Private Practice oriented OMFS Residency programs?

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dwn-test

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Looking to pick the brains of some current/ former residents/interns or who are willing to share some programs that have strong dentoalveolar, implants, anesthesia, orthognathic etc that will be reflected in private practice. Bonus points if you can speak to the work life balance (or lack-thereof) at these residencies.

From my understanding there are the trauma heavy/ full scope programs like LSU NO, Shreveport, Parkland etc, but I couldn't find mention of more 'relaxed' (heavy quotations I know no os program will be easy) programs for those who enjoy the scope of OS, but maybe want to focus more on what their day to day will look like upon graduation.
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Just look for any program not bogged down by cancer and trauma. I think Parkland seems to have a better mix than the other two mentioned programs. Im sure there are many others
 
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carabelliscusp said:
Less prestigious 4 year programs usually
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Are these programs seen as less prestigious because they are more narrow scope? Is it a matter of perceived difficulty of the residency, less trauma/ heavy surgical procedure = easier = less clout? Personally don't see why TNT would be looked down on unless the residency itself is subpar
 
Less prestigious for a lot reasons but it’s usually because they don’t publish, don’t have well known faculty, don’t operate, and don’t have a legacy. The really well known programs have built a huge legacy and history. TNT is only one part of being an oral surgeon. Program directors want to find people willing to work hard.
 
dwn-test said:
Looking to pick the brains of some current/ former residents/interns or who are willing to share some programs that have strong dentoalveolar, implants, anesthesia, orthognathic etc that will be reflected in private practice. Bonus points if you can speak to the work life balance (or lack-thereof) at these residencies.

From my understanding there are the trauma heavy/ full scope programs like LSU NO, Shreveport, Parkland etc, but I couldn't find mention of more 'relaxed' (heavy quotations I know no os program will be easy) programs for those who enjoy the scope of OS, but maybe want to focus more on what their day to day will look like upon graduation.
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Apply to programs that focus on the core scope of omfs. Don’t apply to programs that are heavy in expanded scope. This includes head and neck cancer, cosmetics and craniofacial surgery.

The attendings generally focus on surgically training the fellow instead of the residents, or just plain doing the case themselves, and the residents end up doing a ton of scut work. The heavy focus on say head and neck cancer eats up time they could have spent on traditional omfs. Every couple months you see another thread pop up with a desperate resident asking to transfer out of their program because they are fed up with it. Usually because they think the program is a waste of their time.

There is no shame in admitting the truth - that you will end up like the vast majority of omfs who do office based surgery primarily. Therefore you are smart to ask these questions now.

You should go to programs that focus on
Trauma
Orthognathic
Tmj
DA
Benign path and reconstruction
Implants
Anesthesia
 
Masterus said:
Less prestigious for a lot reasons but it’s usually because they don’t publish, don’t have well known faculty, don’t operate, and don’t have a legacy. The really well known programs have built a huge legacy and history. TNT is only one part of being an oral surgeon. Program directors want to find people willing to work hard.
Click to expand...
‘ Don’t publish’… this is good lol. Listen fellas if your attendings don’t publish much it means they won’t force you to take on doing research projects and helping them write it up. You should be busy operating - not doing research projects. No one wants to do that.

‘ Not well known faculty’… the only thing you guys should be concerned about is if the attendings are good at teaching. Meaning they are patient with the resident and letting them operate the case fully.

I promise you - you will get way more out of a program… as long as the attendings are good at teaching and letting you cut the case. Vice versa - you go to that the attendings cut majority of the whole case. You didn’t do anything but retract for 4-6 years.

It’s what you get out of program.
 
When PDs ask you why you applied to their programs during your interviews, make sure you mention that you heard that their programs are more “relaxed” programs and that you think you would be a good fit because you are a “relaxed” person. They are looking for the right fit people.
 
Colastick said:
When PDs ask you why you applied to their programs during your interviews, make sure you mention that you heard that their programs are more “relaxed” programs and that you think you would be a good fit because you are a “relaxed” person. They are looking for the right fit people.
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Yes, thank you for taking my post entirely out of context. I’m sure the stick up your ass helped separate you from the crowd
 
toothnumber32 said:
‘ Don’t publish’… this is good lol. Listen fellas if your attendings don’t publish much it means they won’t force you to take on doing research projects and helping them write it up. You should be busy operating - not doing research projects. No one wants to do that.

