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OMFS single degree vs. dual degree question

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Squished Rat

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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.

I just wanted to add that one of the single degree pioneers you named has been my mentor and I have spent time with him. When I talked to him about programs, he strongly suggested getting the MD. He felt it was the way to go nowadays. He told me that unless you were already 40 when applying, there was no reason not to do the extra 2 years of an MD program.
 

SororityOMFS

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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.

haha, your post isn't that bad...not sure why those two attacked it.....

The only thing I disagree with is "MD or no-MD doesn't make a difference".

Now rather than wasting time saying "My 6 year is better than your 4 year because of the MD" or "My 4 year covered all the 6 year's stuff that is important without the stupid MD rotations", I wouldn't mind seeing a side by side comparison of the two types of programs. Lets see a 6 year specifically cite the knowledge/skills learned during the non-omfs residency medical school training. Then the 4 years can explain where it comes in to place at their training programs.

For the usual private practice guys...I do wonder what the MD would do for them besides marketing. The very occasional patient who is medically compromised would be best served by a prudent 4 year vs a complacent 6 year, yeah?

The one thing I worry as I go through this all is the public and medical communities thoughts on the DDS degree. Is the opinion out there that "The DDS degree isn't good enough for these surgeons so the wise ones are also going for the MD for a complete knowledge". I worry that the single degree folks will be very limited as more people pursue the MD (if that statement is even true, I don't know what the trends in MD pursuers are). Are the DDS OMFS going to look inadequate?

Then finally, is this truely a moot point? Are programs so different where there are plenty of 4 year programs that can destroy the 6 years in both medical and surgical training?

For those that have attended AAOMS meetings or read the journal often are there any presentations/articles that have shed some light on the AAOMS' opinion and view of the additionaly MD training?
 

buck-E

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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.

I think this is where you are wrong- most single degree guys do not give a crap about having an MD and realize that it has no impact on their daily practice. I had faculty with MDs who agreed with this. I feel comfortable saying that we don't look at the 6-year guys with any sort of envy regarding their MD. I was at a program where there was an MD option (as there are at many 4 year programs) and no one has ever taken the school up on the option- which is very often the case.

You're right, I didn't learn how to do a pelvic exam or how to preform a psych evaluation, but this would not help me in my daily patient care. My first two years of dental school we took all of the basic classes with the med students (ie anatomy, histo, phys, micro, pharm) that give you a solid background. During residency you filled in the gaps be reading and having lectures, but you really learned most about patient care by spending time on the floor and in the SICU. I really do not think that you come out with knowing that much more practical medicine that helps you in daily practice by getting an MD.

In addition in listening to you guys on SDN your two years of med school are a joke- time to relax and moonlight. Go to class (or skip them) and show up for your clinicals (but play the "dentist" card when you really don't want to do something). So my question is how much did you learn in your formal "med school" years that I didn't learn in my 2 months of medicine, 4 months of anesthesia and 9 months of surgical rotations, which help you in daily patient care?

It would be interesting if someone could look at ABOMS or OMSSAT scores to compare medicine section scores between 4 & 6 yr programs to shed further light on this.

I also spent some time in Europe during residency- where they do 3-4 years of medical school, and can tell you I was light years ahead of the guys coming out of medical school (I specifically remember teaching them how to read EKGs!) when it came to patient care.

You are right, it does give you advantages as far as further training (many, but not all fellowships require an MD). In addition, some states may give you advantages getting privileges for cosmetics/cancer. But for those of us who want to practice bread and butter OMFS (trauma, orthognathics, TMJ, T&T) there is no advantage.

In addition in most states you have to choose if you want to practice under your MD or DDS- you can't hold both licenses. If you practice under your MD you can't take out teeth, place implants etc, as it is a breach of the dental practice laws of the state. It often can also be illegal to advertise your MD if you do not hold a current medical license in your state.
 

