Practicing under an MD license as an OMFS

[Jaa_]

I am a current fourth year dental student applying to OMFS (only 6 year programs). I do not plan on taking the CDCA exam, which would allow me to practice in states outside of my home state of New York.

If I complete residency as a licensed physician and decide to move states, can I perform all OMFS procedures under the medical license, or can certain things (exos, implants) only be billed through a dental license? If the answer is no, can some procedures be done under the medical license (orthognathic or neck dissection for example)?

Would appreciate some insight into this!

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[Big Time Hoosier]

I am a current fourth year dental student applying to OMFS (only 6 year programs). I do not plan on taking the CDCA exam, which would allow me to practice in states outside of my home state of New York.

If I complete residency as a licensed physician and decide to move states, can I perform all OMFS procedures under the medical license, or can certain things (exos, implants) only be billed through a dental license? If the answer is no, can some procedures be done under the medical license (orthognathic or neck dissection for example)?

Would appreciate some insight into this!

You have yet to Match. If, for whatever reason, your plans change, it will be a real pain to have to deal with a regional exam after you have graduated. If I were you, I'd just take the test.

Big Hoss

 

[Jaa_]

You have yet to Match. If, for whatever reason, your plans change, it will be a real pain to have to deal with a regional exam after you have graduated. If I were you, I'd just take the test.

Big Hoss

Fair! It is a $3000 exam and for someone who wants to live in NY, it hurts paying that price on top of the 3-4k it costs to apply/ interview/ extern, especially when my scope of practice would be very different from what the exam is testing. It's just a cash grab as I'm sure you of all people would know!

Thanks for your advice.

 

[chlrbwls]

Fair! It is a $3000 exam and for someone who wants to live in NY, it hurts paying that price on top of the 3-4k it costs to apply/ interview/ extern, especially when my scope of practice would be very different from what the exam is testing. It's just a cash grab as I'm sure you of all people would know!

Thanks for your advice.

If i am not mistaken, even as a resident with intentions of getting an MD to be your primary licensure, you have to perform all of your dental procedures under your dental license. i.e. your biopsy, extraction, placement of dental implants. These will be your bread and butter production to make money in private practice.

Furthermore, i suggest listening to this podcast episode:
Let’s talk Oral Surgery episode #2.

While they state MD is definitely attainable via 6 year program, in order for you to utilize that certificate, you must have enough ACGME hours logged for your MD license.

Many states are requiring more and more years and the only way you will able to get them during your 6yr programs is Gen Surgery rotation.

If you dont have enough ACGME credits from Gen Surg, or a Gen Surg program director that is nice enough to attest your rotation hours despite not being the full minimum 2 years. Due to the fact that OMFS is not an ACGME recognized specialty, you will have almost no chance in utilizing your MD certificate unless in certain states: i.e. California which has made an exception for OMFS to be 1 year of ACGME where other states are now requiring 2 to 3 year ACGME. Look this up before you start applying and realize you are stuck at a state that requires super high ACGME hours.

 

[Jaa_]

If i am not mistaken, even as a resident with intentions of getting an MD to be your primary licensure, you have to perform all of you dental procedures under your dental license. i.e. your biopsy, extraction, placement of dental implants. These will be your bread and butter production to make money in private practice.

Furthermore, i suggest listening to this podcast episode:
Let’s talk Oral Surgery episode #2.

While they state MD is definitely attainable via 6 year program, in order for you to utilize that certificate, you must have enough ACGME hours logged for your MD license.

Many states are requiring more and more years and the only way you will able to get them during your 6yr programs is Gen Surgery rotation.

If you dont have enough ACGME credits from Gen Surg, or a Gen Surg program director that is nice enough to attest your rotation hours despite not being the full minimum 2 years. Due to the fact that OMFS is not an ACGME recognized specialty, you will have almost no chance in utilizing your MD certificate unless in certain states: i.e. California which has made an exception for OMFS to be 1 year of ACGME where other states are now requiring 2 to 3 year ACGME. Look this up before you start applying and realize you are stuck at a state that requires super high ACGME hours.

Thank you for this insight! I've listened to that episode. Great podcast.

 

[Eli Manning]

the residency you match to will most likely require you to have a dental license in order to be resident. even if it is a 6 yr program you will not have the MD until later in the program and will be practicing under a dental license up until you get the MD. also, you cant make it in private practice w/o a dental license. you will at some point have to get a license

 

[Masterus]

If i am not mistaken, even as a resident with intentions of getting an MD to be your primary licensure, you have to perform all of your dental procedures under your dental license. i.e. your biopsy, extraction, placement of dental implants. These will be your bread and butter production to make money in private practice.

