Ask me questions about OMFS

[Contach]

Hey everyone,

 

I'm a 2nd year resident at an OMFS program in USA. It's a 6 year program (with MD). I'm hoping to try and answer any of your questions... because I'm sure there are people reading that are interested in more than the "what are my chances at X dental school?" threads.

[ArchEnemy]

Hey everyone,

 

I'm a resident at an OMFS program in USA. It's a 6 year program (with MD). I'm open to answer all of your questions... because I'm sure there are people reading that are interested in more than the "what are my chances at X school?"

 

This is slightly unrelated, but something I have always wondered - Can graduates of OMFS apply to NRMP if they have a change of heart?

[mrewmrew]

Wow that's awesome, it's great to have someone like you on frequent the board. Did you attend dent school in the US? What are your opinions regarding a Canadian choosing a pricier, more well known American dental school over a Canadian one for the sake of increasing his/her specialization chances.. as I'm sure you know Canada has extremely limited specialization spots. I understand that Canadian grads can also apply to US specialist positions - do you believe Canadian citizens who graduated from top US schools (UPenn, Columbia) have an advantage over graduates from UofT, UWO, etc. in this regard?

[koft]

I am going to ask... You got too much free time... you are still in training, get back to work!!!... lol

 

As for me, I am done, i can relax and enjoy!! Anyways, good luck. you have only 3 more years left right? or 4... i can't remember!! I think I should set up a thread on criteria to be board certified in Canada....

[Contach]

This is slightly unrelated, but something I have always wondered - Can graduates of OMFS apply to NRMP if they have a change of heart?

 

Hi, I am assuming your question is in regards to those in 6-year programs who earn their MD. Yes, GRADUATES of OMFS can apply to NRMP after they have completed both the MD, and their OMFS training requirements. I've heard of one person switch to Anesthesia, and a couple people switch to full, legit Plastic Surgery (to be distinguished from the 1 year facial plastics fellowships).. but only AFTER they've completed their full 6 years. Situations like this are pretty rare as OMFS have it very good compared to other medical specialties: lots of relatively short, highly specialized procedures, 85% work in private practice offices (predictable, and good hours), and there are few life-threatening emergencies.

 

But, if you are in the middle of the program (like year 2, or year 4, and you want to switch... no. In the acceptance letter I signed, it said that the medical school would not "support my application to a residency program different than the designated OMFS residency." The medical school basically won't let you, because the OMFS chair/director and medical school likely has an agreement like this in place - the OMFS program needs you once you leave medical school... or they'll have a very awkward open spot in the middle of their program. It would really f up all the other residents' schedules, and compromise patient care as well.

[Contach]

Wow that's awesome, it's great to have someone like you on frequent the board. Did you attend dent school in the US? What are your opinions regarding a Canadian choosing a pricier, more well known American dental school over a Canadian one for the sake of increasing his/her specialization chances.. as I'm sure you know Canada has extremely limited specialization spots. I understand that Canadian grads can also apply to US specialist positions - do you believe Canadian citizens who graduated from top US schools (UPenn, Columbia) have an advantage over graduates from UofT, UWO, etc. in this regard?

 

 

Yea, I attended University of Pennsylvania school of dental medicine.

 

Yes, a lot of these schools are more expensive, and thus you are assuming greater risk by going to these schools. Also, you still have to work very hard in the pre-clinics and on standardized tests. I do think certain American schools make it a lot easier to specialize, as compared to if you went to a Canadian dental school or some other American schools. I think there are a number of reasons for this:

(1) the students who go to these schools go in thinking they want to specialize (it's a self-selecting bunch);

(2) the school has systems in place that help you specialize - whether through information sessions, helping prepare your residency application package, the curriculum allowing for more time doing externships, having different specialty clinics close to the dental school - exposing the students to these fields, exposing students to residents who can give advice, a mentality among administration/faculty/students that specializing is a profitable/logical/enjoyable venture, providing grade inflation to appease disgruntled students who would otherwise get B's, weighing the opinions of specialists greater than general dentists and this attitude subconsciously having an effect on how students see dentistry, and

(3) the influence of those students who you are around... they end up pushing one another, and you can really feel left out if all your friends want to specialize and you are the odd one out who doesn't... It is hard to go against the grain.

