To the Editor:—As a proud single-degree oral and maxillofacial
surgeon (OMS), I am amazed that there are still OMSs
who are attempting to discredit single-degree oral surgeons.
I respect Dr Bagheri, whom I know is an influential oral
surgeon, but I am disappointed by his including himself in
such a letter.1
May I remind Drs Meyer and Bagheri that our specialty
has enough problems dealing with ear/nose/throat and plastic
surgeons regarding privileges; now our specialty is discrediting
itself. As all OMSs are aware, issues and confusion
come up with the medical community for single- and dualdegree
surgeons alike.
I did my oral surgery residency at the University of Maryland
under the direction of Bob Ord, DDS, MD. I was one of
his only 4-year residents, but not for a moment did he
consider me to be beneath his dual-degree residents. He
expected the same medical and surgical knowledge from
me as he did from everyone else. He and his colleagues
prepared all of us to be board-certified oral and maxillofacial
surgeons. I would like to remind Drs Meyer and Bagheri that
all oral surgeons have the capability and knowledge to treat
any medically compromised patient, and most of us know
our limitations. I have had privileges at 5 major hospitals
without anyone questioning my potential to care for patients.
I am one of approximately only 20 California oral
surgeons who holds the cosmetic surgery license for fullscope
cosmetic surgery, and I certainly do a fair share of
orthognathic and trauma surgery, just like my counterpart
dual-degree surgeons. I respect my friends who are dualdegree
surgeons, and I appreciate their knowledge and
dedication, but I refuse to accept that I am less of a doctor
and oral surgeon because I do not have a medical degree. It
is a personal choice to earn the medical degree, and we are
fortunate that the American Association of Oral and Maxillofacial
Surgeons allows us to choose whether it is appropriate
for us. I also have accepted the fact that I may not be
able to do full-body cosmetics or microvascular surgery or
change specialties to ear/nose/throat or plastics (as some
dual-degree OMSs do). I also have no problem with not
being a fellow of the American College of Surgeons (FACS).
Surgeons who are FACSs should be proud of their achievement,
and I am likewise proud of them, but it should be a
personal choice, just as many medical surgeons are not part
of the FACS.
In response to Drs Meyer and Bagheri, the American
Association of Oral and Maxillofacial Surgeons has already
lit the candle, and there are no curses of darkness; we are
doing just fine the way we are. Let us not take a step back
and give fire to the medical community by attacking our
own. Let’s write letters and articles to congratulate and
promote surgeons who have done wonderful things for our
specialty, whether single or dual degree.
ARSHIYA SHARAFI, DDS
San Diego, CA
In reply:—Perhaps Dr Sharafi has misinterpreted the main
point of our letter, which was not an attempt “to discredit
the single-degree oral [and maxillofacial] surgeons.”
It was to encourage those in a position to make
decisions regarding the training of the oral and maxillofacial
surgeon (OMFS) to give the trainees the foundation
of a good surgical education that will not place limitations
on the future careers of said trainees.
Dr Sharafi concedes that during his training under Robert
Ord, DDS, MD, that “he [Dr Ord] expected the same medical
and surgical knowledge from me [Dr Sharafi] as he did
for everyone else” (dual-degree residents?). What he does
not state or know is what might have been the nature of his
training had his department chair not been a double-degree
OMFS. Would the demands and the level of the training
have been the same? Who really knows? As a former oral
and maxillofacial surgery (OMS) department chair, one of us
(RAM) can definitely state that the advancement or evolution
of a specialty depends on acquisition of better training
and greater knowledge. Although the medical degree may
not in and of itself make one a more technically adept
surgeon (there are many skillful single-degree OMFSs), it
certainly does enhance one’s medical knowledge, which
reflects on overall patient care. One should not attempt to
diminish the value of the dual-degree for OMFSs by stating
that “We all (single or dual degree) have the same training.”
Perhaps we are all equally skilled at performing OMS operations;
however, the basic medical knowledge and exposure
to patient care are not in reality the same for the
single-degree as for the dual-degree OMFS; the only acceptable
level of knowledge expected in any residency training
doi:10.1016/j.joms.2010.07.003
