oral maxillofacial surgery VS Otolaryngology

[50 CAL BMG]

DREDAY, that is an incredibly lousy comparison.

First off, I don't think that fixing NOEs and frontal sinus fractures should be within the scope of oral surgery. But I recognize the fact that it is, and I can see how it became so.

Fixing NOEs and frontal sinus fractures, which could occur in conjunction with LeFort 1 and LeFort 2 fractures (injuries which are well-within the scope of oral surgery) isn't much of a stretch. So it's easy to see how injuries a tad further up became part of oral surgery.

Bringing a healthy patient in for an elective procedure on the soft tissues of their face for the purpose of making cosmetic improvements is an entirely different process.

If you can't recognize the difference between the two, then I don't know what to tell you.

Dude you are an fing idiot and none of your arguments even make sense. I do understand that you were not smart, competitive, and talented enough to actually match into a real OMFS program from dental school. You are very bitter from your scuternship and still couldn't get into an OMFS program. There are obviously some personality and patient care issues that have caused you to fail repeatedly. Enjoy your all encompassing medical education and family practice residency. The field of OMFS will definitely be stronger without a putz like you.

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[Clemenza]

Dude you are an fing idiot and none of your arguments even make sense. I do understand that you were not smart, competitive, and talented enough to actually match into a real OMFS program from dental school. You are very bitter from your scuternship and still couldn't get into an OMFS program. There are obviously some personality and patient care issues that have caused you to fail repeatedly. Enjoy your all encompassing medical education and family practice residency. The field of OMFS will definitely be stronger without a putz like you.

50CAL, you're entitled to draw whatever conclusions about me that you like, no matter how factually incorrect they may be. (I do believe, however, that I mentioned having matched into an OMFS program prior to making the decision to medical school.).

That aside, your personal attacks don't address any of my arguments against the kind of expanded scope of oral surgery that you support.

 

[Doc Smile]

50CAL, you're entitled to draw whatever conclusions about me that you like, no matter how factually incorrect they may be. (I do believe, however, that I mentioned having matched into an OMFS program prior to making the decision to medical school.).

That aside, your personal attacks don't address any of my arguments against the kind of expanded scope of oral surgery that you support.

You are something else. . . I do know that after you complete med school, then pharm school, then optometry school, whatever career you decide on after you get your FULL medical education, I would never want to be your patient. <- dont need to be a flipping doctor to make that statement factual.

 

[wolfman26]

50CAL, you're entitled to draw whatever conclusions about me that you like, no matter how factually incorrect they may be. (I do believe, however, that I mentioned having matched into an OMFS program prior to making the decision to medical school.).

That aside, your personal attacks don't address any of my arguments against the kind of expanded scope of oral surgery that you support.

Fact is clemenza, nothing you or the AMA say has affected or will EVER affect the scope with which we practice. So the time you have spent on this thread, you will never be able to get back ever again. sad day.
WE determine that scope and as long as patients accept and are pleased with our treatment, we will continue to do so. keep on polluting this thread with your nonsense. go ahead. no matter how disgruntled you may be, it has not and won't change due to unfounded reasons that you claim. write a book if you would like. Won't change a thing. Enjoy yourself!

 

[Clemenza]

Fact is clemenza, nothing you or the AMA say has affected or will EVER affect the scope with which we practice. So the time you have spent on this thread, you will never be able to get back ever again. sad day.

Never said otherwise, Wolfman. Hell, there are oral surgeons out there who perform breast implants too -- and right you are, the AMA can't do anything about it.

But no one has been talking about rules and regulations and arm-twisting in order to limit anyone's scope. All I've been saying is that I don't think it's proper for oral surgeons to practice outside of the scope of dentistry. For some reason, you're very defensive when it comes to this point.

WE determine that scope and as long as patients accept and are pleased with our treatment, we will continue to do so.

Of course you do. I'm sure the day will come when the ADA considers pallidotomies to be within the scope of oral surgery. Good luck getting referrals from your fellow doctors -- medical or dental -- for anything other than exodontia and other dentoalveolar surgery, odontogenic infections, skeletal malocclusions, cysts and benign tumors of the jaws, implants, and trauma. Again, half of your time or more will be spent extracting teeth because that's what will be referred to you most.

Don't want to practice this way? Want to do more exciting procedures? Then you'll be relegated to working in an academic setting.

 

[FaceGuy]

Don't want to practice this way? Want to do more exciting procedures? Then you'll be relegated to working in an academic setting.

Same can be said for any surgical specialty.

 

[DREDAY]

So an omfs can perform a bicorobal flap for an Noe and orbital fractures, perform preauricular approach for a total joint but can't do a facelift lmao get out of town. This is all about money and nothing else. And you are obviously bitter that you chose the wrong career and are having to do extra schooling and accrue extra loans for it.

Foreign medical graduates don't get the same Education you do. Infact one of the caribean medical schools teaches them using board review books. Does that mean they are not md? I sat on a national dental education curriculum committee and I can tell you that the notable differences between dental and medical education in 1st two years are physical diagnosis, pathophysiology, and psychiatry. I can also attest to that having done 1st and 2nd year of medical school at the same time.

DREDAY that is an incredibly lousy comparison.

