IAOMS Face to Face Issue 42

www.icoms2015.com

REGISTRATION NOW OPEN We are pleased to announce that registration is now open for ICOMS 2015.

The Conference will be held from 27 – 30 October 2015 at the Melbourne Convention and Exhibition Centre, located in the heart of the world’s most liveable city, Melbourne.

Visit the website (www.icoms2015.com) now for all the information you will need to assist in your plans – registration, social events, optional tours and accommodation. You don’t want to miss this experience.

Please find below an invitation message from the IAOMS President Piet Haers and the ICOMS 2015 Conference Chair David Wiesenfeld.

We look forward to welcoming you to Melbourne in October.

CLICK HERE TO REGISTER

PROGRAM A preliminary program for ICOMS 2015 is now available. The program is designed to assist with your travel plans and provide an overall view of the program which will showcase a variety of themes complemented by our invited speakers and free papers sessions. Please visit the website (www.icoms2015.com/program/) to view the preliminary program.

We are pleased to announce an outstanding faculty of national and international speakers for the Conference. Visit the website (www.icoms2015.com/invited-speakers/) for further information.

Pre-Conference Workshops supported by our Industry Partners will be held in the days immediately preceding the Conference. Further information will be available on the website (www.icoms2015.com/program/) shortly.

View the video below for an overview of the program highlights.

22ND I N T ERN AT IONAL C ONFE R ENCE ON ORAL & M A X IL LO FACIAL SURGE R Y

SOCIAL EVENTS To complement the outstanding scientific program, an equally outstanding social program has been developed to allow you the chance to relax, enjoy and experience genuine hospitality whilst you are in Melbourne. Please visit the website for more information (www.icoms2015.com/social-page/)

IAOMS FOUNDATION EVENTS The IAOMS Foundation events held during ICOMS 2015 offer you an outstanding experience while making a valued contribution to the Foundation and its programs. Find out more about these events and book via the online registration form to secure your place (www.icoms2015.com/iaoms-foundation-page/)

ACCOMPANYING PERSONS

We are delighted to invite accompanying persons to the Conference. For more information on the activities on offer please visit the website (www.icoms2015.com/registration/accompanyingpersons/)

SPONSORSHIP & EXHIBITION ICOMS 2015 offers a prime opportunity for providers of services and equipment within this specialised field to establish new and consolidate and grow existing networks and relationships.To find out more please visit the website (www.icoms2015.com/sponsorship-exhibition/)

WE ACKNOWLEDGE THE SUPPORT OF OUR VALUED PARTNERS: ®

PLATINUM PARTNERS M a k e

i t

S i m p l e

GOLD PARTNERS

SILVER PARTNERS

PROUDLY SUPPORTED BY

Please visit the Conference website for further information www.icoms2015.com, or contact WALDRONSMITH Management: 119 Buckhurst Street ❙ South Melbourne VIC 3205 Australia T +61 3 9645 6311 ❙ F +61 3 9645 6322 E ICOMS2015@wsm.com.au ❙ www.icoms2015.com

Issue 42 / July 2015

Editor-in-Chief Javier González Lagunas

Managing Editor Lisa Markovic

Graphic Designer María Montesinos

Executive Committee 2014 – 2016 Board of Directors Piet Haers, President Kishore Nayak, Past President Julio Acero, Vice President Alexis Olsson, Vice President Elect Robert T.M. Woodwards, Treasurer Larry W. Nissen, Foundation Chairman Pierre Désy, Executive Director

Members-at-Large Gabriele A. Millesi Sanjiv Nair Javier Gonzalez Lagunas

Regional Representatives Addellfattah Sadakah, Africa Kenichi Kurita, Asia Henri Thuau, Europe Alejandro Martinez, Latin American Arthur Jee, North American David Wiesenfeld, Oceania

Committee Chairmen Rui Fernandes, Education Committee Joseph Helman, Research Committee Deepak Krishnan, IAOMST Committee Steve Roser, HADR Committee Fred Rozema, IT Advisory Committee Mark Wong, IBCSOMS Committee Juan Antonio Hueto Madrid, eLearning Sub-Committee

CONTACT US IAOMS

5550 Meadowbrook Industrial Court, Suite 210, Rolling Meadows, IL 60008 U.S.A. 1.224.232.8737 / communications@iaoms.org

Letter from the Editor HOW I SEE IT

I

t is not a problem of shares, it is just a matter of justice. With an increasing number of women entering the medical profession, we thought we needed to give a closer look to the situation in our association, and by extension in our speciality. A higher and higher proportion of women is entering the medical/dental schools , so it is the right time to give voice to a number of them. Not because of their gender, but because all of them are leaders in our field.

How will feminization affect our speciality? Just a few numbers: in Spain more then 70% of the medical and dental students are females. In Finland 75% of practicing dentists are women.

In India around 50% of all dental students are women, but only 15% of the deans of dental schools are females. In Canada and in the US women comprise 50 to 60% of all medical students. In the UK, among women finishing their training 44% are pediatricians, 49% are in public health and only 8% are in surgical specialities. In other surgical such as surgery or Orthopedics in the US, women enrolling in residency programs are only 25 and 8% respectively.

Some gender differences have been documented and seem to be common in most countries: better communication skills, less liability, more preventive care, less working hours, job sharing. Those facts, simple as they are, will affect the relationships between doctors and patients, between doctors and the administration, and doctors and their peers. So, in the next few years we will probably face a totally new scenario in the functioning of medicine/dentistry in general and oral and maxillofacial surgery in particular.

In this new issue of Face to Face, our contributors come from all corners of the world, showing the strength of IAOMS worldwide, and showing as well the important role of women in OMFS. Keep your eyes wide open, this is not a fashion, it is the future of our profession.

Javier González Lagunas EDITOR IN CHIEF

“A higher and higher proportion of women is entering the medical/dental schools , so it is the right time to give voice to a number of them”.

CONTENTS July 2015 SPECIALS REPORTS The strong women of maxilofacial surgery.

re hope. o t s e r n o operati

OMS ON A MISSION ades Two dec

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SO YOU WANT TO WORK...

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giu in Bel

FELLOWSHIP

Female maxillofacial surgeon: from west to east.

FROM PROUST TO PIVOT Gabi Millesi.

COPY ME

Infant distraction osteogenesis for airway management.

24 HOURS

A day in the life of a resident of bucomaxillofacial surgery in Argentina.

ALACIBU MEETING. Polo Meneses.

BEYOND THE OR

Hard & Soft.

CELEBRATING WOMEN IN OMF SURGERY Pierre Désy IAOMS EXECUTIVE DIRECTOR

“To improve is to change, so to be perfect is to have changed often” Winston Churchill

W

hen it was decided that this issue of Face to Face would be dedicated to celebrating women in the field of Oral & Maxillofacial Surgery, I contacted three active OMF female surgeons to better understand their perspectives. Through their enthusiastic response, I have learned how women who take unique paths to professional success like OMF surgery often overcome challenges, defying stereotypes and dealing with work-life balance issues. I invite you to learn more about this important topic through articles from some of your female colleagues from around the world.

Continuous Process Improvement: Launch of a New Membership Database In the next few months, IAOMS will launch a new membership database system that we hope will serve you better. The system will be more user-friendly and will help you make professional and personal connections by giving you access to community

forums, group discussions, blogs, and so much more.

This new system will also make joining and renewing membership as well as registration to events a much easier process. In addition, the IAOMS Website will have a new look and the IAOMS Foundation will have its own Website. Stay tuned for more information that will come to you via email and social media in the next few months.

ICOMS 2015 Promotion Finally, I would like to invite you to join your colleagues from all over the world at the IAOMS’ premier biennial International Conference of Oral and Maxillofacial Surgery (ICOMS) in Melbourne, Australia this coming October 27-30, 2015. For more information, please visit the ICOMS 2015 Website.

