If you are applying to OMFS read this thread

[PatsMan1]

Hello everyone!

I think one of the biggest mistakes prospective OMFS applicants make when applying / making their rank list is not focusing on the surgical scope and volume a given program.

Surgical scope and volume is arguably one of the most important if not the most important aspects to look into when evaluating an OMFS program. Unless you are doing fellowship (most do not), you will be getting paid based on what YOU CAN DO. If you don’t do much in residency, you will be behind!

It’s so difficult to do because programs don’t post their statistics online, the statistics programs use at interviews are greatly inflated due to OMS case logging technicalities, and prospective applicants don’t know how to inquire about this.

In terms of scope, I believe dentoalveolar (sedations, wisdom teeth extractions, implants, bone grafting, etc.) is by far the most important. A vast majority of surgeons are in private practice doing dentoalveolar.

You would be so surprised when I tell you many OMFS programs are WEAK at dentoalveolar. There are numerous programs where you place 50 dental implants throughout your entire residency. That is very low! There are numerous programs where sedation numbers aren’t very high, where you are restricted in the way you can sedate due to faculty, and so on.

Most programs are very heavy on trauma and pathology (benign / malignant), and light on other parts (cosmetics, craniofacial, TMJ, orthognathics, etc.). I know of some programs where 80% of their operative experience is trauma. 80% is insane and extremely one dimensional!!!!

My advice to you (doesn’t apply if you are set on doing a fellowship which is likely a very small minority):
1) Find a program strong in dentoalveolar (sedations and implants). This is the base of your OMFS education.
2) It would be great to find a program that has high OR volume and that has diverse types of cases but dentoalveolar is most important.
3) At your interviews ASK residents how many sedations they have done, how many implants they have done, how many orthognathics cases they have done, etc. Best way to find out is to directly ask!


Thank you for reading

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[amali]

All good advice. A lot of programs are gearing towards head and neck cancer/craniofacial. Attendings at these programs may be very weak with dent-alveolar and honestly may have no experience with implants.
Their consensus will be that if you are able to understand free flap principles, it will help with doing implants...it does not.

 

[carabelliscusp]

All good advice. A lot of programs are gearing towards head and neck cancer/craniofacial. Attendings at these programs may be very weak with dent-alveolar and honestly may have no experience with implants.
Their consensus will be that if you are able to understand free flap principles, it will help with doing implants...it does not.

I don't understand why it seems like programs in general are leaning towards cancer cases especially

 

[HockeyDocOMFS]

While I agree with some of this, I think there’s a lot more to consider when making your rank list. My honest opinion is to go to a program where you and your significant other will be happiest. I know plenty of people who are at dentoalveolar heavy programs and are completely miserable because their significant other is unhappy or their family is across the country… 4-6 years is a long time.

Maybe the resident who trains at the dentoalveolar program will be a little faster than you during the first 6-12mo out, but it all eventually evens out.

At the end of the day, all will have long careers and be very successful, regardless of where you train.

 

[PatsMan1]

While I agree with some of this, I think there’s a lot more to consider when making your rank list. My honest opinion is to go to a program where you and your significant other will be happiest. I know plenty of people who are at dentoalveolar heavy programs and are completely miserable because their significant other is unhappy or their family is across the country… 4-6 years is a long time.

Maybe the resident who trains at the dentoalveolar program will be a little faster than you during the first 6-12mo out, but it all eventually evens out.

At the end of the day, all will have long careers and be very successful, regardless of where you train.

Yes for sure there are multiple things to consider such as location, resident autonomy, etc.

I wanted to highlight One factor many do not really think about so much when they apply / make rank list And make the argument they should consider this more


But think about this if you went to a program who never did zygomatic / pterygoid implants, only way to learn will be:
1) spend tens of thousands of dollars on CE (I am seeing costs upward if 30-40,000$ for hands on experience)
2) be lucky with a mentor that can teach you (not likely)
3) join clear choice or a Omfs DSO that will pay for your education (not for everyone)

I know a resident who recently graduated a program weak in dentoalveolar he specifically is working for clear choice to gain full arch experience as he did not get any in residency. Imagine how things would be different if this resident went to a program that was strong with implants and full arch cases?