First off, I don't think that fixing NOEs and frontal sinus fractures should be within the scope of oral surgery. But I recognize the fact that it is, and I can see how it became so.

Fixing NOEs and frontal sinus fractures, which could occur in conjunction with LeFort 1 and LeFort 2 fractures (injuries which are well-within the scope of oral surgery) isn't much of a stretch. So it's easy to see how injuries a tad further up became part of oral surgery.

Bringing a healthy patient in for an elective procedure on the soft tissues of their face for the purpose of making cosmetic improvements is an entirely different process.

If you can't recognize the difference between the two, then I don't know what to tell you.

 

[Clemenza]

So an omfs can perform a bicorobal flap for an Noe and orbital fractures, perform preauricular approach for a total joint but can't do a facelift lmao get out of town.

DREDAY, my argument is that it's not about training. It's about people practicing within their specialties. Facelifts are not a part of dentistry. Granted, neither are treating NOE or frontal sinus fractures, really, but at least they are along the same lines as treating LeFort fractures. Facelifts, however, are way, way, WAY outside of the field of dentistry.

Now, as for training, DREDAY, you're conveniently failing to mention the fact that there are also single-degree oral surgeons who want to be doing facelifts and nose jobs. And you KNOW that they don't even remotely have a medical education. And as for the dual-degree oral surgeons, as I've said, they haven't completed a full medical education.

This is all about money and nothing else. And you are obviously bitter that you chose the wrong career and are having to do extra schooling and accrue extra loans for it.

Oh, yeah. Obviously!

According to you, anyone who thinks that oral surgeons shouldn't be doing facelifts simply wishes they were an oral surgeon. That's brilliant logic, DREDAY. Very mature.

Foreign medical graduates don't get the same Education you do. Infact one of the caribean medical schools teaches them using board review books. Does that mean they are not md?

Not all medical educations are the same, buddy. Were you unaware that FMGs are on the average less competitive for the more highly-selective residencies, as are graduates from Caribbean schools?

I sat on a national dental education curriculum committee and I can tell you that the notable differences between dental and medical education in 1st two years are physical diagnosis, pathophysiology, and psychiatry. I can also attest to that having done 1st and 2nd year of medical school at the same time.

DREDAY, don't give me that "curriculum committee" BS. You're not gonna snow-job me with that nonsense.

Unless, on this curriculum committee, you compared the D1 and D2 years with the M1 and M2 years lecture-for-lecture, topic-for-topic, and detail-for-detail, you don't know dick about what is taught in medical school and thus your comparison is miserably uninformed.

I do. I've been through 'em both....here in the U.S. That means I am intimately familiar with the coursework that dental students and medical students undergo. And I can tell you that they are very different. The scope in dental school is much more narrow and the depth of detail is much more shallow.

"But I've been on a 'curriculum committee'.....so I can accurately compare them." That's rich, DREDAY!!

Oh, and by the way: "physical diagnosis" and "pathophysiology" are HUGE. You talk about them as though they're isolated one-credit courses that have little to do with the practice of medicine. The whole of medical school is physiology and pathophysiology. A good portiobn of dental school, in contrast, is drilling holes into plastic teeth and melting wax onto denture bases and setting denture teeth.

 

[armorshell]

DREDAY, my argument is that it's not about training. It's about people practicing within their specialties. Facelifts are not a part of dentistry. Granted, neither are treating NOE or frontal sinus fractures, really, but at least they are along the same lines as treating LeFort fractures. Facelifts, however, are way, way, WAY outside of the field of dentistry.

Again, you're completely hung up on semantics. Any operator with proper procedural training should be legally and ethically able to perform those procedures.

Doing these procedures was not the original (Think 1940's) intention of oral surgery education but with the slow progression of the oral surgeons role in the hospital environment and slow evolution of scope to what many of today's training programs offer, limiting said scope now would be ridiculous.

Personally, I'm not particularly sure what you're worried about anyway, since you're utterly convinced that no oral surgeon could possibly do any of these procedures with any respectable amount of volume because of their dental backgrounds.

 

[armorshell]

Oh, yeah. Obviously!

According to you, anyone who thinks that oral surgeons shouldn't be doing facelifts simply wishes they were an oral surgeon. That's brilliant logic, DREDAY. Very mature.

I'm pretty sure he was implying that the wrong career you chose was dentistry, not that you wished you were an oral surgeon. You clearly don't.

 

[armorshell]

"But I've been on a 'curriculum committee'.....so I can accurately compare them." That's rich, DREDAY!!

It's about as "rich" as claiming that because you've been to one dental school, and one medical school, that your experience accurately represents every students experience at all dental schools and all medical schools. Similarly, you seem to believe your experience with one OMFS internship makes you sacrosanct when discussing all OMFS residencies and contemporary scope of OMFS.

Oh, and by the way: "physical diagnosis" and "pathophysiology" are HUGE. You talk about them as though they're isolated one-credit courses that have little to do with the practice of medicine. The whole of medical school is physiology and pathophysiology. A good portiobn of dental school, in contrast, is drilling holes into plastic teeth and melting wax onto denture bases and setting denture teeth.

And that's why many OMFS programs with an MD component have their residents take those courses.

