The Nature of Prestige in Medicine

[SupergreenMnM]

He would clearly fall into the "Demigod" catagory...almost a god, but with some dirt (DDS) on him

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[MDizzy]

Hey guys....was just wondering. What about those oral & maxillofacial surgeons who have both a DDS and MD degree? Are they still losers even though they have their medical degrees from a accredited US medical school? Or is the prestige of a dual degree (DDS, MD) oral & maxillofacial surgeon somewhere in between a MD and a DDS? Look at this guy....he's the director of craniofacial surgery at stanford! Could his job still be considered 'prestigious' despite the fact that he has a DDS? This is very confusing!

http://plasticsurgery.stanford.edu/faculty/schendel.html

Sorry if this offends you but I believe that OMS who have DDS and MD are somewhere between MD and DDS in prestige. The reason being is OMS is widely considered a "backdoor" to getting the MD, and you don't even go through the legitimate full 4 years of med school like every other MD. I'm not even sure if the residency program requires a 1 year medicine internship either like every other residency. Someone can clarify with me on that.

 

[Yellowman]

Sorry if this offends you but I believe that OMS who have DDS and MD are somewhere between MD and DDS in prestige. The reason being is OMS is widely considered a "backdoor" to getting the MD, and you don't even go through the legitimate full 4 years of med school like every other MD. I'm not even sure if the residency program requires a 1 year medicine internship either like every other residency. Someone can clarify with me on that.

Mdizzy...no offense taken. I have gotten all different spectrum of responses to 'wow it's great that you are going to medical school to further your education' to 'you're a dentist, what are you doing here in medical school?' i've heard the latter response from mostly medical students like yourself, less from residents and attendings, although it does happen very seldomly. As for the clarification, yes MD, DDS OMS programs require at least 1 - 2 years of general surgery, allowing us to sit for Step III.

As far as prestiege, I 100% agree that the public holds a doctor with MD in higher regard over other doctors in allied health care fields. This, in my opnion, is largely cultural and the media has a large part to do with this (ie: Grey's anatomy, ER etc...) But prestiege is just that....what other's think of you. you should not let that boost your ego in any way, and trust me, once the patient feels that they've been screwed by you or any other doctor, that prestiege garbage goes out the window quickly. in this day in age where patients are better educated than ever, armed with internet knowledge, and in times where patients go doctor shopping, I am not even so sure that the MD title holds as much prestiege as it used to.

The reason being is OMS is widely considered a "backdoor" to getting the MD, and you don't even go through the legitimate full 4 years of med school like every other MD.

I am not so sure about this statement...however. If I am allowed by the medical school admission committee to complete medical school is less than 3 years, and I do better than a lot of my classmates in Step I after not having taken any of the first 2 years of medical school classes (I took step I right out of dental school), I don't exactly feel bad about not attending all 4 years of med school. It would be redundant, and a complete waste of time.

I am not going to come on this thread and try to pound in the idea that dentists aren't medical school rejects, that they make more money etc etc...Each of you medical students here are entitled to your own ideas...some of the opinions posted here hold some merit, others very little in my opinion, but I think some of you may change your views on the capabilities of other allied health professionals either during or at the completion of your residency. It certainly opened my eyes when I discovered that almost all BKA's were performed by podiatrists at Cleveland VA....and it was even more surprising when the vascular surg and orthopedic residents admitted the foot docs do a better job than they can. Amazing.....

BTW, that gentleman in standford plastic surg dept. He completed 4 years of dental school, completed a non-MD OMS program, and attended 4 years of medical school followed by plastics residency.

Well legitimate or not, I'll sign off
Yellowman, DDS, MD 2008

thanks for reading

 

[Cirrus83]

Overall, most everybody has mentioned that they would most likely not do medicine if they knew what it was truly was like. Most agree that they would have given dentistry a good look.

