Training in oral and maxillofacial surgery: a medicine-first perspective (2022)

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  • Abstract
  • Introduction
  • Section snippets
  • References (6)
  • Cited by (4)
  • Recommended articles (6)

British Journal of Oral and Maxillofacial Surgery

Volume 58, Issue 10,

December 2020

, Pages 1333-1334

(Video) Oral Maxillofacial Surgeons have specialized medical and dental training

Abstract

Specialist registration in oral and maxillofacial surgery (OMFS) requires dual medical and dental qualification involving at least eight years of undergraduate study. Training has continued to evolve since dual qualification was introduced and has often resulted in unwarranted repetition. If a time-based curriculum is necessary, second degree trainees should be allowed to pursue research and audit, and gain relevant clinical experience in lieu of repeating previously covered material. Junior surgical training could be integrated into the second degree. A programme that records competencies during the second degree may demonstrate equivalent to other aspects of junior training. One barrier is timetabling, which often restricts the integration of second degree trainees with OMFS units. Junior training in OMFS could be streamlined if the content was agreed nationally. This would also offer the opportunity for those key institutions that implement these changes to take on a prominent role in OMFS training.

Introduction

Specialist registration in oral and maxillofacial surgery (OMFS) has required dual medical and dental qualification since the 1980s. The move towards dual qualification reflected a widening of the scope of practice amongst OMFS surgeons and subsequently encouraged many to pursue increasingly complex surgery.

Dual qualification requires at least eight years of undergraduate study, and a second degree can be particularly challenging owing not least to the considerable financial outlay on tuition fees and maintenance costs, together with the loss of pension contributions.1

Section snippets

Discussion

The General Medical Council (GMC), General Dental Council (GDC), and Joint Committee on Surgical Training (JCST) regulate undergraduate medical, dental, and postgraduate surgical training. Training requirements have continued to evolve since dual qualification was introduced, and in many cases have resulted in unwarranted repetition. For example, dental graduates returning to medical school are often obliged to undergo training in cannulation regardless of previous experience.2 Similarly,

Conclusion

We would encourage stakeholders to reduce unnecessary time spent in training, particularly before higher specialty training. The objectives of undergraduate and junior surgical training frequently overlap, and efforts should be made to avoid needless repetition. We encourage universities and regulators to engage more fully with the accreditation of previous learning, and to design curricula that allow exemptions to be made when previous training and experience have been documented. Junior

Ethics statement/confirmation of patients’ permission

Not required.

Conflict of interest

We have no conflicts of interest.

(Video) Michigan Medicine Oral & Maxillofacial Surgery

References (6)

  • C. Herbert et al.What causes trainees to leave oral and maxillofacial surgery? A questionnaire survey

    Br J Oral Maxillofac Surg

    (2017)

  • M. Garg et al.“Run-through” training at specialist training year 1 and uncoupled core surgical training for oral and maxillofacial surgery in the United Kingdom: a snapshot survey

    Br J Oral Maxillofac Surg

    (2018)

  • J. O’Callaghan et al.

    Cross-sectional study of the financial cost of training to the surgical trainee in the UK and Ireland

    BMJ Open

    (2017)

There are more references available in the full text version of this article.

Cited by (4)

  • Attitude of clinical medical students to Oral and Maxillofacial Surgery as a career: a perspective from two English Medical Schools

    2022, British Journal of Oral and Maxillofacial Surgery

    Oral and Maxillofacial Surgery (OMFS) has been increasing in popularity amongst medicine first trainees. Despite this, there is still limited exposure at the undergraduate level. This study aimed to: evaluate the experience of medical students in the field of OMFS, the awareness of medical students to OMFS resources/societies and to determine the greatest motivators and deterrents for students in pursuing a career in OMFS. An online survey was distributed to 198 students spread across two English universities. 131 students (66.2%) were from University A and 67 (33.8%) students were from University B. A total of 61.1% of undergraduate medical students had no exposure to OMFS up until their current stage of training with no statistically significant differences in OMFS exposure between the year groups (p>0.05). 37% of students considered OMFS as a potential career path with dual qualification being the deterrent in 44% of cases. 97.0% of students were not able to state any organisations/resources available to support them in pursuing a career in OMFS. Within our cohort exposure to OMFS was greater than earlier reports, however; undergraduate exposure to OMFS is still very limited in UK medical schools. Conducting a dental degree following the primary medical qualification appears to be the greatest obstacle to students considering OMFS training. OMFS remains unknown to medical students and healthcare professionals. We need grass root changes at undergraduate level to improve the future of OMFS training.