 

[DREDAY]

I'm also speaking from experience having done both 1st and 2nd year of medical school.

Unlike your misinterpretation I highly value the medical education that i have receive and the pathophysiology and physical diagnosis classes. Those classes are what define medicine. Having done first and second year of medical school and dental school I can say that the difference between the two lies in pathophysiology and physical diagnosis.

DREDAY, my argument is that it's not about training. It's about people practicing within their specialties. Facelifts are not a part of dentistry. Granted, neither are treating NOE or frontal sinus fractures, really, but at least they are along the same lines as treating LeFort fractures. Facelifts, however, are way, way, WAY outside of the field of dentistry.

Now, as for training, DREDAY, you're conveniently failing to mention the fact that there are also single-degree oral surgeons who want to be doing facelifts and nose jobs. And you KNOW that they don't even remotely have a medical education. And as for the dual-degree oral surgeons, as I've said, they haven't completed a full medical education.





Oh, yeah. Obviously!

According to you, anyone who thinks that oral surgeons shouldn't be doing facelifts simply wishes they were an oral surgeon. That's brilliant logic, DREDAY. Very mature.



Not all medical educations are the same, buddy. Were you unaware that FMGs are on the average less competitive for the more highly-selective residencies, as are graduates from Caribbean schools?



DREDAY, don't give me that "curriculum committee" BS. You're not gonna snow-job me with that nonsense.

Unless, on this curriculum committee, you compared the D1 and D2 years with the M1 and M2 years lecture-for-lecture, topic-for-topic, and detail-for-detail, you don't know dick about what is taught in medical school and thus your comparison is miserably uninformed.

I do. I've been through 'em both....here in the U.S. That means I am intimately familiar with the coursework that dental students and medical students undergo. And I can tell you that they are very different. The scope in dental school is much more narrow and the depth of detail is much more shallow.

"But I've been on a 'curriculum committee'.....so I can accurately compare them." That's rich, DREDAY!!

Oh, and by the way: "physical diagnosis" and "pathophysiology" are HUGE. You talk about them as though they're isolated one-credit courses that have little to do with the practice of medicine. The whole of medical school is physiology and pathophysiology. A good portiobn of dental school, in contrast, is drilling holes into plastic teeth and melting wax onto denture bases and setting denture teeth.

 

[Clemenza]

Again, you're completely hung up on semantics. Any operator with proper procedural training should be legally and ethically able to perform those procedures.

Armorshell, did you think that your use of the word "operator" would slip by unnoticed?

You're treating dentistry as if it's an alternate-but-identical profession to medicine (hence your use of the word "operator" to mask the difference between the practice of medicine and the practice of dentistry). It isn't. By definition, dentistry is a much more narrow field than medicine is.

Doing these procedures was not the original (Think 1940's) intention of oral surgery education but with the slow progression of the oral surgeons role in the hospital environment and slow evolution of scope to what many of today's training programs offer, limiting said scope now would be ridiculous.

Ridiculous? Not when oral surgery continues to be a specialty of dentistry rather than medicine. And not when "said scope" proposes that facelifts fall under the definition of "dentistry". And not when it requires only a dental degree to practice.

None of you have been able to come up with an explanation of how performing a facelift can be considered a part of dentistry. In fact, since the beginning of this thread, you have categorically evaded addressing the topic...presumably because you know damn well that facelifts have nothing to do with dentistry.

Personally, I'm not particularly sure what you're worried about anyway, since you're utterly convinced that no oral surgeon could possibly do any of these procedures with any respectable amount of volume because of their dental backgrounds.

I'm not worried at all. I've seen enough of oral surgery in private practice to know that my assessment is spot-on. In fact, Armorshell, don't take my word for it. Why don't you do a google search of oral surgery practices. Find a few dozen private practices that employ only dual-degree oral surgeons and see how many of them don't list third molar extractions among their services. (If third-molar extractions are listed, then you can be pretty sure that exodontia makes up a major portion of their practice).

 

[Clemenza]

It's about as "rich" as claiming that because you've been to one dental school, and one medical school, that your experience accurately represents every students experience at all dental schools and all medical schools.

Nice try, Armorshell. There isn't much deviation between the material covered from U.S. dental school to U.S. dental school, and from U.S. medical school to U.S. medical school. In that respect, there is far less deviation than you'd expect. Every U.S. dental student has spent a lot of his time melting wax onto a denture base in order to set denture teeth. Every U.S. dental student has sat through hours of lectures on partial dentures and crown & bridge and scaling & root planing. And every dental student has, at some point, waxed-up and cast his a gold crown at least once.

Similarly, you seem to believe your experience with one OMFS internship makes you sacrosanct when discussing all OMFS residencies and contemporary scope of OMFS.

You don't have to be a board-certified oral surgeon to know what the scope of oral surgery is. And you don't have to go through an oral surgery residency to draw some basic conclusions about what kinds of experiences residents acquire (although as an intern, I saw exactly what kinds of things the residents around me did and how much of it they did).

Most oral surgery programs have websites, so you can look at the breakdown of the residents' time yourself. Most four-year oral surgery programs have their residents "off-service" for 8 to 12 months. When you combine that the fact that they all have to spend a great deal of time performing bread-and-butter oral surgery procedures, it's a sound conclusion that there isn't much time left for the "expanded scope" procedures. Are there exceptions? Probably. But they're exceptions.