Columbia07

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In addition in most states you have to choose if you want to practice under your MD or DDS- you can't hold both licenses. If you practice under your MD you can't take out teeth, place implants etc, as it is a breach of the dental practice laws of the state. It often can also be illegal to advertise your MD if you do not hold a current medical license in your state.

Is this really true? Wasn't there an article a while back (2005) criticizing OMFS' for having an MD but not obtaining the license (apparently misleading their patients...). However, as you point out, why would people criticize OMFS' for not have an MD license knowing that one is not allowed to hold an MD and DDS license? I think we need some clarification here.
 

Columbia07

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Found it!

http://www.ama-assn.org/amednews/2004/10/18/prl21018.htm


Four of the five board members of the American College of Oral & Maxillofacial Surgeons, of which Dr. Thomas is president-elect, use the MD title. None hold medical licenses.

Many licensed physicians believe that this practice misleads the public and raises concerns about patient safety.

Steven Pearlman, MD, a member of the American Academy of Otolaryngology -- Head and Neck Surgery and president of the American Academy of Facial Plastic and Reconstructive Surgery, said this is yet another example of oral surgeons seeking to work beyond their scope.

"This is parallel to what happened in California," where oral surgeons recently tried and failed to win authority to perform elective cosmetic surgery of the head and neck, Dr. Pearlman said.

"If you are hanging MD on your shingle and you're not licensed, that's wrong," he said. "That's absolutely misleading the public. If these oral surgeons want to do this, they should go through the same pathway as U.S. [medical] doctors."


BTW, Stevie sounds like a jerk...
 

servitup

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Most dual trained surgeones have MD and DDS licenses. Dr. Turvey at UNC is yet another single degree legend who encourages everyone to get the MD.


Is this really true? Wasn't there an article a while back (2005) criticizing OMFS' for having an MD but not obtaining the license (apparently misleading their patients...). However, as you point out, why would people criticize OMFS' for not have an MD license knowing that one is not allowed to hold an MD and DDS license? I think we need some clarification here.
 

buck-E

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147.081 PRACTICING WITHOUT LICENSE; PENALTY.
Subdivision 1. Unlawful practice of medicine. It is unlawful for any person to practice
medicine as defined in subdivision 3 in this state unless:
(1) the person holds a valid license issued according to this chapter;
or
(2) the person is registered to provide interstate telemedicine services according to section
147.032.
Subd. 2. Penalty. Any person violating the provisions of subdivision 1 is guilty of a gross
misdemeanor.
Subd. 3. Practice of medicine defined. For purposes of this chapter, a person not exempted
under section 147.09 is "practicing medicine" or engaged in the "practice of medicine" if the
person does any of the following:
(1) advertises, holds out to the public, or represents in any manner that the person is
authorized to practice medicine in this state;
(2) offers or undertakes to prescribe, give, or administer any drug or medicine for the use
of another;
(3) offers or undertakes to prevent or to diagnose, correct, or treat in any manner or by
any means, methods, devices, or instrumentalities, any disease, illness, pain, wound, fracture,
infirmity, deformity or defect of any person;
(4) offers or undertakes to perform any surgical operation including any invasive or
noninvasive procedures involving the use of a laser or laser assisted device, upon any person;
(5) offers to undertake to use hypnosis for the treatment or relief of any wound, fracture, or
bodily injury, infirmity, or disease; or
(6) uses in the conduct of any occupation or profession pertaining to the diagnosis of
human disease or conditions, the designation "doctor of medicine," "medical doctor," "doctor of
osteopathy," "osteopath," "osteopathic physician," "physician," "surgeon," "M.D.," "D.O.," or any
combination of these designations.


This is an example from a state medical practice act... it may not hold true in all states, but in some places when ENT/Plastics get all worked up about something (ie cosmetic procedures) they may look into the definition of "practicing medicine" or "practicing dentisty" in a state. In this example anyone who designates themselves as an MD (ie on your business cards, or in advertising) is considered to be representing yourself as a physician and therefor practicing without a license unless you hold a state license.
 