  • Duration of specialty training in Oral and Maxillofacial Surgery in the United Kingdom for trainees joining the OMFS specialist list between 2002 and 2019

    2020, British Journal of Oral and Maxillofacial Surgery

    OMFS Specialty Training in the UK is usually 5 years and ‘starts’ at Specialty Training Year 3 (ST3). In 2007 a pilot of ‘run-through’ training started with Core Training (CT) posts linked to specialty training (ST1 posts). ST1 posts are usually 12 months but may be up to 24 months.

    UK OMFS consultants joining the OMFS specialist list between 2002 and 2019 were contacted regarding their training. If their training was extended beyond the expected date of completion, they were asked to give a primary and secondary reason from a simplified list. Results were analysed with Winstat©.

    A total of 382 consultants were contacted, 325 responding (86%) and of these 290 were appointed at ST3 and their mean extension of training time was 0.63 years. For those 35 who were appointed to ST1, their training was on average 0.77 years longer than planned.

    (Video) Oral & Maxillofacial Surgery Residency at Loyola Medicine

    Undertaking a Fellowship (33%) was the commonest reason for extension, followed by administrative delay (24%), unsuccessful attempts at the FRCS exam (12%) and training reasons (10%).

    Female trainees (n=37) spent on average 1.28 years longer than planned in training compared to male trainees (288 - 0.67 years). Gender differences were also present in the main reasons for extension with 12% of female respondents giving family reasons as the main cause, whereas only 2% of males gave this reason. Problems with training was the main cause for extension for 19% of females compared to 8% of males.

    Understanding factors which extend training and the length of these extensions could have the twin benefits of openness for new trainees and directing support to existing trainees. Differential attainment and Equality Diversity & Inclusion (EDI) are domains whose monitoring is required by the General Medical Council and undertaken by training authorities. The small numbers of trainees in OMFS programmes may not always allow training variance to be recognised.

  • How can oral and maxillofacial surgery units best support second degree students?

    2020, British Journal of Oral and Maxillofacial Surgery

    Returning to study for a second degree to enter higher OMFS training often leaves students feeling ‘out in the wilderness’. Many OMFS units are keen to support these students and make use of their skills and enthusiasm by employing them. Often there are barriers to students and units working together. We have explored some of these barriers by surveying second-degree students (both medical and dental) to see what simple measures OMFS units can take to improve their support for students. From the survey we have devised a list of Essential and Desirable criteria to assist OMFS units in supporting students, aiming to have a positive effect on retention through the challenging but necessary period of the second degree.

Recommended articles (6)

  • Research article

    The future of OMFS lies in creating pathways to implement the PMETB recommendations and inspiring our trainees. Enough time has been spent debating, we need to deliver!: Re: Newman L, Brown J, Kerawala C, et al. Our specialty. The future. Is the writing on the wall? Br J Oral Maxillofac Surg 2020 (online ahead of print)

    The British Association of Oral and Maxillofacial Surgeons (BAOMS) has been at the centre of the transition of our specialty in the UK from a branch of dentistry to one of the 10 UK surgical specialties. In this role it has, at different times, pushed boundaries against resistance from other specialties, and redirected the ambitions of the deputy chair of the Postgraduate Medical Education and Training Board (PMETB) review to produce recommendations that were exactly what OMFS needed. The editorial Our specialty. The future. Is the writing on the wall? is just the most recent iteration of half a century of internal debate. Whilst there are some issues with how the authors have presented recruitment data (their figures omit ST1 run-through and do not recognise that the same single, unfilled post may be present for two or more national selection rounds) their first paragraph A debate that we feel is long overdue presents the greatest concern. In this short communication, we illustrate that in the last 20 years the specialty has not been short of debate. In the absence of new and specific evidence that any other route forward would be supported by our national training committee (OMFS SAC), our regulator (GMC), the breadth of our specialty (including our current specialists and our current and future trainees) and, most importantly, would actually address our problems, we should avoid putting energy into an empty debate. Our focus should be on delivering the PMETB recommendations and inspiring our future trainees.