Care to demonstrate to me how I'm wrong?

And that's why many OMFS programs with an MD component have their residents take those courses.

They are not courses, Armorshell. They are the whole of medical school. Besides, whichever two years of medical school dual-degree programs entail, there will be two years of medical school that have not been completed in any form by the residents. Maybe one year, perhaps, if we consider the first two years of dental school to cover about one year's worth of medical education.

 

[Clemenza]

I'm also speaking from experience having done both 1st and 2nd year of medical school.

So.....where's your third and fourth year of medical school? I mean, where's the justification for your claim that your medical education is as legit as that of an ENT or plastic surgeon who attended all four years of medical school?

Oh, wait, lemme guess.........the 200 fillings, 20 crowns, 30 extractions, and 6 root canals you did during your 3rd and 4th year of dental school made up the difference. Pardon me!

Unlike your misinterpretation I highly value the medical education that i have receive and the pathophysiology and physical diagnosis classes. Those classes are what define medicine. Having done first and second year of medical school and dental school I can say that the difference between the two lies in pathophysiology and physical diagnosis.

DREDAY, saying that the "difference between medical school and dental school lies in pathophysiology and physical diagnosis" is like saying the difference between an ant-hill and the Grand Canyons is few hundred billion pounds of rock.

As I said in my previous response to you, physical diagnosis and pathophysiology are not "classes" in medical school. Rather, they are medical school--especially in the second year. In dental school, there is little time spent on pathophysiology of diseases outside of the oral cavity.

 

[DREDAY]

In my program I did 1st and 2nd year medical school concurrently. I do all of 3rd year. I do a compressed 4th year with no breaks and no elective rotations. Therefor my 4th year lasts 6 months. Time wise I spend 2.5 years in medical school. Curriculum wise I get EVERYTHING except elective rotations and breaks. So i do have an accurate perspective of both.

So.....where's your third and fourth year of medical school? I mean, where's the justification for your claim that your medical education is as legit as that of an ENT or plastic surgeon who attended all four years of medical school?

Oh, wait, lemme guess.........the 200 fillings, 20 crowns, 30 extractions, and 6 root canals you did during your 3rd and 4th year of dental school made up the difference. Pardon me!



DREDAY, saying that the "difference between medical school and dental school lies in pathophysiology and physical diagnosis" is like saying the difference between an ant-hill and the Grand Canyons is few hundred billion pounds of rock.

As I said in my previous response to you, physical diagnosis and pathophysiology are not "classes" in medical school. Rather, they are medical school--especially in the second year. In dental school, there is little time spent on pathophysiology of diseases outside of the oral cavity.

 

[DREDAY]

Have u ever thought about the fact that there are programs where you do 1st and 2nd year of medical school concurrently? Obviously not. How bout the fact that there are no breaks for omfs residents at many programs? Like 4th year medical school when students have a ton of breaks for interviews and externships? Omfs residents are dong med rotations during those time off. You are obviously missinformed.

Nice try, Armorshell. There isn't much deviation between the material covered from U.S. dental school to U.S. dental school, and from U.S. medical school to U.S. medical school. In that respect, there is far less deviation than you'd expect. Every U.S. dental student has spent a lot of his time melting wax onto a denture base in order to set denture teeth. Every U.S. dental student has sat through hours of lectures on partial dentures and crown & bridge and scaling & root planing. And every dental student has, at some point, waxed-up and cast his a gold crown at least once.



You don't have to be a board-certified oral surgeon to know what the scope of oral surgery is. And you don't have to go through an oral surgery residency to draw some basic conclusions about what kinds of experiences residents acquire (although as an intern, I saw exactly what kinds of things the residents around me did and how much of it they did).

Most oral surgery programs have websites, so you can look at the breakdown of the residents' time yourself. Most four-year oral surgery programs have their residents "off-service" for 8 to 12 months. When you combine that the fact that they all have to spend a great deal of time performing bread-and-butter oral surgery procedures, it's a sound conclusion that there isn't much time left for the "expanded scope" procedures. Are there exceptions? Probably. But they're exceptions.

Care to demonstrate to me how I'm wrong?




They are not courses, Armorshell. They are the whole of medical school. Besides, whichever two years of medical school dual-degree programs entail, there will be two years of medical school that have not been completed in any form by the residents. Maybe one year, perhaps, if we consider the first two years of dental school to cover about one year's worth of medical education.

 

[FaceGuy]

You guys have got to let it go. Seriously. Anyone who has been in medical school with OMFS residents knows that we are usually far above average by any metric, whether that be grades, board scores, or faculty evaluations on clerkships.

Everything Clemenza has to say is just noise. Only a fool would assert that the only way to learn something is to sit in a lecture hall or lab for 2 years. Most med students don't even show up to the first two years of med school now that 90% of the material is online. Everything taught in medical school can be found in books and the topics deemed important by the accrediting bodies of medicine are tested on standardized exams which ALL physicians must pass.

Equally silly is the idea that more education makes one less qualified to practice medicine. Is it logical to say that doing the things dental students do actually makes someone less educated? Clearly, waxing teeth is irrelevant to a facelift or neck dissection. But it certainly doesn't make someone less qualified to do those procedures.