For what it's worth, I've also known a good # of doctors over the years, and I would say that many/most of them don't regret it at all. One of the doctors at work was actually a wall streeter before she went to medical school, and she definitely didn't regret any of it, but she did say that having been out in the real world helped her on this point-she knew what she was getting herself into and knew what options she'd be missing out on, and that's what made it easier for her.

And both my mother and my uncle seem to love being a doctor (my mother used to be one, and my uncle is a cardiologist).

This isn't to say that I haven't met doctors who wouldn't do it all over and think it's not worth it. I met a pediatrician who's still paying her loans off (and she has fully grown children...she's like 50 lol) and she told me maybe it's a better career path for men but she kinda regretted med school, since I guess her having to raise kids at home kinda hampered her ability to actually pay off her debt or something. But my own pediatrician from when I was a kid was just pushing me to go get published research done so I'd have a better shot at med school , and plenty of other pediatricians I've met were quite happy so don't take this to mean that being a pediatrician means you'll be sad and regretful, it's a pretty awesome specialty if you like kids.

I haven't ever had a doctor tell me they would have considered dentistry instead though, but I guess it's more likely that your family would say something like that since the docs obviously know 4 dentists.

Truth is though, you'd still be happiest doing whatever you love more, and if you don't think you'd love dentistry it makes no sense to go pursue it just because you think the hours are better and the pay is better. Loving your job and being good at it is way more important, and probably improves your salary anyway. And finally, the truth is that most specialties have pretty controllable hours, it's just a matter of whether you're willing to take the pay cut, lol. Go private practice, go find a few other doctors who are simiarly lazy and you could work like 30 hours a week even in internal medicine lol.

 

[badasshairday]

They should make a show like Grey's anatomy except have it be a dental version... "Grey's dentistry." I can see it now.

 

[LIDO]

Sorry if this offends you but I believe that OMS who have DDS and MD are somewhere between MD and DDS in prestige. The reason being is OMS is widely considered a "backdoor" to getting the MD, and you don't even go through the legitimate full 4 years of med school like every other MD. I'm not even sure if the residency program requires a 1 year medicine internship either like every other residency. Someone can clarify with me on that.

You do not go through the full four years because in dental school the first two years are basically the same as in medical school. Hence why some schools like Harvard combine the dental and medical students for the first two years....and others do the same.

The reason behind the DDS/MD for OMS is actually very strange. OMS grads would be perfectly fine doing a four year program and getting the DDS and OMS training without the other two initials, MD. The reason programs integrated this was because of insurance. I just had a conversation with and admissions officer at a dental school about this. Something along the lines that because the OMS surgeon has only the DDS and not the MD, medical insurance companies will not fully cover surgical procedures. This is because dentist have different coverage (none at all in some cases) with insurance companies. So to get around this the schools have integrated the OMS training along with granting the MD initials.

Otherwise the DDS would be able to simply do the four year training and with the suitable rotations/teaching be perfectly capable. Another way insurance companies have plagued medicine........

 

[xylem29]

Sorry if this offends you but I believe that OMS who have DDS and MD are somewhere between MD and DDS in prestige. The reason being is OMS is widely considered a "backdoor" to getting the MD, and you don't even go through the legitimate full 4 years of med school like every other MD. I'm not even sure if the residency program requires a 1 year medicine internship either like every other residency. Someone can clarify with me on that.

I think that an OMS has the same prestige than an MD has. If they have the MD, and are surgeons, I don't see how people wouldn't be impressed when they hear "Hi, I'm Dr. ______. I am an Oral and Maxillofacial surgeron." I hold OMS's in the same regard as all surgeons.

 

[Yellowman]

I think that an OMS has the same prestige than an MD has. If they have the MD, and are surgeons, I don't see how people wouldn't be impressed when they hear "Hi, I'm Dr. ______. I am an Oral and Maxillofacial surgeron." I hold OMS's in the same regard as all surgeons.

