Why do OMFS residents get an MD degree?

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Personally, I think OMFS absolutely need MD degrees. Think about it. 3rd molars are next to a nerve and blood vessels. They are using very sharp instruments in a small space. A lot can go wrong when taking our impacted molars. They need to be ready with emergency equipment and drugs only real doctors can provide.

You can bet when I got my wisdom teeth out, it was by an MD. Sorry guys, but I'm not gonna put my life in the hands of a dentist. I refer my ortho extractions out to oral surgeons with MD's. Bicupids aren't are dangerous as 3rd molars, but you can never be too careful.

It's just too bad orthodontics doesn't offer a joint MD program as well.


I think this guy is just being sarcastic. His statement sounds so ridiculous that it had to be otherwise he is a bonehead fool. But since he is an orthodontist he must just be sarcastic, I cannot believe someone who is an orthodontist to be this ignorant (although I know some ortho that are really dumb i.e. unintelligent). :laugh:

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I think this guy is just being sarcastic. His statement sounds so ridiculous that it had to be otherwise he is a bonehead fool. But since he is an orthodontist he must just be sarcastic, I cannot believe someone who is an orthodontist to be this ignorant (although I know some ortho that are really dumb i.e. unintelligent). :laugh:

Really? It sounded on the level to me.
 
Double post
 
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Right on. I don't use a barber unless he has an MD... You know, he uses sharps.:smuggrin:
 
I did admit several post ago that I had a big Ego and wanted the MD, one step ahead of you bud. Am I jealous that I didn't get the MD? For a long time I was bitter, but not anymore. In fact I think I am liberated and happy that it didn't work out that way for me and I couldn't be happier where I am today.
To each his own. All I'm trying to do is to point out the facts that nobody wants to or care to talk about.:cool:


Dude, what's your story? I'm lost here ...

You're a GP ... applied for 6 year MD OMFS and did not match/accept (personal reason or whatever) ... so now you're doing ortho? Please fill us in.
 
This thread got me thinking ... am I a 4 year or 6 year person?

For what it's worth, and for what very little I know about the intricacies of 4 year VS 6 year OMFS programs ... If I were an OMFS applicant, I would definitely have a bias for 6 year programs.

Just my 2 cents ...
 
You can't tell me the time I'll spend in medical school is a waste for my surgical training? General dentists think they know a lot more about medicine than they do and 4 year guys can't possibly say that they learned anywhere near as much as all the info from step 1,2,3 and our clerkships. Our year in general surgery is also nothing but exceptional training for our specialty and if you don't understand why or think that hernias and patient management is useless you are an idiot. That's all, I read this tread long enough and some comments about ego and how the MD is useless finally pissed me off.
 
Just out of curiosity, can the 6 year people give specific instances in daily
Oral Surgery practice ( I'm not talking about residency - I'm talking about what 90 % of oral surgeons do on a daily basis )
where the Medical knowledge obtained just in medical school (not in residency or dental school or information that 4 year OMS guys otherwise wouldn't know ) significantly altered their treatment plan and or decision making for that patient. Just curious to hear specific examples.​
 
Just out of curiosity, can the 6 year people give specific instances in daily
Oral Surgery practice ( I'm not talking about residency - I'm talking about what 90 % of oral surgeons do on a daily basis )
where the Medical knowledge obtained just in medical school (not in residency or dental school or information that 4 year OMS guys otherwise wouldn't know ) significantly altered their treatment plan and or decision making for that patient. Just curious to hear specific examples.​

I'm giving an IV anesthetic to someone and they develop an arrhythmia. I did a month of cardiology (and have yet to do two months of ER at resident level) and I've seen almost all of them treated.

Is my diabetic or HTN patient as controlled as they can be before I slam a bunch of implants in them? How do I know? How could their primary care provider change their management?

Ext pt develops osteomyelitis. How long is an ID doc going to want them on abx and what kind? How will they be given?

Patient is admitted to you for a mandible fx and is acting funny. Is this something you can discharge them with or do you need to call psych? What do you tell them?

OMSPlayer05, I would never say that a medical degree will make me a better OMFS than you. Maybe you're smarter than me and you think all of the stuff I just listed is ridiculous. Some of us see benefit in it. Right now I am in the depths of medical school and I can find applicable things to being an OMFS in every rotation. Relax man!
 
oh man, why are the 4 year guys so angry?
Let me tell you something that may shock you, but bread and butter oms is in big trouble, google perio dudes in your chosen area to go practice, they basically practice oral surgery. The scope of our practice will change and the more broad the training the better. When we are doing the complex bone grafting so implants are possible, my comfort taking bone from the hip or fibula and management of older, sicker patients and my big fat M.D. make me more comfortable:laugh: Can I trach., did I spend more time on trauma during general surgery that a single degree spends on the whole surgery rotation: sure. I want all kinds of tricks in my bag. Thats just me. When I get a call at 2:40 am and the my hometown hospital wants me to manage the patients issues I will be glad I have more training.

are you going to do vaginal exams: no
are you going to do psych evals: no
are you going to manage cardiology patients primarily: no
That's not the point. Look toward the future all you young guys pondering if an MD is useful.
 
