i know i am doing more and have more responsibility/autonomy/leeway than without the degree. During my SICU month i was put into a schedule with 2 second year GS residents, and we each had one week of nights in the unit and you literally "run" the unit at night by yourself(there is an attending somewhere in a call room i guess). You are responsible for placing all the lines in new trauma patients, placing chest tubes into patients who need it and running any codes on existing patients(actually nurses do most of the work:thumbup:), not to mention having to actually make real medical decisions on your own. I just have a hard time believing that without the MD you would ever get that kind of autonomy or leeway in training. And i dont care what anyone says, the repetition of having to make those types of decisions and perform those types of actions constantly ON YOUR OWN is what makes you comfortable with what you do. Just cause you round with the chief and watch he or she make decisions will never give you any comfort when your on your own.

I used to think that there was little difference in the training of either a 4 or 6 year but since going through almost all the MD and GS portion at least down here in good old shrevesville I now have come to believe that without the MD you are missing out on lots of training.

Sorry just my .02, but i am a very big advocate of the Medical Degree, i cant see why you wouldnt want the further training.
 

EuroOMFS

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Recently, there was an article in the plastic surgery journal about orthognathic surgery for the next generation. I hope that the next generation for orthognathic surgeons is not plastic surgeons.

The July 2007 issue of Clinics in Plastic Surgery is about orthognathic surgery. I think it demonstrates clearly plastic surgery's interest in "our" procedures. There are plenty of PRSs out there (also here in Europe) who feel dentists have no business doing this sort of surgery, and that it belongs with plastics. A good buddy of mine who's a PRS resident, used to be of that opinion. I think I've convinced him otherwise by now :cool:
 
B

Battlesign

I do. I have a huge inferiority complex and lets face it....at the end of the day my MD makes me feel like the bulge in my pants is that much bigger....:laugh:

Ok seriously....I learned quite a bit in med school and think that the MD adds to your training immensely. I think it kinda does it indirectly though, and yes it has everything to do with others perception. For instance, i'm doing my GS/anesthsia year right now and during these rotation months i know i am doing more and have more responsibility/autonomy/leeway than without the degree. During my SICU month i was put into a schedule with 2 second year GS residents, and we each had one week of nights in the unit and you literally "run" the unit at night by yourself(there is an attending somewhere in a call room i guess). You are responsible for placing all the lines in new trauma patients, placing chest tubes into patients who need it and running any codes on existing patients(actually nurses do most of the work:thumbup:), not to mention having to actually make real medical decisions on your own. I just have a hard time believing that without the MD you would ever get that kind of autonomy or leeway in training. And i dont care what anyone says, the repetition of having to make those types of decisions and perform those types of actions constantly ON YOUR OWN is what makes you comfortable with what you do. Just cause you round with the chief and watch he or she make decisions will never give you any comfort when your on your own.

I used to think that there was little difference in the training of either a 4 or 6 year but since going through almost all the MD and GS portion at least down here in good old shrevesville I now have come to believe that without the MD you are missing out on lots of training.

Sorry just my .02, but i am a very big advocate of the Medical Degree, i cant see why you wouldnt want the further training.

Amen...sounds like they raise you boys right down in the south.
 
B

Battlesign

99% of people I talk to who want to go into OMFS don't want to do major surgery. They all want to go into private practice and perform minor procedures.

So what does it matter, even if one gets the an MD, and 'better training'.

Personally, I don't have an inferiority complex, and don't need an MD to make myself feel better at the end of the day.

I sure as hell don't think having an MD, would impress a family dentist either.

I can tell from your statement that you are quite a man. You are probably a Tanner stage 1...well maybe 2....Oh, that's right, sorry you wouldn't know what that is. It means you have no hair on your balls...but then again you don't really need hair on your balls when they haven't dropped yet.
 

Squished Rat

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I can tell from your statement that you are quite a man. You are probably a Tanner stage 1...well maybe 2....Oh, that's right, sorry you wouldn't know what that is. It means you have no hair on your balls...but then again you don't really need hair on your balls when they haven't dropped yet.