You can extrapolate this to many other things (regular full arch, soft tissue procedures for implants, etc.)

Another story I spoke to an Omfs practice owner this person hired a resident out of a weak dentoalveolar program as an associate. The new hiree told the owner he does not know how to take out wisdom teeth because the resident went to a program very weak in dentoalveolar. The owner had to spend 2 months intensely teaching the new associate how to extract wisdom teeth. Not every practice owner is going to dedicate their time doing this (I consider the associate to be lucky to be in a good situation). You can only imagine how this can go in many other practices!!!

 

[Big Time Hoosier]

Aren’t programs heavy in dentoalveolar surgery traditionally called periodontics residencies?

Big Hoss

 

[PatsMan1]

Aren’t programs heavy in dentoalveolar surgery traditionally called periodontics residencies?

View attachment 376401

Big Hoss

Expert comment from the verified expert

 

[piratewow]

Yes for sure there are multiple things to consider such as location, resident autonomy, etc.

I wanted to highlight One factor many do not really think about so much when they apply / make rank list And make the argument they should consider this more


But think about this if you went to a program who never did zygomatic / pterygoid implants, only way to learn will be:
1) spend tens of thousands of dollars on CE (I am seeing costs upward if 30-40,000$ for hands on experience)
2) be lucky with a mentor that can teach you (not likely)
3) join clear choice or a Omfs DSO that will pay for your education (not for everyone)

I know a resident who recently graduated a program weak in dentoalveolar he specifically is working for clear choice to gain full arch experience as he did not get any in residency. Imagine how things would be different if this resident went to a program that was strong with implants and full arch cases?

You can extrapolate this to many other things (regular full arch, soft tissue procedures for implants, etc.)

Another story I spoke to an Omfs practice owner this person hired a resident out of a weak dentoalveolar program as an associate. The new hiree told the owner he does not know how to take out wisdom teeth because the resident went to a program very weak in dentoalveolar. The owner had to spend 2 months intensely teaching the new associate how to extract wisdom teeth. Not every practice owner is going to dedicate their time doing this (I consider the associate to be lucky to be in a good situation). You can only imagine how this can go in many other practices!!!

Conversely, if you don’t get orthognathic, path, trauma exposure you can’t take CE at all really. You just don’t do it at all or do a fellowship. You can learn dentoalveolar out in private practice. Another thing to consider is some programs are weak dentoalveolar and weak across the board, so just because a program “focuses” on dentoalveolar does not mean it’s good at it.

 

[nade0016]

I will try to be unbiased in my opinion on this thread. Sure, surgical scope is a part of any decision to apply to a residency. But lets not forget that you don't get to pick you program. The applicant gets to rank programs they want to match too, but not everyone get their third, let alone first, choice. As a PD and Chairman my job is to try and get residents as much procedure experience as possible. But everything comes with a trade off. If a chief resident is in the OR doing trauam, orthogs, path, etc. They are not in clinic doing DA and implants. CODA requires all programs to obtain a certain number of major cases while DA and implant numbers are not CODA requirements. Therefore, to keep my program open I need PGY3/4 residents doing major cases, not matter they are. So the trade off is major cases versus DA/Implants. My experience has been that most residents want to be in the OR doing major cases not "shucking wizzies". Even when the resident has already signed a contract in PP to do just that.

Additionally, for those who think that if you do not get exposure to something you cannot learn the surgery after residency or translate yours surgical skills into different procedures. I 100% disagree. I performed very few orthognathics in residency, only placed 10 implants and never performed one cleft graft. Yet those procedures are my main practice now. So how did I learn to perform these procedures? I took CE courses and read books just like everyone else does.

Does surgical scope matter in "ranking" programs? Sure. Should it be the only thing focused on? Nope.

Make sure you like the residents, they seem interested in you as a person and that the program supports its residents.

And lastly, you get out of residency what you put in. This is not hyperbole, the best residents are the ones who learn independently, explore different learning modalities and put in the time. Residency is not dental school. You will not be spoon fed information on powerpoint slides to memorize for a single test.