:thumbup:


You can't tell me the time I'll spend in medical school is a waste for my surgical training? General dentists think they know a lot more about medicine than they do and 4 year guys can't possibly say that they learned anywhere near as much as all the info from step 1,2,3 and our clerkships. Our year in general surgery is also nothing but exceptional training for our specialty and if you don't understand why or think that hernias and patient management is useless you are an idiot. That's all, I read this tread long enough and some comments about ego and how the MD is useless finally pissed me off.
 
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First off Septocaine, bread and butter OMS is not in trouble. My practice is thriving like none other. This is a true golden age atleast where I am practicing. Yes there is competition but there is plenty of work for everyone. In addition, you are so out of touch with the current professional and economical environment of our profession. Your GS internship will be an afterthought when you get into private practice. All those times you had GS patient's on pressors in the ICU will become a distant memory, as it really has no bearing on OMS, except in rare instances. There is a huge, huge dichotomy between what you have experienced and what you actually use on a daily basis. For example, If there is an isolated facial trauma case ie mandible fx, IM usually admits the patient ( which is nice from a convenience standpoint and from a liability standpoint if they are medically compromised) and and it would be foolish, whether you are single degree or double degree, to think otherwise. There is something called liability when you get out and practice. As a resident you are really shielded from that reality. Yes there are ramifications to your actions as residents but when your butt is on the line everyday as a practioner,most people are willing to share the risk, whether you have the MD or not. It is foolish for 6 year guys to think they are going to be managing these complex medical issues when you have someone much more qualified, such as Internal Medicine. That doesn't mean we are exempt from know these things but it allows us to share the burden of managing this patient with someone more qualified ( no disrespect to your medical education or one year gs internship). No hospital or patient for that matter, expects a specialist, such as an OMS, to manage complex medical issues when there are many more capable hands available. It is ok as a practioner to not take on the whole burden. In general, OMS residents have this cavalier or cowboy attitude that we can and should do it all. But when you finally get out and practice, you will feel much different then you do right now as a resident. Trust me, I was just there a short while ago.
 
I will preface my remarks by saying that I am not criticizing anyones views, nor am I saying that my ideas are 110% correct. Im just a very philosophical thinker and want to strike-up a logical discussion....

Why SHOULDNT an oral surgeon need a medical degree? Better yet, why isnt dentistry a subspecialty of medicine? Is the oral cavity not part of the human body?? Is there an area marked by an invisible line that encompasses the teeth, oral tongue, mucosa, maxilla, and mandible in which any procedure (operative, medical, etc) localized to it has NO systemic effects? If this is the case, why do PRS, OTO/ENT, and any other surgeons need to obtain a medical degree? Cant they just open their respective schools and earn DPRS and DOTO/ENTS in order to practice in their field?

Maybe dentists should be required to obtain a medical degree - their training should include 4 years of medical, 2 years of dental, and additional years of post-doctoral study. (A case could probably be made for any of the other medically-related doctoral programs out there...).

From my standpoint, the medical degree is a necessity. Simply put, Ill summarize it with this syllogism:

The oral cavity/maxillofacial region (A) is a part of the human body (B).
To diagnose and treat the human body (B), one must earn a medical degree (C).
Therefore, since (A)=(B), and (B)=(C), then (A) MUST equal (C).
Thus, to treat the oral cavity/maxillofacial region (A), one must earn a medical degree (C)
 
You guys are killin' me with your egos and "lets whip it out and measure" attitudes.

I had the fortune of going to a dental school where the OMFS program offered both routes. I had faculty that were both single degree and dual degree. I worked closely with both single and dual degree OMFS in private practice as a GP. I did an internship where my attendings were both single degree and dual degree. Residency the same... Never once did I base my respect/admiration for these role-models by the initials that followed their names.

The decision to pursue an MD as part of your OMFS training is largely a PERSONAL DECISION. Some may do it because of ego or an inferiority complex. Others may do it because it fulfills an educational desire. Others to open more doors in fellowship training. Its a personal decision that has to take into account undergraduate debt, dental school debt, family circumstances and other financial obligations. But don't be fooled. Having the MD doesn't automatically give you some superior status as a doctor and surgeon!