As always, thank you for reading this short piece.

Contact me if you have any questions or would like to discuss ideas you may have – pdesy@iaoms.org. ■

www.iaoms.org/membership/renew

President’s Corner Face 2 Face July 2015 Piet Haers IAOMS President

T

his is another great issue of our Face2Face.

Our Editor has a great talent in focusing each issue on a relevant topic. And this time it presents a very important topic indeed.

Women in OMF Surgery.

The content of this issue of Face2Face gives ample evidence that we can only succeed in meeting these challenges by acknowledging and promoting the training and facilitating the professional career of women-surgeons worldwide.

The facts and numbers mentioned in the editorial speak for themselves. The human story of this reality is meaningfully illustrated by means of the testimonies of women-colleagues in their individual contributions to this issue.

However, the biggest deficit in the presence and representation of women is found in the ranks and positions that provide leadership and hence, power to make changes. The current discussion on the ”representation of women in the board room of companies” illustrates that this is a global issue of fairness, but also of securing success for the future.

We all should reflect on this important aspect in the changing world of delivering clinical care and participating in research. A good way in doing so is to integrate the “feminization” of the workforce in medicine, dentistry and OMF Surgery in a broader analysis that takes into account changing views of new generations of surgeons about the place their professional activities occupies in their life.

But the profession also has to reflect on how to meet the demands of a population that in some parts of the world is aging , in other parts increasing significantly in numbers of patients in need but also in numbers of patients whom thanks to improving standards of living and more robust healthcare systems have now access – and hence, demands – to high quality care. Can we contribute to models aiming to balance the increased demand with appropriate provision of care? And how do we look after those in need, where there is insufficient access to adequate care.

IAOMS has in the past done surveys on OMFSworkforce, and has been aiming the educational efforts of the Foundation in those countries where there is a great willingness to improve standards of care and surgical techniques. And most of us have visited countries where there is less than one OMF Surgeon per million inhabitants.

Several analysts have clearly demonstrated that quality of life in countries in need has only started to improve if large numbers of women were empowered to become pioneers of change. Surely, this also applies to surgery?

What about IAOMS? We currently have one female colleague as voting member in the Executive Committee, as member at large. This means that she stood for election by council, and has successfully been voted three times to represent the fellowship in the Executive Committee. But all regional representatives, whom are delegated by the regional associations are male, and so are the chairs of the committees represented in the Executive Committee as well as the Board members. And yes, there is also still an underrepresentation amongst the membership of our committees. But we can proudly say that there was equal representation in the number of our IAOMS Foundation SIG fellows.

You will agree to conclude that it is time for change in IAOMS as well. We urgently need more womensurgeons in leadership functions. All fellows are entitled to stand as members at large, and to volunteer to join our different committees. National Associations can appoint female councilors to the IAOMS Council, and regional associations can delegate women-surgeons to the Executive Committee.

I very much look forward meeting you all in Melbourne for our upcoming ICOMS. This will be a unique opportunity to make progress in this matter and to enjoy a superb scientific program as well as appealing IAOMS Foundation activities. We need all of you there to make it a truly successful meeting with a lasting impact on our association. Yours sincerely. ■

FOUNDATION ACTIVITIES FOR ICOMS2015 22ND INTE R N A T I O N A L C O N FE R E N C E ON ORAL & MAXILLOFACIAL SURGERY

MONDAY 26th OCTOBER

TOUR OF LYON HOUSE MUSEUM and Lunch Lyon house museum is a private home in melbourne with an extensive collection of australian contemporary art.

Cost: $150 pp, includes transfers, guided tour and lunch.

Time: 1130-1500 hrs

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THURSDAY 29th OCTOBER

IAOMS FOUNDATION LUNCHEON

Proudly sponsored by Time: 1230 -1400 hrs Melbourne Convention Centre Guest Speaker: Professor Robyn Guymer “THE BIONIC EYE-CAN WE SEE OUR WAY FORWARD?” Cost: $ 150 pp Inclusions: Two Course Luncheon with wine/soft drinks and presentation.

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FRIDAY 30th october

KLS Martin Foundation Golf Day Proudly sponsored by Collaborate: 1) ANZAOMS Patient Education 2) AUDI Centre Melbourne 3) Bilia Volvo (Australia) 4) IAOMS Board of Directors 5) IAOMS Executive Committee 6) MIS Implants Time: 1145-1900 hrs Depart/Return: Melbourne Convention Centre Cost: $ 400 pp Inclusions: T ransfers, 18 holes Golf at the Victoria Golf Club, shot-gun start, lunch, closing drinks and snacks at 19th Hole.

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FRIDAY 30th october

MCG TOUR The Melbourne Cricket Ground (MCG) is more than simply one of the world’s great sporting arenas; for over 150 years it has been Melbourne’s heartbeat. Here, giants have lived up to a nation’s hopes, heroes have walked the corridors, and moments of suspense have been watched by millions around the country, and the world. Home to the 1956 Olympic Games, contests of international cricketing champions and legendary battles of Australian Rules Football, to step inside the MCG is to be energised by a spirit of greatness. Enjoy a seated lunch served in the spectacular Great Southern Stand overlooking the ground and then undertake a tour of the “G” and enjoy a rare insight into this great arena and its rich history.

Time: 1200-1615 hrs. Depart/Return: Melbourne Convention & Exhibition Cost: $ 190 pp Inclusions: Return coach transportation, two course lunch and wine in a private function room in the Great Southern Stand and a private tour of the MCG.

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FRIDAY 30th october

FAREWELL TO MELBOURNE ICOMS2015 DINNER ON THE COLONIAL TRAMCAR RESTAURANT Bid Farewell to Melbourne as you dine in one of Melbourne`s historic Colonial Tram Car Restaurants. Enjoy a 5 course meal and quality beverages as you cruise the streets of Melbourne -a unique experience.

Time: 2015 for a 2030 hrs departure and 2330 hrs return.

Cost: $200 pp

The IAOMS Foundation encourages you to support the Foundation by attending the Foundation activities at ICOMS2015.

All bookings can be made on the ICOMS2015 Registration Website www.icoms2015.com

special report

The strong

women of maxillofacial surgery

01

The Role of Women in Nigerian Maxillofacial Surgery

By Prof. Olugbenga Ogunlewe

Department of Oral and Maxillofacial Surgery College of Medicine University of Lagos and Lagos University Teaching Hospital Idi-Araba, Lagos, Nigeria

T

he practice of oral and maxillofacial surgery has been skewed towards the male for some time until 1993 when female maxillofacial surgeons started to emerge. Currently there are 92 Oral and Maxillofacial surgeons across Nigeria. Thirteen of these are females. This is considered to be a significant number considering the fact that no special preferences were given to the female Oral and Maxillofacial Surgeons during the period of rigorous

training (6 years), in spite of obvious incumbrances of their gender in studying, working and caring for their families.

The work–life imbalance has been attributed to the under representation of females in surgical specialties.

These challenges persist beyond the initial training, thus the Nigerian female Oral and Maxillofacial Surgeons have managed to successfully combine working and caring for their families and remain happily married.

Though few in number, Nigerian female oral and maxillofacial surgeons have made great impact in the profession rising to some top positons in hospital, university administration and academia.

Of the 13, two have attained Professorial heights, two are in the Nigerian Military and are currently Lieutenant Colonels, one of who is in a commanding position.