Licensed physicians have the right to engage in anything for which they have been appropriately trained, even if they are also dentists.

I agree, however, that it is hard to consider facial cosmetic surgery and other medical procedures within the scope of dentistry. That is why I went to medical school. I suppose the single degree surgeons feel they can learn what they need to know to perform these procedures via means other than a formal medical education, and they may be correct. The only difference is that there is no standardized way to assess that a single degree surgeon has actually achieved a minimally acceptable medical knowledge.

Dual degree surgeons on the other hand have fulfilled all of the requirements to obtain medical licensure, thus they have every right to practice medicine (even if they also practice dentistry).

I will not be feeding the troll any more and suggest everyone else who has said their peace do the same. I have no rebuttal for the fact I didn't do the first two years of medical school except that by every objective measure, I am performing better than most of the medical students who did. And like it or not, those measures are in place to test what is important, even if some of the minutiae aren't covered.

 

[Gingiva]

I don't see how the numbers add up. Doing some research on previous DREDAY posts, it appears that you must have started dental school in 2005 and finished in 2009. You most likely started OMFS residency July 2009, how is it possible that you have done the 1st and 2nd years of medical school and also spent enough clinical time on OMFS rotations to have an accurate perspective?

I'm also speaking from experience having done both 1st and 2nd year of medical school.

Unlike your misinterpretation I highly value the medical education that i have receive and the pathophysiology and physical diagnosis classes. Those classes are what define medicine. Having done first and second year of medical school and dental school I can say that the difference between the two lies in pathophysiology and physical diagnosis.

 

[armorshell]

Armorshell, did you think that your use of the word "operator" would slip by unnoticed?

You're treating dentistry as if it's an alternate-but-identical profession to medicine (hence your use of the word "operator" to mask the difference between the practice of medicine and the practice of dentistry). It isn't. By definition, dentistry is a much more narrow field than medicine is.

I wasn't trying to mask anything in particular (I use operator all the time, usually when I write notes in reference to myself), but that does illustrate your obsession with terminology and semantics fairly well.

Ridiculous? Not when oral surgery continues to be a specialty of dentistry rather than medicine. And not when "said scope" proposes that facelifts fall under the definition of "dentistry". And not when it requires only a dental degree to practice.

Your logic is completely circular, and you refuse to address the root of why you believe it's improper for someone who is trained in a procedure to perform that procedure, solely because of background. While many others back their arguments up with reasoning and evidence, you continue to simply repeat yours and assume they stand on principle, which is simply incorrect. You're begging the question.

None of you have been able to come up with an explanation of how performing a facelift can be considered a part of dentistry. In fact, since the beginning of this thread, you have categorically evaded addressing the topic...presumably because you know damn well that facelifts have nothing to do with dentistry.

Nomenclature is irrelevant in this discussion. Training and outcomes are more important. If OMFS have adequate training and obtain desirable outcomes, name alone should not bar anyone from practice. Last time I looked at my diploma, neither D nor the S in my D.D.S. were scarlet letters.

50 years ago would you have argued that ENT should not by doing facelifts because ENT and PRS are different and disgruntled ENT's should simply suck it up and do a full PRS residency if they care to do facelifts, and as we all know ENT is not PRS?

If an ENT received an MBA concurrently with medical school would you similarly dismiss them from doing facelifts because they do not fall under the scope of business?

I'm not worried at all. I've seen enough of oral surgery in private practice to know that my assessment is spot-on. In fact, Armorshell, don't take my word for it. Why don't you do a google search of oral surgery practices. Find a few dozen private practices that employ only dual-degree oral surgeons and see how many of them don't list third molar extractions among their services. (If third-molar extractions are listed, then you can be pretty sure that exodontia makes up a major portion of their practice).

How about Perenack, Quereshy, Evelhoch, all the administrators of the OMFS cosmetics fellowships? No adequate scope there? Everyone realizes that this is not the primary path most OMFS take, but it is viable for those who choose it (as is craniofacial or cancer/microvascular) as can be evidenced by many who are ACTUALLY doing it. Again, your inability to differentiate your personal experience from what is actually happening in the community is almost commendable.

 

[armorshell]

Nice try, Armorshell. There isn't much deviation between the material covered from U.S. dental school to U.S. dental school, and from U.S. medical school to U.S. medical school. In that respect, there is far less deviation than you'd expect. Every U.S. dental student has spent a lot of his time melting wax onto a denture base in order to set denture teeth. Every U.S. dental student has sat through hours of lectures on partial dentures and crown & bridge and scaling & root planing. And every dental student has, at some point, waxed-up and cast his a gold crown at least once.

Sounds like you've attended quite a few dental or medical schools to be able to assemble that knowledge. Again, you're ignoring dental schools that literally attend all the same classes as medical students for the first two years, etc...

The second part is true, but you're arguing with a strawman. No one is saying medical and dental schools are equivalent; they aren't. That's why we go to medical school. The fact that you believe that no part of dental school is clearly a minority opinion in medical education community, evidenced by the 50 or so medical schools willing to grant OMFS residents degrees after 12-30 months of medical school only.