The simple fact of the matter is that whether you are a single-degree OMFS or a dual-degree OMFS you are still held to the same standard of care. Whether your residency was 4 years in length, 6 years in length, 7 years or a combination of the above with a fellowship- at the end of the day you still sit for the same written and oral board certification examination! To that end, I don't believe there is any published study showing any significant difference in the board passage rates between single and dual degree surgeons. If there is, I'd love to read it for myself.

If you want to be a good doctor and surgeon, go to a strong residency program and WORK YOUR @$$-off! READ, STUDY, OPERATE, TEACH your junior residents. Pick the brains of your attendings. Learn from their experiences. Be serious on your off-service rotations and learn everything you can. When its all said and done, consider doing a fellowship! There is probably a lot more value (medically/surgically and financially) in a fellowship as opposed to just having an MD degree.

And for those chest-thumpers that think they are gonna manage their patients on their own they are either foolish or delusional. You need to do what is best for your patient. That means sharing the complicated medical care and responsibility with other doctors who are experts in their respective fields. We are specialists and experts in the face. Our primary purpose on a day-to-day basis is to serve the surgical needs of the dental community and to a lesser extent to provide surgical services for trauma/oncology/reconstruction/comsetics and craniofacial patients. Don't think for a second that our plastic surgery and ENT counterparts with their big phat MD are any better qualified to manage all the medical needs of their patients.

So unless you are a total tool or had the misfortune of matching into a glorified perio-residency you should have an equivalent or superior fund of knowledge to your MD colleagues in the areas of pharmacology/physiology, anesthesia, general medicine, pathology, BLS/ACLS/PALS/ATLS etc etc...

Be glad most of you live in the USA where you can pursue such an amazing specialty whether you want to be single-degree or dual-degree!
 
Dual degree OMFS are taking the specialty to greater heights. The age of the single degree academic attending is coming to an end. In another 15 years or so, all attendings other than dentoalveolar housecats will be dual degree and many will be fellowship trained. This will increase the scope of our specialty and continue to advance the specialty. Students choosing to pursue residency now can either be part of that or they will be left behind. I don't believe single degree guys will be less successful or anything but by the end of our careers, every powerful voice in OMFS will have an MD. That WILL shape the specialty, whether the single degree guys like it or not. I think this will also spark more and more residencies to switch to MD integrated if there is any possible way to find an affiliated med school.

By the way, no one else on the planet other than us can get a legit MD in 2 years. Tremendous bargain for the knowledge and respect earned.
 
Just curious, but how often do the omfs guys do a medical residency after their 2 year MD. I ask because when I was in med school, 2 of the 3 oral surgeons in our class did exactly that. They each did a 5 year general surgery residency after. And I know one of them went on to a 2 year plastic surgery fellowship. He now practices plastic surgery full time. I haven't kept up with the other 2 guys. For those guys that did surgical residencies and fellowships, that is a long road requiring massive dedication. Is this fairly common, or were these guys in my class just animals (I mean that in a good way)?
 
Just curious, but how often do the omfs guys do a medical residency after their 2 year MD. I ask because when I was in med school, 2 of the 3 oral surgeons in our class did exactly that. They each did a 5 year general surgery residency after. And I know one of them went on to a 2 year plastic surgery fellowship. He now practices plastic surgery full time. I haven't kept up with the other 2 guys. For those guys that did surgical residencies and fellowships, that is a long road requiring massive dedication. Is this fairly common, or were these guys in my class just animals (I mean that in a good way)?

Its pretty rare. Every few years a resident in an integrated OMFS program jumps ship after med-school and doesn't complete their last 1-2 years of residency. They go off and match in some other specialty. Most commonly its Anesthesiology, but some go off and do medicine, general surgery followed by plastics, or ENT. Most people just don't have the patience to be eternal students/residents though.

Here in Miami I know a guy that did 4 years of dental school, a 4 year OMFS residency and became board certified, followed by 4 years med school (worked on the side as an OMFS during that time), then 5 years of general surgery (became board certified), then 2 years of plastics (became board certified), followed by a craniofacial fellowship! He does mainly dental-alveolar surgery (doesn't do his own anesthesia anymore), a good amount of orthognathics, a little trauma and a supposedly a fair-share of facial cosmetics and boob-jobs a month. Kinda a long road if you ask me to be practicing 90% what you were already trained/qualified to do 12 years earlier.
 
I guess I fail to see the strength in the examples you have provided. Those examples are really only relevant to GP's/Perio and remaining dental specialties... But NOT OMFS....

