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  • History

Oral and maxillofacial surgery is a unique surgical specialty that sits astride the base professions of medicine and dentistry. In some nations, it is a specialty of dentistry; in others, a specialty of medicine, and in some countries, both medical and dental qualifications are necessary. Specialist oral and maxillofacial surgeons use their medical and dental expertise to diagnose and treat a wide spectrum of diseases, injuries, and congenital defects affecting the mouth, teeth, jaws, face, head and neck. The varied background and training of oral and maxillofacial surgeons can lead to difficulties identifying qualified professionals and to address this uncertainty, the International Association of Oral and Maxillofacial Surgeons (IAOMS) appointed a Steering Committee to investigate the potential for an international certification standard.

The Steering Committee1 was composed of 11 members from different nations and they began their efforts in January, 2012. The Committee soon agreed that adoption of a certifying standard was valuable, not only for the protection of the public, but also as a vetting instrument for local licensing and health administration agencies with oversight responsibilities for health professionals in their jurisdictions. However, creating a uniformly acceptable certification standard proved more difficult since basic qualifications (medical, dental or both medical and dental degrees),training curriculums, scope of practice and licensing implications varied significantly in different nations and regions. And since the most common method for determining if candidates had achieved the necessary standard for certification was through testing, additional challenges were posed by the ability to develop fair and valid examinations across language and cultural barriers.

The Steering Committee was extremely fortunate to be composed of individuals with considerable experience in education and standard setting practices. This background allowed members to distinguish between issues of fundamental importance and those that represented convention or regional practices. Once agreement was reached that any certification process developed by the Committee would have no licensing ability unless adopted by local authorities, it became easier to proceed. Completion of four tasks was necessary before an international certification process became feasible. Concurrence needed to be reached as to what constituted core topics in oral and maxillofacial surgery. These topics covered subject areas and procedures that every certified oral and maxillofacial surgeon should demonstrate a level of expertise beyond that of the average practitioner. Agreement was also necessary about an acceptable training curriculum with suitable numbers and types of cases as part of the operative training experience. Next, methods to test both cognitive and applied skills was essential to distinguish the specialist from the non-specialist. This critical distinction forms the basis of a psychometrically valid standard setting certification exercise. Finally, a format for examination consisting of multiple choice and oral examinations conducted by a panel that included native speakers in a candidate’s language was adopted.

The satisfactory attainment of these goals made an international certification process a realistic possibility and these results were presented to the IAOMS by the Steering Committee. In keeping with one of the most cherished goals of the IAOMS, “to promote the improvement of quality and safety of health care world wide through the advancement of patient care, education and research in oral and maxillofacial Surgery”, the IAOMS Executive Committee elected to support the creation of a separate organization to provide a certification counterpart to the IAOMS’ educational efforts. The International Board for the Certification of Specialists in Oral and Maxillofacial Surgery (IBCSOMS) was founded in May, 2013 to define an international standard for specialists in oral and maxillofacial surgery. The first group of Directors of the new organization was appointed to develop an operational infra-structure and a process of certification and this body has been named the Senate. Through its certification and re-certification process, it will provide a mechanism to distinguish practitioners who have achieved and maintained a level of expertise as defined by a global standard and not an individual perception. And while the IBCSOMS was first inspired, then created, and later supported by the IAOMS, both bodies agree that autonomous leadership is essential to preserve the validity of the certification process.

Before and after the formal establishment of the IBCSOMS, much needed to be done to determine how it would function after conjecture became reality. The IBCSOMS benefited enormously through the contributions made by the Steering Committee, but we would not have made such rapid progress were it not for the intersection of career paths. In a fortuitous coincidence,Ms. Cheryl Mounts, was planning her retirement from the American Board of Oral and Maxillofacial Surgery after 19 years of inspired service as its Executive Vice President. Her experience with specialist certification and examination, healthcare organizations and professional associations is unique and un-matched and the IBCSOMS was able to entice her to join our organization with the challenge of developing a global certification process for oral and maxillofacial surgery. With her expertise, address book, and leadership skills, Cheryl propelled our fledgling organization along and in the 13 months since the creation of the Board, we have a nascent organization, a virtual office, an operational plan, and the infra-structure necessary to begin certifying specialists in 2015. And all of this was accomplished from her kitchen table, with no other staff besides herself, a computer and a mobile telephone!

The IBCSOMS hopes to conduct our first examinations in 2015. When this occurs, the definition and execution of an international standard of practice will complete a powerful initiative first undertaken by the IAOMS involving the development of training standards and educational programs to meet these standards. The efforts of both organizations, the IAOMS and IBCSOMS, serve to improve the welfare of the global community by elevating the standards of the specialty of oral and maxillofacial surgery.

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