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Integration of the medical degree in oral and maxillofacial surgery: A 10-year follow-up
LETTERS TO THE EDITOR J Oral Maxillofac Surg 60:844, 2002
References
INTEGRATION OF THE MEDICAL DEGREE IN ORAL AND MAXILLOFACIAL SURGERY: A 10-YEAR FOLLOW-UP
1. Edwards RC, Foley WL: Expanding the specialty: A survey of the oral and maxillofacial residencies in the United States. J Oral Maxillofac Surg 51:559, 1993 2. Laskin DM: The MD degree: A panacea or a problem? J Oral Maxillofac Surg 55:209, 1997
To the Editor:—It is not often that an article generates 2 Discussions. I would like to address some of the comments included in the Discussions that followed the article by myself and Drs Pulsipher and Sinn that appeared in the Journal (J Oral Maxillofac Surg 59:1471, 2001). I appreciate Dr Booth (J Oral Maxillofac Surg 59:1477, 2001) checking the references in our article, but unfortunately he failed to check the fourth reference. Dr Booth correctly pointed out that a 1993 article by Edwards and Foley1 did not state that 38% of residencies were MD-oral and maxillofacial surgeon (OMS) programs and that 43% of the OMS residents had their MD degree. The article by Edwards and Foley (first reference) in fact did not make this statement. It should have been referenced to Dr Laskin2 (fourth reference) and I apologize for any confusion that may have caused. I disagree with the statement that the “controversy over single degree versus double degree is only relevant to those persons who believe that our specialty should be solely single or solely double-degree oriented.” I would think that informed decision making would be important to graduating dental students who are about to devote 4 to 7 years to postgraduate training. I currently train 4-year residents who, upon finishing residency, are competent in performing fullscope oral and maxillofacial surgical procedures. Unfortunately, there are places in which legislation makes it more difficult for a qualified non-MD oral and maxillofacial surgeon to practice some procedures. I agree completely with Dr Kelly (J Oral Maxillofac Surg 59:1478, 2001) in that “the reasons for obtaining a medical degree include the enhancement of fundamental knowledge and the provision of a common basic surgical training for one who aspires to be an oral and maxillofacial surgeon.” I continue to believe that the majority of people that will enter our specialty will not be guided by “the lure of high salaries . . . into private practice” as Dr Booth would have us believe. For many of us, especially in academics, there is more to it than “economics.” Dr Booth also states that “as the lure of high salaries begins to draw more dental graduates directly into private practice, the number of persons willing to enter residencies in OMS, as well as spend the added time to acquire a second degree, will quickly diminish.” For the sake of our specialty, I hope that Dr Booth is wrong.
doi:10.1053/joms.2002.34953
RECURRENCE RATES IN ORAL CANCER To the Editor:—There is a misleading error in Steven R. Schimmele’s article, “Delayed Reconstruction of Continuity Defects of the Mandible After Tumor Surgery” in the November 2001 issue (J Oral Maxillofac Surg 59:1340, 2001). Dr Schimmele states that “seventy percent of these lesions (squamous cell carcinoma [SCC]) will recur in the first postablative year” and goes on to call this a “70% recurrence rate.” According to information from lectures, papers, and chapters by Robert Marx, 65% to 70% of oral SCC patients who have a recurrence will have that recurrence within 1 year of their ablative surgery. That is not the same as a 70% recurrence rate for oral SCC. Dr Marx uses this statistic to recommend reconstruction at 1 year rather than waiting 3 to 5 years as was done in the past. I do not necessarily disagree with Dr Schimmele’s recommendations for delayed reconstruction, but the data should be reported correctly.
ERICK J. EKLUND, DDS Santa Cruz, CA
Reference 1. Marx RE, Saunders TR: Reconstruction and Rehabilitation of Cancer Patients, in Fonseca RJ, Davis WH (eds): Reconstructive Preprosthetic Oral and Maxillofacial Surgery. Philadelphia, PA, Saunders, 1986, pp 347-428
ALAN S. HERFORD, DDS, MD Loma Linda, CA
doi:10.1053/joms.2002.34322
Letters to the Editor are considered for publication (subject to editing and abridgment), provided they are submitted in 1 of 2 ways. If typewritten, they must be submitted in duplicate, signed by all authors, double-spaced, and should not exceed 40 typewritten lines of manuscript text (excluding references). You may also e-mail your Letters to the Editor to [email protected]. The same length limits apply. Letters should not duplicate similar material being submitted or published elsewhere. Letters to a recent Journal article must be received within 6 weeks of the article’s publication. Receipt of letters is not acknowledged and there is no guarantee that your letter will be published. We cannot provide prepublication proofs. Submitting the letter constitutes your permission for its publication in any current or subsequent issue or edition of the Journal, in any form or media, now known or hereafter developed.