 

[Life of Pablo]

As a PD and Chairman my job is to try and get residents as much procedure experience as possible. But everything comes with a trade off. If a chief resident is in the OR doing trauam, orthogs, path, etc. They are not in clinic doing DA and implants. CODA requires all programs to obtain a certain number of major cases while DA and implant numbers are not CODA requirements. Therefore, to keep my program open I need PGY3/4 residents doing major cases, not matter they are. So the trade off is major cases versus DA/Implants. My experience has been that most residents want to be in the OR doing major cases not "shucking wizzies". Even when the resident has already signed a contract in PP to do just that.

I'm sure at your program, your residents do a ton of DA so I can see why they'd want to be in the OR; however, there are some programs out there that don't get much DA experience at all. I think this post is more geared towards avoiding those programs (if possible) for people wanting to go into private practice.

OMS is a pretty broad field. I have some buddies that take out more thyroids than wisdom teeth it feels like. Definitely understand the type of program you are ranking when you make your list. You can't 100% choose where you go, but you have some say at least.

 

[amali]

I'm sure at your program, your residents do a ton of DA so I can see why they'd want to be in the OR; however, there are some programs out there that don't get much DA experience at all. I think this post is more geared towards avoiding those programs (if possible) for people wanting to go into private practice.

OMS is a pretty broad field. I have some buddies that take out more thyroids than wisdom teeth it feels like. Definitely understand the type of program you are ranking when you make your list. You can't 100% choose where you go, but you have some say at least.

I think one of the issues is that you may not fully know a program until you are enrolled there. You have the interview and a few discussions with residents...but everyone tries to boast their program during this time.

Another issue is programs change their scope all the time. That program you matched into may get a new chairman that is head and neck trained. Guess what...you get to assist on more fibula flaps than place dental implants.

Agree with the above about residency is what you make of it. However, graduating residents may find themselves in a tougher position when interviewing against other residents that were doing zygoma/pterygoid implants, all on fours, and various other dentoalveolar procedures. Sure...you can learn all that stuff after residency. But it might be a little difficult when you get that first fee for service patient expecting a perfectly placed all on four and its your first one.

 

[dratc]

And lastly, you get out of residency what you put in. This is not hyperbole, the best residents are the ones who learn independently, explore different learning modalities and put in the time. Residency is not dental school. You will not be spoon fed information on powerpoint slides to memorize for a single test.

I agree with everything @nade0016 wrote, but just wanted to highlight this last paragraph. The scope at my program has change in a large way twice during my time. I came in to a lot of zygomas, full arch, etc, but that attending decided to go to private practice (this was NOT expected by anyone). Then a new attending was doing lots of cool grafting for severely resorbed arches and getting fancy with different complicated implant treatment plans, and then they left to private practice. Now we do very little implants which is sort of a shock to everyone in the program. But I still have a responsibility for my own learning. No matter where you end up, it could be a drastically different program than was sold you. So have a can do attitude and do your best to make up on your own for any deficiencies.

 

[deleted1047421]

I agree with everything @nade0016 wrote, but just wanted to highlight this last paragraph. The scope at my program has change in a large way twice during my time. I came in to a lot of zygomas, full arch, etc, but that attending decided to go to private practice (this was NOT expected by anyone). Then a new attending was doing lots of cool grafting for severely resorbed arches and getting fancy with different complicated implant treatment plans, and then they left to private practice. Now we do very little implants which is sort of a shock to everyone in the program. But I still have a responsibility for my own learning. No matter where you end up, it could be a drastically different program than was sold you. So have a can do attitude and do your best to make up on your own for any deficiencies.

Bingo.

Many don’t realize that a programs case volume and experience for residents can hinge literally on one attending. As a resident you better pray nothing happens to that star attending and their case load until you’re done with your chief year.

 

[PatsMan1]

I think one of the issues is that you may not fully know a program until you are enrolled there. You have the interview and a few discussions with residents...but everyone tries to boast their program during this time.

Another issue is programs change their scope all the time. That program you matched into may get a new chairman that is head and neck trained. Guess what...you get to assist on more fibula flaps than place dental implants.

Agree with the above about residency is what you make of it. However, graduating residents may find themselves in a tougher position when interviewing against other residents that were doing zygoma/pterygoid implants, all on fours, and various other dentoalveolar procedures. Sure...you can learn all that stuff after residency. But it might be a little difficult when you get that first fee for service patient expecting a perfectly placed all on four and its your first one.