Also the female Oral and Maxillofacial surgeons

have occupied administrative positons in healthcare facilities in various states in the Country. One of them was the director of clinical services in an 800 bedded tertiary hospital, one a dean of the faculty of dental sciences of a University while another two are heading secondary health facilities. The Nigerian female Oral and Maxillofacial Surgeons are competing favourably with their male counterparts. Though most were trained by men, the females now take active part in training the future generation of Oral “The world and Maxillofacial as we surgeons and know it is participate as examiners at gradually the fellowship evolving and examinations of the West African College roles are changing by of Surgeons and the National Postgraduate Medical College of the day.”

Nigeria. The progress made cannot be quantified and with the ever progressing world of technology we live in, much more can be expected in future. The ability for the females to combine their jobs with their personal lives is getting increasingly easier. Papers and articles can be written from the comfort of the home as well as access to a library of information to improve oneself. Crucial to this and a point that must not be underestimated is

Female Oral and Maxillofacial Surgeons participating at the conference marking of the National Post graduate Medical of Nigerian’s Examination in May 2015

the drive and determination females in the field of Oral and Maxillofacial surgery exhibited which has been an inspiration to many hopefuls following in their footsteps.

The world as we know it is gradually evolving and roles are changing by the day. It would not be surprising in the nearest future if the gender imbalance is corrected in the field of Oral and Maxillofacial Surgery. For the ones currently on ground, we admire and salute their contributions to the profession. ■

special report

02

Struggling in the surgical world...

By Dr. Neelam Andrade

Prof. and HOD Department of Oral and Maxillofacial Surgery Nair hospital dental college. Mumbai, India

I

n 1983, I completed my graduation in dentistry and with a B.D.S. degree in my hand, I chose to enter the branch of oral and maxillofacial surgery.

Having secured the admission, I was enrolled under the guidance of an honorary Professor who did not perform any surgical procedures himself. From the very first day I felt out of place and regretted my decision.

Lucky enough, after a couple of months, the head of my department asked me to attend all his surgical O.T.S. This new situation brought in a lot of jostling and unacceptance from the HOD’s own students especially from my male colleagues. Irrespective, I continued to work hard and learn how to perform surgery even if that meant coming back after graduation on an observer’s post for a period of 6 months.

It all seemed very gloomy with no clue where the roads would lead me. But 18 months after graduation, I managed to get the lecturer’s post in my own alma mater. Slowly, and after 22 years of employment, I finally reached the post of Professor and Head of Department in my own institute.

In spite of being a fairly good orator, at the beginning I was never allotted a prime time for my scientific presentations at the national conferences. I continued and strived harder, and today I see myself more recognized and I have also been allotted a few prestigious Orations. I have been fortunate not to face any gender bias within my university, I am the faculty member in the Board of Studies of our Health University.

Regarding official posts and elections within our national association, the less said the better. If records are compared, I am the only one who has so far contested (and lost!!) the maximum number of elections against my male peer competitors. But I, even in defeat, gained popularity and finally climbed the ladder, from member of the Executive to President of

Giving Oration at the 3rd National Symposium on Orthognathic Surgery

AOMSI, a position for which I contested 3 times.

During my tenure as President of AOMSI many changes were made. One that I am truly proud of is initiating the Oral and Maxillofacial Surgeon’s Day on February 13th nationwide.

I would say, reaching and remaining on the upper rung, is a climb against all odds for women surgeons. You

With the members of the Executive Committee, as President, AOMSI, 2013

ultimately do get accepted for what you are worth, your work does get recognized, but it is a long climb, and it is also a long wait. It needs a lot of perseverance, patience, a strong will, a mind to digest the ill feelings, and strength to keep going.

“It needs a lot of perseverance, patience, a strong will, a mind to digest the ill feelings, and strength to keep going”.

Along with the Team of Surgeons At The Live Surgery Workshop On Cleft Lip And Palate, Maharashtra State Chapter AOMSI.

But importantly, you definitely need an understanding and loving family to support you when you feel weak and wish to give up. Being a parent further adds on hindrances. Balance and commitment combined with a feeling of a guilt are a common cocktail. Understanding children, supportive family members, a strong desire and an ambitious perspective helps you sail against all obstacles.

As it is said, “no pain, no gain,” but the fruits of patience have a sweetness of their own. No doubt “it is hard to be a woman (surgeon).” You must think like a man, act like a lady and work like a horse. Finally you will reach your goals, but the wait is long. Those that really deserve my gratitude for their undoubted faith in me as a teacher and a surgeon, are my students and my patients who never doubted my skills as a woman surgeon.

All said and done, the trip has been rough, the challenges were many, but the satisfaction is overwhelming. I have no regrets and if given the choice again, I would still choose to be a Woman Maxillofacial Surgeon. ■

Conducting AOCMF workshop, Mumbai.

special report

NextGen

03 A Maxillofacial Surgeon Who Is a Woman – Is Such a Thing Possible? Yes, in Estonia It Is!

By Dr. Irina Raudjärv

Maxillo-facial Surgery Center LLC

I

n terms of its population – a mere 1.3 million people – Estonia is a very small country. However, this smallness provides an excellent environment for innovation. Over the last couple of decades, Estonia has witnessed some major changes, including, naturally, in the IT sphere. The field of medicine has seen the application of a number of IT solutions – such as electronic prescribing, electronic health records and electronic medical tests results – which make the work of medical professionals considerably easier.

Estonia is a small and open country, and doctors here provide medical assistance to patients from various different countries and speak several languages accordingly. It is not a rare case that besides their native Estonian our doctors also speak fluent Russian and Finnish (Russian due to reasons related to Estonia’s history, and Finnish because it is very similar to Estonian and there have long been close cultural ties between the two countries). A good command of English is also rather more the norm than the exception among our doctors, mainly because they rely heavily on English-language professional literature for their ongoing education.

Although Estonian society has undergone major changes since the country regained its independence in 1992, some things have remained much the same.

For example, the fact that the majority of doctors are female. This tendency continues: women made up approximately 80% of those who received a medical degree over the last five years (of about 200 annually).

Medical professions, especially those of the dentist and general practitioner, are popular among women, but it is equally important to keep in mind that medical studies require a high degree of dedication and discipline; we don’t mind saying that it tends to be hard-working Estonian women that often cope well with these requirements.

There are a number of other professional fields in Estonia that are markedly different from those in

the ‘old’ democracies in the west, in that they too are characterised by the prevalence of women. The profession of judge is an example of another walk of life that involves a similar degree of responsibility. About two thirds of judges in Estonia are women in fact.

FEMALE SURGEONS ARE MORE OF A RARITY HERE, HOWEVER, BUT NOT IN THE FIELD OF MAXILLOFACIAL SURGERY. In Estonia, there are two hospitals which employ maxillofacial surgeons. One is in the city of Tartu, home to the University of Tartu, and the other is in Estonia’s capital, Tallinn (www.visitestonia.com). In the Tartu hospital, there is only one male maxillofacial surgeon currently working, as compared with six female surgeons.

In Tallinn, the hospital employs three male and two female maxillofacial surgeons. All doctors working at Tartu University Hospital (www.kliinikum.ee) are also obliged to teach at the University of Tartu. The University of Tartu, one of the oldest universities in North-Eastern Europe, established in 1632, is the only provider of higher education in the field of medicine in Estonia (www.ut.ee). I am proud to be both an alumnus and a teaching staff member of this university.

Back in my student days, my professor took note of me from quite an early stage and invited me to assist with operations. I was always both ready for and interested in such opportunities.

She used to pick out the brightest and most hardworking students from among her classes. As classes were quite small and there were no ‘guest’ students from other universities coming in for residency, she knew all of us very well and had a free rein to select the best.

A competition and an oral exam were held for residency candidates, and the residency admission committee of four based their decision on the students’ exam results. The exam was of course the same for male and female applicants. In my opinion, the sex of a candidate did not play a significant role in the decision, but all had an equal opportunity.

