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

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