You and life of Pablo are spot on

Let’s not forget a vast majority of those that graduate will do private practice (dentoalveolar) and minimal to no OR! Wouldn’t it be nice to go to a program that prepares you for this?

 

[Big Time Hoosier]

Let’s not forget a vast majority of those that graduate will do private practice (dentoalveolar) and minimal to no OR! Wouldn’t it be nice to go to a program that prepares you for this?

Please see my comment above.

Big Hoss

 

[rotichawal]

I’m curious to know what people consider high enough dentoalveolar volume, I don’t remember anyone even mentioning it on the interview trail. The classic adage has been that you can come out of any program competent in teeth and titanium. Maybe it’s not true anymore.

Regardless, if you don’t want to do maxillofacial surgery, don’t do OMFS. Not worth the time and effort if you don’t want to use the training that takes up most of your on-service time.

 

[AONLINE]

Another story I spoke to an Omfs practice owner this person hired a resident out of a weak dentoalveolar program as an associate. The new hiree told the owner he does not know how to take out wisdom teeth because the resident went to a program very weak in dentoalveolar. The owner had to spend 2 months intensely teaching the new associate how to extract wisdom teeth.

Is this for real? There is such a thing as an oral surgeon who graduated from an accredited OMS program in the US who does not know how to take out wisdom teeth? I just can't wrap my head around it.

 

[bergus95]

I’m curious to know what people consider high enough dentoalveolar volume, I don’t remember anyone even mentioning it on the interview trail. The classic adage has been that you can come out of any program competent in teeth and titanium. Maybe it’s not true anymore.

Regardless, if you don’t want to do maxillofacial surgery, don’t do OMFS. Not worth the time and effort if you don’t want to use the training that takes up most of your on-service time.

Dentoalveolar is different than sedations. But I’m thinking op is referring to wizzies under sedation.

 

[deleted1047421]

Is this for real? There is such a thing as an oral surgeon who graduated from an accredited OMS program in the US who does not need to know how to take out wisdom teeth? I just can't wrap my head around it.

Lol
Don’t believe everything you read on the internet.
There doesn’t exist a single program in the US where omfs graduates don’t know how to extract thirds under sedation following completion of their program.

 

[PatsMan1]

I’m curious to know what people consider high enough dentoalveolar volume, I don’t remember anyone even mentioning it on the interview trail. The classic adage has been that you can come out of any program competent in teeth and titanium. Maybe it’s not true anymore.

Regardless, if you don’t want to do maxillofacial surgery, don’t do OMFS. Not worth the time and effort if you don’t want to use the training that takes up most of your on-service time.

you do realize a vast majority of OMFS restrict their practice to essentially teeth and titanium right?

Very few OMFS are full time hospital based
Very few OMFS are part time hospital based (when I say part time I mean you go to hospital minimum once a week)

 

[PatsMan1]

Lol
Don’t believe everything you read on the internet.
There doesn’t exist a single program in the US where omfs graduates don’t know how to extract thirds under sedation following completion of their program.

Nope this is real the practice owner who hired that associate told me that story

 

[PatsMan1]

Please see my comment above.

Big Hoss

So you’re saying like 75% of practicing OMFS should have gone to a perio residency?

 

[yappy]

Regardless, if you don’t want to do maxillofacial surgery, don’t do OMFS. Not worth the time and effort if you don’t want to use the training that takes up most of your on-service time.

This is all of my referrals. I am interested to see the case volume of maxillofacial VS dental alveolar for private practice.

 

[deleted1047421]

Nope this is real the practice owner who hired that associate told me that story

What program did this individual graduate from and approximately when.

Again I don’t believe a word of this.

 

[HockeyDocOMFS]

You and life of Pablo are spot on

Let’s not forget a vast majority of those that graduate will do private practice (dentoalveolar) and minimal to no OR! Wouldn’t it be nice to go to a program that prepares you for this?