You don't have to be a board-certified oral surgeon to know what the scope of oral surgery is. And you don't have to go through an oral surgery residency to draw some basic conclusions about what kinds of experiences residents acquire (although as an intern, I saw exactly what kinds of things the residents around me did and how much of it they did).

You don't know what kind of experiences residents acquire, you know what kind of experiences residents acquire at one particular program. Any dental student who has done a few externships can tell that there are stark differences between, scope, resident involvement and caseloads at different programs and it's interesting that someone with your experience missed that.

Most oral surgery programs have websites, so you can look at the breakdown of the residents' time yourself. Most four-year oral surgery programs have their residents "off-service" for 8 to 12 months. When you combine that the fact that they all have to spend a great deal of time performing bread-and-butter oral surgery procedures, it's a sound conclusion that there isn't much time left for the "expanded scope" procedures. Are there exceptions? Probably. But they're exceptions.

Care to demonstrate to me how I'm wrong?

I don't, because for the most part you're correct. We're not talking about every oral surgeon here though, and we never have been. We're talking about surgeons who had either an exceptional experience in certain expanded scope areas during residency (minority) or surgeons who obtained fellowship training (minority). We're talking about people who have gone out of their way to obtain the experience necessary to competently perform these procedures. Everyone in this thread, OMFS, dental student or ENT have been talking about exceptions to the rule. Interesting how you missed that, maybe your apparent tendency to assume that if something is true in one case, it must be true for all cases?

 

[Clemenza]

In my program I did 1st and 2nd year medical school concurrently. I do all of 3rd year. I do a compressed 4th year with no breaks and no elective rotations. Therefor my 4th year lasts 6 months. Time wise I spend 2.5 years in medical school. Curriculum wise I get EVERYTHING except elective rotations and breaks. So i do have an accurate perspective of both.

First and second years concurrently, without cutting out or abridging any courses?

4th year condensed into 6 months, simply by eliminating the 2 to 4wk electives and the one month vacation?

I'm really smelling some BS here, DREDAY.

And on top of that, we need to take a look at your residency training as well! Out of your six year program, only 3.5 years are actually spent working at the resident level. One of those years is spent in general surgery (where you won't be working on the head and neck), and 4 to 6 months is spent in anesthesia. That means that as little as 2 years of your 6 year residency is devoted to oral and maxillofacial surgery. And considering the fact that you'll need to become proficient in performing the core OMFS procedures (e.g. trauma, orthognathics, dentoalveolar, etc.), you'll spend about half of those two years doing pure, bread-and-butter, oral surgery. Not exactly the kind of head-and-neck surgical training that ENTs get during their residencies. Probably not even the kind that plastic surgeons get either, considering the fact that they are far more likely to have an healthy supply of cosmetics cases than oral surgery programs are.

 

[Clemenza]

You guys have got to let it go. Seriously. Anyone who has been in medical school with OMFS residents knows that we are usually far above average by any metric, whether that be grades, board scores, or faculty evaluations on clerkships.

I'd like to see some proof of that, FaceGuy.

Everything Clemenza has to say is just noise. Only a fool would assert that the only way to learn something is to sit in a lecture hall or lab for 2 years. Most med students don't even show up to the first two years of med school now that 90% of the material is online. Everything taught in medical school can be found in books and the topics deemed important by the accrediting bodies of medicine are tested on standardized exams which ALL physicians must pass.[/quote]

Sure. And I have no doubt that I could learn how to build a nuclear reactor from start to finish by reading books and using online resources.

Whether medical students attend lectures or not is absolutely irrelevant, and you should know this. First off, many dental schools are the same way. But secondly, medical students are responsible for the materials covered in lecture (plus additional assigned readings, etc.). Your assertion that our not attending lectures somehow detracts from what we cover in medical school is absurd.

Equally silly is the idea that more education makes one less qualified to practice medicine. Is it logical to say that doing the things dental students do actually makes someone less educated? Clearly, waxing teeth is irrelevant to a facelift or neck dissection. But it certainly doesn't make someone less qualified to do those procedures.

It does when you spend time doing those kinds of tasks instead of learning about medicine.

Licensed physicians have the right to engage in anything for which they have been appropriately trained, even if they are also dentists.

Then these "back door" or "alternate" avenues into practicing medicine should be done away with. Oral surgery should fight to become a specialty of medicine that one gets into by going into medical school.

I agree, however, that it is hard to consider facial cosmetic surgery and other medical procedures within the scope of dentistry. That is why I went to medical school. I suppose the single degree surgeons feel they can learn what they need to know to perform these procedures via means other than a formal medical education, and they may be correct. The only difference is that there is no standardized way to assess that a single degree surgeon has actually achieved a minimally acceptable medical knowledge.

Tell that to the ADA and the ABOMS and AAOMS, who don't make any distinction between dual-degree and single-degree oral surgeons when it comes to scope of practice.

The position of these governing bodies is that all oral surgeons should be doing these procedures, which automatically indicates that they view the MD degree as completely unnecessary.

Dual degree surgeons on the other hand have fulfilled all of the requirements to obtain medical licensure, thus they have every right to practice medicine (even if they also practice dentistry).

Marginally.