 

Yes, I think graduates of Penn/Columbia/a few other American schools have real advantages over Canadian dental school grads in applying for American residency programs... Residency directors of American programs have a familiarity with students and faculty from such schools, and may see a student in the top 30% from a certain school and say "hey, I've accepted students X and Y a few years ago, and they did similarly to Applicant B.. Furthermore X and Y did well throughout their residencies, so we should expect similarly Applicant B." They may also be able to phone their friend, who is an attending at such a school and ask them to give a candid opinion on the applicant - this would go a long way. As for evaluating how a U of T/UWO student compares... there is a lot of uncertainty, likely due to nothing more than the residency director's ignorance... they just haven't had as much experience with grads from Canadian schools, so they will see such a student as a greater risk (he may not know as much, he may be used to things being done differently, there may be cultural differences in treatment planning, etc). I noticed that a lot of the residency programs would accept students from the same schools year after year... And this is how I makes sense of it all...

 

I remember meeting a couple Canadian-dental students on the OMFS interview trail... there were very few... There were many more Canadian-born American-educated dental students... I think this also goes back to my first paragraph.

[Contach]

I am going to ask... You got too much free time... you are still in training, get back to work!!!... lol

 

As for me, I am done, i can relax and enjoy!! Anyways, good luck. you have only 3 more years left right? or 4... i can't remember!! I think I should set up a thread on criteria to be board certified in Canada....

 

I find myself having prolonged periods of apathy towards Medicine, then I find myself wandering onto these forums. The American MD requires you to take many standardized tests and do a bunch of core clinical rotations - it is already getting tiring. Also, it can be hard to take the time to learn things that I'm not interested in

 

5 years left - I'm counting down!

 

Feel free to chime in whenever you'd like! The more the merrier!

[HilaryH]

Hey! Thanks so much for giving up your time to do this.

[Soprano]

Hey everyone,

 

I'm a 2nd year resident at an OMFS program in USA. It's a 6 year program (with MD). I'm hoping to try and answer any of your questions... because I'm sure there are people reading that are interested in more than the "what are my chances at X dental school?" threads.

 

Where are your OMFS and how did prepare your app for it (Did you practice first or did you directly go to the program?)

What are the selecting criteria for the program?

Cheers

[mrewmrew]

Thanks for all the info! Do you have any information regarding what % of your graduating class at UPenn specialized (any specialty, not just OMFS)? I heard that some schools release this data.

[Contach]

Hey! Thanks so much for giving up your time to do this. I've been thinking of applying south for dentistry in case I don't make it in Canada. May I know what kind of grades are required to get in? (% or GPA-wise) Also, do American dental schools only favour science degrees? The reason I am asking is since my degree is split between science and environmental subjects--just worried I may be at a disadvantage. Thank you

 

Hello! I think a 3.6-3.7 is a pretty good GPA when it comes to dental schools in the USA. USA undergrads tend to give lower grades to their students, and Canadian undergrads are very generous... that benefits us a lot when we apply to American schools with our AADSAS converted GPA. But before you go about applying to American schools: think about how you will pay for the education. There are some scholarships out there, but mostly merit-based scholarships or for URMs. Canadian government student loans won't give you very much, and even if you cap out on your Canadian private bank loans - you still may have troubles. Crunch the numbers as per your situation.

I don't think they discriminate between science and non-science majors. I had plenty of people in my dental school class who were arts majors. The american educational system recognizes the advantages of diversity, and values a diverse student body. This becomes readily apparent when you talk to someone at a good undergrad institution, and only half of their experience is in the classroom - the rest is extra-curriculars/experiential learning. I think this is how higher education should be. I had a Dental school classmate who was a Music Major in undergrad, and is now in OMFS.

 

Where are your OMFS and how did prepare your app for it (Did you practice first or did you directly go to the program?)

What are the selecting criteria for the program?

