Ask An Expert: Challenges in Implementing OMS into a Contemporary Dental School Curriculum

Article from Australia

Seth Delpachitra

Head of OMS

Royal Denton Hospital of Melbourne

What position/s do you currently hold?

Currently, I am the head of OMS at the Royal Dental Hospital of Melbourne, and an Associate Professor of OMS at The University of Melbourne. I also work at several public hospitals across Victoria.

Can you give us a snapshot of the Australian dental student curriculum when it comes to Oral and Maxillofacial Surgery?

Absolutely. In Australia, dental schools are held to a national standard set by the Australian Dental Council, so all schools must include an introduction to each dental specialty as part of their training. Unfortunately, that is where the guideline ends – and so not all dental schools are the same. Some schools have a deeply integrated OMS programme into their four- or five-year degrees, where students have dedicated lectures, a broad scope of learning, and hands-on clinical exposure to surgery.

On the other side of the spectrum, there are other Australian universities which do not have an oral and maxillofacial surgeon on staff at all and rely on their other academic staff to lead the discipline.

You’ve mentioned the importance of involving clinical leaders in dental schools. Why do you think that is?

It is absolutely critical. Dental schools which have a relationship with their local OMS units, or have an oral and maxillofacial surgeon leading their clinical discipline, are much more likely to produce a high-quality programme built into the degree coursework. Surgeons not only bring the clinical knowledge and expertise, but have a series of relationships and networks with tertiary surgical units and other surgeons, and can leverage these to facilitate a comprehensive clinical-based experience for students.

Universities often find it difficult to navigate the complex administrative aspects of hospitals, including accreditation, and dual-employed clinicians are in the ideal position to act as a liaison between the two organisations.

Sounds like a challenge. What are some of the other challenges you’ve faced in trying to increase OMS exposure in dental school?

Where do I start!? I think at the most basic level - the biggest challenge we have in Australia is the structural separation of the national college (Royal Australasian College of Dental Surgeons) from universities in Australia. The specialist OMS curriculum for training surgeons is provided by the RACDS; for all other dental specialties, this is facilitated by individual universities. This automatically limits the number of academic oral and maxillofacial surgeon positions in universities, as there is no ability to link staff position to university revenues.

At a geographic level, due to healthcare funding structures and an increasing separation between medicine and dentistry, most dental schools are not co-located within hospitals anymore, and this automatically separates dentistry from the main area of practice of oral and maxillofacial surgery.

As I mentioned, there are huge administrative and legal considerations in getting dental students into hospital, as far as liability insurance, placement rostering and coordination, and student scope of practice are concerned.

Finally, and importantly, the scope of practice of general dentistry is rapidly growing, and degree programs are getting filled with additional teaching in so many directions that specialty dentistry can so often get crowded out.

Where do you see dental schools going in the future when it comes to teaching OMS?

I hope that OMS remains part of the core curriculum for dental students – not just for the surgical dentistry elements, but for the richer understanding of medicine in general that comes with being an oral and maxillofacial surgeon.

OMS is a diverse specialty at the intersection of the two disciplines of both dentistry and medicine and provides important perspective for dental students in their formative years. It is crucial that we continue to advocate for ongoing involvement of oral and maxillofacial surgeons in university dental education.