This notion is pretty much in line with what I've experienced during my medical school clekships and in the hospital wards/OR. Physicans on service don't care much about what initials you have behind your name, as long as you provide quality care in THE MOST EFFICIENT WAY POSSIBLE. THis is often because different specialties work collaboratively on samepatients...eg: OMFS gets consulted frequently to internal medicine svc for facial cellulitis, oral abscess etc....When many of you folks start your medical school career, you'll realize that providing medical care is extremely time consuming...thus a doctor who cannot manage his time well on wards will quickly be...shall we say...disliked.

It's interesting as the 'hostility' towards non-MD health professionals seem to decrease the more advanced I get into my education.

Hostility decreases the following way....

Pre-med (vast majority can't get into med school) > Med school >>> Residency

You do not go through the full four years because in dental school the first two years are basically the same as in medical school. Hence why some schools like Harvard combine the dental and medical students for the first two years....and others do the same.

The reason behind the DDS/MD for OMS is actually very strange. OMS grads would be perfectly fine doing a four year program and getting the DDS and OMS training without the other two initials, MD. The reason programs integrated this was because of insurance. I just had a conversation with and admissions officer at a dental school about this. Something along the lines that because the OMS surgeon has only the DDS and not the MD, medical insurance companies will not fully cover surgical procedures. This is because dentist have different coverage (none at all in some cases) with insurance companies. So to get around this the schools have integrated the OMS training along with granting the MD initials.

Otherwise the DDS would be able to simply do the four year training and with the suitable rotations/teaching be perfectly capable. Another way insurance companies have plagued medicine........

Your admission officer should do some more research before he informs dental students about dental specialties that he doesn't know much about. Whether you are a single or dual degree surgeon, there is no difference in the insurance reimbursement. The only thing common about insurance is that the reimbusement rates are low and that the insurance companies take their sweet time paying you. Obtaining the MD as OMFS merely reflects that the specialty has expanded in its scope. In fact, OMFS in Europe is a medical specialty, not dental.

Also, while it is true that the first two years of dental school curriculum is same as that in medical school, it's only the subject matter that is the same. That is, you learn about the same things as a medical student does, however the depth in which it is taught isn't quite the same. This isn't to say that dental school curriculum is inadequate or inferior, it's just a reflection of the type of medical diagnostic skills a typical dentist requires. Dentists are not educated to manage a patient's systemic illness, they are taught when and how to render necessary dental treatments in patients with medical problems. For example, vast majority of dental students who are ready to take part I dental boards after studying dental decks etc...will NOT pass USMLE step I, as the material in Step I is more complex. However, a driven dental student can easily pass Step I with some additional self-study time....as I and many other dual degree OMFS guys out there have proved.

 

[LIDO]

This notion is pretty much in line with what I've experienced during my medical school clekships and in the hospital wards/OR. Physicans on service don't care much about what initials you have behind your name, as long as you provide quality care in THE MOST EFFICIENT WAY POSSIBLE. THis is often because different specialties work collaboratively on samepatients...eg: OMFS gets consulted frequently to internal medicine svc for facial cellulitis, oral abscess etc....When many of you folks start your medical school career, you'll realize that providing medical care is extremely time consuming...thus a doctor who cannot manage his time well on wards will quickly be...shall we say...disliked.

It's interesting as the 'hostility' towards non-MD health professionals seem to decrease the more advanced I get into my education.

Hostility decreases the following way....

Pre-med (vast majority can't get into med school) > Med school >>> Residency



Your admission officer should do some more research before he informs dental students about dental specialties that he doesn't know much about. Whether you are a single or dual degree surgeon, there is no difference in the insurance reimbursement. The only thing common about insurance is that the reimbusement rates are low and that the insurance companies take their sweet time paying you. Obtaining the MD as OMFS merely reflects that the specialty has expanded in its scope. In fact, OMFS in Europe is a medical specialty, not dental.