I'm giving an IV anesthetic to someone and they develop an arrhythmia. I did a month of cardiology (and have yet to do two months of ER at resident level) and I've seen almost all of them treated.
You are supposed to learn this in residency regardless of medical school. Why wouldn't you know how to treat this in the acute/ambulatory setting after being certified in BLS/PALS/ACLS and ATLS and subsequently re-certified at least one more time during your residency? Why wouldn't you know how to treat this after a formal 4-6 months of Anesthesia Rotation or after 2 months of Medicine or 1 month of ER or Cardiology? How about the other 2-3 years of your residency where you are doing GA's and IV sedation in the clinic????


my diabetic or HTN patient as controlled as they can be before I slam a bunch of implants in them? How do I know? How could their primary care provider change their management?
Again, why wouldn't you recognize this stuff? I can understand if you are a GP or a periodontist who doesn't get the exposure to sick people and multiple systemic diseases that an OMFS sees on a daily basis...


pt develops osteomyelitis. How long is an ID doc going to want them on abx and what kind? How will they be given?
Why do I need an MD to communicate with an infectious disease doc? Why would I need an MD to understand the microbiology of osteomyelitis and the pharmacology involved in treating it? If they want a patient on 6-8 weeks of Vancomycin, I can place the request in for a PICC line and I can write a standing order for the necessary lab tests... Again, I fail to see your point.

is admitted to you for a mandible fx and is acting funny. Is this something you can discharge them with or do you need to call psych? What do you tell them?
Do I need an MD to consult psych? Ok granted most 4 year OMFS do not do a formal psych rotation, but we certainly get exposed to psych through the ER and Medicine rotations. We are taught the basics in the H & P course in providing a mental examination. Nobody practices alone in this day and age. Pick up the phone and page the psych dude or dudette on call.

, I would never say that a medical degree will make me a better OMFS than you. Maybe you're smarter than me and you think all of the stuff I just listed is ridiculous. Some of us see benefit in it. Right now I am in the depths of medical school and I can find applicable things to being an OMFS in every rotation. Relax man!
You are absolutely right though. Knowledge and experiences gained in med-school and off-service rotations are beautiful things that are complementary to your training as a specialist. It is important to find what is relevant to your specialty and to apply it when possible.

I'm in no way knocking MD OMFS... I think they have done wonderful things for our specialty and I do believe they are gonna likely be the trend for the future in academia and fellowship training. Its already that way in almost every country Europe. But the MD OMFS must not lose touch with their roots in dentistry, their primary referral base, and the ones that thump their chest as superior to their single-degree counterparts need to take a few steps back and be more humble.
 
Took the words out of my mouth....if you finish residency and don't know how to handle any of those BASIC scenarios...you failed to do your part. And yes, you would pretty much suck. Kidding me?

I guess I fail to see the strength in the examples you have provided. Those examples are really only relevant to GP's/Perio and remaining dental specialties... But NOT OMFS....

You are supposed to learn this in residency regardless of medical school. Why wouldn't you know how to treat this in the acute/ambulatory setting after being certified in BLS/PALS/ACLS and ATLS and subsequently re-certified at least one more time during your residency? Why wouldn't you know how to treat this after a formal 4-6 months of Anesthesia Rotation or after 2 months of Medicine or 1 month of ER or Cardiology? How about the other 2-3 years of your residency where you are doing GA's and IV sedation in the clinic????



Again, why wouldn't you recognize this stuff? I can understand if you are a GP or a periodontist who doesn't get the exposure to sick people and multiple systemic diseases that an OMFS sees on a daily basis...



Why do I need an MD to communicate with an infectious disease doc? Why would I need an MD to understand the microbiology of osteomyelitis and the pharmacology involved in treating it? If they want a patient on 6-8 weeks of Vancomycin, I can place the request in for a PICC line and I can write a standing order for the necessary lab tests... Again, I fail to see your point.


Do I need an MD to consult psych? Ok granted most 4 year OMFS do not do a formal psych rotation, but we certainly get exposed to psych through the ER and Medicine rotations. We are taught the basics in the H & P course in providing a mental examination. Nobody practices alone in this day and age. Pick up the phone and page the psych dude or dudette on call.


You are absolutely right though. Knowledge and experiences gained in med-school and off-service rotations are beautiful things that are complementary to your training as a specialist. It is important to find what is relevant to your specialty and to apply it when possible.

I'm in no way knocking MD OMFS... I think they have done wonderful things for our specialty and I do believe they are gonna likely be the trend for the future in academia and fellowship training. Its already that way in almost every country Europe. But the MD OMFS must not lose touch with their roots in dentistry, their primary referral base, and the ones that thump their chest as superior to their single-degree counterparts need to take a few steps back and be more humble.
 