Do you also think that going to a 6-year program is a waste of 2 years if you're going into private practice then? 😝

I haven't heard of a single OMFS leaving a program and struggling in dentoalveolar private practice, but that's a small sample size. Maybe some residents are a little slower at first than others but it's fairly irrelevant. Overall I agree to find out what the scope of the program is, but I also think there should be a lot of other stuff taken into consideration when making your rank list. Attendings are always coming and going, and hospital/dental school policies are always changing.

 

[Life of Pablo]

 

[Big Time Hoosier]

So you’re saying like 75% of practicing OMFS should have gone to a perio residency?

I guess so since I said it, and I can’t take it back.

Big Hoss

 

[dentmass]

I posted this in the other thread but there is no better dentoalveolar training in residency than moonlighting and seeing 20-30 patients in a day and doing wizzies, implants, full mouths and supplementing your income with 50-100k extra income a year. No training within a program can top this. Louisville and UAB officially let you moonlight. They let you do it for 5 years of residency after intern year.

You don’t really know how to do wizzies until you’re running a full schedule of 30 patients under local and you are breaking root tips. It will make private practice with sedation a completely different story.

 

[PatsMan1]

Do you also think that going to a 6-year program is a waste of 2 years if you're going into private practice then? 😝

I haven't heard of a single OMFS leaving a program and struggling in dentoalveolar private practice, but that's a small sample size. Maybe some residents are a little slower at first than others but it's fairly irrelevant. Overall I agree to find out what the scope of the program is, but I also think there should be a lot of other stuff taken into consideration when making your rank list. Attendings are always coming and going, and hospital/dental school policies are always changing.

Yes 6yr is a waste if your doing private but many people enter OMFS residency not knowing what they want to do doing 6yr keeps options open for fellowship generally (but one could contest this as well)

 

[PatsMan1]

I posted this in the other thread but there is no better dentoalveolar training in residency than moonlighting and seeing 20-30 patients in a day and doing wizzies, implants, full mouths and supplementing your income with 50-100k extra income a year. No training within a program can top this. Louisville and UAB officially let you moonlight. They let you do it for 5 years of residency after intern year.

You don’t really know how to do wizzies until you’re running a full schedule of 30 patients under local and you are breaking root tips. It will make private practice with sedation a completely different story.

100% agree but most programs don’t allow moonlighting

 

[PatsMan1]

View attachment 376504

I guess so since I said it, and I can’t take it back.

Big Hoss

Expert insight from our verified expert!

 

[Ancient_amalgamator]

Yes 6yr is a waste if your doing private but many people enter OMFS residency not knowing what they want to do doing 6yr keeps options open for fellowship generally (but one could contest this as well)

6 years in addition to 1-2 years fellowship is also a waste if you are not sure why you are in a field in the first place!
It has been common to see fellow residents/applicants fall in the current hype of the specialty rather than having an actual purpose! No wonder why there is a downtrend in leaders in our specialty.

 

[PatsMan1]

6 years in addition to 1-2 years fellowship is also a waste if you are not sure why you are in a field in the first place!
It has been common to see fellow residents/applicants fall in the current hype of the specialty rather than having an actual purpose! No wonder why there is a downtrend in leaders in our specialty.

You think it is reasonable for a 4th year dental student to know if they want to pursue a fellowship and have a specific fellowship they want to do in mind? I personally wouldn’t expect that. How much exposure to OMFS does a 4th year dental student really have?

I personally agree in that most surgeons restricting practice to teeth and titanium isn’t best for the field as a whole but it is what it is unfortunately

 

[AONLINE]

So you’re saying like 75% of practicing OMFS should have gone to a perio residency?

On the other hand I have a classmate who matched to a perio residency but decided to deny the acceptance in order to re-apply to OMFS. I haven't seen the reverse.

 

[Ancient_amalgamator]

You think it is reasonable for a 4th year dental student to know if they want to pursue a fellowship and have a specific fellowship they want to do in mind? I personally wouldn’t expect that. How much exposure to OMFS does a 4th year dental student really have?

I personally agree in that most surgeons restricting practice to teeth and titanium isn’t best for the field as a whole but it is what it is unfortunately

For a D4 to have a good idea about the specialty, a resident who is undergoing training at least knows why he is in it. Residents have more impact on dental students and faculty then guide them to the right path. Proper mentorship to dental students comes from both residents and attending. that's why attending sets the standards high, so we follow through. it is unfortunate that you are missing all of that, my friend!
It is a cascade effect, if you know, they will know, or everyone is just following the hype of social media out there.
pretty sad!