Also, while it is true that the first two years of dental school curriculum is same as that in medical school, it's only the subject matter that is the same. That is, you learn about the same things as a medical student does, however the depth in which it is taught isn't quite the same. This isn't to say that dental school curriculum is inadequate or inferior, it's just a reflection of the type of medical diagnostic skills a typical dentist requires. Dentists are not educated to manage a patient's systemic illness, they are taught when and how to render necessary dental treatments in patients with medical problems. For example, vast majority of dental students who are ready to take part I dental boards after studying dental decks etc...will NOT pass USMLE step I, as the material in Step I is more complex. However, a driven dental student can easily pass Step I with some additional self-study time....as I and many other dual degree OMFS guys out there have proved.

I would opt to trust the admissions officer considering his the OMS that works with his practice was just promoted to head chair. He has been doing this for 30 years and I doubt his advice is misguided. If you really do not think dental and medical insurance differ.....you really need to do your homework....they do.

I agree that dental students do not study each subject to the same depth. At the same token dental students also have hours of endless lab work to do each night, while the medical students can sit back and study during this time. According to a few dental and medical students that I have spoken with, the first two years of dental school are harder than medical school. But the second two years of medical school are harder than dental when rotations begin.

Besides that, does it not proove that since a medical school awards an MD after doing rotations in a hospital setting that dental students and medical students are at the same level? With that, if a dentist can get his MD and perform such difficult operations is it not believable that a dentist could complete just about any rotation if provided with the background and skills?

Obviously people going into dental school question some things. Such as prestige and what sort of mental challenge the future holds, but students entering medical school must also have worries........if they did not and they were more comfortable than dental students then they would not be here.

I have sat on both sides of the spectrum. When thinking about entering medicine I have worried about the lack of a family life, long hours, on-call, nights/weekends, money/hour. Also, malpractice is a huge issue. The American Medical Association recently made a statement to Congress that loots of doctors are fleeing states, retiring, stop practicing and not performing those risky/interesting procedures that we all love.

Going into dentistry one may worry about how challenging the profession may be or the amount of debt incurred by opening a practice. The nice thing with dentistry is that you can go into general practice and even take advanced edu. courses to perform procedures done by perio.'s, endo's, ortho's etc. Also, if you feel that you need a more intense life ...... go for OMS.

Whatever.....this conversation is endless. We are all unsure about things. Anybody who states they are not either have not thought everything out/been exposed to the real issues or are trying to cover up some honest feelings. Nobody ever said that a job will be perfect, but after all the work we are doing it better be pretty close to just that. Yes, all the work that we are all doing.

How about we bash comm. majors or some other easy backdoor out of college (no offense to comm majors....sorry.....it is a VERY easy major at my school....despite having a good department). We are all healthcare providers.....with whatever choice that is made.

 

[Yellowman]

I agree that dental students do not study each subject to the same depth. At the same token dental students also have hours of endless lab work to do each night, while the medical students can sit back and study during this time. According to a few dental and medical students that I have spoken with, the first two years of dental school are harder than medical school. But the second two years of medical school are harder than dental when rotations begin.

Besides that, does it not proove that since a medical school awards an MD after doing rotations in a hospital setting that dental students and medical students are at the same level? With that, if a dentist can get his MD and perform such difficult operations is it not believable that a dentist could complete just about any rotation if provided with the background and skills?

Lido, I agree with you on many of the points you make, but comments like above is what makes dentists look like they have to prove to the physicans that our curriculum is just as difficult as theirs, and that we're not all med school rejects. Comments like above are unnecessary as comparing dental and medical school curriculum is like comparing apples to oranges. One is not necessarily harder than other....it's different. Who cares which one is harder? There is absolutely no reason to justify dental profession or curriculum to anyone here on this board.

And you are not getting my point...I NEVER said that MD's are superior to DDS or vice versa....just that the curriculum is DIFFERENT which is simply a reflection of the different types of work we do. Stating that one degree is 'better' than other is just a practice in ego boosting....it's not professional. You don't have to tell me that dental school is hard...I've completed dental school and is about to complete medical school. I've done both, so I think I have some insight that most of people on this board does not.