“As a female surgeon, I am in a better position to understand the issues of pregnant and breastfeeding women and the concerns of young mothers.”

As at the time of writing in 2015, one male and five female residents are undergoing residency training in oral and maxillofacial surgery, while there are 28 residents in general surgery residency, of whom 15 are women. Over the period 2006–2014, a total of nine surgeons have completed oral and maxillofacial surgery residency.

As is probably the case elsewhere as well as in Estonia, residents are effectively working 24/7. In Estonia, the duration of residency in oral and maxillofacial surgery is five years and during this period one’s personal or family life is basically put on hold. This is one reason why completing residency may be more of a challenge for women. Having a baby duringresidency training is rather exceptional.

According to survey data, 20% of university students have a baby (this tendency is somewhat more prevalent in Scandinavia: in Norway, the percentage is 25% and in Sweden and Finland, 21% and 17% respectively). The Estonian government has taken important steps in this respect to make the situation easier. Estonia has introduced a parental leave policy according to which residents are entitled to receive the benefit for a maximum period of 435 days. The amount of parental leave equals to the person’s average salary for the preceding year.

However, students are not entitled to this benefit.

When a new mother chooses to stay at home, her position is secure for three years and during this period, she has the right to return to her previous job.

All this has been done with the goal of increasing the number of Estonian women giving birth, although no major changes are yet apparent. In this respect, highly

qualified Estonian women with a higher education tend to decide in favour of their professional career.

Naturally, most women want to have children, but it is a commonly held norm that first you need to make a career and secure yourself financially. In Estonian society, success is widely highly-regarded: people are very hard-working and ambitious, trying hard to build up a career and improve their financial situation. So, having children and spending time with them doesn’t always come in first place.

Has having a child affected my professionalism, that is, my work as a surgeon, in any way?Yes, but definitely in a positive way. As a female surgeon, I am in a better position to understand the issues of pregnant and breastfeeding women and the concerns of young mothers. I am better at finding a solution to their problems and I do not need to consult a pediatrician in each and every trivial matter.

There was a time I did not feel very comfortable with child patients, but now, being a mother myself, I have a better grasp of their world and we often become good friends.

Why did I decide to choose this professional field and become a maxillofacial surgeon? My choice as a student and resident was an easy one – I was deeply inspired by the world of surgery and the crown jewel of our department, a female professor. I felt that I would like to get to know her better and be more like her. I know that this is exactly how some young female students look up to me as their model.

As a mother, wife and surgeon, I hope that I will be able to set a dignified example. A female maxillofacial surgeon in Estonia! ■

OMS on a mission TWO DECADES OF “OPERATION RESTORE HOPE” “Operation Restore Hope” is an Australian based surgical charity which provides aid to less privileged children in the Philippines with a primary focus on Clefts.

By Dr. Ann Collins

T

he mission began in 1994 at the Cebu City Medical Centre, and since then two missions a year have been carried out. The October Mission has been coordinated by myself together with the late Professor Geoffrey McKellar operating at the Lapu Lapu District Hospital on Mactan Island in Cebu. Cebu is the second largest city in the Philippines and is 1 hour’s flight south-west from Manila. It is estimated that there are 200,000 children in the Philippines with unoperated cleft lips and

“

It is estimated that there are 200,000 children in the Philippines with unoperated cleft lips and palates; approximately 20,000 new patients are born each year”.

Main entrance to Lapu Lapu hospital.

palates; approximately 20,000 new patients are born each year.

“Operation Restore Hope” has endeavored to fulfill the objectives of volunteer cleft missions as originally set out in the report by the Eighth International Congress of Cleft Lip and Palate and associated craniofacial anomalies in Singapore in 1997. A volunteer Cleft Mission should have well defined objectives with long term plans with good organization and close co-ordination. In particular, there should be minimal morbidity and no mortality. Finally, as ambassadors of good will and humanitarian aid the participants must make every effort to understand and respect local customs and protocols.

“Operation Restore Hope” has fulfilled these objectives by providing good quality surgical services, training local staff, and having great respect for local customs and protocols. It continues to work closely with the Rotary Clubs who have provided the administration support together with transport and accommodation for patients who have come to Cebu from other islands.

Over the years, significant amounts of equipment including anaesthetic machines, operating tables, dental chairs, autoclaves have been sent up to Cebu together ,each year , with the necessary equipment and consumables required for each mission. The Surgeons bring their own surgical instruments on each mission.

The involvement of the hospital Doctors and nursing staff is an integral part of the success of the mission; this includes pre-operative assessment and operative involvement and they also provide the post-operative care and ensure the return of patients each year for follow-up and further surgery.

Operating theatre LAPU LAPU HOSPITAL IN CEBU, Dr. Ann Collins on the left and Dr Geoff McKellar on the right.

The team includes surgeons, anaesthesiologists and nursing staff.

Two operating tables are available in Outside the operating theatre; the day’s the OR and the aim is to run both tables patients waiting for for 1 week. Planning commences before their operation ! the mission and supplies are set-up by airfreight to Cebu. The team meets within a 2 hour period. The complications experienced on Friday and Saturday prior to the were similar to other cleft missions including wound commencement of the mission so supplies can be infections, occasional dehiscences, post-operative unpacked, the operating theatre set-up and bleeding and post-operative chest infections. equipment checked. On Sunday morning The mission has the support of local there always seem to be 70-100 THE Doctors so any post-operative problems patients to be assessed both by the INVOLVEMENT that occur after the team have left are surgeons and anesthesiologists.

OF THE HOSPITAL well looked after. No mortalities have The patient ages range from a few been reported. months to adults in their thirties DOCTORS AND and forties with an extensive NURSING STAFF IS AN “Operation Restore Hope” plans to range of presentation of cleft INTEGRAL PART OF continue for the next 20 years. We deformities. The surgical objective THE SUCCESS believe that the involvement of the local is to ensure that a cleft lip and palate OF THE MISSION staff has made the success of the mission is within the surgical capabilities of the and that the fact that we return every year team and the anaesthetic assessment to the same hospital allows for follow-up and ensures that the patients are fit for a general staged surgery. Therefore in mending lips and closing anaesthetic. The more complicated patients with gaps we are merely not only giving “lip service” but rare facial clefts and other craniofacial deformities are providing an experience for all involved which is referred to The Philippines Children Medical Centre worthwhile and memorable. ■ in Manila. Ideally, each operation should be completed

So you want to work...

...IN BELGIUM?

By J. Schoenaers Belgian delegate to the IAOMS / Migration of OMFS specialists

B

elgium, officially the Kingdom of Belgium, is a federal monarchy in North Western Europe. It is a founding member of the European Union and hosts the EU’s headquarters as well as those of several other major international organizations such as NATO and also the UEMS (European Union of Medical Specialists).

descendants are estimated to have formed around 25% of the total population: 2.8 million new Belgians.

Three official languages are practiced: Dutch/Flemish (60 %), French (39%), German (1%). Belgium is divided in 2 main regions: the northern Flemish most densely inhabited region and the Southern Walloon region: the Communities (http://en.wikipedia.org/wiki/Belgium)

Belgium covers an area of 30,528 square kilometers and has a population of about 11 million people.

Belgium is situated close to the Atlantic channel, between France, United Kingdom, The Netherlands, and Germany. Longest Distances: 280 km SE-NW/ 222 km NE-SW. The climate is maritime temperate.

National Authorities in Belgium (www.belgium.be) Access to the internet site of the Federal Public Service controlling Health, Food Chain Safety and Environment is gained by the link www.health.fgov.be

Almost all of the Belgian population is urban - 97%.