Squished Rat

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Found it!

http://www.ama-assn.org/amednews/2004/10/18/prl21018.htm


Four of the five board members of the American College of Oral & Maxillofacial Surgeons, of which Dr. Thomas is president-elect, use the MD title. None hold medical licenses.

Many licensed physicians believe that this practice misleads the public and raises concerns about patient safety.

Steven Pearlman, MD, a member of the American Academy of Otolaryngology -- Head and Neck Surgery and president of the American Academy of Facial Plastic and Reconstructive Surgery, said this is yet another example of oral surgeons seeking to work beyond their scope.

"This is parallel to what happened in California," where oral surgeons recently tried and failed to win authority to perform elective cosmetic surgery of the head and neck, Dr. Pearlman said.

"If you are hanging MD on your shingle and you're not licensed, that's wrong," he said. "That's absolutely misleading the public. If these oral surgeons want to do this, they should go through the same pathway as U.S. [medical] doctors."


BTW, Stevie sounds like a jerk...

I think you are taking this article out of context. The problem a lot of people were having was with single degree guys who went and got an MD at the University of Antigua and then started advertising as an MD. They did not do a year of general surgery which is what leads to problems with getting a medical lisence. All the dual degree guys I know have no problems having a medical and dental lisence. I think most dual degree guys and maybe most single degree guys will also agree that getting an MD through correspondence for the most part in a foreign country is a bit shady. Regardless, you have to do one year post med school residency to get lisenced and that was where the problem lay.

It should also be noted that in reference to his remark about oral surgeons trying for and not gaining elective cosmetic privleges is at one point during a "turf war" for lack of a better word in CA which OMFS did win. THe govenor ended up agreeing the OMFS were adequately trained to do cosmetics.
 

north2southOMFS

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But for those of us who want to practice bread and butter OMFS (trauma, orthognathics, TMJ, T&T) there is no advantage. .

And that is where you and i will disagree forever.


In addition in most states you have to choose if you want to practice under your MD or DDS- you can't hold both licenses. If you practice under your MD you can't take out teeth, place implants etc, as it is a breach of the dental practice laws of the state. It often can also be illegal to advertise your MD if you do not hold a current medical license in your state.

? Find me one state where you can't hold both licenses. In fact, if you have both i think most states would encourage you to hold both licenses. You clearly have your facts wrong.


Colombia07 what you are thinking of is a couple of dinks on the ACOMS went online and got their "MD" from a caribbean sham school with no rotations, classes, intern year, STEP tests etc... Essentially it was a sham so they could put MD behind their name. They issue is not even that they never got licenses, it was that they were never eligible to ever get licenses here. That is why they came under fire. It was an embarrasment to all of us with real medical degree's. Pay no attention to buck-e, he clearly has no clue about state medical and dental licensure. Everyone with a real medical degree through their OMFS residency gets a full state licensure when they finish. In fact, when you take the last medical board exam you are required to simulaneously apply for state licensure.
 

Columbia07

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Thanks for the clarification.
 
B

Battlesign

I agree that there are fantastic single degree surgeons out there. I also agree that there are fantastic dual trained surgeons out there. The truth is that dual trained surgeons do have an MD, which means they have more training, regardless of how you look at it. That training may or may not impact the ultimate scope of that surgeon.

I don't think that you realize how much you think that you knew, but couldn't know until you really knew it.:idea: For example, when you graduate from dental school, and begin OMFS residency you think that you are some big shot. Cruising around the hospital taking care of complex patients during your intern year. Then you get to medical school and you realize just how much you don't know and really because of a lack of knowledge just how dangerous you are.

It is that dental mentality "I can take a course and read a book and I am some kind of expert". I love the GP that does a 3-week orthodontic course and starts treating complex orthodontic patients. They think that they are amazing.

A little bit of knowledge is dangerous when you think that you have mastered subjects by reading about it.
 

