Parkland/UT Southwestern OMFS Program Overview - 2024 Update

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PARKLAND/UT-SOUTHWESTERN OMFS PROGRAM 2024 UPDATE

We have not had an update since 2017. There have been a few changes to our program since then, and I will do my best to update things as best as I can. This likely won’t go into too much depth with our VA and JPS rotations, but those are both very important with regards to our surgical training. We have added 2 new faculty members: Michael Oh DMD, MD(Parkland alumni from 2021 class) and Patrick Wong DDS, MD (grad of A&M/Baylors program in 2023, craniofacial trained at Oklahoma under Dr. Tiwana – starting summer 2024). We have also added a level 1 trauma center in Dallas that we cover 365 – Dallas Presbyterian Hospital. We do over 400 OR cases per year here and run the head and neck tumor board.

I am going to start with a detailed breakdown by year:


Year 1
July through December – 4mo OMFS, 1mo ENT, 1mo anesthesia
Day 1 of residency, you will be suturing lacs, providing botox, and performing a plethora of dentoalveolar cases in our outpatient clinic. You will also be taking call on a q6/7 basis, holding sticks in the OR with the chance of performing the procedure, and likely closing most of the cases with the guidance of your 5th year. Interns will also rotate to help cover our private/faculty clinic, where they will assist in working up orthognathic cases and helping attendings with any other pre-/post-op patients.

You will get your hands dirty on ENT, helping stitch legs up after free flaps and removing some tonsils. There is no time spent in the ENT clinic as all will be in the OR. On Anesthesia, you will be getting used to intubating patients in the OR and placing IVs.

January through June – 5mo of Medical School, 1mo OMFS
You will be taking classes with the medical students during the organ blocks for the entire academic year, minus when they are on summer breaks (June and July – go back on service). Some residents spend their time during these months working on some research and going to AAOMS/ACOMS to present their findings. We have a strong showing at research conferences due to financial help and support from our faculty. More on this in the research section below.

You will be going back to OMFS for June while the medical students enjoy their summer breaks. We also send 2 of our categorical interns to JPS for ~2-3 weeks during this month as their non-cats leave. This is an incredibly high-yield experience as you are taking primary call on a q2/3 basis and are running their outpatient clinic. If time permits, you can pop into the OR with the OMFS team but running the OPC will be the primary focus.

Year 2
July through December – 1mo OMFS, 5mo Med School
You are on service in July with the incoming interns and the newly appointed 5s and 6s. You will be taking buddy call for ~2 weeks with the new interns and non-cats as you will help get them acclimated to hospital and clinic life.

Once August hits, you will be going back to medical school to finish up your pre-clerkships. This lasts from August until Christmas break, which is when your dedicated Step 1 studey time begins.

January through June – 1mo OMFS, 5mo Med School
You have ~6 weeks of dedicated Step 1 study time (2 weeks of Christmas break, 4 weeks of January). It is expected for you to take Step 1 before the deadline is over. Most residents tend to take the exam early so they can have a little bit of time off before clerkships beginning, but this differs with each person.

From February until June, you will be completing clerkships in Neurology, Internal Medicine, and General Surgery. You will take the associated shelf exam at the end of each block with all of the other medical students. During the 2 months of Gen Surg clerkship, 1 month is spent on OMFS (paid included).

Year 3
July through December – 6mo Med School
You will continue with clerkships and complete Psychiatry, Ambulatory Medicine, Ob/Gyn, and Pediatrics. No time will be spent on service during this time, and you continue to take the shelf at the end of each block.

January through June – 3mo OMFS, 2mo Med School, 1mo Anesthesia
January will consist of your last, official clerkship before preparing for Step 2, which is family medicine. It is expected for you to complete Step 2 between the end of this clerkship and before you graduate in May. You will spend ~2.5- months on OMFS during this time as well. You will also complete an elective in both Emergency Medicine (4 weeks - does not count towards clerkship requirements but is mandatory Med School elective) and anesthesia (4 weeks - prepping you to begin your full experience during PGY-4). You will receive your MD in May and will have General Surgery orientation during the last 2 weeks of June to help prepare you for the PGY-4 year.