I will not be feeding the troll any more and suggest everyone else who has said their peace do the same. I have no rebuttal for the fact I didn't do the first two years of medical school except that by every objective measure, I am performing better than most of the medical students who did. And like it or not, those measures are in place to test what is important, even if some of the minutiae aren't covered.

Oh, I see. Anything you didn't cover as part of your "medical education" is unimportant minutiae. Wonderful.

 

[Clemenza]

Sounds like you've attended quite a few dental or medical schools to be able to assemble that knowledge. Again, you're ignoring dental schools that literally attend all the same classes as medical students for the first two years, etc...

Why don't you identify for me two schools that do this. Show me their websites where I can see, course-for-course, lecture-for-lecture, that they are taking everything that the medical students are taking. When I was in dental school, the hygiene students took periodontics with us....but they were responsible for much less material on their exams.

You don't know what kind of experiences residents acquire, you know what kind of experiences residents acquire at one particular program. Any dental student who has done a few externships can tell that there are stark differences between, scope, resident involvement and caseloads at different programs and it's interesting that someone with your experience missed that.

I did an externship when I was in dental school, and while the program where I did the externship saw more trauma and pathology than the one where I did my internship, the programs were far more similar than they were different.

I don't, because for the most part you're correct. We're not talking about every oral surgeon here though, and we never have been. We're talking about surgeons who had either an exceptional experience in certain expanded scope areas during residency (minority) or surgeons who obtained fellowship training (minority). We're talking about people who have gone out of their way to obtain the experience necessary to competently perform these procedures. Everyone in this thread, OMFS, dental student or ENT have been talking about exceptions to the rule. Interesting how you missed that, maybe your apparent tendency to assume that if something is true in one case, it must be true for all cases?

As I understand it, all of the governing bodies within dentistry (ADA, ABOMS, etc. missed it too. To my knowledge, none of them mandate that oral surgeons have medical degrees, and none of them mandate that oral surgeons have completed fellowships in cosmetics in order to perform cosmetic surgery

 

[Clemenza]

I wasn't trying to mask anything in particular (I use operator all the time, usually when I write notes in reference to myself), but that does illustrate your obsession with terminology and semantics fairly well.

Well, Armorshell, obviously "semantics" was important enough to make dentistry separate from medicine and become its own independent profession. I'm simply saying that they should stick to their own rules. You're saying that it's now ok to blur the lines.

Your logic is completely circular, and you refuse to address the root of why you believe it's improper for someone who is trained in a procedure to perform that procedure, solely because of background. While many others back their arguments up with reasoning and evidence, you continue to simply repeat yours and assume they stand on principle, which is simply incorrect. You're begging the question.

Once again, if someone wants to practice medicine, they should go to medical school and complete a medical residency in order to do it.

What's so objectionable about that position?

Nomenclature is irrelevant in this discussion. Training and outcomes are more important. If OMFS have adequate training and obtain desirable outcomes, name alone should not bar anyone from practice. Last time I looked at my diploma, neither D nor the S in my D.D.S. were scarlet letters.

When it comes to practicing medicine they are. Single-degree oral surgeons have historically had a tough time obtaining hospital privileges to perform procedures that are outside of mainstream oral surgery. Hence the rise of the dual-degree program.

50 years ago would you have argued that ENT should not by doing facelifts because ENT and PRS are different and disgruntled ENT's should simply suck it up and do a full PRS residency if they care to do facelifts, and as we all know ENT is not PRS?

There's a big difference: ENT is a specialty of medicine. Oral surgery is a specialty of dentistry.

 

[DREDAY]

Once again you are miss-informed.

Sample schedule

1st year
july1 - September 30
OMFS on-service --> 3 months

September - June 30
1st and 2nd year Medical school

2nd year
July1 - June 30
3rd year medical school
3rd year elective OMFS --> 1 month

3rd year
July1 - December 30
4th year medical school

January 1 - April 1
OMFS on-service --> 3 months

March 1 - June 30
Anesthesia --> 4 months


4th year
July 1 - June 30th General Surgery
OMFS on-service --> 1 month

5th year
July 1 - June 30th
OMFS on-service --> 12 months

6th year
July 1 - June 30th
OMFS on-service --> 12 months

OMFS on-service total --> 32 months

First and second years concurrently, without cutting out or abridging any courses?

4th year condensed into 6 months, simply by eliminating the 2 to 4wk electives and the one month vacation?

I'm really smelling some BS here, DREDAY.

And on top of that, we need to take a look at your residency training as well! Out of your six year program, only 3.5 years are actually spent working at the resident level. One of those years is spent in general surgery (where you won't be working on the head and neck), and 4 to 6 months is spent in anesthesia. That means that as little as 2 years of your 6 year residency is devoted to oral and maxillofacial surgery. And considering the fact that you'll need to become proficient in performing the core OMFS procedures (e.g. trauma, orthognathics, dentoalveolar, etc.), you'll spend about half of those two years doing pure, bread-and-butter, oral surgery. Not exactly the kind of head-and-neck surgical training that ENTs get during their residencies. Probably not even the kind that plastic surgeons get either, considering the fact that they are far more likely to have an healthy supply of cosmetics cases than oral surgery programs are.