As far as insurance issue is concerned, here at my program, single degree surgeons routinely bill medical insurance without ANY problems....but I guess there can always be exceptions to the rule.

Besides that, does it not proove that since a medical school awards an MD after doing rotations in a hospital setting that dental students and medical students are at the same level? With that, if a dentist can get his MD and perform such difficult operations is it not believable that a dentist could complete just about any rotation if provided with the background and skills?

I don't see how a medical student obtaining his MD after clerkship in a hospital puts med and dental students at the same level. This sentence doesn't make sense. Again, there is no 'level' in my opinion. It's two very different jobs, thus the different degrees. One is not 'better' than the other....but I think the point of this thread is that the MD degree holds more prestiege in the eye of the lay public than other allied health professions, which I have previously posted, I agree with. There is no need to take offense to this, because it's true. Recognizing this fact doesn't mean that this notion is true, just that such a notion exists. Also, amongst the health care prefessionals, this notion is either non-existent or not as prevalent.

And lastly, althouh Communcation major is definitely worth bashing, let's not forget political science....

 

[El Guapo78]

The insurance issue is different for medicine and dentistry. However, oral surgeons whom perform orthognathic surgery, trauma recon, cancer recon etc. bill medical insurance. Medical insurance companies view all oral surgeons the same whether they have an MD or not, and all get reimbursed. Some oral surgery procedures (wisdom teeth, alveolar bone graft, etc) are covered by some dental insurance, oral surgeons will bill dental insurance and get reimbursed.

 

[MDizzy]

I think that an OMS has the same prestige than an MD has. If they have the MD, and are surgeons, I don't see how people wouldn't be impressed when they hear "Hi, I'm Dr. ______. I am an Oral and Maxillofacial surgeron." I hold OMS's in the same regard as all surgeons.

Do you consider general dentists "surgeons?" I've seen over on the dental board some claim that dentists are surgeons and perform surgery and they use their DDS as justification since it says "doctor of dental surgery."

Or do you subscribe to the popular view that says one isn't a surgeon until they have completed a full surgical residency?

 

[Tired]

Wait, pre-meds are actually arguing with dental students? Since when do any of you care about teeth? Why do you know anything or care about about dental school curriculum? Do you read The Onion?

http://www.theonion.com/content/node/28699

 

[Yellowman]

Do you consider general dentists "surgeons?" I've seen over on the dental board some claim that dentists are surgeons and perform surgery and they use their DDS as justification since it says "doctor of dental surgery."

Or do you subscribe to the popular view that says one isn't a surgeon until they have completed a full surgical residency?

general dentists are not surgeons and most don't call themselves so. Anyone who calls him or herself as such is exercising self-ego boosting....however this 'ego boosting' aren't necessarily only praciticed by dentists....MD's, DOs they all do it too in other ways as they are human as well...

 

[LIDO]

Do you consider general dentists "surgeons?" I've seen over on the dental board some claim that dentists are surgeons and perform surgery and they use their DDS as justification since it says "doctor of dental surgery."

Or do you subscribe to the popular view that says one isn't a surgeon until they have completed a full surgical residency?

This point can be viewed in a couple of ways. Many general dentist go through continued edu. courses so that they perform different endodontic and prosthetic operations. So in some cases you can consider a general dentist, partially a surgeon.

For the most part I do not think that general dentist walk around claiming that they are surgeons of the human body.

On a sidenote......anybody watch those new laser dentistry procedures....pretty awesome.

 

[pennybridge]

repost.

http://forums.studentdoctor.net/forumdisplay.php?f=17

 

[LIDO]

Do you consider general dentists "surgeons?" I've seen over on the dental board some claim that dentists are surgeons and perform surgery and they use their DDS as justification since it says "doctor of dental surgery."

Or do you subscribe to the popular view that says one isn't a surgeon until they have completed a full surgical residency?

This point can be viewed in a couple of ways. Many general dentist go through continued edu. courses so that they perform different endodontic and prosthetic operations. So in some cases you can consider a general dentist, partially a surgeon.