:laugh::laugh::laugh:
 

Columbia07

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I can tell from your statement that you are quite a man. You are probably a Tanner stage 1...well maybe 2....Oh, that's right, sorry you wouldn't know what that is. It means you have no hair on your balls...but then again you don't really need hair on your balls when they haven't dropped yet.

Could be SMR1 or SMR2... we're not really sure of the sex. :cool:
 

DREDAY

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I do. I have a huge inferiority complex and lets face it....at the end of the day my MD makes me feel like the bulge in my pants is that much bigger....:laugh:

Ok seriously....I learned quite a bit in med school and think that the MD adds to your training immensely. I think it kinda does it indirectly though, and yes it has everything to do with others perception. For instance, i'm doing my GS/anesthsia year right now and during these rotation months i know i am doing more and have more responsibility/autonomy/leeway than without the degree. During my SICU month i was put into a schedule with 2 second year GS residents, and we each had one week of nights in the unit and you literally "run" the unit at night by yourself(there is an attending somewhere in a call room i guess). You are responsible for placing all the lines in new trauma patients, placing chest tubes into patients who need it and running any codes on existing patients(actually nurses do most of the work:thumbup:), not to mention having to actually make real medical decisions on your own. I just have a hard time believing that without the MD you would ever get that kind of autonomy or leeway in training. And i dont care what anyone says, the repetition of having to make those types of decisions and perform those types of actions constantly ON YOUR OWN is what makes you comfortable with what you do. Just cause you round with the chief and watch he or she make decisions will never give you any comfort when your on your own.

I used to think that there was little difference in the training of either a 4 or 6 year but since going through almost all the MD and GS portion at least down here in good old shrevesville I now have come to believe that without the MD you are missing out on lots of training.

Sorry just my .02, but i am a very big advocate of the Medical Degree, i cant see why you wouldnt want the further training.



agreed. well said.
 

buck-E

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I do. I have a huge inferiority complex and lets face it....at the end of the day my MD makes me feel like the bulge in my pants is that much bigger....:laugh:

Ok seriously....I learned quite a bit in med school and think that the MD adds to your training immensely. I think it kinda does it indirectly though, and yes it has everything to do with others perception. For instance, i'm doing my GS/anesthsia year right now and during these rotation months i know i am doing more and have more responsibility/autonomy/leeway than without the degree. During my SICU month i was put into a schedule with 2 second year GS residents, and we each had one week of nights in the unit and you literally "run" the unit at night by yourself(there is an attending somewhere in a call room i guess). You are responsible for placing all the lines in new trauma patients, placing chest tubes into patients who need it and running any codes on existing patients(actually nurses do most of the work:thumbup:), not to mention having to actually make real medical decisions on your own. I just have a hard time believing that without the MD you would ever get that kind of autonomy or leeway in training. And i dont care what anyone says, the repetition of having to make those types of decisions and perform those types of actions constantly ON YOUR OWN is what makes you comfortable with what you do. Just cause you round with the chief and watch he or she make decisions will never give you any comfort when your on your own.

I used to think that there was little difference in the training of either a 4 or 6 year but since going through almost all the MD and GS portion at least down here in good old shrevesville I now have come to believe that without the MD you are missing out on lots of training.

Sorry just my .02, but i am a very big advocate of the Medical Degree, i cant see why you wouldnt want the further training.

Interesting... In the program I interned at and the one I am now an attending at OMFS residents take call in the SICU just like the surgery residents. Where I was a resident you were the only one on call for Neurosurg. In all of these situations you were the only one there to make all of the medical decisions- no chief there for help. All of these were at 4 year programs. I agree that you learn a lot on those nights when you are there on your own making all of the decisions, but it has nothing to do with having an MD.

It comes with learning your medicine (whether formally in and MD program, or through independent study and medicine rotations in a 4 year program) and consistently proving to the other surgical services that we are just as well trained as they are. At all of the programs I have been at other services love having 4 year OMFS residents on their service- they are treated no differently than their own residents- are hard workers and very well prepared. In many instances we were preferred over MDs rotations (ie neurosurg would much rather have OMFS for the rotation than ED). It has nothing to do with whether or not you have an MD behind your name.