 

[armorshell]

Why don't you identify for me two schools that do this. Show me their websites where I can see, course-for-course, lecture-for-lecture, that they are taking everything that the medical students are taking. When I was in dental school, the hygiene students took periodontics with us....but they were responsible for much less material on their exams.

http://www.hsdm.harvard.edu/index.php/academics/dmd/
http://dental.columbia.edu/index.html
http://sdm.uchc.edu/prospective/predoctoral/curriculum/basicsciences.html

Here are three that take the first two years together with medical students. Of these, Harvard has literally no distinction between med and dental, Columbia and UConn I believe have customized the tracks more. There are another half dozen schools which do this as well (Nova, Midwestern, WUHS)

I did an externship when I was in dental school, and while the program where I did the externship saw more trauma and pathology than the one where I did my internship, the programs were far more similar than they were different.

So now we've bumped up to n=2! Great. I did 9 weeks of externships at 4 programs and got to see stark differences between them, and organized thorough program reviews through the OMFS study club, so I indirectly got a chance to experience a dozen more programs through my classmates. Your inexperience with what OMFS has to offer seems atypical compared to the average oral surgery applicant.

As I understand it, all of the governing bodies within dentistry (ADA, ABOMS, etc. missed it too. To my knowledge, none of them mandate that oral surgeons have medical degrees, and none of them mandate that oral surgeons have completed fellowships in cosmetics in order to perform cosmetic surgery

There's no effort on parts of any of the governing bodies of oral surgery to mandate that all oral surgeons are de facto credentialed to perform cosmetic surgery. Even I know the credentialing bodies have their own methods of determining what is an acceptable body of experience and knowledge base, which most oral surgeons wouldn't meet (and are perfectly happy with not meeting).

 

[Clemenza]

Once again you are miss-informed.

Sample schedule

1st year
july1 - September 30
OMFS on-service --> 3 months

September - June 30
1st and 2nd year Medical school

2nd year
July1 - June 30
3rd year medical school
3rd year elective OMFS --> 1 month

3rd year
July1 - December 30
4th year medical school

January 1 - April 1
OMFS on-service --> 3 months

March 1 - June 30
Anesthesia --> 4 months


4th year
July 1 - June 30th General Surgery
OMFS on-service --> 1 month

5th year
July 1 - June 30th
OMFS on-service --> 12 months

6th year
July 1 - June 30th
OMFS on-service --> 12 months

OMFS on-service total --> 32 months

Ok. So let me get this straight. From September to June, you take all of the medical school courses that the 1st and 2nd year medical students take (i.e. same lectures, same syllabus material, same everything), and you take every last exam that the 1st and 2nd year medical students take, and you are required to pass all of the courses that the 1st and 2nd medical students are required to pass?

If so, then I don't know how the hell anyone can do that. Oral surgery residents at your program must be super-geniuses, above and beyond any other medical student. Medical school is exceptionally challenging for those of us who are mere mortals with human brains, and I sure as hell wouldn't be able to handle all of the second-year courses dumped on top of the first-year courses. I mean, considering the fact that we had 4 hours of lecture each day (plus assigned readings) in the first and second years, that'd mean I'd be responsible for studying eight hours-worth of lecture each day. No way I could manage that, DREDAY.

Jeez. I mean, I was smart enough to match into an OMFS program, but I'm definitely not smart enough to be in yours. Definitely not. Definitely.

 

[FaceGuy]

I'd like to see some proof of that, FaceGuy.

Average Step 1 score over the past 2 years here for us lowly dentists who took none of the first two years of med school is right around 230.

Sure. And I have no doubt that I could learn how to build a nuclear reactor from start to finish by reading books and using online resources.

If you are smart enough, yes.

Your assertion that our not attending lectures somehow detracts from what we cover in medical school is absurd.

Can't have it both ways. Either you NEED the lectures or you can read and learn on your own. Which is it? Most of our colleagues in medical school have indicated to me that lecture attendance was quite poor and not necessary for success in the first two years.

It does when you spend time doing those kinds of tasks instead of learning about medicine.

No. I learned dentistry in dental school. Go figure. I learned medicine in medical school. Novel concept, I know.

Oh, I see. Anything you didn't cover as part of your "medical education" is unimportant minutiae. Wonderful.

Yes. Give me an example otherwise if you have one.

 

[armorshell]

Sure. And I have no doubt that I could learn how to build a nuclear reactor from start to finish by reading books and using online resources.

You mean like this 17 year old did?

http://www.dangerouslaboratories.org/radscout.html

 

[Doc Smile]

You mean like this 17 year old did?

http://www.dangerouslaboratories.org/radscout.html

That is actually dreday. He is the only person smart enough to do that AND do medical school quicker than clemenza!

Who new this would turn into a pissing match?

 

[armorshell]

That is actually dreday. He is the only person smart enough to do that AND do medical school quicker than clemenza!

If it is dreday then I can explain the sores all over his face. Guess what, it's not radiation?

 

[OHNSresident]

I apologize for the interruption, but I was looking for an OHNS thread. I must have gotten lost here in a dentistry forum.

 

[Doc Smile]

I apologize for the interruption, but I was looking for an OHNS thread. I must have gotten lost here in a dentistry forum.

I apologize for the correction but this thread was dead until you wanted to be witty