The population density of Belgium is 365 per square kilometer. Hence it faces serious environmental problems. 92% of the population has Belgian citizenship, and other European Union member citizens account for 6%. People of foreign background and their

Several headings are available in English. As medical specialty recognition and licensing is not a Federal but a Community issue (Flemish or Walloon) specific documents may be available only in a Dutch or in French version. www.gezondheid.belgie.be/eportal/ index.htm?fodnlang=en

The Belgian Oro-Maxillo-Facial Society Historically the medical specialty of Stomatology was the first one in Europe to install its Royal Scientific Society of Stomatology in 1901. This was the start of the actual Royal Belgian Scientific Society of OroMaxillofacial Surgery. The internet site of the Belgian OMFS specialty (scientific and trade union) is at www.omfs.be.

Oro-maxillofacial Surgery in Europe is a “medical “specialty, and is core member of the UEMS ( European Union of Medical Specialists) under heading Section and Board number 16. www.uems.eu > medical-specialties > Oro-MaxilloFacial Surgery.

Belgian delegates always have been instrumental and supportive to the European medical specialist organization and the professional directives by this organization are applied.

Education and training leading to the specialty of Oro-Maxillofacial Surgery in Belgium This OMFS specialty has evolved and although its official registered name in the Federal Governmental Services is still “Stomatology,” all of the resident training programs have since two decades imposed that the legal basic specialty training in which the title of “Stomatology” (obtainable after 2 years of residency training) is furthered to the title “Specialist In Stomatology with Extended Competences in OroMaxillo-Facial Surgery (obtainable after two extra years of higher /specialized residency training).

The possession of two basic official Belgian diploma’s is mandatory in order to take part in the selection procedure giving access to the OMFS residency training: one of Medical Doctor (MD: Doctor in Medicine, Surgery and Obstetrics) and one of Dental Surgery (DDS: LTH / LSD).

The acquisition of both of these diploma’s may be inversed: MD later DDS or DDS later MD. In Belgium there are 7 medical schools and 4 dental schools , and there are two nonrelated Committees of Specialty Recognition, each authoritative for one of both Communities.

Due to manpower planning and budgetary control of medical expenses Belgian government introduced contingence planning in which, based upon socioeconomic analyses and anticipative planning of needs, the amount of access tickets to OMFS training are being defined and advertised on a yearly base. This specialist education has been “academized” and is

structured along the European directives for the Higher Educational Area as declared in the Bologna Process. www.ec.europa.eu > education > policy > bologna In the period 2006 – 2010 there were yearly 4 vacancies for OMFS training in Belgium: 2 for each Community (for Flemish/Dutch and for Walloon / French). Since 2011 these specialty recruitment numbers have been augmented .

Demographics of the Oro-Maxillofacial Surgery Specialty in Belgium Based upon recent report by the Directorate General HealthCare of Belgium www.health.belgium.be/hwf published by the ‘plan team’ at www.health.belgium.be/eportal/Healthcare/ Consultativebodies/Planningcommission/ StudiesPublication/index.htm?fodnlang=nl This report of 2014 is based on real numbers of licensed and registered Stomatologists and OroMaxillo-Facial Surgeons in Belgium for the period of 2006 to 2012. (Trainees not included).

Numbers: overall, by region, by specialist level, by sex, by age, by country of origin are cited: – There are 388 double qualified Stomatologists and Oro-Maxillofacial Surgeons in Belgium of which (excluding retired and inactive ones)

Belgian OMFS manpower (in FTE) d 60 years of age pyramid between 30 an % Of total volume 30 < 35 35 < 40 40 < 45 45 < 50 50 < 55 55 < 60 60 < 65 Males

Females

OMFS manpower (17). Some others have adopted Belgian nationality.

For Belgium contact Federal Public Service (FPS) Health, Food Chain Safety and Environment Eurostation II Place Victor Horta 40 box 10 1060 Brussels (Belgium) Contact Center : +32 (0)2 524 97 97 E-mail : info@health.fgov.be The basic document to submit a candidacy for immigration as a foreign OMFS specialist into Belgium can be found on: www.health.belgium.be/filestore/18064767/ aanvraagformulier%20erkening%20UE_EEE_ Switzerland%20beroepstitel%20huisarts%20 -%20geneesheer%20specialist.pdf

– 285 give proof of ongoing clinical activities: 49 of them practice in Brussels Capital, 162 in the Flemish Region, 71 in the Walloon Region.

– 185 of these 285 are Oro-Maxillo-Facial surgeons: 22 practice in Brussels Capital, 120 in the Flemish region, 28 in the Walloon region.

– Feminization is occurring, although effective female OMFS performance in FTE ( Full Time Equivalent) proofs to be less than their numerical appearance in younger generations.

– Socio-economical position: observed median bruto income 348.209 €/year: • 7 % are employed.

• 65 % have independent medical status.

• 28 % have no income from practice retirement...).

Density of Oro-Maxillofacial (in FTE) in Belgium – Brussel Capital 1 / 24.000 inhabitants.

– Flemish region 1 / 37.000 inhabitants.

– Walloon region 1 / 50.000 inhabitants.

International mobility for Medical Specialists www.gezondheid.belgie.be/eportal/Healthcare/ healthcareprofessions/Doctors/Specialiseddoctors/ Internationalmobility/index.htm#out_EEA Licensed practice by foreign OMFS surgeons in Belgium with non-Belgian citizenship is rather low: 6 % of the

A major difference exists in the procedures imposed to foreign OMFS specialist with regard to professional immigration into Belgium depending on their geographical origin: from within the EU or from outside the EU. The actual Medical Authority for registration and licensing of a medical specialists in the EU resides always at the level of the EU member state.

European agreements have been adopted and turned into professional directives for the member states.

The EU member states are committed to adhere to the advises and have a signed agreement to apply the directives by the EU. But differences within the EU do exist between national regulations , especially in the double and single qualified OMFS specialty.

For non EU candidate commuters, the requirements will be even more elaborate, as equivalence of Medical and of the Dental diploma’s is not warranted, and residence training programs may not be judged acceptable.

a t a D e h T The Data

Nationality N %N

Belgium France Netherlands Eastern Europe Southern Europe Western Europe

263 93,93 6 2,14 3 1,07 1 0,36 6 2,14 1 0,36

Totaal Europ Union* 17 Grand total 280

6,07 100,00

Note that participation in the European Board of Oro-Maxillo-Facial Surgery assessment, is exclusively reserved to Medically qualified Specialists with registration and license in a EU member state. So NonEU trained and certified specialists are not eligible to sit the test.

Moreover, having obtained the European fellowship diploma after a successful pass of the EBOMFS Assessment does not provide the holder of this certificate free movement throughout the EU: differences do exist in education and certification between EU countries. These can be prohibitive for automatic clearance of demand for installation by the host country. ■

Copy Me Suzanne U. McCormick, MS, DDS and Stephanie J. Drew, DMD

INFANT DISTRACTION OSTEOGENESIS FOR AIRWAY MANAGEMENT Distraction Osteogenesis has revolutionized the management of children born with craniofacial deformities. Children born with milder forms of congenital micrognathia may not have acute airway compromise at birth, yet may fail to improve as they grow. We present a case of a young lady who at 18 months of age underwent distraction for mandibular hypoplasia and failure to thrive.

1

2

The pre-operative CT scan revealed micrognathia, with good bone stock for placement of bilateral mandibular distractors.

3

For infant mandibular distraction Osteogenesis, the mandible is addressed via an extra-oral approach.

A submandibular incision is made in the region of the planned distractor site, below the level of the marginal mandibular branch of the facial nerve.

4

5

The dissection is carried to the bone, and a subperiosteal pocket created on the buccal and lingual aspects of the mandible.

The distractor is laid on the bone, with the activation port oriented distally.

6

7

A skin tunnel is created for the exit site of the DO activation arm.