I am at a place where there are both 4yr and 6yr. The 4yrs know their limitations when it comes to med, and the 6yrs need the 4yrs to catch up on OS when we come back from GS. We work really well together, and when weaknesses are identified, each type of OMFS track helps each other out.

5yrs after residency, I don't think it will matter much. The only benefit of my MD in the short term will be to be a little more competitive for fellowships if I choose to right after residency. As I have always believed, a strong program is what is important, as we all know that not all OMFS programs are the same. A resident, regardless of degree, will only be as strong as their program. It was, however, my preference for the MD that I chose a 6yr program. To each their own.

Stop the bickering and cock-fighting people.
 
No one will ever really be able to say how having an MD has or has not affected their practice unless they practiced as a single degree for a few years then went back and got an MD.

These arguments are always awesome. Everyone is always suppose to pretend the MD doesn't mean anything and was a worthless ego inflator. Of course it inflates our ego - so does your DDS! You can't tell me you didn't have a bit of pride the day you told your friends you got into dental school or the day you graduated from dental school.

Why shouldn't we be proud of an MD? How can extra schooling not affect your knowledge base and the way you practice? Why should we pretend like it's not a big accomplishment? Besides, in our American culture, and probably the rest of the world's, the MD is top of the medical food chain. It's a fact in our culture. Your opinion about the way our culture views an MD versus a DDS are interesting and irrelevant.

You get mad when an MD calls you "just a dentist" and doesn't respect your knowledge yet you do the same thing to double degree oral surgeons. It makes no sense, like root canals and periodontists pulling thirds.
 
But the MD OMFS must not lose touch with their roots in dentistry, their primary referral base, and the ones that thump their chest as superior to their single-degree counterparts need to take a few steps back and be more humble.


Absolutely,

I hope that OS will not forget its roots.
 
FTW OMFS;9189387]. Of course it inflates our ego -
QUOTE]

Thank you for admitting your ego, I wish many more will do the same.

I don't think any reasonable person would deny there's some aspect of having an MD that boosts the ego, I think most people are just arguing that's not the primary impetus behind their choosing to do an OMFS/MD program.
 
FTW OMFS;9189387]. Of course it inflates our ego -
QUOTE]

Thank you for admitting your ego, I wish many more will do the same.

I'm waiting for someone to admit their jealousy, envy, insecurity, frustration with the public perception an MD indicates superiority, and/or feelings of inferiority...
 
If a carpenter wants to read a book on history, on his own time, no one would say "why? are you crazy?" He is simply interested and willing to spend the time. Now, the relevance of that info, as it relates to his job specifically, could be challenged; but that has no bearing on his mere interest to want to read. His vocabulary will definitely improve, he may come across an ancient technique about art and sculpture that he could potentially apply in his line of work, but that's not the first thing that comes into mind when we talk about history, is it. Point is, wanting to know and getting a degree for it has nothing to do with applying the knowledge.
 
Absolutely,

I hope that OS will not forget its roots.


...and I hope that you will stop posting on the OMS resident pages.

MY GOD...I have never heard someone so overtly bitter in my life. You obviously have no ground to stand on to back your opinion regarding:
- oral surgery residencies (as you have not been accepted into one),
- the potential advantages of having an MD as an oral surgeon (because you will neither be an OMS nor an MD),
- or the nature of why someone else makes a decision (because you can't possibly know how someone else feels or thinks...only what they tell you or your much-too-often-expressed opinion about it stated as fact)

I will tell you as a current dual degree resident that there are several reasons I have a desire to obtain this extra degree. First off, let me say I am a dentist, am proud to be a dentist, and am happy to be perusing a career in a dental specialty. It just happens that my dental career requires some additional training in medicine. So, rather than get an abbreviated version during a 4yr residency, why not get the entire volume of medical knowledge gained by obtaining an MD in a 6yr residency. Much like the hygienists currently doing operative and basic extractions, doesn't it seem logical that a dentist (having additional training) would be a better choice? Particularly if the work was to be done on your family member?

Secondly, some of us are fueled by a thirst for knowledge. Med school has given me the understanding of the "why" rather than just learning the "what" necessary to treat a particular patient. You mention that "...a DDS OMS is just as qualified to do bread and butter OS..." and I think every here agrees with that. The point is not "can you function in a private practice office with a 4yr OMS cert", the point is how do you manage the other stuff? The harder, more complicated, and possibly emergent stuff? Some of us perusing the MD feel we are better equipped for the non-bread-and-butter oral surgery procedures and complications. It's a personal preference which, in some places, is being echoed by the hospitals we are seeking to operate out of. I know many practicing oral surgeons with both 4yr and 6yr degrees and I don't know ANY that go home at night thinking "Well, I didn't need to know 'X' today...what a waste of knowledge." I have heard from 4yr guys how glad they were they didn't do the extra schooling because they finished quicker and don't practice outside of their office anyway. However, I have heard from some of the MD's how glad they were they went to med school, who are all doing surgeries on a weekly if not daily basis.