‘ Not well known faculty’… the only thing you guys should be concerned about is if the attendings are good at teaching. Meaning they are patient with the resident and letting them operate the case fully.

I promise you - you will get way more out of a program… as long as the attendings are good at teaching and letting you cut the case. Vice versa - you go to that the attendings cut majority of the whole case. You didn’t do anything but retract for 4-6 years.

It’s what you get out of program.
Click to expand...

Agree and disagree on a few things here. Not sure why going to a program that publishes is a bad thing. I know for a fact no program is making you do research - it is only there if you are interested. All residents should be exposed to at least a little bit of research. I think our specialty is lacking heavily in this area, and it is part of the reason why periodontists are taking implants from OMFS - because they do sooo much research in it and GPs know that they know the ins and outs. The overall OMFS literature is horrible compared to our medical counterparts.

If you don’t know how to read a research paper or write a manuscript, then you are no better than a plumber. Surgery is just “monkey see monkey do” at the end of the day. At the end of the day, we are doctors and should know how to read and write manuscripts.
 
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HockeyDocOMFS said:
Agree and disagree on a few things here. Not sure why going to a program that publishes is a bad thing. I know for a fact no program is making you do research - it is only there if you are interested. All residents should be exposed to at least a little bit of research. I think our specialty is lacking heavily in this area, and it is part of the reason why periodontists are taking implants from OMFS - because they do sooo much research in it and GPs know that they know the ins and outs. The overall OMFS literature is horrible compared to our medical counterparts.

If you don’t know how to read a research paper or write a manuscript, then you are no better than a plumber. Surgery is just “monkey see monkey do” at the end of the day. At the end of the day, we are doctors and should know how to read and write manuscripts.
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I didn’t say it’s a bad thing to go to a program that publishes. All programs have chairs that have published articles and textbook chapters lol.
I was just making a point that many programs have soft requirements for residents that upon graduation they need to engage in a research project or present at a meeting etc. the more heavily involved the attendings are in research… the higher the likelihood they are to ‘ask’ a resident to get involved in a project. Before the resident realizes they are knee deep in a project and it’s hard to just not continue doing the work. They end up spending hours of their free time doing research for their attendings.

I agree doing research benefits the field but the vast majority of residents are not at all interested in doing that. They are overworked, underslept. They just want to graduate and cut as many cases as they can. Which - not to my surprise- many residents are not operating to their full extent.

You need to stop talking out of your @$$. No one said we shouldn’t know how to read a journal article. Just be real dude. Stop twisting what I’m saying.

Look at the end of the day there are plenty of unhappy residents. I’m trying my best here to give real life advice that can benefit the next generation. Once I was a predent applying years ago and this place helped me out. Just trying to pay it forward.
 
toothnumber32 said:
I didn’t say it’s a bad thing to go to a program that publishes. All programs have chairs that have published articles and textbook chapters lol.
I was just making a point that many programs have soft requirements for residents that upon graduation they need to engage in a research project or present at a meeting etc. the more heavily involved the attendings are in research… the higher the likelihood they are to ‘ask’ a resident to get involved in a project. Before the resident realizes they are knee deep in a project and it’s hard to just not continue doing the work. They end up spending hours of their free time doing research for their attendings.

I agree doing research benefits the field but the vast majority of residents are not at all interested in doing that. They are overworked, underslept. They just want to graduate and cut as many cases as they can. Which - not to my surprise- many residents are not operating to their full extent.

You need to stop talking out of your @$$. No one said we shouldn’t know how to read a journal article. Just be real dude. Stop twisting what I’m saying.

Look at the end of the day there are plenty of unhappy residents. I’m trying my best here to give real life advice that can benefit the next generation. Once I was a predent applying years ago and this place helped me out. Just trying to pay it forward.
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The “soft requirement” you are talking about is actually a CODA requirement. All residents needs to be involved in at least 1 scholarly activity of some sort to graduate.