Year 4
July through June – 1mo OMFS, 5mo Anesthesia, 6mo General Surgery
You will do some sort of combination of 6 months of general surgery, 5 months of anesthesia, and 1 month of OMFS. This will be your hands-on anesthesia training where you are running your own ORs and sedations. Step 3 will typically be taken some time during this year as well. You are rewarded 1 year of ACGME-accredited post-graduate training needed to obtain your medical license. For those who need a 2nd year per your state’s policy, we can get signed off for this as we have a good relationship with our General Surgery department. No Parkland alumni have ever had issues obtaining their medical license.

Year 5
July through June – 12mo OMFS
12 months on OMFS. You rotate on different blocks – 10 weeks at the VA, 10 weeks at JPS, and 30 weeks covering Parkland/UTSW/Children’s/Presbyterian. During those 30 weeks, you are helping cover these sites with 2 other PGY-5s (3 of you in total).

Year 6
July through June – 12mo OMFS
12 months on OMFS. You rotate as being chief of each service, which includes 10 weeks VA, 20 weeks JPS (with 1 other chief), 10 weeks “private” (CMC/UTSW), and 10 weeks Parkland. The 2 chiefs who cover CMC/UTSW and Parkland will also help cover Presbyterian together and alternate depending on the day of the week.

Total:
35 months on OMFS
1 month on ENT
7 months on anesthesia (5 months running room independently in 4th year and 2 months as medical students)
6 months General Surgery
23 months in medical school.



*One important thing to note is that we are a very top-heavy program. The majority of operating room cases will involve the 5s/6s splitting a case if it is bilateral, and typically the 6 doing the case if it is unilateral (depends on time of year and chief’s mood lol). Attendings will be extremely hands-off during cases and only scrub in either during an extremely critical portion or if you need guidance. Interns will get their hands dirty for simpler cases, like infections and dentoalveolar, with some helping cut orthognathic cases, but this isn’t common*


THE NUMBERS AND OUR SCOPE
CODA Procedure Count
Trauma – 982
Pathology – 1,275
Orthognathic – 440
Reconstruction/Cosmetics – 1,780
Others – 3,606

Detailed Breakdown
Mandible fractures – 506
Orbital fractures – 115
Mid/Upper Face fractures – 237
TMJ surgery – 224
Nerve Repairs – 158
Cleft lip/palate (ABGs included) – 26
Rhinoplasty – 95
Blepharoplasty – 21
Tracheostomy – 110
Implants – 1,296
Sedations - ~800
Infections – too many to count

CODA requires each chief to graduate with 175 “major” OR procedures
During the 2022/2023 academic year, our chiefs graduated with 1,616 each (8,083 total)

OR block times:
Parkland – 3 days
CMC – 2 days
UTSW – 2 days
JPS – 7 days
Presbyterian – 2 days
VA – 1 day
*and a plethora of add-on/urgent cases*


OUR FACULTY (full-time unless listed otherwise)
Program Director: Thomas Schlieve DDS, MD (Main campus; maxillofacial oncology and reconstructive surgery (MORS)-trained)
Program Chair: Rawle Philbert DDS (Main campus; general OMS)
Richard Finn DDS (VA; implants, facial cosmetics)
John Zuniga DMD, PhD (Main campus; TMJ, microneurosurgery)
Aya Hamao-Sakamoto DDS, PhD (Main campus; runs clinic, general OMS)
Mohammad Al-Obaidi DMD, MD (Part-time main campus; general OMS)
Michael Oh DMD, MD (Main campus; general OMS)
Patrick Wong DDS, MD (Main campus; craniofacial-trained)
Randy Sanovich, DDS (Part-time main campus and Presby; facial cosmetics)
John Stella DDS (JPS director/chair; orthognathics, implants)
Michael Warner DDS, PhD (JPS; TMJ, cosmetics)
Herman Kao DDS, MD (JPS; trauma, general OMS)
Fayette Williams DDS, MD (JPS; Head & Neck Oncology, Microvascular)
Roderick Kim DDS, MD (JPS; Head & Neck Oncology, Microvascular)
Brett Shirley DDS, MD (JPS; Head & Neck Oncology, Microvascular)
Richard Patterson DDS (JPS)
Todd Wentland DDS, MD (JPS)