The foot plates are adapted to the mandible on either site of the planned osteotomy,

8

9 The planned osteotomy site is scored using a thin fissure bur and copious irrigation.

The osteotomy is completed using either the fissurebur or Piezo surgery,

10

The monocortical bone cut is made on the buccal aspect and also on the superior and inferior borders.

11 The osteotomy is completed using a thin chisel through cortical bone only, with care to protect the inferior alveolar nerve as well as the developing tooth buds.

12 13 Light fingerpressure can complete the osteotomy.

The Distractors are placed in the prior orientation and fixated to place using monocortical screws.

14 15 Device activation is verified and the device left “activated” with a 1mm gap prior to closure.

The site is closed in layers and the skin is closed in a subcuticular fashion. The activation port site is dressed with antibiotic ointment. ■

From Proust to Pivot

AN APPARENTLY INNOCENT QUESTIONNAIRE FOR ORAL AND MAXILLOFACIAL SURGEONS You’ve heard of the Proust Questionnaire adapted and made famous in the back pages of Vanity Fair Magazine, it was named not for questions, but for the answers given by Marcel Proust to a set of questions asked by his friend Antoinette Faure.

Then, for many years Bernard Pivot conducted a cultural program in french TV called “Apostrophes.” All his guests received the same 10 questions at the end of the interview.

So, in Face to Face we thought that being oral and maxillofacial surgeons human beings as the rest, those questionnaires were a great method to let us know some personality traits of our interviewees. Enjoy, and compare their answers with those of celebrities!!!

Gabi MILLESI What is your favorite word? Well done What is your least favorite word?

You have to What is your favorite drug? Loud, rhythmic music What sound or noise do you love?

Crickets in twilight and swallows in a blue summer sky What sound or noise do you hate? Ringing of the phone What is your favorite curse word? Damn it Who would you like to see on a new banknote? Bertha von Suttner, she was the first woman who received the Nobel Prize for Peace achievements, in 1905.

What profession other than your own would you not like to attempt? Agent of an insurance company If you were reincarnated as some other plant or animal, what would it be? A labrador dog, I see how everyone spoils and hugs our dog Emmi.

On what occasion do you lie?

Only, if my 85 year old mother would be upset.

What do you most dislike about your appearance? Getting older Which living person do you most despise? Any person with religious fanatism.

If Heaven exists, what would you like to hear God say when you arrive at the Pearly Gates? Well done, you made the best out of your chances.

What is your idea of perfect happiness? Harmony and laughter together, being on the same mental wave.

What is your greatest fear? To fall sick What is the trait you most deplore in yourself? To have too high expectations in others.

What is the trait you most deplore in others? Falsehood Which living person do you most admire? Angela Merkel, because of her diplomacy and her unvarnished authenticity in a difficult, male dominated, political world. (Later I realized that Johan Reyneke chose the same person, very funny!)

What is your greatest extravagance? To sleep in in the morning on week-ends and to relax in the sun in a deckchair in the garden on a Sunday afternoon.

What is your current state of mind? How to organize my final 15 professional years.

What do you consider the most overrated virtue? Political correctness because it is often only on paper.

What is the quality you most like in a man? Straight forward, dynamic, honesty.

What is the quality you most like in a woman? The female fifth sense and sure instinct.

Which words or phrases do you most overuse? It is on my list What or who is the greatest love of your life? My daughters Flavia and Elena and my husband, Werner.

When and where were you happiest? After finishing Medical University, still being independent, I felt I could tear down the world.

Which talent would you most like to have? Speak English, Spanish and French as a native speaker.

If you could change one thing about yourself, what would it be? Stop getting older physically but saving my energy and further enlarge my professional expertise.

What do you consider your greatest achievement? That I am a happy, balanced person with a great family, excellent living and a successful career. But consciousness of happiness is an inherited gift.

If you were to die and come back as a person or a thing, what would it be? One time is enough Where would you most like to live? I love Vienna but once I would like to live at the sea.

What is your most treasured possession? Collecting original and beautiful objects from art to my shell collection which decorate my house and remind me of nice moments.

What do you regard as the lowest depth of misery? Sickness What is your favorite occupation?

Travelling and exploring as much as possible of the beauty and diversity of the world in my leisure time besides taking care of patients not only as a surgeon but as a listening doctor.

What is your most marked characteristic? Being nearly always in a good mood, to like to laugh and to be friendly besides being dutiful.

What do you most value in your friends? Personal interest in my life and support if needed.

Who are your favorite writers?

Hilary Mantle, Ken Follett, Noah Gordon, any books with real historical background.

Who is your hero of fiction?

James Bond?!

Gabrielle Milesi is a senior staff member of the Craniomaxillofacial Surgery Department at the Medical University of Vienna. She is a Member at Large of the Executive Committee of the IAOMS and organized the successful ICOMS that was held in Vienna in 2005. Her main activity is in Orthognathic surgery.

Who are your heroes in real life?

Doctors without borders.

What is your greatest regret?

That I did not work with a “guru” in orthognathic surgery for some years while being independent.

It is so much easier to become a guru yourself after working with a guru.

What are your favorite names?

Any names with alot of vowels, italian or spanish names.

How would you like to die? To fall asleep in the knowlegde that my kids are doing well.

What is it that you most dislike?

Finding out that I was not told the truth.

What is your motto? If the sun shines and nature blossoms, it will be another day in paradise. ■

Which historical figure do you most identify with? Alexander von Humboldt, he had a genious mind and scientific curiosity in his time.

FOUNDATION CHAIRMAN’S MESSAGE

ICOMS and beyond 2015

I was recently asked an interesting question about the Foundation and it centered around “Why does the Foundation need so much money to function and where is the money going?” The answer is somewhat involved but I will try to simplify it.

1

HOW THE IAOMS FOUNDATION IS FUNDED? Historically, the IAOMS Foundation has run with reserves of between $150,000 and $200,000 with annual donations ranging from as little as $30,000 to last year’s high of $112,000 (this does not include the matching gift of $80,000 from the KLS Martin Group) The Foundation has previously funded the “basic” OMS educational programs in Thailand, Peru, Indonesia, East Africa, The IAOMS Foundation helps those in need by building a lasting Malaysia, Paraguay, El Salvador and the Microvascular sustainable environment to improve the health and quality of life Course in Nigeria, assurgeons well as learn about one-half of the worldwide.

Your donation will help new previous Fellows in Oncology/Reconstruction and procedures to heal their countrymen and aid patients with no Imagine the difference.

Cleft/Craniofacial hope of healing without your gift.Surgery.

Change starts with you.

Generous corporate donations and grants have provided funding for the other one-half of the Fellowship funding. Additional “in-kind” funding of speakers from national associations have also helped augment the funding for the various basic OMS courses.

2

WHAT ACTIVITIES IS THE FOUNDATION SUPPORTING? The Foundation also funded $5,000 in 2013, 2014 and 2015 to support the development of the International Board for the Certification of Specialists in Oral and Maxillofacial Surgery (IBCSOMS). The Foundation Board recently agreed to fund up to twenty $1,000 scholarships for the planned HADR course to be held prior to the 2015 ICOMS. All of these projects’ funding was decided by actions of the Foundation Board. With regards to the first part of the question, “Why does the Foundation need so much money?”

In order for foundations to be financially sound and able to predictably fund projects for many years, a foundation needs significant reserves that are constantly growing through ongoing donations and returns on investments. One of the “best practices” for foundations is to target an overall annual return on investments that is sufficient to fund projects and operations. That approach ensures that the reserves remain intact and grow in perpetuity and the foundation is able to predict future funds available to fund projects.

With our current reserves and if we continue to apply the “best practices” guidelines, the IAOMS Foundation has a very small amount or return on investments to fund projects. For this reason, the IAOMS Foundation Board of Directors chooses to utilize some of the reserves for projects as well as soliciting in-kind donations, while constantly attempting to increase member and corporate donations that will further enhance the reserves.