Additionally, who knows where the field is headed in the future but I certainly won't be able (realistically) to return to obtain the MD if it turns out I need it later. So the prospect of getting it now seems the obvious choice. Why take a chance on reducing the surgical variety available to me due to the potential inability to get credentialed without an MD?

Sure, the OB/GYN rotation isn't directly used ;) but neither is endo, operative, fixed, etc. and I went through all that too...even after I matched OMS when the possibility of being a general dentist had been removed. That's just life and sometimes we have to do things "just because" they are part of the journey towards a goal.

Just that you felt it necessary to mention you "almost became cool...except for personal reasons" tells me a great deal about you're insecurities regarding NOT getting into an OMS residency. It is quite clear you are atop the list of dental school OMS wannabe's that now blast it and talk about how you "coulda" or "woulda" but didn't because you chose not to. I agree, it was probably by choice...only not yours. I guess that's why your now repping the Ortho 2012 banner.

I'll start looking for your anti-ortho posts next Jan after their match.
 
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With all this OMFS MD/non-MD talk, has anyone wondered how dentistry alone hasnt gotten to the point where it requires medical school training (i.e. dentistry as a medical subspecialty)? I mean, dentists prescribe meds, perform invasive procedures (sometimes requiring management of very sick patients) that arent simply localized to the mouth, administer anesthesia, etc. For example, you could argue that a dermatologist only needs a focused/abbreviated medical school education in order to practice within their scope, much like a dentist's training (hence, why do they need an MD)....

Dont get me wrong, Im not knocking dentists or physicians (specifically dermatologists, in this example)....I have a dental and medical degree, and value them both equally. Im just trying to figure out the reasoning behind it....
 
With all this OMFS MD/non-MD talk, has anyone wondered how dentistry alone hasnt gotten to the point where it requires medical school training (i.e. dentistry as a medical subspecialty)?

Dentistry will never become a medical specialty, atleast not in the U.S.

There are many reasons why it would be a bad idea, I will only go into the most simple one.

There is already going to be a shortage of dentists and physicans in the future.

Making dentistry a specialty of medicine would drastically reduce the number of dentists graduating each year even further (not to mention make it next to impossible to become a dentist). Talk about access to care?

Anyway, dentists are fully capable the way they are trained now and it would be pointless to change it.
 
There is already going to be a shortage of dentists and physicans in the future.

Making dentistry a specialty of medicine would drastically reduce the number of dentists graduating each year even further (not to mention make it next to impossible to become a dentist). Talk about access to care?

I recall having heard discussions about "separating" some medical specialities from medicine in order to shorten the path to obtain qualifications in those specialities. Opthamology comes to mind. An old teacher of mine (an orthopedic surgeon) used to say that orthopedic surgeons shouldn't really need an MD. They should be trained like dentists are trained, ie four to six years of "orthopedic surgery school". I was never really sure if he was joking but I guess at some level this was really his opinion.

The long road from high school to finished speciality training, escpecially in Europe, I think will at some point call for a change in training pathways. To make them shorter. I think they've started working a little bit with this in the UK. Not sure how though.
 
....



Secondly, some of us are fueled by a thirst for knowledge. Med school has given me the understanding of the "why" rather than just learning the "what" necessary to treat a particular patient. You mention that "...a DDS OMS is just as qualified to do bread and butter OS..." and I think every here agrees with that. The point is not "can you function in a private practice office with a 4yr OMS cert", the point is how do you manage the other stuff? The harder, more complicated, and possibly emergent stuff? Some of us perusing the MD feel we are better equipped for the non-bread-and-butter oral surgery procedures and complications. It's a personal preference which, in some places, is being echoed by the hospitals we are seeking to operate out of. I know many practicing oral surgeons with both 4yr and 6yr degrees and I don't know ANY that go home at night thinking "Well, I didn't need to know 'X' today...what a waste of knowledge." I have heard from 4yr guys how glad they were they didn't do the extra schooling because they finished quicker and don't practice outside of their office anyway. However, I have heard from some of the MD's how glad they were they went to med school, who are all doing surgeries on a weekly if not daily basis.