ALUMNI
Our Parkland alumni are leaders in our field. Parkland is proud of our rich history, and we continue to pursue opportunities to remain one of the premier training programs for OMFS. Our notable alumni include Department chairs, program directors, numerous program faculty, presidents of AAOMS and the American Board of OMFS, and internationally respected and recognized surgeons across a broad scope. Some of our alumni are listed below:

Dr. RV Walker, Dr. Scott Boyd, Dr. Larry Cunningham, Dr. Ray Fonseca, Dr. Ghali Ghali, Dr. Alan Herford, Dr. Felice O’Ryan, Dr. Likith Reddy, Dr. Douglas Sinn, Dr. Trevor Treasure, Dr. Tim Turvey, Dr. Steve Schendel, Dr. John Stella, Dr. Roger West, Dr. Larry Wolford, Dr. Mike Zide, Dr. Rick Finn, Dr. Robert Alexander, Dr. James Bertz, Dr. Jim Burk Jr., Dr. Jeffrey Dean, Dr. Karel Deleeuw, Dr. Phillip Freeman, Dr. Nestor Karas, Dr. Mark Kohn, Dr. David C. Hoffman, Dr. John La Banc, Dr. Chris Crecelius, Dr. Kevin McBride, Dr. Mike Melugin, Dr. Brett Miles, Dr. Waldemar Polido, Dr. Jeff Moses, Dr. Noel Stoker, Dr. Cesar Guerrero, Dr. James Wilson, Dr. Steven Holmes, Dr. Joe Cillo, Dr. Dan Petrisor, Dr. Fayette Williams, Dr. David R Kang, Dr. Herman Kao, Dr. Brett Shirely, Dr. Neeraj Panchal, Dr. Ryan Mirchel, Dr. Alaaaldin Radwan, Dr. Andrew Read-Fuller


DIDACTICS
Wednesday evening didactics which involve weekly chief presentations on past and future cases, as well as many guest speakers, such as Dr. GE Ghali, Dr. Edward Ellis, Dr. Deepak Krishnan, Dr. Donita Dyalram, Dr. Paul Tiwana, Dr. Todd Hanna, and many more. The topics range from ethics in OMS, how to start a practice, and the broad scope that our specialty manages. Additionally, 2-4 times per month we have a morning lecture on the implants and business models of OMS. Residents will also attend a histopathology lecture with our oral pathologist roughly 1 morning every other month.

Board preparation includes annual OMSITE exams and mock boards provided by faculty for chief residents. Residents frequently attend national OMS conferences, many holding positions in ROAAOMS.


PROGRAM CULTURE
The best part about our program is how tight-knit we are among residents and faculty members. Residents spend a lot of time together regardless of if they are at the hospital or not. There are many OMS program outings and parties throughout the year as well, with some being hosted at our faculty members’ houses. Part of why we attract such strong applicants is due to our residency culture, and this is something we take great pride in.


ON-CALL
For main campus (UTSW, Parkland, Children’s), call is taken on a roughly ~q6-7 basis depending on the time of the year. All hospitals on main campus are within a 5min drive from one another and are usually manageable. This is split amongst our categorical and non-categorical interns, as well as our PGY-2, 3, and 4s when they briefly come back onto service. We have no GPR, so we are 365 dentoalveolar call. We take q3 facial trauma call at UTSW, Parkland, and Children’s which is split amongst us, Plastics, and ENT. We will cover all bony trauma at Children’s when ENT is on face call as well.

We are roughly q2-3 weeks facial trauma call at JPS. JPS has their own non-categorical interns who hold the pager and staff their clinics, but our 5s and 6s are back-up call for them. We also cover Cook Children’s out in Fort Worth, but the fellow will hold the pager – we will have occasional cases at this hospital. Lastly, we have credentials at Baylor All-Saints in Fort Worth – 5th and 6th year residents will occasionally operate here with Dr. Stella.