Cheers

 

I don't fully understand your question. I'm in NY. I went straight from dental school to OMFS. I would say that most (60-70%) of the students who matriculate into OMFS programs come straight from dental school. Probably another 20-30% have some kind of internship/GPR experience, and then that leaves probably 10% (or probably even less) who matriculate with some kind of general dental work experience. I hear Canadian OMFS programs like to see the applicant have some general dentistry work experience before they apply - this is completely opposite for American OMFS programs. It seems like they prefer students who are fresh out of dental school, and they also really like students to have done an internship (but they recognize that the best applicants out of dental school will get accepted without having to do an internship year). They look unfavorably on work experience, because these individuals (1) have been out of the academic scene for a while and it may be hard for them to get back into studying mode - this can be especially difficult if it's a 6 year program with a medical school component, (2) can be hard to train (as they've already learned bad habits), (3) and often are older, thus more likely to have responsibilities outside of work (detracting from their time they can dedicate to OMFS).

Selection criteria. First and foremost: grades are king. Dental school GPA and board scores (now they require you to take the NBME exam - which is like the USMLE step 1). Medical schools will also want to see your DAT score, and undergraduate transcripts. Secondly, they like to see externships, and letters of recommendations from OMFS people, showing that you've explored OMFS, understand what its about, and have spent time with residents. Thirdly, you have to be able to get along with the attendings and residents. This will become evident at the interview. Finally, everything else is probably not nearly as important, including: research, extra-curriculars, hobbies, dental clinical skills, OMFS knowledge.

 

Thanks for all the info! Do you have any information regarding what % of your graduating class at UPenn specialized (any specialty, not just OMFS)? I heard that some schools release this data.

 

No problem! I think about 33% of my class got in to a specialty right after graduating. Another 33% went into GPRs and AEGDs, and another 33% went into private practice. Of those who went into GPRs and AEGDs.. I'd say 1/3 to 1/2 went into a specialty after their 1 year of GPR/AEGD... They do publish official numbers, and they give them out during the interview, but I don't know what they are for my year...

[Soprano]

I apologize; I meant to ask the name of school where you are doing your OMFS.

I guess NYU.

Thanks for your response, GL.

[dds2016guy]

Hi, guys, thanks for taking the time to answer questions! I am about to go into my third year in a canadian dental school, but my school rank is quite low (not within first half of the class). Will it be too late for me to consider a specialty even if I manage to boost my ranking in upcoming 2 years? What are some things I can do to improve my application?

[Contach]

Hi, guys, thanks for taking the time to answer questions! I am about to go into my third year in a canadian dental school, but my school rank is quite low (not within first half of the class). Will it be too late for me to consider a specialty even if I manage to boost my ranking in upcoming 2 years? What are some things I can do to improve my application?

 

Hi!

 

What I do think will help: To apply to OMFS in the USA, you have to take the NBME (an international medical graduate test ). It's a very challenging test, and you are aiming for the equivalent of a USMLE step 1 passing score (this is the US medical board exam). If you get a bit above that passing score, you are golden and have opened up doors to many OMFS interviews, even if your rank is not in the top 5 or 10% of the class. For those schools that sit in classrooms with the Medical students (ie. McGill / UBC) this test should be a lot easier.

 

Sadly, for OMFS, grades are king. The next most important thing after dental school grades/dental school rank/board score is to show interest in the field by doing OMFS externships. Some of the more intense externships include LSU-NO, Parkland (Texas), Gainesville (Florida), (and others) and you'll get more respect for doing these more intense externships at well established programs who consistently do broad scope OMFS. Definitely get to know the OMFS attending at your school - you'll need letters of recommendations. And if your attending knows someone, this can be of a great help. 

 

And of course, an internship year in OMFS after you have graduated dental school will help a lot. An internship year, along with a 'pass' on the NBME will make you a great candidate for OMFS programs. But I wouldn't recommend trying to write your NBME while in your intern year.. An intern year involves a lot of long hours, lots of nights on call, and you'll be far too tired to get a decent amount of studying in.

 

What I don't think will help: Even though I did a lot of these things during dental school - I do NOT think extracurriculars, volunteering, student government, or hobbies help with OMFS externships. However, I think it is important to do for yourself, your community, and to make you a well rounded person - just know that it won't help your application much. I also feel that not many programs care much about research. Interest in the field can be shown in other ways: externships, being involved in the OMFS club at your school, knowing stuff about the future of OMFS, etc. Also, many programs don't have a research requirement for their residents.

 

 

Side Note:

When I started this thread, I thought I'd get a lot of questions about the scope of OMFS, or what a resident's lifestyle is like.... But I haven't gotten any of these types of questions....