WestCoast

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I agree that there are fantastic single degree surgeons out there. I also agree that there are fantastic dual trained surgeons out there. The truth is that dual trained surgeons do have an MD, which means they have more training, regardless of how you look at it. That training may or may not impact the ultimate scope of that surgeon.

I don't think that you realize how much you think that you knew, but couldn't know until you really knew it.:idea: For example, when you graduate from dental school, and begin OMFS residency you think that you are some big shot. Cruising around the hospital taking care of complex patients during your intern year. Then you get to medical school and you realize just how much you don't know and really because of a lack of knowledge just how dangerous you are.

It is that dental mentality "I can take a course and read a book and I am some kind of expert". I love the GP that does a 3-week orthodontic course and starts treating complex orthodontic patients. They think that they are amazing.

A little bit of knowledge is dangerous when you think that you have mastered subjects by reading about it.

this is true. that's why in medicine, these physicians are always reading and studying and trying to stay sharp. you can't assume you know as much as you know about medicine and surgery because you spent 2 months on medicine and 4 months on general surgery. its like telling internal medicine doc's that 3 yrs of training that they get is useless because they can just read about it, or general surgeons that 5 yrs is useless because they can learn as much they need to know about pt management in 4 months and reading about the rest.
 

north2southOMFS

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The truth is that dual trained surgeons do have an MD, which means they have more training, regardless of how you look at it. That training may or may not impact the ultimate scope of that surgeon.
.

Careful battlesign, you get chastized around here for even thinking that.
 

shabu2

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I don’t think that you realize how much you think that you knew, but couldn’t know until you really knew it.:idea: For example, when you graduate from dental school, and begin OMFS residency you think that you are some big shot. Cruising around the hospital taking care of complex patients during your intern year. Then you get to medical school and you realize just how much you don’t know and really because of a lack of knowledge just how dangerous you are.

I didn't realize Battle and I were in the same program. ;) Exactly how i am feeling now in med school. I thought I knew a lot in d-school, but med school is a whole different ball game.
 

Doggie

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I didn't realize Battle and I were in the same program. ;) Exactly how i am feeling now in med school. I thought I knew a lot in d-school, but med school is a whole different ball game.

I am graduating med school this coming May, and I still dont know ****.....really. :scared:
 

LSU-Cowboy

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I am graduating med school this coming May, and I still dont know ****.....really. :scared:

i graduate in may also....amazing how much shighte i learned ....went back on service for a month.....and felt like i didn't know a thing....
 

Dr.Millisevert

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I have a question...

For those who attend 4 year programs with the MD option.

In order to get your MD licensed you must complete another 1-2 years of ACGME accredited training.

Is it possible to say do a 2 year ACGME accredited H/N recon fellowship or something similar (that is of more interest to most OMFS graduates) instead of doing another 1-2 years of Anesth or Gen surg? If so, how would you find a position like this.. would you contact American H/N society? Would you have to do a H/N fellowship associated with an ENT or Gen surg program or .... Do you think it would in anyway be possible to do one of the CODA approved H/N (Maryland, Miami, UCSF, Mich, etc) and also get ACGME credit for it as well? I think most would prefer to spend those extra years at least associated with an OMS program instead of gen surg if at all possible. :thumbup:

Thanks :thumbup:
 

Dr.Millisevert

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I have a question...

For those who attend 4 year programs with the MD option.

In order to get your MD licensed you must complete another 1-2 years of ACGME accredited training.

Is it possible to say do a 2 year ACGME accredited H/N recon fellowship or something similar (that is of more interest to most OMFS graduates) instead of doing another 1-2 years of Anesth or Gen surg? If so, how would you find a position like this.. would you contact American H/N society? Would you have to do a H/N fellowship associated with an ENT or Gen surg program or .... Do you think it would in anyway be possible to do one of the CODA approved H/N (Maryland, Miami, UCSF, Mich, etc) and also get ACGME credit for it as well? I think most would prefer to spend those extra years at least associated with an OMS program instead of gen surg if at all possible. :thumbup:

Thanks :thumbup:

bump

Anyone?
 
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