Realize that if annual donations are maintained at $125,000 per year, it will take 16 years to reach $2,000,000 in our reserves and 80 years to reach $10,000,000, without spending down our reserves. If each of our 4,000 members would donate only $250 per year (less than $5 per week), we could reach our $5,000,000 goal within 5 years.

ne r u o b l e M In As we rapidly move toward the ICOMS 2015 in Melbourne, Australia, I want to first remind you of the many Foundation activities that will be occurring during the week. Beginning with the Luxmuseum Tour on Monday and culminating with the Dinner Tram Tour on Friday evening, there are numerous exciting events that you will not want to miss. I want to personally thank John Curtin and his team for organizing this excellent Foundation program and the many sponsors for their generous donations. Tickets for these events are selling quickly and some of the events are of limited attendance, so please make your reservations soon at www.icoms2015.com.

Again, thank you, John for your dedication.

Matching funds from the KLS Martin Group, the first year of a multi-year agreement of up to $400,000.

I hope this helps to clarify why, as your Foundation Chairman, I have emphasized the need for increased donations throughout my term. Thank all of you for your donations, particularly the KLS Martin Group, for their $400,000 5-year challenge matching gift. I look forward to future discussions on these issues and hope you will consider donating to the Foundation, if you have not, or increasing your donations in the future.

See you in Melbourne.

£

Larry W. Nissen, IAOMS Foundation Chairman

THANK YOU for your past donations and I hope you will continue to support (www.iaoms.org/foundation) the

p i h s w o l l e F

A female maxillofacial surgeon from West to East

Lorena Pingarrón Martín MD, PhD

Oral and Maxillofacial Surgery Rey Juan Carlos University Hospital, Madrid (Spain)

S

ince I decided to go to medical school I made something clear: I would become a surgeon.

During my fifth year at university I discovered my specialty, oral and maxillofacial surgery, and how widespread the field of intervention in this kind of surgery is.

But what I liked the most was oncology and reconstruction, which I was learning during my training in La Paz University Hospital. I also realized that microsurgical reconstruction and oncology require the biggest sacrifice, personally and professionally.

At the end of my residency period, my career path led me to taking on a fellowship at Ninth People Hospital, Shanghai. This opportunity seemed a bit of a miracle as I realized I was finally reaching one of my goals and my family and close friends continued to support me in my occupational choices. In that moment my career took a serendipitous direction as I felt this was a chance that only comes once in a lifetime. So China was waiting for me, and I had a duty to take advantage of it.

When people ask me about my experience in Shanghai I always say that it was the most incredible professional experience for me as a maxillofacial surgeon. Even more so because it was a year of continuous personal learning as a woman, a female surgeon who wants to succeed, but also wants to enjoy the most important treasure in life: my family.

A year later I came back to Madrid, and was back home just at the perfect moment: at the beginning of my career, the time in life when we try to obtain a symbiosis with work and life accomplishments.

Perhaps it is because at this time we have families, need space and time to be in many places, seemingly at once. Life can get complicated with your partner, health, child and parental issues, yet most women find this to be part of what we need to do.

Inner meaning is essential to women’s careers all along the way. For men’s, too, although men show it with less intensity than women do.

“I had direct examples of brilliant female women maxillofacial surgeons, as I had in Spain during my training as resident”.

The field of surgery is still male dominated, while medical school enrollments, on the other hand, are 70 percent women. Surgery programs today include about 30 percent women. Women need to do better, because for us, the balance between surgery and family also exists.

“But on the other hand, in Shanghai, where I found “my asian family” by my professors in microsurgical skills, I had direct examples of brilliant female women maxillofacial surgeons...!

Patriarchy is the structural and ideological system that perpetuates the privilege of masculinity.

This system, from my point of view and experience as part of a surgical team in Spain and in Shanghai, is much more developed in Asia, where the female surgeon tends to adopt a helpless posture. But on the other hand, in Shanghai, where I found “my Asian family” in my professors in microsurgical skills, I had direct examples of brilliant female women maxillofacial surgeons, as I had in Spain during my training as resident. These females colleagues I refer to, became real friends and showed me that female surgeons have three options:

1

She can deny there is any difference between herself and her male colleagues and become “one of the boys,” and the men will respond by treating her as a “neuter.”

2 3

She can adopt almost a caricature of the traditional female role with a helpless, and dependent posture.

She may feel compelled to become “superwoman” with the goal of compulsive excellence in both career and family roles and a continued need to prove her competence in all areas.

The only person responsible for choosing which professional role to develop is oneself; and the equilibrium between being a mother, wife, friend, daughter and surgeon, is the key to a successful and plentiful life. But we create our own miracles so, let´s create them. ■

“... the equilibrium between being a mother, wife, friend, daughter and surgeon, is the key to a successful and plentiful life.”

Hours A DAY IN THE LIFE OF A RESIDENT OF BUCOMAXILLOFACIAL SURGERY IN ARGENTINA

By María Agustina de Sagastizábal

I

n 2011, I graduated with a Degree in Odontology from “Universidad Católica”, in La Plata. Currently, I am on my third year of the Bucomaxillofacial Surgery and Traumatology Residency in “Hospital Interzonal San Juan de Dios”, a hospital specialized in chronic and acute conditions. I decided to study this course of studies since I’m very keen on solving difficult surgery cases which were rejected by other specialists.

Our Surgery team consists of the Head of Service, a specialist in Bucomaxillofacial Surgery and Traumatology, two permanent staff surgery-oriented odontologists, two Postgraduate Degree students, and three residents (one per year of residency).

Orthodontics is also part of the Service provided by the hospital, run by three professionals, as well as the General Odontology area run by ten permanent staff odontologists. I get on very well with my peers and it is easy to sense the cozy atmosphere in our place of work. We know each other very well and this helps us understand certain behaviors, get some help whenever we need it and celebrate our success and happy times.

Dr. Sagastizábal works in the Department of Maxillofacial Surgery, the Interzonal Hospital of Acute and Chronic “San Juan de Dios” in La Plata, Buenos Aires, Argentina.

The Service provided is organized in two shifts: one in the morning and one in the evening, and doctors see patients from Monday to Friday from 7.30 am to 5 pm, and on Saturdays from 7 am to 1 pm. We have five boxes with dental chairs, an operating room to perform surgical procedures under local anaesthesia, and two operating rooms to perform Major Surgery procedures under general anaesthesia.

. m . a 5 1 .

6

My day starts with a healthy breakfast. I read the newspaper and go through the appointments of the day. I take a shower, get dressed, brush my teeth, get all my stuff and purse, and go to the hospital. I am lucky enough to live 6 blocks away from the hospital so it only takes me a few minutes to get there.

Hospital San Juan de Dios in La Plata, Buenos Aires (Argentina)

8.00 a.m.

7.30 a.m.

I arrive at the hospital and clock in with my electronic card in a machine used by all employees. Then I go to my Service and, together with the rest of the team, we visit every hospital room to check on the patients. We evaluate their symptoms and vital signs, check their wounds, control the nursesâ&#x20AC;&#x2122; reports and update their medical charts.

On Tuesdays and Thursdays we perform surgeries under general anaesthesia in the operating room. These are surgeries of medium and high complexity (trauma, cracks, oncological surgery, orthognathic surgery, TMJ, cysts, and tumours). On Mondays, Wednesdays, Fridays and Saturdays, we have pre and post-surgical consultations, with an analysis and discussion of clinical cases.

9.30 a.m.

We perform procedures with local anaesthesia. They generally are low or medium complexity surgeries (biopsy, retained teeth, drainage, cysts, and tumours).