I know that not all of the Canadian schools have OMFS programs/residents to ask these questions to. So I assumed people would be curious? Is anyone interested in these things? No question is too basic!

[Soprano]

I kind of lost all my messages from you. 
Could you please elaborate on resident life, run me through the 6 years?
DO you get paid along the way at all? If so, is it good enough to support a family?
How difficult is it compared to dental school?
Cheers

[Contach]

I kind of lost all my messages from you. 

Could you please elaborate on resident life, run me through the 6 years?

DO you get paid along the way at all? If so, is it good enough to support a family?

How difficult is it compared to dental school?

Cheers

 

During medical school (usually years 2 and 3 or 2 through 4 of the 6 year program) - most programs will treat you as a normal medical student. You do all the mandatory rotations (3rd/4th year medical school), some will make you do 2nd year of medical school too (ie. classroom didactics). There are a few programs that will make you take OMFS call while in medical school - but these are rare.

 

When you are on OMFS service (~30-40 months) of the 6 year program, you will start as an intern (usually the 1st of your 6 years), taking overnight call q2-q4 (every 2nd, to every 4th day. )During the day, you will help with the clinic, doing work-ups for larger OR cases, follow-ups, doing complicated teeth extractions - impactions, comorbid patients, sometimes easy teeth extractions referred within the hospital, doing biopsies, incision and drainages, doing consults amongst the hospital inpatients (ie. rule out dental infection, or check for teeth that are aspiration risk), and taking care of the patients on your service (like the one who got the double jaw surgery and needs orders placed b/c the nurses are asking). You may also be spending a lot of time in the lab pouring up models and doing orthognathic model surgery (afterhours). If you are lucky, you will get to go to the OR once a week.

As you move up in ranks (after your intern year), you'll spend more time in the operating room (trauma, orthognathics, oral maxillofacial pathology are the most common procedures that all programs will do, and depending on if your program does extended scope stuff like cosmetics, salivary gland surgeries, TMJ surgeries, head and neck cancer) and shift towards increasing amounts of sedation procedures, sometimes doing the sedation part, and sometimes doing the surgical part. Lots of wizzies, implants, sinus lifts, bone grafts, etc. You'll also likely have a lighter call schedule: meaning more time for reading, and learning on your own time. Much of this will be self-directed, but many programs will have a routine lecture schedule (1 or 2 times a week), journal club (once a month), or attending rounds (varies) that offered more structured opportunities to learn.

When you are chief (your final year), you will be in charge of the service. Lots of presentations, and lots of people management. Hopefully you'll be teaching your 5th years how to do what you already know. You'll likely be on "back-up" call a lot. Meaning you may be on call for many months at a time, and will be called at random times b/c interns don't know what they are doing, or need advice, or you need to take a patient to the OR late at night for an emergency (but in OMFS this is relatively rare compared to other surgical specialties).

Somewhere in these 6 years you have to do 1-2 years of general surgery (only a few programs, depending on the state, require you to do 2 years of general surgery). You are treated as a general surgery intern, and rarely see the OR. You are often there to manage patients, do scut work, and learn how to manage the peri-operative period. Here is where you will learn to deal with SICK patients. Also, you will fit in 5 months of anesthesia training (4 in adult anesthesia, and 1 in pediatric anesthesia) - this is required for all OMFS programs to be certified. You will start off shadowing, but quickly learn to handle your own room by yourself. As a resident, you will almost always have an attending anesthesiologist by your side during intubation and extubation (the most risky parts of anesthesia). These 5 months, a long with the in clinic anesthesia experience will allow you to routinely do in office sedations with ease. Learning how to manage an airway is what sets us apart from general dentists who try the weekender course and have never had experience intubating a patient.

 

You get paid a resident stipend for the years you are a resident (ie, the years you are not a medical student). Like of the 6 years, you may pay 2 years of tuition to the medical school, and the other 4 years you'll get paid like any other medical resident. This ranges anywhere from 42k / year to 61k / year (pre-tax) - depending on that area's cost of living. Benefits will be nice (4 weeks paid vacation, health insurance, sick days, malpractice covered through the hospital's/attending's, disability, etc). Is that enough to raise a family? Depends how you want to live. 