  • Research article

    2012 – The year when BAOMS and its officers prevented closure of all UK shortened medical and dental courses

    British Journal of Oral and Maxillofacial Surgery, Volume 58, Issue 10, 2020, pp. 1343-1347

    (Video) Live Webinar with Board-certified Oral & Maxillofacial Surgeon

    In Spring 2011 the Department of Health (DH) received a request to review European Union Directive 2005/36 EU – the directive relating to the recognition of professional qualifications. The Department of Health lawyer raised concerns that the existing shortened dental courses may be in breach of EU law. There were three shortened dental courses in the UK: 4year graduate entry courses in Liverpool/Peninsula and 3-year Dental Programme for Medical Graduates (DPMG) in Kings, London. During the summer the General Dental Council (GDC) was made aware of these concerns. In autumn 2011 the Chief Dental Officer for England with the GDC, told the Dental Deans’ Council (DDC) that shortened dental courses were illegal. On 12th Jan 2012 students on the DPMG were told that they would have to complete a full 5-year dental degree. The GDC said that this interpretation of EU law would also impact on shortened medical courses. In view of the potentially enormous impact that this would have on OMFS training, BAOMS engaged all the resources it could and by assembling legal opinions including written contributions from Sir David Edward, whose opinion was being misinterpreted by the GDC and DH, and by sharing these resources with all the stakeholders, BAOMS was able to preserve shortened dental and medical courses. Now that the UK has left the European Union, negotiations around mutual recognition of qualifications may mean this issue will resurface. We should remain vigilant.

  • Research article

    The ‘R’ word – do dental core trainees possess it?

    British Journal of Oral and Maxillofacial Surgery, Volume 58, Issue 10, 2020, pp. 1255-1260

    Resilience is the process of ‘bouncing back’ from stresses in life. High resilience is associated with less anxiety and psychological distress, and is therefore an important trait for health professionals. We know of no work to date on the resilience of dental core trainees (DCT) as they make the unique transition from dental practice to a hospital-based setting. To elicit data on the self-perceived resilience of this group, and to find out if resilience correlated with the perceived stress of scenarios in Oral and Maxillofacial Surgery (OMFS), we distributed surveys (the Brief Resilience Scale (BRS) and five clinical scenarios) to DCTs in the Yorkshire and Humber region, and asked them what would improve their resilience. A total of 38 responded: 4 had high, 11 had normal, and 23 had low levels of resilience. An inverse correlation was seen between resilience and the perceived stress of the scenarios. A total of 28/31 OMFS DCT1s responded (90%). Self-perceived resilience was low. High levels of resilience were associated with low levels of perceived stress from the scenarios. The trainees felt that approaches that were supported by the literature would improve their resilience. Resilience training could therefore be considered for this group, and it could have a positive impact on their well-being and potential benefits for patient care.

  • Research article

    An Open Debate on Training: Articles about training in Oral and Maxillofacial Surgery (OMFS) in the United Kingdom have been published in BJOMS since its beginning, but hitherto none have been published as a special issue on that subject. Historically, this topic has been extensively debated in various powerhouses of the speciality. The aim of the current issue was to give a voice to all readers of the journal, at every level of their career, contributing to the debate.

    British Journal of Oral and Maxillofacial Surgery, Volume 58, Issue 10, 2020, p. 1215

  • Research article

    Legislation for Oral and Maxillofacial Surgery (OMFS) in the UK lags behind the patient care we provide: an illustrative timeline and recommendations for the future

    British Journal of Oral and Maxillofacial Surgery, Volume 58, Issue 10, 2020, pp. 1290-1296

    OMFS is the surgical specialty which bridges dentistry and medicine. As the specialty of OMFS emerged from the dental specialty of Oral Surgery during the 1980s the Dentists Act 1984, whose purpose included preventing medical practitioners providing unregulated general dental care, was published. In 2008 the Postgraduate Medical Education and Training Board (PMETB) review of training in OMFS concluded that dual qualification was essential and recommended that OMFS specialists should only be required to register with one regulator, the General Medical Council. For OMFS to continue to provide high quality patient care, and to help the GDC and GMC in their roles regulating our specialty, BAOMS has identified 5 areas for regulatory change: (1) All OMFS specialists should be able to practice the full curriculum of OMFS with only GMC registration if they wish to – this was recommendation 4 of the PMTEB Review of OMFS in 2008. (2) If an OMFS specialist or trainee is registered with both the GMC and GDC. (3) A Memorandum of Understanding between the GMC and GDC should prevent any fitness to practice concerns being processed by both regulators. (4) Dually registered OMFS specialists should be able to indicate that they have had “appraisal of the full scope of practice” to comply with GDC Continuing Professional Development (CPD) regulations. (5) Oral Surgery specialist list should retain Route 11 for OMFS specialists as the Oral Surgery Curriculum is entirely within the OMFS curriculum. Legislative changes may be the best route to deliver these recommendations. Until these changes happen, the GMC, GDC and BAOMS should work together in the best interests of patients.