Furthermore, i suggest listening to this podcast episode:
Let’s talk Oral Surgery episode #2.

While they state MD is definitely attainable via 6 year program, in order for you to utilize that certificate, you must have enough ACGME hours logged for your MD license.

Many states are requiring more and more years and the only way you will able to get them during your 6yr programs is Gen Surgery rotation.

If you dont have enough ACGME credits from Gen Surg, or a Gen Surg program director that is nice enough to attest your rotation hours despite not being the full minimum 2 years. Due to the fact that OMFS is not an ACGME recognized specialty, you will have almost no chance in utilizing your MD certificate unless in certain states: i.e. California which has made an exception for OMFS to be 1 year of ACGME where other states are now requiring 2 to 3 year ACGME. Look this up before you start applying and realize you are stuck at a state that requires super high ACGME hours.

I would say this isn’t entirely true. Many states recognize the need for oral surgeons and lack there of and understand it is not feasible to have 3 years of ACGME. As such, they have made exceptions to the ACGME for oral surgeons. You just have to apply for the waiver.

 

[schmoob]

An oral surgeon is a dentist. If you leave NY, how will you perform dental procedures? I could be wrong but I doubt there is a medical code for placing an implant.

 

[caffeine jitters]

Shouldn't the 6 year residency enable them to practice with a dental license in states with reciprocity?

 

[Big Time Hoosier]

Shouldn't the 6 year residency enable them to practice with a dental license in states with reciprocity?

If they had a dental license to begin with during that time.

Big Hoss

 

[caffeine jitters]

If they had a dental license to begin with during that time.

Big Hoss

Would that work if they took dlosce, got licensed in colorado, but did their residency in NY?

Edit: Also NY accepts PGY-1 for licensure, so couldn't they apply for NY licensure after their first year of residency then ride out the remaining 5 years and obtain reciprocity from the states that offer it?

 

[schmoob]

Would that work if they took dlosce, got licensed in colorado, but did their residency in NY?

Edit: Also NY accepts PGY-1 for licensure, so couldn't they apply for NY licensure after their first year of residency then ride out the remaining 5 years and obtain reciprocity from the states that offer it?

No. They need to complete an entire postgraduate program. So completing a GPR does qualify for GP licensure in NYS, but only completing PGY1 of a multi-year specialty residency does not qualify one for GP or Specialist licensure because they are still in a resident status.

Just take the boards and save yourself the headache.

 

[deleted923283]

Fair! It is a $3000 exam and for someone who wants to live in NY, it hurts paying that price on top of the 3-4k it costs to apply/ interview/ extern, especially when my scope of practice would be very different from what the exam is testing. It's just a cash grab as I'm sure you of all people would know!

Thanks for your advice.

What until you hear how much boards costs! Just another toll along the road.

 

[DavesNotHere]

An oral surgeon is a dentist. If you leave NY, how will you perform dental procedures? I could be wrong but I doubt there is a medical code for placing an implant.

Plastic surgeons have placed them. They can charge cash for them…or they can use 21248 or 21249.

not super common…but it happens.

You can definitely practice on just a medical license in theory…you’d just have to accept cash. Whether or not the insurance companies would accept dental codes submitted from an MD, i’m not sure probably could do it with a headache.

to get an oral surgery certificate it would probably come down to the residency program being okay with it.

 

[yappy]

In the future it is likely that 6 year OMS will have an MD degree, but not have a license to practice medicine due to changing requirements. Therefore, I would recommend maintaining a dental license.

 

[deleted923283]

In the future it is likely that 6 year OMS will have an MD degree, but not have a license to practice medicine due to changing requirements. Therefore, I would recommend maintaining a dental license.

Already the case for many surgeons in states.

 

[schmoob]

Plastic surgeons have placed them. They can charge cash for them…or they can use 21248 or 21249.

not super common…but it happens.

You can definitely practice on just a medical license in theory…you’d just have to accept cash. Whether or not the insurance companies would accept dental codes submitted from an MD, i’m not sure probably could do it with a headache.

to get an oral surgery certificate it would probably come down to the residency program being okay with it.

But would you feel confident with a plastic surgeon placing implants? Or would you feel more comfortable with a dentist doing it?

I think the bottom line is it would be foolish to go to dental school and not get a dental license, oral surgeon or not. The headache of taking the boards is less than the cumulative headache of trying to work around not having a dental license.

 

[deleted1047421]

In the future it is likely that 6 year OMS will have an MD degree, but not have a license to practice medicine due to changing requirements. Therefore, I would recommend maintaining a dental license.

Plastic surgeons have placed them. They can charge cash for them…or they can use 21248 or 21249.

not super common…but it happens.