Our program covers 365 24/7 facial trauma call at Presbyterian hospital as well. The PGY-5 will be on primary call during this time as only 5s and 6s are allowed at this hospital. This is run like a private practice, however, as the 5 can usually see the consults in the AM unless something urgent comes in.

The 5th year holds the pager for the VA when they are on-service there – not much usually comes in.

Parkland, Children’s JPS, Presbyterian, and Cook Children’s are all Level 1 trauma centers, while UTSW is a Level 2 trauma center.


RESEARCH
All residents are expected to complete at least ONE project before the end of residency. This can be either a publication, presentation at a conference, case report, etc. The department will pay for flights and hotels twice per year as long as it is less than $1250 per trip – additional money is possible if approved before the trip. Many of the residents present a poster at AAOMS, and the department will pay for travel and lodging for this or any other conference. This past year of 2023, we sent 12 residents to AAOMS and 5 to ACOMS to present their research – no other program does this. There are many opportunities and projects that residents are running, so it is very easy to get involved with research if this interests you.


LOCATION, LOCATION, LOCATION
Another strong suit of our program is the location. Many of the full-scope, cowboy-type programs are usually in “less desirable” locations, so we are proud to be one of the few full-scope programs in a lively city. Dallas housing was once very affordable with 1 beds going for ~$1300, but it is now a little more expensive as the city continues to flourish (~$1600 for 1br). Don’t forget, we have all major sports teams and no state-income tax down here as well!


MEDICAL SCHOOL
We will do all organ blocks with the medical students for ~10 months and have 1 month off dedicated time to study for Step 1. After this, we do roughly 13 months of clerkships and electives and have to pass each shelf exam. Step 1 and Step 2 have to be passed before graduating from medical school (spring of our PGY-3 year). Most complete Step 3 during their 4th year while on gen surg or anesthesia.

We do not receive income while in medical school, and we owe 3 years of in-state tuition (~$22k per year for tuition). Medical students are encouraged to take call for OMFS while in medical school to help with income (you are paid for your shifts). Most of us took call during our pre-clerkships on days when we have nothing mandatory – you must show up for rounds both when you’re coming on and going off call.

During medical school, you continue to receive your Parkland Resident health insurance (deducted from future paychecks or can pay out of pocket each month). This allows you to avoid expensive medical school health insurance.


MOONLIGHTING
Moonlighting is currently not allowed at our program.


EXTERNSHIPS ENCOURAGED
If you have any interest in our program, PLEASE come hang out with us for a week or 2. We highly encourage people to come extern, and Dr. Schlieve takes this into consideration when sending out interview invites and completing our rank list.

You will be on call with the residents and enjoying happy hour with them after clinic hours. Dental students are also allowed to extract teeth and perform dentoalveolar surgeries in our clinic with the guidance of a resident. You will also be scrubbing into OR cases and helping close incisions/lacerations or sinking screws into recon plates.

Call rooms are available for externs, but most stay at a local Airbnb/hotel when they are not on-call. All dental students are allowed to extern (D1 to D4). With that being said, most who do come see our program will have some sort of clinical experience as our externship is as hands-on as you want it to be. Most externs are excited about how many teeth that they extract; most other externships are fairly hands-off. We had an extern recently extract 73 teeth during his 1-week externship here.

You will mainly be at Parkland Hospital and the associated outpatient clinic, but badges can be obtained for our UTSW site next door. We are in the midst of adding back Childrens access for externs as well, but this is still in the works. Regardless, there is plenty to see and do at Parkland!

More information on applying to externship can be found at: Internship & Externship: Oral and Maxillofacial Surgery - UT Southwestern, Dallas, Texas


SOCIAL MEDIA
Please follow us on Instagram at instagram.com/ParklandOMFS to stay up to date on what our program has to offer.



Thank you for taking the time to read this and feel free to contact me directly on here or Instagram with any questions or concerns.

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