This is the worst defense of getting an MD. I am extremely confidant in emergent situations. How many trachs and emergent airway procedures have you done in med school. If they let you rotate in Critical Care, how many decisions were you making on sick patients at 2 am. My guess is none. Meanwhile, we get great exposure to all of this throughout residency. When the **** hits the fan, who do you want, someone from a 6 year "ivy league" program who held sticks for their entire residency, or a 4 year guy very well trained.

There are great reasons for the 6 year MD as mentioned above, but this isnt one of them. I am sure you are at a program that gives you great exposure while on service and provides learning opportunities in complex situations, but there are many six year programs (and 4 year programs) that do not. You dont need an MD to treat complex patients and complex surgical problems.
 
"ivy league" program who held sticks for their entire residency, or a 4 year guy very well trained.

Hey, I was just wondering: I see the phrase "held sticks" alot and I never understood what it actually means. I am assuming it means assisting only. But I did not want to start a new thread just for that. Could someone clarify that for me?

Thanks :)
 
Hey, I was just wondering: I see the phrase "held sticks" alot and I never understood what it actually means. I am assuming it means assisting only. But I did not want to start a new thread just for that. Could someone clarify that for me?

Thanks :)
"sticks" = retractors. The expression "holding sticks" is a disparaging way of suggesting that a given program's surgical training is of poor quality, because your OR time will be spent retracting tissue and watching while your attending does all the meaningful work.
 
I think getting the MD has more pros than cons, so it’s only logical to invest 1 or 2 more years. Sure you’ll get set back when it comes to finances and you’ll think it’s a waste of time more often than not, but you’ll come out a more rounded person.

With a 4 yr program you’ll have to learn the medicine on your own, piece meal, and may not fully understand the molecular events leading to clinical manifestations, which may leave you feeling a little dissatisfied. In a 6 yr you’ll have a better grasp of the fundamentals and have a chance to develop your analytical and critical thinking skills by actively applying them in academic and clinical scenarios. You’ll also have extra time to read about OS at your leisure without the fatigue from call or 12 hr days. This will help when you come back on service.

When it comes to surgical training, the 4 yr person will tend to get more training simply because they spend more time on service, don’t have to worry about medical exams, and their curriculum is not interrupted. The 6 yr person usually spends about a half year less in clinical training, which technically makes them less well trained but that’s debatable because most programs regardless of length have you doing the major surgeries during your last 2 years. So with a level playing field, you’ll learn as much as you put in, being limited only by the strength of your program.

Getting an MD not only increases your understanding of medicine but allows you to develop better doctor-patient relationship skills (behavioral science), most importantly making the patient feel more comfortable, understood, and respected. This goes a long way in developing a strong referral base, as patients will report back to their dentist if their experience was less than stellar in any way. If a patient feels good about you they’re more likely to accept your treatment plan and not sue you if their lip feels a little funny.

Emergent situations don’t arise very often in private practice if the patient is young and healthy and you’re doing routine dentoalveolar procedures (3rds, implants, grafts) under IV. With a medical background however, you’re more likely to screen out cases that may have potential complications or more confidently manage them since you’ll better understand why you’re taking certain actions.
 
There are few places like Kaiser Permanente Southern California that will require that you have both an M.D. and Dental degree as an OMFS to work for them. I know a recent grad that was turned away because he was single degree OMFS. An M.D. isn't a bad thing to have.
 
"sticks" = retractors. The expression "holding sticks" is a disparaging way of suggesting that a given program's surgical training is of poor quality, because your OR time will be spent retracting tissue and watching while your attending does all the meaningful work.

Thanks
 
The question posted by the initiating member was never really addressed objectively. His question was:
"Why do some OMFS residents go through two years of medical school during a six-year residency to end up with an MD degree?"

Some have answered that it allows dual-degreed OMS to manage in-patients, manage arrhythmias in an office setting, etc... I think both of these and other subjective reasons have been adequately discredited. Most practitioners in private practice, whether it be a 'faculty practice' in the hospital or a private practice outside the hospital, have no interest in managing patients, healthy or medically-complex. Most hospitals have designed a system where Surgical Subspecialties (PRS, ENT, Neurosurgery, etc...) have their patients admitted to a hospitalist service (eg. Medicine, Pediatrics) or to the General Surgery Service. Managing these patients on your own is simply inefficient and a waste of your time.
On the topic of managing in office emergencies (arrhythmias), it is part of CORE OMS training. Our exposure to Anesthesia and Medicine, as well as performing over a thousand IV Sedations/General Anesthesia is what qualifies and gives us the privilege of providing anesthesia/sedation services to our patients. We are all required to know to manage relevant emergencies as part of the ACLS guidelines. Each state OMS Society as well as AAOMS has a list of emergency medications that every practitioner is required to have in their offices in the event of a medical emergency. No one will blame you for not carrying Dronedarone or Propafenone for treating a dysrhythmia.
While on the topic of arrhythmias, I can vouch that the vast majority of OMS, can read and interpret an EKG, better and more accurately than most Orthopedic Surgeons, Plastic Surgeons, ENTs, etc... Once these surgical subspecialty surgeons are out of medical school for a few years, they are simply not exposed to EKGs, meanwhile all OMSs that provide Sedation services see and hear the monitors multiple times a day in their practices and make it their duty to know, and are able to interpret, many dysrhythmias. It doesn't make OMS more 'doctorly' than other Surgical Subspecialties.