You can definitely practice on just a medical license in theory…you’d just have to accept cash. Whether or not the insurance companies would accept dental codes submitted from an MD, i’m not sure probably could do it with a headache.

to get an oral surgery certificate it would probably come down to the residency program being okay with it.

Oral surgeons are issued their GA permit by the state dental board, not the state medical board.
We would be seriously handicapped and non productive without our ability to administer general anesthesia.
In order to get your ga permit from a dental board you need to have a dental license.

Omfs residents and dental students reading this should understand two things:

1) getting their dental license should be a top priority for any oral surgeon for many reasons. The cost to obtain the dental license should be seen as negligible.

2) we should all be proud of the privileges that we have as an omfs to obtain a ga permit through our dental degree and license.

 

[schmoob]

Oral surgeons are issued their GA permit by the state dental board, not the state medical board.
We would be seriously handicapped and non productive without our ability to administer general anesthesia.
In order to get your ga permit from a dental board you need to have a dental license.

Omfs residents and dental students reading this should understand two things:

1) getting their dental license should be a top priority for any oral surgeon for many reasons. The cost to obtain the dental license should be seen as negligible.

2) we should all be proud of the privileges that we have as an omfs to obtain a ga permit through our dental degree and license.

This is the type of excellent advice we should be promoting on SDN. It is excellent guidance without immature comments like buying private islands.

 

[D1Bound]

I would say this isn’t entirely true. Many states recognize the need for oral surgeons and lack there of and understand it is not feasible to have 3 years of ACGME. As such, they have made exceptions to the ACGME for oral surgeons. You just have to apply for the waiver.

I didn't know that could be waived. That's good news for people pursuing that route

 

[Big Time Hoosier]

excellent guidance without immature comments

I guess I am no longer wanted on SDN. 😢

Big Hoss

 

[D1Bound]

This is the type of excellent advice we should be promoting on SDN. It is excellent guidance without immature comments like buying private islands.

There's not a single thing wrong with wide reaching aspirations to purchase property. As Dave Ramsey says, "Live like no one else, so you can live like no one else, so you can give like no one else."

 

[D1Bound]

I guess I am no longer wanted on SDN. 😢

Big Hoss

I want you on SDN. You are a pillar of this community

 

[DavesNotHere]

In the future it is likely that 6 year OMS will have an MD degree, but not have a license to practice medicine due to changing requirements. Therefore, I would recommend maintaining a dental license.

considering that’s not a problem in any state right now that prediction seems farfetched. but agreed keeping a dental license is a good idea.

Already the case for many surgeons in states.

which states? let’s investigate

 

[DavesNotHere]

But would you feel confident with a plastic surgeon placing implants? Or would you feel more comfortable with a dentist doing it?

I think the bottom line is it would be foolish to go to dental school and not get a dental license, oral surgeon or not. The headache of taking the boards is less than the cumulative headache of trying to work around not having a dental license.

would i feel confident them? No…i don’t even think they should do orthognathic…you said there wasn’t a medical code and i corrected you.

 

[schmoob]

would i feel confident them? No…i don’t even think they should do orthognathic…you said there wasn’t a medical code and i corrected you.

Thank you. I was not aware there was a medical code for it.

 

[schmoob]

considering that’s not a problem in any state right now that prediction seems farfetched. but agreed keeping a dental license is a good idea.



which states? let’s investigate

I googled random dual degree oral surgeons in Florida. I found a Dr. Barbick. His NPI taxonomy is a dentist, specializing in oral and maxillofacial surgery. He is not listed as having a medical license despite having an MD.

 

[deleted1082923]

I googled random dual degree oral surgeons in Florida. I found a Dr. Barbick. His NPI taxonomy is a dentist, specializing in oral and maxillofacial surgery. He is not listed as having a medical license despite having an MD.

A very large percentage of oral surgeons with dual degrees do not have active medical licenses (which makes you wonder why they even got the MDs in the first place...). Technically, you shouldn't advertise having an MD if you don't have a medical license, but if you look up a lot of oral surgeons with state databases of active medical licenses, you will find they do not have active medical licenses, and only have active dental licenses.

 

[caffeine jitters]

A very large percentage of oral surgeons with dual degrees do not have active medical licenses (which makes you wonder why they even got the MDs in the first place...). Technically, you shouldn't advertise having an MD if you don't have a medical license, but if you look up a lot of oral surgeons with state databases of active medical licenses, you will find they do not have active medical licenses, and only have active dental licenses.

Isn’t an M.D. just an academic degree though? Would it be unethical to list the degree if not eligible for licensure in that particular state due to ACGME?