  • Research article

    Redeployment of junior maxillofacial surgery staff during COVID-19—the Gloucester ITU experience
View full text

© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

FAQs

How long does it take to become a maxillofacial surgeon? ›

If coming from a dentistry background, your specialty training will take 13 years after your dental degree. If coming from a medical background, your specialty training will take 11 years after your medical degree.

How do I become a maxfax surgeon UK? ›

To become a consultant in oral and maxillofacial surgery (OMFS) in the United Kingdom you have to have studied dentistry, passed the exam for membership of the Faculty of Dental Surgery (MFDS), studied medicine, passed the exam for membership of the Royal College of Surgeons (MRCS), done a five year specialist ...

How much do oral and maxillofacial surgeons make UK? ›

How much does a Maxillofacial surgeon make in United Kingdom? The average maxillofacial surgeon salary in the United Kingdom is £96,259 per year or £49.36 per hour. Entry level positions start at £91,478 per year while most experienced workers make up to £99,281 per year.

How do I become an oral and maxillofacial surgeon in Germany? ›

Anyone wishing to work as an OMF surgeon in Germany must complete a medical and a dental degree at the same time. The prospective specialist must then complete a 5-year further training course to become a specialist in oral and maxillofacial surgery.

What is the hardest doctor to become? ›

A Note for Medical Students

Apart from the top 5 specialties mentioned above, Interventional Radiology, Radiation Oncology, Vascular Surgery, General Surgery and Med/Peds are among the most difficult domains to become a doctor.

What is the highest paid dentist? ›

High Paying Dentist Jobs
  • Oral and Maxillofacial Surgeon. Salary range: $254,000-$397,000 per year. ...
  • Endodontist. Salary range: $247,000-$390,000 per year. ...
  • Orthodontist. Salary range: $260,000-$374,500 per year. ...
  • Maxillofacial Prosthodontist. ...
  • Periodontist. ...
  • Prosthodontist. ...
  • Pediatric Dentist. ...
  • Dentist Private Practice.

How long is maxfax training? ›

Our Medicine Maxfax Entry Programme MBBS is a four-year medical degree designed specifically for qualified dentists who are registered with the UK General Dental Council and who wish to pursue a career in oral and maxillofacial surgery.

How much do OMFS make UK? ›

The average pay for an Oral & Maxillofacial Surgeon is £194,611 a year and £94 an hour in London, United Kingdom. The average salary range for an Oral & Maxillofacial Surgeon is between £128,054 and £250,854. On average, a Doctorate Degree is the highest level of education for an Oral & Maxillofacial Surgeon.

How hard is it to become an oral surgeon? ›

The training is rigorous and can take from four to eight years to fully complete. Though obtaining the education for this job is difficult, oral and maxillofacial surgeons have high job satisfaction.

How can I become maxillofacial surgeon? ›

  1. The Path to Become an Oral and. Maxillofacial Surgeon.
  2. Dental School.
  3. Earning DDS or DMD (4 years).
  4. Board Certification.
  5. Majority of OMSs pursue board certification.
  6. Undergraduate. Education.
  7. Including dental requisites.
  8. Residency/ Surgical Training.

What do maxillofacial surgeons earn? ›

The average pay for an Oral & Maxillofacial Surgeon is £191,788 a year and £92 an hour in London, United Kingdom.

How hard is it to become an oral surgeon? ›

The training is rigorous and can take from four to eight years to fully complete. Though obtaining the education for this job is difficult, oral and maxillofacial surgeons have high job satisfaction.

How do you become a maxillofacial doctor? ›

Since the speciality requires dual qualification in medicine (Bachelor of Medicine, Bachelor of Surgery; MBBS/MBChB) and dentistry (Bachelor of Dental Surgery; BDS/BChD), immense drive, commitment and enthusiasm are essential in this specialty.

Videos

1. Retromandibular Approach | Transparotid | Oral & Maxillofacial Surgery | Syed Amjad Shah
(Breaking Barriers in the way of Knowledge Sharing)
2. Subciliary approach for Periorbital region | English | Oral Maxillofacial Surgery | Syed Amjad Shah
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3. Day in the Life of an Oral and Maxillofacial Surgeon
(Antonio J. Webb, M.D.)
4. Dr. Ghali E. Ghali, DDS, MD - Oral Maxillofacial Surgery
(Willis-Knighton Health System)
5. So You Want to Be an ORAL & MAXILLOFACIAL SURGEON (OMFS) [Ep. 30]
(Med School Insiders)
6. Oral & Maxillofacial Surgery Virtual Shadowing with Dr. Zambrano 11/13
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