Vol. 118 No. 4 October 2014
EDITORIAL
Academic oral and maxillofacial surgery
Mentoring as a partnership in personal and professional growth and development is seen to be central to academic oral and maxillofacial surgery (OMFS). The efficacy of mentoring in the academic OMFS setting is challenged by clinical, administrative, research, and other educational demands. Nevertheless, mentorship is important; in a survey of 24 US medical schools, faculty members with mentors had significantly higher career-satisfaction scores than those without mentors. A 2004 study of Canadian obstetrics/gynecology fellows found that those who had a mentor were more likely to achieve promotion. Similarly, in a 2002 study, 38% of junior faculty members who did not have mentors left the organization, compared with 15% of those who did have mentors; 38% of junior faculty members who did not have mentors left the organization, compared with 15% of those who did have mentors. In some fields, fewer than 20% of faculty members had a mentor; women seem to have more difficulty finding mentors than men, but mentorship is perceived to have an important influence on career development, specialty choice, research productivity, publication, and grant success. What can we learn from this literature? Unfortunately, the poor quality of the studies does not allow conclusions to be drawn on any aspect of academic and professional development. The limitations of the evidence preclude its use to suggest mentorship strategies that should be implemented at academic institutions. What should we do? In my view, we must develop education and faculty development initiatives and subject them to the same valid outcomes assessment as those expected for clinical trials. We must also foster and promote the advantages of practicing OMFS in an academic health care center. What are some of those advantages? 1. Students a. Undergraduate These are usually but not necessarily science students who make excellent summer research students in whom we have the opportunity to stimulate an early interest in OMFS. b. Medical and dental In this group of students we have an opportunity to influence primary care practitioners and build a
2.
3.
4.
5.
6.
future referral base for teaching center referrals. In this group we can also promote interest and understanding of OMFS. c. Postgraduate (PGY) During residency, academic clinicians have the opportunity to recruit the best PGY students to an academic career. In the broader sense, we can promote patient-centered collaboration among all PGY clinical disciplines, which by definition will demonstrate respect and understanding of overlapping disciplines while at the same time will strengthen the scope of OMFS. Colleagues In today’s modern academic health care center, there is a remarkable depth of fascinating faculty members with whom one can collaborate in both research and scholarly activity. From our senior colleagues we can learn and teach, with our junior colleagues we can teach and learn, and with our contemporaries we can confess. Scope of practice Many advanced diagnostic and treatment procedures require tertiary level facilities and support infrastructure. A very broad scope of practice is often possible only when there are support systems such as an intensive care unit, advanced imaging expertise, sophisticated surgical equipment, and medical/ nursing team care. Remuneration It is not unusual for private practice overhead to run at 60% or more, which in effect translates to the clinician working for the landlord, staff, and suppliers about 3 days of each week. Although this is not a straight-line comparison, the academic clinician often uses this time to publish and conduct research. “Peer review” Everyone benefits from regular institutional clinical appraisal. In most academic health care centers, this departmental activity is mandatory, and, importantly, it is protected by state evidence acts. Regular clinical appraisal not only enhances patient care but also serves as a benchmark to foster clinical outcomes research. Shape the future When one practices in an academic health care center, one participates in the rapid increase in
385
EDITORIAL 386 Precious
scientific knowledge that is the foundation on which future health care advances are made. One truly has an opportunity to shape the future. In summary, academic oral and maxillofacial surgery still has a lot going for it!
OOOO October 2014
David S. Precious Dalhousie University Halifax Nova Scotia, Canada [email protected] http://dx.doi.org/10.1016/j.oooo.2014.06.009
EDITORIAL
Academic oral and maxillofacial surgery
Mentoring as a partnership in personal and professional growth and development is seen to be central to academic oral and maxillofacial surgery (OMFS). The efficacy of mentoring in the academic OMFS setting is challenged by clinical, administrative, research, and other educational demands. Nevertheless, mentorship is important; in a survey of 24 US medical schools, faculty members with mentors had significantly higher career-satisfaction scores than those without mentors. A 2004 study of Canadian obstetrics/gynecology fellows found that those who had a mentor were more likely to achieve promotion. Similarly, in a 2002 study, 38% of junior faculty members who did not have mentors left the organization, compared with 15% of those who did have mentors; 38% of junior faculty members who did not have mentors left the organization, compared with 15% of those who did have mentors. In some fields, fewer than 20% of faculty members had a mentor; women seem to have more difficulty finding mentors than men, but mentorship is perceived to have an important influence on career development, specialty choice, research productivity, publication, and grant success. What can we learn from this literature? Unfortunately, the poor quality of the studies does not allow conclusions to be drawn on any aspect of academic and professional development. The limitations of the evidence preclude its use to suggest mentorship strategies that should be implemented at academic institutions. What should we do? In my view, we must develop education and faculty development initiatives and subject them to the same valid outcomes assessment as those expected for clinical trials. We must also foster and promote the advantages of practicing OMFS in an academic health care center. What are some of those advantages? 1. Students a. Undergraduate These are usually but not necessarily science students who make excellent summer research students in whom we have the opportunity to stimulate an early interest in OMFS. b. Medical and dental In this group of students we have an opportunity to influence primary care practitioners and build a
2.
3.
4.
5.
6.
future referral base for teaching center referrals. In this group we can also promote interest and understanding of OMFS. c. Postgraduate (PGY) During residency, academic clinicians have the opportunity to recruit the best PGY students to an academic career. In the broader sense, we can promote patient-centered collaboration among all PGY clinical disciplines, which by definition will demonstrate respect and understanding of overlapping disciplines while at the same time will strengthen the scope of OMFS. Colleagues In today’s modern academic health care center, there is a remarkable depth of fascinating faculty members with whom one can collaborate in both research and scholarly activity. From our senior colleagues we can learn and teach, with our junior colleagues we can teach and learn, and with our contemporaries we can confess. Scope of practice Many advanced diagnostic and treatment procedures require tertiary level facilities and support infrastructure. A very broad scope of practice is often possible only when there are support systems such as an intensive care unit, advanced imaging expertise, sophisticated surgical equipment, and medical/ nursing team care. Remuneration It is not unusual for private practice overhead to run at 60% or more, which in effect translates to the clinician working for the landlord, staff, and suppliers about 3 days of each week. Although this is not a straight-line comparison, the academic clinician often uses this time to publish and conduct research. “Peer review” Everyone benefits from regular institutional clinical appraisal. In most academic health care centers, this departmental activity is mandatory, and, importantly, it is protected by state evidence acts. Regular clinical appraisal not only enhances patient care but also serves as a benchmark to foster clinical outcomes research. Shape the future When one practices in an academic health care center, one participates in the rapid increase in
385
EDITORIAL 386 Precious
scientific knowledge that is the foundation on which future health care advances are made. One truly has an opportunity to shape the future. In summary, academic oral and maxillofacial surgery still has a lot going for it!
OOOO October 2014
David S. Precious Dalhousie University Halifax Nova Scotia, Canada [email protected] http://dx.doi.org/10.1016/j.oooo.2014.06.009