For the most part I do not think that general dentist walk around claiming that they are surgeons of the human body.

On a sidenote......anybody watch those new laser dentistry procedures....pretty awesome.

 

[RokChalkJayhawk]

One more crappy in vitro study that proves absolutely nothing.

Go Alternative Medicine!

Just like in-vitro studies didn't do things like make penicillin or play a role in the development of the polio vaccine.

Thank you, but I'll take my science.

 

[pennybridge]

Interestingly, the complete soup also lacked cytotoxic activity.

jeez, just about anything passes for "interesting" these days

 

[MDizzy]

This point can be viewed in a couple of ways. Many general dentist go through continued edu. courses so that they perform different endodontic and prosthetic operations. So in some cases you can consider a general dentist, partially a surgeon.

For the most part I do not think that general dentist walk around claiming that they are surgeons of the human body.

On a sidenote......anybody watch those new laser dentistry procedures....pretty awesome.

I don't think taking continuing ed courses on a procedure and performing the procedure makes a general dentist a "partial surgeon." You're either a surgeon or you're not. No weekend course is ever going to replace 5+ years worth of a surgical residency.

 

[LIDO]

I don't think taking continuing ed courses on a procedure and performing the procedure makes a general dentist a "partial surgeon." You're either a surgeon or you're not. No weekend course is ever going to replace 5+ years worth of a surgical residency.

Of course different degrees of surgeons exist and I agree that a 5 year surgical residency does hold more weight in the surgical field. The point stands that some dentist perform surgical procedures, even if they may be minor.

 

[Yellowman]

Of course different degrees of surgeons exist and I agree that a 5 year surgical residency does hold more weight in the surgical field. The point stands that some dentist perform surgical procedures, even if they may be minor.

This is true....dentistry is far more surgical / procedural than medical by nature. Many procedures are quite invasive, much more so than what many MD's might think. However, a doctor who practices surgical procedures part time doesn't make them a 'surgeon'. For example, many family practice docs perform excision of skin tags, perform soft tissue biopsies, trephination, I&D, aspiration (especially for olecranon bursitis fluid) etc....which are all surgical procedures by definition. These docs however, never refer themselves as surgeons, because they are not. Thus general dentists calling themselves dental surgeons are not representing themselves accurately. I would have to agree here with MDizzy....the title surgeons should be reserved for someone who has completed an accredited surgical residency.

 

[MDizzy]

This is true....dentistry is far more surgical / procedural than medical by nature. Many procedures are quite invasive, much more so than what many MD's might think. However, a doctor who practices surgical procedures part time doesn't make them a 'surgeon'. For example, many family practice docs perform excision of skin tags, perform soft tissue biopsies, trephination, I&D, aspiration (especially for olecranon bursitis fluid) etc....which are all surgical procedures by definition. These docs however, never refer themselves as surgeons, because they are not. Thus general dentists calling themselves dental surgeons are not representing themselves accurately. I would have to agree here with MDizzy....the title surgeons should be reserved for someone who has completed an accredited surgical residency.

Stop the presses! A med and a dent agreeing with each other! That's unprecedented on SDN!

 

[Long Dong]

This is true....dentistry is far more surgical / procedural than medical by nature. Many procedures are quite invasive, much more so than what many MD's might think. However, a doctor who practices surgical procedures part time doesn't make them a 'surgeon'. For example, many family practice docs perform excision of skin tags, perform soft tissue biopsies, trephination, I&D, aspiration (especially for olecranon bursitis fluid) etc....which are all surgical procedures by definition. These docs however, never refer themselves as surgeons, because they are not. Thus general dentists calling themselves dental surgeons are not representing themselves accurately. I would have to agree here with MDizzy....the title surgeons should be reserved for someone who has completed an accredited surgical residency.

I disagree here, example dermatological surgeons (mohs micrographic surgery) cut out skin cancers and do alot of reconstructive surgery without having done a surgical residency.