Oral and Maxillofacial Surgery: It’s Future as a Specialty

Abstract

The specialty of Oral & Maxillofacial Surgery (OMFS) as we know it now is bound to change drastically in our lifetime. The driving forces for this change are varied and multifactorial, some of which are the cost and length of training combined with the prevailing dichotomy in scope of practice between traditional and expanded areas of practice. The formation of sub-specialties within the specialty—oncologic and reconstructive surgery, facial aesthetics, hospital based practitioners and office based practitioners, dental and medically qualified practitioners complicate the issue further. At an international level there is a continuous debate about the need to level the playing fields of training in OMFS in different parts of the world and measures implemented towards it. In addition there is an acute need to accept emergence of new technology in practice and training and consider the competition from allied medical and dental specialties. Internationally the specialty has always been on a pendulous path remaining undecided on the idea of whether it wants to stay a dental specialty or whether it wants to incorporate the medical degree. In the USA where this trend initially started, the specialty is protected by the national, regional and local organizations as a dental specialty without any practical differences in the scope of practice between single or double degree practitioners. In the UK and many parts of Europe, the specialty has taken leaps and bounds towards the medical path of training and it could very well be only a matter of time before the Specialty remains only remotely associated with Dentistry. The primary challenge was a lack of understanding which centered around the debate of whether a medical as well as a dental qualification was required prior to surgical training. The International Association of Oral and Maxillofacial Surgeons (IAOMS) has debated this vexatious issue ever since its inception 50 years ago. Unfortunately, it took most of the first forty years sparring on this issue within the Association. In 2001, it was finally decided through acceptance of the International Guidelines for Training and Education in Oral and Maxillofacial Surgery, that regional differences in training existed and were acceptable. This document stated that the actual surgical training in the oral and maxillofacial region was what qualified one to become an oral and maxillofacial surgeon in the country or region, regardless of whether one had dental and/or medical qualification. The issue was very succinctly presented by Laskin [1] where he makes a case for some basic issues to be addressed to resolve the situation. Primarily among these is K. Nayak (&) International Association of Oral and Maxillofacial Surgeons (IAOMS) 2012-13, Bangalore, India e-mail: kishorenayak@gmail.com