 

[PatsMan1]

For a D4 to have a good idea about the specialty, a resident who is undergoing training at least knows why he is in it. Residents have more impact on dental students and faculty then guide them to the right path. Proper mentorship to dental students comes from both residents and attending. that's why attending sets the standards high, so we follow through. it is unfortunate that you are missing all of that, my friend!
It is a cascade effect, if you know, they will know, or everyone is just following the hype of social media out there.
pretty sad!

Hard to get good idea when:
1) most programs do not practice full scope Omfs (many lack cosmetics, craniofacial for example) so many dental students aren’t even seeing what the entire field has to offer!
2) generally dental schools give students little time for externships and shadow in OMFS clinic

Not sure how you expect d4 students to know if / what fellowship they want to pursue prior to even starting Omfs residency that’s crazy

Even if you have a good mentor your not really exposed to much OMFS as a dental student so not sure how one would make such a decision lol

 

[Ancient_amalgamator]

Hard to get good idea when:
1) most programs do not practice full scope Omfs (many lack cosmetics, craniofacial for example) so many dental students aren’t even seeing what the entire field has to offer!
2) generally dental schools give students little time for externships and shadow in OMFS clinic

Not sure how you expect d4 students to know if / what fellowship they want to pursue prior to even starting Omfs residency that’s crazy

Even if you have a good mentor your not really exposed to much OMFS as a dental student so not sure how one would make such a decision lol

sure man! hopefully you will figure it out in the next three years. all the best

 

[dentmass]

yeah OMFS is extremely hard to get a feel for because the scope is wider than any other dental specialty. You’re limited by what you see at your school and if that doesn’t intrigue you enough you won’t go on externships to see other sides of the scope. Not all programs do the same thing whereas for the other specialties they all do mostly the same thing.

 

[Contach]

Everyone is full of **** though. Every surgeon (and surgeon in training) will inflate how much they are actually doing. So can you really trust what they say at an interview?

If I were to do it again, I'd aim for a program that offers "full-scope," but not what I consider "extended scope". Bear with me here:
Full-scope (or core) I think of as: dentoalveolar, orthognathics, pathology, TMJ, trauma, infections.

Extended scope is that extra jazz that very few of us will do: cosmetics, cancer ablation, reconstruction, craniofacial. Generally these require fellowships. Oftentimes programs are trying to dazzle up their program by saying they do these cleft cases, or cosmetics. But really what we need to learn is that full-scope stuff.
A program that does a lot of this extended scope is what I'd try and avoid. Because of course it is going to take time away from the full-scope stuff. You only have so many hours in a day. We are all busy.

I'd also try to avoid programs that overburden their residents with insurance scut work and non-clinical things that take time out of a resident's day.
Id also try and avoid malignant programs. Mental health is important.

 

[Contach]

While I agree with some of this, I think there’s a lot more to consider when making your rank list. My honest opinion is to go to a program where you and your significant other will be happiest. I know plenty of people who are at dentoalveolar heavy programs and are completely miserable because their significant other is unhappy or their family is across the country… 4-6 years is a long time.

Maybe the resident who trains at the dentoalveolar program will be a little faster than you during the first 6-12mo out, but it all eventually evens out.

At the end of the day, all will have long careers and be very successful, regardless of where you train.

Agree with this.

And to add: It is much easier to learn dentoalveolar on your own than learn infections, or orthognathics on your own. If you don't learn these full-scope things in residency, you've likely lost your shot, and that door will never be open to you.

After enough reps, every one of us becomes fast and good enough.

 

[Ivy.ch]

Ask the outgoing chiefs about the program during the interview… they’re usually chilling in the back enjoying the free food and drinks… they have no reason to fluff things for you…they’ll never have to work with you.