11.30 a.m.

We gather the team and analyse the morning retrospectively. We conclude our work with a discussion about the surgeries performed on Tuesday and Thursday, and we also read some scientific articles and bibliography according to the pathologies treated. We decide the course of treatment and we choose the surgeon and his or her assistants. We prepare the surgical cassette and all the necessary instruments to successfully perform the procedure.

On Tuesda ys and Th ursdays we perfor m surgerie s u general ana esthesia in nder the operating r oom.

Hours 14.00 p.m.

After lunch, we perform some health care clinical practice under local anaesthesia.

These are generally low complexity surgeries, performed by first and second year residents. On Wednesdays we have discussions and debates, and many times we have teachers as special guests. And on Fridays we do statistical work.

16.30 p.m.

We visit again the hospitalization rooms, check on the admitted patients and update their clinical charts. We also prepare the clinical charts of patients who have an appointment the following day, and then finally finish our work in the Service.

17.30 p.m.

I arrive home, where I live with my boyfriend. Although we don’t have much free time, sometimes we enjoy going for a walk or doing some sport. I’ve played volleyball for fifteen years, it gives me pleasure and helps me get rid of tension and reduce stress, apart from clearing my mind. Whenever I can I train and at weekends I play volleyball matches, my team competing in the local league.

Volleyb all rid of t helps me get en stress. sion and reduc e

20.00 p.m.

We are on a ‘pasive’ call so that when there is an emergency we phone the designated professional, who immediately comes to the hospital and deals with the situation. As they are ‘pasive’ calls they do not affect my personal life much for they are occasional and and very organized.

athedral. c a t a l P a L

A real challenge: the XIX CIALACIBU Lima, Peru 2015

H

ow to organize a Latin American congress on maxillofacial surgery in Peru? This is the question that a group of Peruvian surgeons asked themselves in 2006 while participating in CIALACIBU taking place in that beautiful Mexican city, Cancun, Mexico. Cancun was just starting to be rebuilt after the largest natural disaster in its history and our Mexican colleagues showed us that goals can be achieved despite adversity. This congress was flawless and we remember it well because for the first time, a Peruvian was part of the Steering Committee for ALACIBU. Why had more than 40 years ellapsed without an ALACIBU meeting being organized in Peru? This was the second question we asked ourselves and answered immediately with more than 10 answers and a single conclusion: everything is possible and it only depends on us. This was one of those moments that motivates and encourages one, not only to keep on practicing the specialty that you love every day, but also to decide to work as a team with institutional and professional goals.

These conditions are the foundations of the existence of a specialty such as ours.

Our first proposal to host CIALACIBU was rejected at the XVI CIALACIBU in Foz Iguazu (Brazil 2009) and we continued to insist during the XVII CIALACIBU in Santiago de Chile (Chile 2011) held jointly with XX ICOMS. At this meeting we Peruvians were really excited as we were elected unanimously to host the

XIXth CIALACIBU. On Margarita Island (Venezuela 2013), we were ratified as hosts and our Venezuelan brothers left us with a high standard to overcome; in the same year we attended the XXI ICOMS in Barcelona (Spain 2013) chaired by Javier Gonz谩lez Lagunas who then put us in contact with the company Barcel贸 Congresos, a key part in the logistics and technical organization of CIALACIBU LIMA 2015.

Six and a half months before the congress started, we had closed the registration of free presentations, and were happy to receive around 600 free papers.

We could also confirm the 64 speakers who would shape the scientific program and generously accepted to go to Lima with an exciting title: Complications, Controversies and Lessons Learned. The project filled us with much expectation because only master teachers share all their experience from this point of view.

On Sunday, April 19 at 08:30 am we started promptly with the pre-congress courses. Fully filled auditoriums greeted us, something unusual in Latin America because it was Sunday and that Latin idiosyncrasy that affects many of us (but not all...). At the same time, the Closed Assembly of the ALACIBU began with the presence of the IAOMS President, Dr. Piet Hears, the full Executive Committee and the important presence of fifteen Presidents and Representatives of the Latin American countries. This assembly was chaired by Dr. Luiz Lobo (Brazil) where major agreements for the region were reached and by unanimous decision,

Dr. Adrian Bencini (Argentina) was elected as the new 2017-2019 President Elect. Cancun, Mexico would once again serve as the backdrop for the XXI CIALACIBU in 2019.

Know that...

The Peruvian organizing committee (who wore the same tie color that changed every day) worked synchronously, meeting goals, and taking pride in seeing the joy of participants when their expectations were fulfilled. We wanted everybody to enjoy the Congress in a friendly Peruvian context, we all tasted the famous Peruvian gastronomic tours at lunch during the four days of the congress, which certainly satisfied the most demanding of palates. Delegates also enjoyed a Peruvian Night with the best authentic dances and meals, a dinner of Masters honoring all the speakers and authorities and the Wayna Raymi (Festival of Youth) where our residents shared some moments of the youthful style that characterizes them. During this time of fellowship, the famous Peruvian Pisco also served its purpose to relax and cheer up many people.

On Wednesday, April 22nd, Dr. Piet Haersâ&#x20AC;&#x2122; held a motivational Presidential Conference, followed by an Open ALACIBU Meeting attended by the highest authorities in oral and maxillofacial surgery of IAOMS from Spain, USA and 14 Latin American countries.

During this emotional ceremony Dr. Luiz Lobo concluded his excellent management and delivered the Medal of the ALACIBU Presidency to Dr. Mario Scarrone (Uruguay), who thereupon took oath and handed the Medal to Dr. Leopoldo Meneses, the first Peruvian President of ALACIBU, for his management in 2015-2017.

This XIX CIALACIBU met many of our challenges and goals. We were able to prove to ourselves that teamwork allowed us to achieve our successes and we were reminded that true teachers share everything they know. In particular that Latin American oral and maxillofacial surgery is a family that grows and expands.

See you at the XX CIALACIBU in BUENOS AIRES 2017!!! â&#x2013;

Beyond OR

&

HARD

SOFT

By Javier González Lagunas

Y

es, we are talking about skills.

Normally when selecting the right person to work in our practice, our focus during the interview or in the CV assesment, is in the so-called hard skills: can you properly use a management program?, how many neck dissections have you perfomed? can you handle the process of harvesting prfc?....depending wether you are looking for administrative staff, a new young surgeon or a scrubnurse. Those skills are reasonably easy to measure and evaluate. However those skills, that are technical in nature, are only the starting point to a succesful career.

“You will probably find a sudden stop in your professional development if you do not acquire a good level of soft skills”.

But you will probably find a sudden stop in your professional development if you do not acquire a good level of soft skills. Soft skills are the personal attributes, habits and attitudes that enhance social interaction. They are not easy to define and are difficult to quantify. But they will make a difference when some employer is in the process of selecting a new member to be incorporated into the team.

Are you good in mentoring and teambuilding? Can you effectively leader a group? Are you assertive? Can you handle your time? Can you conduct a business meeting? How good are you in managing conflicts and negotiating? Or something as simple as that: can you listen and pay attention to others? Are you verbally articulate? Can you stand the pressure?

So now take some time to think about it. How much of your post-graduate training is devoted to hard skills

(i.e. a course on how to install zygomatic implants?) and how much time to devote to improve your soft competences (i.e how to deliver a great talk)? No, do no think that all soft skills are natural and a part of your personality. It is not easy, but you can also learn them. Enroll in a course or hire a coach...

You have to seriously consider this particular training. In a scenario of high competence, employers think it is easier to train a new member of the staff in a particular hard skill (i.e how to perform a Lefort 1 osteotomy ), rather than to train an employee in soft skills. Those competences, though soft, can make the difference between getting hired in your “dream-job” or not. ■

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