User talk:Entp105

October 2007
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= Craniofacial surgery =

If you will notice on the talk page on the article: "Craniofacial surgery". I have listed more information regarding Craniofacial surgery Fellowships available to OMFS surgeons. These fellowships are legal equivalents to PRS Craniofacial fellowships and both types of fellowships complete similar types of and number of cases. Both are considered equal in regards to training someone to become a Craniofacial surgeon.

Craniofacial surgery is a shared surgical field similar to hand surgery.

OMFS is not listed under ACGME, but neither is Osteopathic Plastic surgery residencies, but similarly they are are also legal equivalents and legally allowed to perform the same operations as an ACGME PRS graduate.

Please add to the "talk page" with additional information prior to continued reverts to this article.

Thank you!

Jwri7474 03:16, 21 October 2007 (UTC)

To Whom It May Concern:

You are not correct. It is not a shared specialty. The specialties overlap in certain limited areas, but this small area of overlap does not mean equivalent. ACGME is the accrediting body for surgeons in the United States of America and it states that the specialty is one of Plastic Surgery.

Being a ACGME aproved, residency trained Craniofacial Surgeon, and the Director of Craniofacial Surgery at my University, I take umbrage to the fact that you consider them legal equals. They are not. OMFS is a dental specialty in the United States, it is not a surgical subspecialty. I seriously doubt that any OMFS is doing Craniosynostosis cases, Ear reconstruction, facial nerve transfers or hypertelorism repairs (to name a few). It is well beyond the scope of that specialty, and without the mandated training in General surgery, and Plastic surgery it will remain as such. In addition, these broad surgical privileges are not granted to single degree OMFS, nor dual degree OMFS in any private hospitals that I am aware of. New York City Health and Hospitals Corporation is an anomaly. It is very easy to broaden the scope of your practice when your are indemnified by the City of New York.

This may not be the case in Great Britian. Therefore, since I initially wrote this piece, and it is the one referred to for the United States I will continue to correct it.

In regards to Osteopathic Plastic Surgery, Osteopathic Plastic Surgeons can still sit for the American Board of Plastic Surgery Qualifying Exams. OMFS cannot.

Dear Entp105,

Osteopathic Plastic surgeons are not ACGME accredited either, yet you still infer that they are able to provide craniofacial surgery regardless of whether they are "fellowship trained" or "board certified" or not. (which is true) Furthermore, if it is also my understanding that less than half of "allopathic" PRS craniofacial fellowships are even certified by ACGME anyhow.

ACGME does not 'own' the field of craniofacial surgery, ACGME PRS programs are simply one of a few different programs that offer education in these surgical techniques.

Most OMFS residencies (dual or single degree) log just as many if not more (depending on the program) Lefort I,II,III advancements as most US plastics program. On average trainees in both specialties do very few fronto-orbital advancements and craniosynostosis (as residents). When it comes down to who is competent to do a certain procedure or not it really has to do with how many cases have you logged. Neither PRS nor OMFS programs provide (I feel) enough cases for most to be fully competent craniofacial surgeons. That is why they have fellowships as I'm sure you'll agree. There are craniofacial surgery fellowships available to both OMFS and PRS graduates (I'm sorry if you disagree on this point, but it is true). Not only in the UK, but '''even in the US it is legally within the scope of OMFS to provide this form of treatment and if an OMFS graduate has completed a craniofacial surgery fellowship and has logged just as many if not more similar cases as a PRS craniofacial fellow then they would be both just as competent and legally able to provide these surgical services. ''' Jwri7474 07:40, 9 November 2007 (UTC)

Ent105, If you feel someone like Bernard Costello (http://www.dental.pitt.edu/patients/cran.php) should not be calling himself a "craniofacial surgeon", maybe you should contact him and explain to him why you feel he should not be allowed this title.

Also, I'm sorry you take offense to this however, if you still disagree that they are "legal equals"; then I challenge you to take BJ Costello or any other similarly trained OMFS craniofacial surgeon to court and get his license revoked from providing craniofacial surgery services. Plastic surgeons tried to do this in California recently against single degree OMS providing facial cosmetic surgery and they lost. The courts supported OMS ability to provide these services, what makes you think that they will not support OMS in the provision of craniofacial surgery? (especially when even at the resident level OMS trainees log a lot more "relavent procedures" ie. orthognathic and H/N distraction cases than most plastic trainees).


 * You mentioned that, you doubt any OMFS in the US are doing craniosynostosis cases, ear reconstruction, facial nerve transfers or hypertelorism repairs. Well, I would be more than happy to send you a list of names that currently do if you require them.

Regarding international differences and wiki: Wiki is a source of information on topics from an international perspective. The title of the page was "craniofacial surgery" it was not "craniofacial surgery in the United States", therefore it is going to reflect information from around the world. If you wish to add a subsection to this article entitled "craniofacial surgery training in the US", then by all means go ahead. However, you have yet to prove that it is illegal for OMFS to practice "craniofacial surgery" even in the US. So, I will continue to support the fact that they are until proven otherwise. Jwri7474 07:55, 9 November 2007 (UTC)