 

[deleted1047421]

Extended scope is that extra jazz that very few of us will do: cosmetics, cancer ablation, reconstruction, craniofacial. Generally these require fellowships. Oftentimes programs are trying to dazzle up their program by saying they do these cleft cases, or cosmetics. But really what we need to learn is that full-scope stuff.
A program that does a lot of this extended scope is what I'd try and avoid. Because of course it is going to take time away from the full-scope stuff. You only have so many hours in a day. We are all busy.

Agree fully.

It would a wise decision to focus on the core full scope of the specialty.

Expanded scope surgery (cancer/microvascular, cosmetics, craniofacial) cases are on the fellowship/attending level.

What this means is that the attendings and fellows are going to be very hands on in the operating room with these cases. Resident involvement in the actual critical portions of the surgery is often very limited.

This is a double hit on the residents. Not only do they not really get to cut these cases fully, the expanded scope portion took up such a large portion of the curriculum it takes away from other things like orthognathic and implants. Residents basically end up doing a lot of rounding and follow ups in the clinic.

 

[rotichawal]

Residents basically end up doing a lot of rounding and follow ups in the clinic.

During residency interviews, I remember hearing about mandatory q1-q2h flap checks when on call. I don't know why in 2023 residents are still made to do these when cook dopplers + 1:1/1:2 ICU nursing ratios exist.

 

[deleted1047421]

I'd also try to avoid programs that overburden their residents with insurance scut work and non-clinical things that take time out of a resident's day.

Lol don’t forget research projects.

I’m in a good mood today. I’ll give this one to you guys for free.

 

[PatsMan1]

Agree with this.

And to add: It is much easier to learn dentoalveolar on your own than learn infections, or orthognathics on your own. If you don't learn these full-scope things in residency, you've likely lost your shot, and that door will never be open to you.

After enough reps, every one of us becomes fast and good enough.

Yes but most practicing OMFS do not make their career on orthognathics / trauma / TMJ / pathology

 

[carabelliscusp]

Yes but most practicing OMFS do not make their career on orthognathics / trauma / TMJ / pathology

Curious how often private practice (or mostly PP) OMFS does benign path stuff. I could see this being a big part of PP along with dentoalveolar, but I say that as a student, so obviously no clue.

 

[rotichawal]

Yes but most practicing OMFS do not make their career on orthognathics / trauma / TMJ / pathology

The issue is that much like Europe, we are increasingly starting to face the oral surgery vs. OMFS divide in both training and practice. While I don’t expect to ever see a true specialty split, I wonder how sustainable the current training model is given that most residency training does not reflect future practice for the majority of graduates.

 

[White_Sponge_Nevus]

Shameless plug, I feel like a lot of people here could contribute to the thread below, which isn't entirely unrelated. Lots of good discussion going on.

6yr Program Off Service/Med School Time: What does your program do? What would you change?

Currently done with my program's med school requirements, in the thick of the off-service gen-surg, with anesthesia still to go. Done with Step 1,2,3. Overall, I am happy with the way my program handles the off service/med school time. We have PGY-1, 5, 6 as all 12 months OMFS. PGY-2 is M2...

forums.studentdoctor.net

 

[DDSER1]

The issue is that much like Europe, we are increasingly starting to face the oral surgery vs. OMFS divide in both training and practice. While I don’t expect to ever see a true specialty split, I wonder how sustainable the current training model is given that most residency training does not reflect future practice for the majority of graduates.

Difference is that in Europe maxillofacial surgery is the dominant head & neck specialty. In America ENT and PRS have strongholds on cancer and craniofacial, so you’ll always have to compete for cases against them unless youre rural

 

[rotichawal]

Difference is that in Europe maxillofacial surgery is the dominant head & neck specialty. In America ENT and PRS have strongholds on cancer and craniofacial, so you’ll always have to compete for cases against them unless youre rural

Craniofacial, yes. Government regulations on insurance reimbursements mean that these procedures still make a good chunk of change, and you can do craniofacial as a private practice surgeon still.

H&N I’m personally going to disagree. Even among ENT, a fairly small cadre of residents will pursue further cancer training. The length of these procedures and the morbidity of these patients turn off many prospective applicants. Furthermore, at least in your early career, you’re going to be married to academia—these are not easy cases to be doing while running an independent private practice. From my conversations with people in the field, you can more or less hang up a shingle and start seeing high volume cancer if that’s what you’re into.