Abstract
There have been strategic clinical, educational, and research advances in the field of Oral Medicine over the past several decades. In many cases, Oral Medicine experts are contributing the lead role in these advances nationally and internationally. In addition, American Board of Dental Specialty recognition of Oral Medicine as a specialty in 2015 has positioned Oral Medicine professionals to substantively enhance the delivery of oral health care to medically complex patients as well. It is now important and timely to capitalize on this contemporary foundation, to advance the field of Oral Medicine in the United States for the next generation of Oral Medicine specialists and practitioners. This article provides the results of analyses of the present dynamics and economic opportunities, as well as solutions to existing perceived barriers.
| Original language | English |
|---|---|
| Pages (from-to) | 409-414 |
| Number of pages | 6 |
| Journal | Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology |
| Volume | 126 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 2018 |
Bibliographical note
Publisher Copyright:© 2018
Funding
We now turn our attention to the Oral Medicine Residency programs in relation to the next generation of Oral Medicine practitioners. Here, the history is rich with advanced education programs that have trained many Oral Medicinists. Programs that were initiated in the late 1960s and early 1970s originated at Indiana University, the University of Washington, the University of Pennsylvania, and the University of California at San Francisco. During the 1980s, programs emerged at the National Institutes of Health, the U.S. Navy, and the University of Texas Health Science Center at San Antonio. During the last 20 years, there have been programs at the University of Medicine and Dentistry of New Jersey, Harvard University, the Carolinas Medical Center, the University of Southern California, and Tufts University, and in the University of Alberta and the University of British Columbia in Canada. Critical to these training programs are questions that encompass the number of graduates needed, the career path of these graduates, and the skillset required for these graduates to serve the public during a 35-year career that will span 2020 to 2055. In an effort to address these issues, we surveyed the Program Directors of the 11 active advanced education programs in Oral Medicine in North America. Information regarding their graduates, year of graduation, Diplomate status, and employment status were requested. In addition, 179 American Board of Oral Medicine (ABOM) Diplomates who were in “active status” were e-mailed a request for information regarding their year of graduation and name of the Oral Medicine Residency program they attended. Responses were received from 9 Program Directors and 154 of 179 (86%) of the active Diplomates. presents a compilation of these data and demonstrates that a majority of graduates successfully pass the ABOM Board examination and enter academia or a government position. Approximately a third is in private practice, and a minority is in industry or has an unknown status. illustrates the growth trend in the number of ABOM Diplomates by decade since 1956. Growth in the number of Diplomates has plateaued over the past 3 decades, with an average of 3.9 graduates obtaining ABOM Diplomates status annually in the past 2 decades. This number is nearly equivalent to the 3.8 Diplomates predicted to retire per year over the next decade based on a 35-year career. Table II Figure 1 These data indicate that the current number of Diplomates is stable but not growing. We therefore ask, “Is that concerning?” Should the Academy and directors of advanced education programs in Oral Medicine be strategically planning for tackling this issue and begin wrestling with this early maturation of the specialty? Targets for discussion include addressing the need for trained providers and specialists who seek a career in private practice, the presence of a perceived shortage, the current and predicted wait times for appointments, and the number of practitioners needed to treat the conditions we train our graduates to manage. As our institutions continue to grapple with these issues, there is an additional layer of complexity involving how Oral Medicine accommodates training to emphasize precision medicine, augmented cognition, big data, molecular biology, and creative disruption. Fortunately, there is considerable potential for impact and health care changes resulting from specialty recognition and our Academy, Diplomate, Fellow, and graduate programs working in unison toward a common goal. For example: • Patients can benefit from implementing the objectives of the “Choosing Wisely” program advocated by the American Board of Internal Medicine Foundation. 13 The aims of this modeling are to promote conversations between clinicians and patients by helping patients choose care that is (1) supported by evidence, (2) not duplicative of other tests or procedures already received, (3) free from harm, and (4) truly necessary. • In this context, access to care can be improved by formally targeting insurance and legislative decision-makers, whereupon payers of health care are educated of the importance of Oral Medicine–related health care issues and the difference we can make in providing improved quality of life for millions of patients. • Oral Medicine Residency Program Directors should be actively engaged in enhancing the curricula and training experiences that allow for growth in the numbers of applicants, in the training of residents, and in the creation of opportunities for externs and fellows to expand their knowledge base and types of issues they could be addressing, with consideration of the needs of the future. • Continued involvement in the World Workshop of Oral Medicine (WWOM) remains critical to the collaborative growth of our profession. WWOM VI was conducted in April 2014 in collaboration with the AAOM in Orlando, FL, USA. Twenty-five countries were represented in this conference. WWOM VII is scheduled for September 24–26, 2018, in Gothenburg, Sweden, in conjunction with the 14th Biennial European Association of Oral Medicine Congress, September 27–29, 2018. As with prior World Workshops, the roster of WWOM VII attendees represents a comprehensive registry of participants from around the globe. • Interprofessional education can grow and benefit from our involvement. 14 These activities will require financial, personal, organizational, and political investments that will stimulate growth and prominence of Oral Medicine both in clinical practice and at academic centers.
| Funders | Funder number |
|---|---|
| National Institutes of Health (NIH) | |
| The University of Texas Health Science Center at San Antonio | |
| U.S. Navy Air Systems Command |
ASJC Scopus subject areas
- Surgery
- Oral Surgery
- Pathology and Forensic Medicine
- Dentistry (miscellaneous)
- Radiology Nuclear Medicine and imaging