844
References
INTEGRATION OF THE MEDICAL DEGREE IN ORAL AND MAXILLOFACIAL SURGERY: A 10-YEAR FOLLOW-UP
1. Edwards RC, Foley WL: Expanding the specialty: A survey of the oral and maxillofacial residencies in the United States. J Oral Maxillofac Surg 51:559, 1993 2. Laskin DM: The MD degree: A panacea or a problem? J Oral Maxillofac Surg 55:209, 1997
To the Editor:—It is not often that an article generates 2 Discussions. I would like to address some of the comments included in the Discussions that followed the article by myself and Drs Pulsipher and Sinn that appeared in the Journal (J Oral Maxillofac Surg 59:1471, 2001). I appreciate Dr Booth (J Oral Maxillofac Surg 59:1477, 2001) checking the references in our article, but unfortunately he failed to check the fourth reference. Dr Booth correctly pointed out that a 1993 article by Edwards and Foley1 did not state that 38% of residencies were MD-oral and maxillofacial surgeon (OMS) programs and that 43% of the OMS residents had their MD degree. The article by Edwards and Foley (first reference) in fact did not make this statement. It should have been referenced to Dr Laskin2 (fourth reference) and I apologize for any confusion that may have caused. I disagree with the statement that the “controversy over single degree versus double degree is only relevant to those persons who believe that our specialty should be solely single or solely double-degree oriented.” I would think that informed decision making would be important to graduating dental students who are about to devote 4 to 7 years to postgraduate training. I currently train 4-year residents who, upon finishing residency, are competent in performing fullscope oral and maxillofacial surgical procedures. Unfortunately, there are places in which legislation makes it more difficult for a qualified non-MD oral and maxillofacial surgeon to practice some procedures. I agree completely with Dr Kelly (J Oral Maxillofac Surg 59:1478, 2001) in that “the reasons for obtaining a medical degree include the enhancement of fundamental knowledge and the provision of a common basic surgical training for one who aspires to be an oral and maxillofacial surgeon.” I continue to believe that the majority of people that will enter our specialty will not be guided by “the lure of high salaries . . . into private practice” as Dr Booth would have us believe. For many of us, especially in academics, there is more to it than “economics.” Dr Booth also states that “as the lure of high salaries begins to draw more dental graduates directly into private practice, the number of persons willing to enter residencies in OMS, as well as spend the added time to acquire a second degree, will quickly diminish.” For the sake of our specialty, I hope that Dr Booth is wrong.
doi:10.1053/joms.2002.34953
RECURRENCE RATES IN ORAL CANCER To the Editor:—There is a misleading error in Steven R. Schimmele’s article, “Delayed Reconstruction of Continuity Defects of the Mandible After Tumor Surgery” in the November 2001 issue (J Oral Maxillofac Surg 59:1340, 2001). Dr Schimmele states that “seventy percent of these lesions (squamous cell carcinoma [SCC]) will recur in the first postablative year” and goes on to call this a “70% recurrence rate.” According to information from lectures, papers, and chapters by Robert Marx, 65% to 70% of oral SCC patients who have a recurrence will have that recurrence within 1 year of their ablative surgery. That is not the same as a 70% recurrence rate for oral SCC. Dr Marx uses this statistic to recommend reconstruction at 1 year rather than waiting 3 to 5 years as was done in the past. I do not necessarily disagree with Dr Schimmele’s recommendations for delayed reconstruction, but the data should be reported correctly.
ERICK J. EKLUND, DDS Santa Cruz, CA
Reference 1. Marx RE, Saunders TR: Reconstruction and Rehabilitation of Cancer Patients, in Fonseca RJ, Davis WH (eds): Reconstructive Preprosthetic Oral and Maxillofacial Surgery. Philadelphia, PA, Saunders, 1986, pp 347-428
ALAN S. HERFORD, DDS, MD Loma Linda, CA
doi:10.1053/joms.2002.34322
Letters to the Editor are considered for publication (subject to editing and abridgment), provided they are submitted in 1 of 2 ways. If typewritten, they must be submitted in duplicate, signed by all authors, double-spaced, and should not exceed 40 typewritten lines of manuscript text (excluding references). You may also e-mail your Letters to the Editor to [email protected]. The same length limits apply. Letters should not duplicate similar material being submitted or published elsewhere. Letters to a recent Journal article must be received within 6 weeks of the article’s publication. Receipt of letters is not acknowledged and there is no guarantee that your letter will be published. We cannot provide prepublication proofs. Submitting the letter constitutes your permission for its publication in any current or subsequent issue or edition of the Journal, in any form or media, now known or hereafter developed.
844