 

[schmoob]

A very large percentage of oral surgeons with dual degrees do not have active medical licenses (which makes you wonder why they even got the MDs in the first place...). Technically, you shouldn't advertise having an MD if you don't have a medical license, but if you look up a lot of oral surgeons with state databases of active medical licenses, you will find they do not have active medical licenses, and only have active dental licenses.

I agree. Why tell patients you have an MD if you cannot practice medicine? I understand that it is an academic achievement, but under that logic we could all list our B.S./B.A. which no one does.

 

[DavesNotHere]

Isn’t an M.D. just an academic degree though? Would it be unethical to list the degree if not eligible for licensure in that particular state due to ACGME?

Again…where is this happening? No one has shown that yet.

 

[schmoob]

which states? let’s investigate

California, Connecticut, Illinois, Kentucky...

FSMB | State Specific Requirements for Initial Medical Licensure

www.fsmb.org

 

[nade0016]

I write from a position of knowledge on one aspect of this. You absolutely can practice 100% of OS under a medical license. If you look up "plenary medical license" you will see that all US medical licenses are plenary and therefore you are allowed to perform ANY "medical" procedure. That being said, malpractice will dictate which procedures you are allowed to perform. IF you have a full medical license to practice in that state. So to answer the first question in the forum, yes, you technically could practice under a medical license only. I am aware of at least one person in this country practicing OS under a medical license only as the dental license had been revoked in that state.

Now, please review all the other comments in the thread as those are stated with knowledge and I agree that getting the dental license will be necessary at some point and you don't want to be without that. It could really limit your options.

 

[Jaa_]

I write from a position of knowledge on one aspect of this. You absolutely can practice 100% of OS under a medical license. If you look up "plenary medical license" you will see that all US medical licenses are plenary and therefore you are allowed to perform ANY "medical" procedure. That being said, malpractice will dictate which procedures you are allowed to perform. IF you have a full medical license to practice in that state. So to answer the first question in the forum, yes, you technically could practice under a medical license only. I am aware of at least one person in this country practicing OS under a medical license only as the dental license had been revoked in that state.

Now, please review all the other comments in the thread as those are stated with knowledge and I agree that getting the dental license will be necessary at some point and you don't want to be without that. It could really limit your options.

This is the logic I was using in my thought process. Living in NY, I can obtain dental licensure by passing part I and II of the boards, and not taking the CDCA exam. The problem is that some OMFS programs outside of NY require that you be "eligible to obtain licensure" in that state, which can be interpreted in a few ways and may require that I have taken this test during dental school.

At the end of the day I just paid to take the test. Thanks all for the input.

 

[deleted1047421]

I’ve seen more than one oral surgeon having to take a wreb or nerb exam in the final years of their residency. This puts them in a difficult situation and a hassle given that they have not practiced general dentistry in several years.
Doing it now is a smart move.

A dental license enables an oral surgeon to effectively practice the full scope of the specialty without any hindrance. Having a dental license affects everything from being able to be credentialed with dental insurance companies (meaning you can bill and get paid), having malpractice insurance, obtaining hospital privileges, and getting your state ga permit.

As long as you have a dental license in good standing and a ga permit, having a medical license is unnecessary. The opposite is not true.

As some have already mentioned that it is technically possible to practice solely under a medical license. This brings forth many questions :

Can one obtain adequate malpractice insurance? Does omsnic or medpro require you to have a dental license ?

Can you administer ga? Will a medical board grant a ga permit ? If not, do you want to pay for a DA or crna to come into your office to sedate patients for you?

Can you survive on a cash only practice since you will not be credentialed with dental insurance companies ?

For the limited procedures that you can bill medical insurance for would you be comfortable with the dismal reimbursement from medical insurance ? (For many, low pay would absolutely defeat the purpose of becoming an omfs).

 

[Flashes23]

Such a pointless discussion to have over 3k. Days salary in the long run, maybe less. Suck it up take the test.

 

[Jaa_]

Such a pointless discussion to have over 3k. Days salary in the long run, maybe less. Suck it up take the test.

I asked the question more so to learn about how licensure works in OMFS. I wouldn't call it pointless as there seems to be a few conflicting opinions here to learn from. I registered for the exam. 3k is a days salary when it's a days salary, not when you're trying to make those loans stretch to cover that NY rent!

 

[nade0016]

Its certainly not lost on me about the money part. Some folks can afford to pay 3K for an exam or put it on a credit card. For others the options are vary limited. So I understand where looking at options comes from. Final decision is never as simple as it looks. But I am glad you registered and are going to take the exam. I had a 3rd year resident having to take a licensing exam this year as they wanted to do a fellowship and that state required a full dental license. So here is someone 3 years out trying to go back and find patients and take an exam that they have not been training for. Very stressful. Good luck to you.