Congratulations on matching! July 1st is quickly approaching, and I’m sure this date holds a lot of mixed feelings for you. Before starting, I’m sure you will receive a lot of opinions about what you should and should not do, so I included some things to think about prior to starting. I’ve put this into residency-focused material and things to consider outside of residency. Although I’m including a list of many things, by no means is this comprehensive or required. This is purely a means of sharing available resources.
Residency
Most programs will assume that on the day you start, you know next to nothing about oral surgery. That being said, there are also things that they expect you to know from dental school. These include the basics of local anesthesia, anatomy, general suturing concepts, and the procedures within the scope of oral and maxillofacial surgery. It is highly unlikely they would expect you to know the approaches for procedures or the indications or contraindications of each. It’s important to keep in mind that a lot of residency is problem-solving. Start with an open mind and be willing to be taught. Below are resources available to you to either refresh your knowledge or serve as a reference for your studies.
- BLS/ACLS/PALS/ATLS
Every program will in some form have residents complete BLS/ACLS/PALS. Some may even start with ATLS, but usually, that is incorporated with general surgery. These courses can sometimes be overwhelming and are a lot of information to memorize. The thing to keep in mind is that these algorithms will serve as the basis for how to manage nearly any emergency. Download the PDFs to your phone as you never know when you may need to use them. Better yet, take your time doing the course and have the information down cold. This is one of the few things to absolutely do before residency.
BLS/ACLS/PALS Algorithms - Anatomy
As mentioned earlier, a lot of residency is problem-solving. In order to solve problems, you need a firm foundation of the tools you have and the environment you are working in. In our field, anatomy is the environment. With a firm grasp of anatomy, you can consider what your goal of treatment is, what to avoid, and relative contraindications. Not knowing the anatomy is very dangerous, and it can lead to malpractice or injury to the patient. Refresh and commit to memory the muscles, nerves, and vessels of the face. Fortunately, you will be working with this anatomy for the rest of your life and therefore should be enough incentive to have a firm understanding of it. - Local anesthesia
With anatomy, you understand where you’re working, whereas local anesthesia is one of your most important tools. Although the local anesthetics we use have a very safe profile, they are not without risk. You should be able to quickly calculate the maximum dosages you can use for lidocaine, septocaine, marcaine and when each of those is contraindicated. - Suturing
Similar to local anesthesia, suturing is another important tool at the OMFS disposal. Review the OMFS Suturing Guide on the website and know which types of sutures you have available as well as basic techniques. Also included is information about local anesthesia. - Step 1
Some programs require taking step one prior to matriculation or very early. Step one is an entirely different beast and requires a separate place for discourse. However, the same skills you used to take the CBSE are applicable for step one. There are also endless amounts of forums and resources available to you. If you are attending one of these programs, you know what you need to do and the road is well worn with advice. Listen to your senior residents and follow their instructions. - Books and Journals
There are several different textbooks available for oral surgery. Everyone has a preference and some are better than others in certain respects. The important thing is to have a primary literature resource to reference during your studies. Some of the more popular ones are included below:- Peterson’s Principles of Oral and Maxillofacial Surgery
- Atlas of Oral and Maxillofacial Surgery
- Fonseca Oral and Maxillofacial Surgery
- Oral and Maxillofacial Surgery Clinics (journal)
- JOMS (get it free while a resident)
Life
For those transitioning from dental school to residency, the focus on the residency aspect tends to blind people of their considerations for things going on in their life. During this time period, people are not only transitioning from dental school but often into their first paying job, loan repayment, long-term relationships including marriage, and other big life events. Don’t let residency completely overwhelm you to the extent that you disregard these things. There are some very important things you can do during this time to save money and set yourself up for long-term success. - Personal Finance
For many entering residency, it is likely the first large paycheck you’ve ever received in addition to having a student loan burden greater than most other professions. Take the time to evaluate your situation and create a plan. Inaction is a very poor judgment choice for somebody that has made it this far. Don’t make any excuses and take care of your financial health. I would encourage every single resident to read the White Coat Investor at the bare minimum. It is not perfect, but it sets you up with a firm foundation of personal financial knowledge. If you do not want to pay for the book, his website has basically all the information you need. Some of the more pertinent articles I have linked below. A second book option is The Psychology of Money, by Morgan Housel. Both are great reads that I recommend.
- Licensure
Licensure is by no means a requirement for programs other than being “license eligible.” This means you have passed one of the dental boards and are able to be licensed in a state if you applied. I am unaware of any programs that specifically require an independent dental license in the state you are training. If that is the case, please comment below to update those looking. Reasons to still apply for your license include moonlighting, building years of practice in the eyes of the state, and getting it out of the way so you don’t have to do it at the end of residency. Cons include taking the time to do it and paying licensure fees each year. This is purely a personal decision. I applied for licensure immediately after dental school and I do not regret it.
- Mental and Physical Health
Residency is a very difficult time both mentally and physically. Four to six years is also a very long time to neglect your health. Don’t forget to put systems in place to eat well, exercise, and relax. Attention to mind, body, and spirit go a long way in keeping you focused during residency. These are also very personal things for each individual to approach. I will not give any specific advice here other than pay attention to these things and have a plan in place for creating and maintaining good habits. For advice on habits, Atomic Habits by James Clear is a great read with many suggestions to put processes in place to take care of yourself.
Since I personally recommend enjoying your free time prior to starting, I have kept this article and advice brief. It is meant to be a resource to peruse to your liking and for you to reference if necessary. Good luck on July 1st and welcome to the world of OMFS!