I understand you are trying to pay it forward, but just clarifying a few things that way people don’t try to avoid these strong programs that might have a more research presence in our field. Your original post was a bit too doom and gloom on it, is all
 
toothnumber32 said:
Apply to programs that focus on the core scope of omfs. Don’t apply to programs that are heavy in expanded scope. This includes head and neck cancer, cosmetics and craniofacial surgery.

The attendings generally focus on surgically training the fellow instead of the residents, or just plain doing the case themselves, and the residents end up doing a ton of scut work. The heavy focus on say head and neck cancer eats up time they could have spent on traditional omfs. Every couple months you see another thread pop up with a desperate resident asking to transfer out of their program because they are fed up with it. Usually because they think the program is a waste of their time.

There is no shame in admitting the truth - that you will end up like the vast majority of omfs who do office based surgery primarily. Therefore you are smart to ask these questions now.

You should go to programs that focus on
Trauma
Orthognathic
Tmj
DA
Benign path and reconstruction
Implants
Anesthesia
Click to expand...
I was shocked when a classmate told me some programs don’t let their residents push their own drugs. How can a program not be strong in anesthesia?
 
D1Bound said:
I was shocked when a classmate told me some programs don’t let their residents push their own drugs. How can a program not be strong in anesthesia?
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Likely hospital or dental school policy. Sucks though. Thankful to be somewhere we actually get to practice operator/anesthetist.
 
toothnumber32 said:
‘ Don’t publish’… this is good lol. Listen fellas if your attendings don’t publish much it means they won’t force you to take on doing research projects and helping them write it up. You should be busy operating - not doing research projects. No one wants to do that.

‘ Not well known faculty’… the only thing you guys should be concerned about is if the attendings are good at teaching. Meaning they are patient with the resident and letting them operate the case fully.

I promise you - you will get way more out of a program… as long as the attendings are good at teaching and letting you cut the case. Vice versa - you go to that the attendings cut majority of the whole case. You didn’t do anything but retract for 4-6 years.

It’s what you get out of program.
Click to expand...

“Are these programs seen as less prestigious because they are more narrow scope? Is it a matter of perceived difficulty of the residency, less trauma/ heavy surgical procedure = easier = less clout? Personally don't see why TNT would be looked down on unless the residency itself is subpar”



I responded to what the person asked above me honestly about what makes a program prestigious. I’m not talking about what makes a program good or personally good for a resident.

What is prestige in OMFS?

People know programs like NOLA, UAB, Parkland. People know their faculty, know they operate, know they do research. That’s the reality. If you publish more, people know you. Look at the pubs of Tiwana, Waite, Kaban, Wofford, Posnick etc and many more. Their research into surgery is what earned them fame, not their operating skills. You will not be remembered in 100 years for having good hand skills.
 
carabelliscusp said:
Less prestigious 4 year programs usually
Click to expand...
Masterus said:
Less prestigious for a lot reasons but it’s usually because they don’t publish, don’t have well known faculty, don’t operate, and don’t have a legacy. The really well known programs have built a huge legacy and history. TNT is only one part of being an oral surgeon. Program directors want to find people willing to work hard.
Click to expand...
Less prestigious? Please explain. Thank you.
 
If you truly want to focus on extractions and implants only, then perio or a good gpr should be considered. Don’t take this advice as condescending. If you aren’t interested in the rest of OMFS, you will find yourself draining pus at 3 am and hating your life. You’ll also be disappointed when you spend way more time repairing dog bites l and putting together gun shot wounds than implants. I even like this stuff and still have had times in residency where I seriously questioned my life decisions.

Perio residency is easier. You avoid TMJ patients. You’ll get at least as good, and in some cases better implant training. And you can always refer to OMFS all the crap you don’t want to deal with.

Income can be comparable as well.
 
dratc said:
If you truly want to focus on extractions and implants only, then perio or a good gpr should be considered. Don’t take this advice as condescending. If you aren’t interested in the rest of OMFS, you will find yourself draining pus at 3 am and hating your life. You’ll also be disappointed when you spend way more time repairing dog bites l and putting together gun shot wounds than implants. I even like this stuff and still have had times in residency where I seriously questioned my life decisions.

Perio residency is easier. You avoid TMJ patients. You’ll get at least as good, and in some cases better implant training. And you can always refer to OMFS all the crap you don’t want to deal with.