Now for the objective answer. The dual-degree path opens doors to fellowships that have evolved in the last twenty years (eg. Craniofacial and Head/Neck Cancer). However, keep in mind, that OMSs represents less than 10% of those sub-specialties. We need to push OMS further into these sub-specialties and the dual-degree path allows us to do so.
It is true that more and more dual-degreed programs (46/101), especially those Medical School Based OMS Programs (10/101), are giving preference for dual-degree full time attending staff. However, many of these programs still have single degree Chairmen and do not have preferences (eg. NYU, UNC, etc...) of single vs dual degree for their attending staff.
Lastly, is a personal choice. I've had residents that have told me they've always wanted to go to medical school albeit their plans to go straight into private practice focusing on dentoalveolar procedures with a healthy variety of Facial Trauma, Orthognathics, TMJ, etc... Others, with large dental school loans, regret accruing more medical school loans (his loans totaled to over half a million). So, it is a choice everyone needs to make for themselves.

However, the worst thing we can do is create a dichotomy and superiority of dual vs single-degree OMSs. In many parts of Europe, Maxillofacial Surgery is a Medical Subspecialty. Even within the last decade, there were talks of the AMA absorbing the specialty. That would probably be the worst thing to happen to OMS (unless you have no intention of performing dentoalveolar procedures, orthognathics, TMJ, dental implants, reconstructive surgery for dental rehabilitation purposes, etc... Most states won't allow you to administer some sedation medications, especially if you're both the operator and anesthetist, so our scope of anesthesia would be altered as well under Medicine.) At the end of the day referrals for most OMS procedures are fed by Dentists and Dental Specialties. Even if it hypothetically does become a Medical Specialty, Dentistry will just recreate a similar specialty and rebrand it rather than refer to someone with solely a medical background.
 
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I have a question. I thought the residency program was 3 years after getting a D.M.D or D.D.S. So does that mean to get the M.D. it’s 2 more tears or 3 more years because that person said 6 year residency with 2 for the M.D. I understood it to be a 4 dental plus 3 OMFS residency.


Quick and dirty version: As a dental specialty, a dental degree is required while a medical degree is optional. About 40% of the programs in the USA offer (or require) a medical degree as part of the residency. Completely optional and depends on your goals.
 
I have a question. I thought the residency program was 3 years after getting a D.M.D or D.D.S. So does that mean to get the M.D. it’s 2 more tears or 3 more years because that person said 6 year residency with 2 for the M.D. I understood it to be a 4 dental plus 3 OMFS residency.

Your understanding is very flawed. Like, completely messed up.
 
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I have a question. I thought the residency program was 3 years after getting a D.M.D or D.D.S. So does that mean to get the M.D. it’s 2 more tears or 3 more years because that person said 6 year residency with 2 for the M.D. I understood it to be a 4 dental plus 3 OMFS residency.
OMFS with MD is 4 years of OMFS and 2 year of med school, so 6 years
 
I have a question. I thought the residency program was 3 years after getting a D.M.D or D.D.S. So does that mean to get the M.D. it’s 2 more tears or 3 more years because that person said 6 year residency with 2 for the M.D. I understood it to be a 4 dental plus 3 OMFS residency.
OMFS without MD is always 4 years.
 
Personally, I think OMFS absolutely need MD degrees. Think about it. 3rd molars are next to a nerve and blood vessels. They are using very sharp instruments in a small space. A lot can go wrong when taking our impacted molars. They need to be ready with emergency equipment and drugs only real doctors can provide.

You can bet when I got my wisdom teeth out, it was by an MD. Sorry guys, but I'm not gonna put my life in the hands of a dentist. I refer my ortho extractions out to oral surgeons with MD's. Bicupids aren't are dangerous as 3rd molars, but you can never be too careful.

It's just too bad orthodontics doesn't offer a joint MD program as well.

My extraordinarily ignorant friend-- there is only one Cupid, and he resides with me.
 
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