So yes, you do get the same "autonomy and leeway" without an MD behind your name when it comes to training.
 

umkcdds

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the MD is purely for hospital politics and insurance billing.

and the 4-year residents spend more time actually doing surgery.
 

MAXILLOFACIAL2B

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Honestly this argument is pointless. There are many OMS with an MD that never use it. The issue is not having an MD or not, the real issue is the lack of interest of many OMS in integrating themselves in the hospital setting. Unlike other surgical areas, as an OMS you can be in private and never step foot inside of a hospital. In ortho, neurosurgery, plastics, etc...the kinds of cases they do requires that they are part of a hospital and not isolate themself as most OMS have in private practice. What the field needs is not more OMS with MDs or fellowships, what it needs is more OMS who are willing to affiliate with teaching programs, and their local hospital taking trauma call. What's interesting is 5 out of the 6 attendings that won FEDA awards (Faculty Education Development Awards) do not have an MD, which goes to show that the future of OMS still lies with surgeons without MDs. Being that the majority of Chairs and PDs of OMS programs do not hold an MD is proof that the degree is not doing much for the specialty. The respect OMS has gained in hospitals did not happen from switching to MD tracks, it happend because of the pioneers (e.g., Fonseca, Ellis, Marx, Assael, Tucker, Haug, Kent, Block, Laskin, etc...) that were in the trenches and not abadoning their specialty to make $$$ in 100% private practice. So the take home message is MD or no-MD doesn't make a difference, what is the most important is what you make of your training and career. All the surgeons I listed above do not have an MD and I think its safe to say that most of us would be lucky to have half the skills they have and accomplish 10% of what they've accomplished.
 

armorshell

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Didn't they just start awarding the MD recently? If so, the fact the most PDs and top surgeons don't have MDs doesn't really mean anything if the degree wasn't awarded until the 70's or later.
 

servitup

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Exactly. In 20 years, most leaders in the field and academics will have the MD. If not, I will be back on this thread in 2028 to eat crow.

Didn't they just start awarding the MD recently? If so, the fact the most PDs and top surgeons don't have MDs doesn't really mean anything if the degree wasn't awarded until the 70's or later.
 
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OMFSeh

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Ok seriously....I learned quite a bit in med school and think that the MD adds to your training immensely. I think it kinda does it indirectly though, and yes it has everything to do with others perception. For instance, i'm doing my GS/anesthsia year right now and during these rotation months i know i am doing more and have more responsibility/autonomy/leeway than without the degree. During my SICU month i was put into a schedule with 2 second year GS residents, and we each had one week of nights in the unit and you literally "run" the unit at night by yourself(there is an attending somewhere in a call room i guess). You are responsible for placing all the lines in new trauma patients, placing chest tubes into patients who need it and running any codes on existing patients(actually nurses do most of the work:thumbup:), not to mention having to actually make real medical decisions on your own. I just have a hard time believing that without the MD you would ever get that kind of autonomy or leeway in training. And i dont care what anyone says, the repetition of having to make those types of decisions and perform those types of actions constantly ON YOUR OWN is what makes you comfortable with what you do. Just cause you round with the chief and watch he or she make decisions will never give you any comfort when your on your own.

I used to think that there was little difference in the training of either a 4 or 6 year but since going through almost all the MD and GS portion at least down here in good old shrevesville I now have come to believe that without the MD you are missing out on lots of training.

Sorry just my .02, but i am a very big advocate of the Medical Degree, i cant see why you wouldnt want the further training.