Income can be comparable as well.
Click to expand...
Questioning your life at 3am while knee deep in pus and lacs is a universal intern canon event
 
dratc said:
If you truly want to focus on extractions and implants only, then perio or a good gpr should be considered. Don’t take this advice as condescending. If you aren’t interested in the rest of OMFS, you will find yourself draining pus at 3 am and hating your life. You’ll also be disappointed when you spend way more time repairing dog bites l and putting together gun shot wounds than implants. I even like this stuff and still have had times in residency where I seriously questioned my life decisions.

Perio residency is easier. You avoid TMJ patients. You’ll get at least as good, and in some cases better implant training. And you can always refer to OMFS all the crap you don’t want to deal with.

Income can be comparable as well.
Click to expand...
Yea, I’ve even had a young perio tell me straight up OMS is better for the money. He wants to go into academics and isn’t concerned about salary, but he said private practice OMS beats perio. I’ve never seen a corporate advertise big numbers for perio either. What numbers have you seen for perio exactly?
 
D1Bound said:
Yea, I’ve even had a young perio tell me straight up OMS is better for the money. He wants to go into academics and isn’t concerned about salary, but he said private practice OMS beats perio. I’ve never seen a corporate advertise big numbers for perio either. What numbers have you seen for perio exactly?
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The perio I worked with in corporate would produce 10-15k and take home half of that. OS did similar numbers but saw twice the number of patients.
 
niko472 said:
The perio I worked with in corporate would produce 10-15k and take home half of that. OS did similar numbers but saw twice the number of patients.
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Was the perio doing a bunch of LANAP and implants?
 
niko472 said:
No lanap. A lot of implants and osseous.
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What about sedation did the perio offer it? To me, what separates an OMS is the medical management and offering sedation that they’ve been thoroughly trained in. If I’m an upper class customer, I want “the best” to do my treatment. I want someone who can manage my airway and save my life. Idk maybe I’m off and maybe perio really does clean house as much as OMS
 
D1Bound said:
What about sedation did the perio offer it? To me, what separates an OMS is the medical management and offering sedation that they’ve been thoroughly trained in. If I’m an upper class customer, I want “the best” to do my treatment. I want someone who can manage my airway and save my life. Idk maybe I’m off and maybe perio really does clean house as much as OMS
Click to expand...
In my locale perio are the “best” for developing, placing, and maintaining implants. They also save the tooth if possible.
 
D1Bound said:
Yea, I’ve even had a young perio tell me straight up OMS is better for the money. He wants to go into academics and isn’t concerned about salary, but he said private practice OMS beats perio. I’ve never seen a corporate advertise big numbers for perio either. What numbers have you seen for perio exactly?
Click to expand...

I’m more familiar with OMFS, but a few of the perio folks I know make anywhere from 2/300k up to a million. It can be very lucrative. OMFS is likely more consistently and predictably profitable, but perio is no slouch.
 
It looks like for the most part you question has been answered but something to consider is you may not know what you actually want to do as a career yet. If you are absolutely positive all you want is to take out teeth or place implants I’d recommend not doing a residency because training for 4 years to only do implants/teeth is a waste of time/effort and large opportunity cost.

I’d recommend, if you’re absolutely set on doing OMS, to most importantly go to a residency where the residents primarily operate(not assist), the faculty actually teach and the program has good experience in core oms procedures like trauma, orthognathic, tmj, benign path and not just bread and butter teeth/titanium. Some cancer/cleft/cosmetics is great but having fellows or doing too much of these procedures can dilute your training. When I applied I remember telling a mentor I wanted to avoid programs with lots of trauma but now years into my career I enjoy trauma and orthognathic much more than standard extractions and implants. It doesn’t pay as well but it’s very professionally rewarding to help someone who was injured in a car accident or needs a mandibular advancement to look/chew and breath better. Even treating a nasty infection in the hospital is fun sometimes. Eventually taking out teeth and doing implants all day can get kind of boring.

Extern at a lot of programs, talk to the faculty at programs you like and get recommendations for similar programs. The last thing you want is to go to a country club type program where you barely operate and realize when you graduate you really love one aspect of oms and were terribly undertrained for 4 years
 
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