 

Difficulty can vary depending on the person, and what year of the program you are in, but probably most importantly, it is a matter of perspective. Many of those who go into OMFS are very gifted to begin with. Some of them continue to try hard, others decide to ease off. Nonetheless, it is by far the most intense dental specialty training program, but I would say not nearly as intense as most of the medical specialty residency programs out there (general surgery, being notoriously bad, but even internal medicine has pretty long hours, albeit hours are in flux as of recently b/c of the new ACGME hour restrictions on residents; of course, family medicine residency is a cake walk in comparison). Once you are in to an OMFS program, there is probably less pressure, but likely higher time requirements. At the same time, you are doing something that interests you, so it's not like learning the TCA cycle, you are learning cool stuff, that has direct relevance to what you'll be doing for the rest of your life - which in my mind makes it easier. In medical school, it can be difficult to learn about psych, or Ob/Gyn, for example b/c there is little motivation. It waxes and wanes, but it seems like most say that medical school is a nice break b/c we are not pressured to do well (like the rest of our medical school classmates), and then intern year and chief year are the worst. Lots of new expectations, and lots of responsibility that you aren't used to.

 

That was long but hope it helps!

[Que]

I don't have any questions...just want to say thanks for answering all the questions!!

[Soprano]

That was great, thanks Contach.

[Contach]

The bane of my existence: explaining to medical students what an OMFS is, why I am in medical school, and at the same time guaranteed my residency spot.

 

Also, check this article out, entitled, "Oral and Maxillofacial Surgery: a unique profession."

 

http://ravallirepublic.com/lifestyles/health-med-fit/article_afb3a80c-32ed-11e4-a3e5-0019bb2963f4.html

 

Back to learning about vaginas! This week, I hopefully get to deliver a baby!

[Contach]

Cool article about an OMFS who is the Oral Surgeon for the Anaheim Ducks' hockey team. My dream!

 

http://www.latimes.com/sports/la-sp-c1-hockey-dentist-20140114-dto-htmlstory.html

 

it was also published in AAOMS a while back.

[bigpetey]

Hi, I have spoken with some Dentists in Alberta and they said that taking a 6 year OMS residency doesn't help in Canada. They said you cannot practice under the MD so jsut do a 4 year. Is there anything to back this up?

 

Thanks

[CC36]

What are your thoughts on the 4 year OMFS programs which do not offer MDs compared to the 6 year programs which do MDs? Specifically, does the 6 year program allow one to have a wider scope of practice? And if so what procedures?

[Contach]

Hi, I have spoken with some Dentists in Alberta and they said that taking a 6 year OMS residency doesn't help in Canada. They said you cannot practice under the MD so jsut do a 4 year. Is there anything to back this up?

 

Thanks

 

Hi - great point. At the moment you can't practice/bill under the MD in Canada. However, you CAN advertise that you have an MD. It's not an ideal situation, but I've heard some rumors that they are trying to change this. For dentoalveolar, you wouldn't be billing anything under an MD license anyways. So, I guess you are looking at trauma.. but I know Canadian OMFS do trauma... so I imagine that they are billing for it under their dental license.... 

[Contach]

What are your thoughts on the 4 year OMFS programs which do not offer MDs compared to the 6 year programs which do MDs? Specifically, does the 6 year program allow one to have a wider scope of practice? And if so what procedures?

 

The general consensus is no, a dual-degree trained OMFS (dental license and MD) is not inherently entitled to have a wider scope than a single-degree OMFS.  More important to one's scope of practice is what types of procedures he/she learned during their residency program, and their comfort level with said procedures. Some 4-year programs do cosmetics, most don't, and same is true for 6-year programs (some do, most don't).

 

There is an argument (that I would tend to side with), that if you want to do a fellowship, an MD (6-year track) will help you be more competitive. Remember that some of the OMFS fellowships are shared with ENT. Most of the fellowship-trained OMFS i know do have an MD. 

[jerm174]

More important to one's scope of practice is what types of procedures he/she learned during their residency program, and their comfort level with said procedures. Some 4-year programs do cosmetics, most don't, and same is true for 6-year programs (some do, most don't).

 

This might be a question for all residencies in general, but if a specific procedure isn't learned during the program, how would one become familiar with it? Is that what a fellowship is for?