I disagree with your post. During my residency, I had lots of autonomy and they treated me the same even though I am single degree. In my anesthesia rotation, I was given my own operating room to run and I did everything, from inital induction and intubation, lines, maintenance and eventual extubation. The attending would be present for intubation and sometimes extubation and that's it. I did a wide variety of cases whether it be neurosurgery, neuro-interventional, surgical oncology, ENT, plastics, general, OB/GYN, optho, transplant, etc. I was performing awake fiberoptics, rapid sequences, lumbar blocks, etc. The anesthesia attendings treated us the same as the anesthesia residents and had the exact same expectations.

The same can be said for my other rotations, whether it be neurosurgery, SICU, or trauma. I was taking call in the hospital by myself, placed all my central and A-lines, was running the NSICU by myself, placing EVDs, chest tubes, doing DPLs, whatever needed to be done. Your experiences sound very similar to my experience during residency. The MD is great for theory, but it is what you are capable of doing that matters. Even as a single degree person, you are ultimately held to the same standard as a MD. And btw, I've seen my fair share of MDs who sucked at intubation, lines, etc. Just my .02
 

armorshell

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Exactly. In 20 years, most leaders in the field and academics will have the MD. If not, I will be back on this thread in 2028 to eat crow.

I wasn't necessarily saying that, but you're probably right for a completely different reason. I don't think the MD is necessary at all to do oral surgery, but I do think the quality of person it takes to become a leading surgeon will probably have gotten the MD in the first place.

The leaders are going to be the ones who want to do the big fellowships and chase after faculty positions, which at least in the opinion of this board, require an MD, more for politics than anything as numerous people have mentioned above. So I suppose all I'm trying to say is that yes, you're probably correct, but the reason probably doesn't have anything to do with what you learn in those 2-3 years.

IMFYO the biggest reason 4 year guys aren't doing the academic thing like the MD guys are is because they don't want to, though it appears as time goes on the perception is becoming that they can't, which is dangerous ground.
 

north2southOMFS

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the MD is purely for hospital politics and insurance billing.

and the 4-year residents spend more time actually doing surgery.

Your an idiot. At shreveport we do 42-44 months on OMFS alone. That is 3 1/2 years right there. Tell me one 4 year program that does that many months. You can't because it wouldn't allow time for anesthesia and medicine and surgery rotations........******.:thumbdown:
 

north2southOMFS

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Honestly this argument is pointless. There are many OMS with an MD that never use it. The issue is not having an MD or not, the real issue is the lack of interest of many OMS in integrating themselves in the hospital setting. Unlike other surgical areas, as an OMS you can be in private and never step foot inside of a hospital. In ortho, neurosurgery, plastics, etc...the kinds of cases they do requires that they are part of a hospital and not isolate themself as most OMS have in private practice. What the field needs is not more OMS with MDs or fellowships, what it needs is more OMS who are willing to affiliate with teaching programs, and their local hospital taking trauma call. What's interesting is 5 out of the 6 attendings that won FEDA awards (Faculty Education Development Awards) do not have an MD, which goes to show that the future of OMS still lies with surgeons without MDs. Being that the majority of Chairs and PDs of OMS programs do not hold an MD is proof that the degree is not doing much for the specialty. The respect OMS has gained in hospitals did not happen from switching to MD tracks, it happend because of the pioneers (e.g., Fonseca, Ellis, Marx, Assael, Tucker, Haug, Kent, Block, Laskin, etc...) that were in the trenches and not abadoning their specialty to make $$$ in 100% private practice. So the take home message is MD or no-MD doesn't make a difference, what is the most important is what you make of your training and career. All the surgeons I listed above do not have an MD and I think its safe to say that most of us would be lucky to have half the skills they have and accomplish 10% of what they've accomplished.

You dental students are killin' me here. Explain how one doesn't "use" their MD? The MD isnt a tool that allows you to bill more, or even operate better, it allows you to have a better understanding of medicine! It helps with eveyday medical decisions you will be making in your private or teaching practice everyday. It opens more doors in your training so you can train more, have more options when your finished. Did you even read my post? I'd bet that if those single degree guys above had the option to get a medical degree when they did train about 90% would have it. Your point is idiodic, you say we need more academicians right? But then you say its pointless for those same guys to have more training? another...:thumbdown:
 
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