Call room blues - life of an Oral and Maxillofacial Surgery Resident
*BEEP BEEP BEEP, BEEP BEEP BEEP*
If you know, you know.
The dreaded beeping of the pager waking me up in the middle of the night. Being a resident at a level 1 trauma center in Louisville, KY, you never know what you're going to get called about...and man, do I have some stories that we'll have to save for another time.
Yes, that pager can really feel like a burden sometimes. But I love my job. Whether it's that 2am trauma call, a cleft palate/lip, or (as many of you may be familiar with) some wisdom teeth extractions in clinic, I get an opportunity everyday to make a positive difference in patient's lives. In this post, I want to give you just a glimpse of what OMFS entails.
What is an Oral and Maxillofacial Surgeon?
We're not just wisdom teeth extractions! Here's a good description straight from the American College of OMS:
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia and provide care in an office setting. They treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. Oral and maxillofacial surgery is a surgical specialty recognized by the American College of Surgeons and is one of nine dental specialties recognized by the American Dental Association, the Royal College of Dentists of Canada, and the Royal Australasian College of Dental Surgeons. Typical training for an oral and maxillofacial surgeon includes:
After completion of surgical training most undertake final specialty examinations. The certifying body in the United States is the American Board of Oral and Maxillofacial Surgery. The average total length of education and training after secondary school is 12 to 14 years. In addition, graduates of oral and maxillofacial surgery training programs can pursue fellowships, typically 1 – 2 years in length, in the following areas:
|
So, what does a typical day look like for an OMFS resident?
Depends...but there are some constants.
4:30am: Wake up, scrubs on, caffeine. I have been on the Alani-nu train lately while I round in the mornings (sponsor me please).
5-6am: Pre-round. This is where we check on our in-patients before the entire team goes together. Chatting with the nurses to see if any events occurred overnight, checking labs and notes, etc. I also like to set the tone for the day by having coffee ready in the lounge and some tunes going.
6am-7am: Rounding. We see said in-patients as a team. Debrief on anything that occurred overnight. This is usually when I'll contact any other services for consults or updates as well and get ready for our surgeries for the day.
7:30am-5pm: SURGERY, SURGERY, SURGERY! My personal favorite. Depends on the day, but we're typically in the OR most days and have a very robust clinic for outpatient surgery. Afternoons are usually booked out with consults.
Late afternoon: Notes. My personal least favorite, but it is what it is.
Evening: "Tuckin' em in". This is where we see our patients post-op if they're in-patient and check in with the evening shift nurses. I always try to make it a point to tie up any other loose ends so that work doesn't carry on to the next day if possible.
After-hours: I've been pretty good about it so far, but I'll try my best to get a workout in, make dinner, study up on cases a bit. And then MAYBE get some sleep at a reasonable hour.
Repeat.
Of course, things are different when we take trauma call. That's a beast in itself and may be a good topic for further discussion at a different time. Our service takes call everyday for our main UofL Hospital and Norton Children's Hospital. So, if someone has an odontogenic infection, alveolar fracture, or anything else that is specific to our service, we are available. We take facial trauma call every 3rd day. So, anyone who has trauma to the face, we're your guys on those days and split that call with ENT and plastic surgery on the other days. We take in-house call meaning we sleep in the hospital on-call room. If I'm lucky, I can expect a couple hours of sleep on those nights. This is different at every hospital, but that's the way we do it in Louisville.
Sure, the training and day to day work can be grueling, but I personally love this specialty. The scope is pretty broad and I'm challenged and learning something new everyday. We see a wide range of patients: young to old, healthy to sick, and have a skillset to help them all the same. Like other surgery specialties, our practice comes with near-instant gratification from surgical outcomes and our procedures are typically highly favorable with low mortality rates.
Lifestyle is generally really positive for OMFS. A survey reported an 87% satisfaction rate in the specialty. Attending surgeons are well-compensated with a reported mean salary of $465,000/year. Note that this is what is reported and can vary depending on scope, location, and job setting. Most oral surgeons choose to work in a private practice setting, but you can also work as an attending surgeon at an academic hospital where you'll typically be presented with some of the more complex surgeries and can hold a teaching appointment.
Personally, I'm not sure what route I want to take yet following my residency. There is so much within the specialty that I enjoy spanning from bread and butter dentoalveolar surgery to corrective jaw surgery to facial cosmetic surgery. Some days I could see myself at a teaching institution, and some days I see myself running my own practice. I'm not sure yet! TBD.
If you think you've got what it takes to become an OMFS, find yourself some mentors within the specialty and think long and hard about it. It's a competitive specialty (~47% match rate) and a long, gritty road to get there. Sometimes the grass does look greener on the other side when I talk to my friends currently out in practice...but then I remember that I truly couldn't see myself doing anything else other than OMFS.
Dr. Sammy Huynh, DMD, MS
Sammy is a current Oral and Maxillofacial Surgery resident at the University of Louisville in Kentucky. Following his graduation from the University of South Carolina in 2018 with a degree in Biology, he moved to Charleston and completed his master’s degree in medical sciences at the Medical University of South Carolina. He continued to receive his DMD from the MUSC JBE College of Dental Medicine in 2023. Upon graduation, Sammy moved to Louisville, KY to further his surgical training in OMFS where he will earn his MD in the process from the University of Louisville. Sammy has a particular interest in orthognathic, dentoalveolar, pediatric craniofacial, facial cosmetic, and facial trauma surgery.
What’s an achievement! Rough road but bright at the end! Go Dr. Sammy Huynh!❤️