Challenges and Professional Interests of OMS Residents: A Cross-Sectional Survey

To What Extent is Each Area of Oral-Maxillofacial Surgery Practiced in the United States Today?

Do academic Affiliated OMS Programs Recruit Residents With More Scholarly Activity Compared to Nonacademic Affiliated Programs?

The Effect of Oral and Maxillofacial Surgery Curriculum on United States Medical Licensing Examination Step 1 Performance

Patterns of Paging Activity Among Oral and Maxillofacial Surgery Residents: Implications for Patient Care

Barriers to Research Among Residents in Oral and Maxillofacial Surgery

Barking Up the Wrong Tree

Several studies have evaluated resident and trainee remediation strategies across various surgical subspecialties. However, limited research exists on this topic within the Oral and Maxillofacial Surgery (OMS) literature. The purpose of this study was to identify cross-sectional patterns of evaluation and remediation strategies for underperforming OMS residents in the United States. A cross-sectional cohort study was conducted using a 22-question survey administered to OMS residency Program Directors of all programs approved by the Commission on Dental Accreditation (CODA) within the United States. The predictor variables included the demographics and resident assessment methods of responding programs. The outcome variables included the results of remediation strategies and corrective action plans for residents identified as struggling over the preceding 10 years. Responses were anonymized, and descriptive statistics were used to analyze the collected data. Completed surveys were obtained from 29 (29%) CODA-approved programs. Twenty-five of 29 (86%) programs reported placing 64 residents on corrective action plans. Nine of 29 (31%) programs reported that 14 residents were dismissed during that period. The most common deficiencies in residents requiring corrective action plans were cognitive skills (37.9%), clinical skills (20.7%), and interpersonal skills (20.7%). Residents were almost always given a warning prior to initiating remediation or probation (96.6%), with verbal (46.4%) and written (53.4%) warnings being used with nearly equivalent frequency. Remedial action most often included general counseling (15.9%), more frequent feedback sessions (15.9%), assignment of a mentor (15.2%), didactic remediation (13.3%), psychiatric/psychologic counseling (11.26%), and lengthened training time (6.6%). Most programs reported utilization of a formal remediation protocol (75.9%) and 85.7% of programs subjectively felt their process was effective. Almost one-quarter of respondents (24.1%) stated that no formal remediation protocol exists at their institution. Most OMS programs utilized some form of remediation protocols, but their usage was inconsistent and infrequent. The evaluation and remediation processes among OMS residency programs have significant variability, relying heavily on program or institution-specific protocols.

PURPOSE: Virtual surgical planning (VSP) is the gold standard for preoperative treatment planning for orthognathic surgery.1 Prior to the implementation of VSP, traditional orthognathic preoperative preparation required hours of labor and utilization of a dental laboratory. This often limited orthognathic surgery to providers with dental training. The combination of VSP and 3-dimensional printing has allowed orthognathic surgeons the ability to more accurately and efficiently create treatment plans for these cases.2 This technology has also allowed practitioners such as plastic surgeons to begin to perform orthognathic procedures. This review serves to illustrate how plastic surgeons use VSP and highlight its impact on surgical outcomes and research output within orthognathic surgery. METHODS: A literature search was conducted in the PubMed database to identify all articles published before January 2020 that report perioperative use of VSP technology in orthognathic surgeries. Only articles that were written in English, involved operations on live human patients, and used VSP to plan or assist with orthognathic surgery were included in the analysis. All articles that fit inclusion criteria were reviewed to determine the year of publication, type of orthognathic surgery performed, how VSP was used, and the primary outcomes measured. RESULTS: A total of 419 publications regarding VSP in orthognathic surgery resulted from initial search. Of them, 244 publications were authored by oral and maxillofacial surgeons, 28 publications by plastic surgeons, and 34 by surgeons with training in both fields. TEMPORAL TREND OF PUBLICATIONS: Prior to the late 1990s, VSP in orthognathic surgery publications was primarily authored by oral and maxillofacial surgeons. Plastic surgeons first began publishing on VSP technology for orthognathic surgery in 1998. Since then, there has been a rising trend in plastic surgery usage of VSP paralleled by increasing VSP publications in the field, with 2 publications before the year 2010 (7.2%), 9 from 2010 to 2015 (32%), and 18 between 2015 and 2019 (64%). CATEGORIES OF PUBLICATIONS: Most publications from oral and maxillofacial trained surgeons highlight optimal positioning of craniofacial bones, anticipated stability and functionality of occlusion, and the interplay between orthodontic treatments and orthognathic surgery. In contrast, plastic surgeon authored papers often discuss postoperative facial aesthetics by ensuring facial symmetry and treatment especially in the cases of congenital craniofacial abnormalities like cleft lip/palate, Treacher-Collins, and hemifacial microsomia. CONCLUSIONS: VSP is an increasingly utilized tool that reduces the workflow without compromising accuracy and outcomes in orthognathic surgery. This is the first paper to create a temporal relationship between a new technology and the emergence of plastic surgeons into a field typically predominated by oral and maxillofacial surgeons. As plastic surgeons become more familiar with this technology, they have produced literature that provides alternative perspectives on orthognathic surgery that will push the field forward. REFERENCES: 1. Langdon J, Patel M, Brennan P. Operative Oral and Maxillofacial Surgery. 2nd ed. CRC Press; 2010. 2. Baker SB, Goldstein JA, Seruya M. Outcomes in computer-assisted surgical simulation for orthognathic surgery. J Craniofac Surg. 2012;23:509–513.

A Bow to Daniel Laskin

The Most Influential Publications in Oral and Maxillofacial Surgery Over the Past Decade

Incorporating Simulation Into Oral and Maxillofacial Surgery Residency Education and Training: Christiana Care's Method

Chief Resident Case Experience and Autonomy Are Associated With Resident Confidence and Future Practice Plans

Proceedings From the 2013 American Association of Oral and Maxillofacial Surgeons Research Summit

S234: Evaluation and Rejuvenation of the Upper Facial Third

Training Satisfaction Versus Dissatisfaction Among Chief Residents in Oral and Maxillofacial Surgery—A Pilot Survey