3 years out of dental school. AMA!

[free99]

Awesome thread, thanks @bjpenn for sharing the experience and knowledge with all of us. Curious about your choice to go into GD - did you consider specializing? What about general dentistry is attractive to you? Any plans to acquire a practice in the near future or do you like focusing strictly on the dentistry?

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[bjpenn]

I didn't want to go through the process of applying all over again, and I'm in my 30s. Dentistry is actually my second career. If I could do it again, I would try to do pedo or endo. I think being a specialist in an are thats not saturated makes you extremely valuable.

I have a classmate who's now around 36-37 and he just got accepted to NYU Peds after doing 2 years GPR. He just had a kid a year ago too. That seems way too hard for me to do, but it is possible.

I think I enjoy endo the most-the idea of trying to determine the end of the root and cleaning/filling it up. Pedo is also interesting because baby teeth are pretty easy.

I'm currently looking for a practice to buy, but thats taking a while because there are a ton of crappy offices for sale and it takes a lot of time to evaluate a potential one.

I'm also toying with the option of doing a startup in this rural area to live in, but I want to have kids in 3 years, and not sure how the wife feels about it.

 

[SM555]

Hey Bjpenn, thanks for doing this.
After you graduated and began working, how was the transition from always having someone check every step of your work, to being (for the most part) on your own while doing procedures. I know you mentioned your speed was lacking but would you say you felt confident with most procedures or did you have to ask the other dentists you were working with for help at times? Do you think your skills would have enabled you to work completely alone in a private practice immediately after graduating?

 

[bjpenn]

Expect a transition. I think the best is being in the office with experienced docs. I was slow in the beginning, and during my down time I would just ask them lots of questions, and even shadow to learn from their mistakes. There were times when I would see them make a mistake and I was so glad it was them and not me, haha. A big part of dentistry is communication, not just with the patient, but your staff.

If you work alone, you have no idea how you're doing or how your stuff is compared to others. I guess if you work with really high maintenance patients, they will let you know, but I don't advise to work in an office alone right out of school with high maintenance patients. They could give you bad reviews and that stays on the internet forever. hope that helps.

 

[dlilb]

Thanks for the AMA. Always learn something new. Can you talk about how you got your license? Did you do PGY-1? Any tips you could pass on?

 

[Greyangel6]

Thank you for the AMA, it's been helpful! My question is, if you see the docs making a mistake, you learn from it, but would you let them know, especially if they don't think it was a mistake (could be because they've been out of school for so long) and they're your boss? I dread that kind of confrontation haha...

 

[bjpenn]

Thanks for the AMA. Always learn something new. Can you talk about how you got your license? Did you do PGY-1? Any tips you could pass on?

My license: just went to the state dental board website and looked at the requirements.
Tips: everything in the thread above

 

[bjpenn]

Thank you for the AMA, it's been helpful! My question is, if you see the docs making a mistake, you learn from it, but would you let them know, especially if they don't think it was a mistake (could be because they've been out of school for so long) and they're your boss? I dread that kind of confrontation haha...

Yea, when you work in a group practice as an associate, having a thick skin is best. Not everyone can be considerate all the time. Most often times I didn't say anything because I make mistakes too. Today, I had to redo 1-2 fillings I did 6 months ago. 1 fell out, and the other one had some discoloration around the margin. Not sure whose to blame- either it was my technique or maybe the assistant didn't cure right, or maybe the curing light needed repair. Either way, you redo your work for free at the expense of chair time,and materials.

One disadvantage of working at a group practice is when a pt returns for either a crown seat/broken crown/denture done by another doctor. This happened to me yesterday: pt didn't return after july to have her bridge seat #18-20. The previous doctor works at my company's office about 60 miles away. I ended up spending an hour trying to seat it because he did an ext on #19 and prepped 18/20 and took a final impression on the SAME visit!! WTF. I ended up texting him in a nice way, " Hey I"m going to try and seat your bridge, but do you mind seeing her when you come back in two weeks?" I wanted to say something else, but just don't want to make things uncomfortable.

That's one of the issues at my office right now. Seating other people's work. Apparently, I was told that's how the previous doctors did it in the office, but thats a lame excuse. This guy gets a 5pct more than me for each procedure, and I'm supposed to seat it for free and deal with all the headache? The manager and the front desk don't give a damn- they just want to be able to tell the owners that they saw a lot of patients. They have no idea/don't care about the liability involved in seating other people's work. This is one of the most annoying things I've had to deal with as an associate.

 

[bjpenn]

For all the people who are wondering about gprs. I just asked my friend who did a 1 year residency in nyc if she felt comfortable extracting wisdom teeth in a private office:

i wouldn't do it
i don't feel comfortable
too much liability involved.

yay.

 

[suarez 7]

For all the people who are wondering about gprs. I just asked my friend who did a 1 year residency in nyc if she felt comfortable extracting wisdom teeth in a private office:

i wouldn't do it
i don't feel comfortable
too much liability involved.

yay.

Does your friend recommend GPRs in general - has it made her more polished and did she learn new clinical skills during that yr?

 

[bjpenn]

I'm sure she learned, but its a requirement to practice in NY, and you don't really get paid much. Did you consider why other states don't require a gpr? I mean if you had a choice between a GPR vs a job as an associate where you can learn and make more money, why would you choose a GPR?

 

[bsp1013]

GPRs are for people who don't understand they can make money doing dentistry.

Don't want to/can't do a procedure? Refer or take CE. Cheaper than a year of lost income doing a gpr, IMO.

 

[Faux]

GPRs are for people who don't understand they can make money doing dentistry.

Don't want to/can't do a procedure? Refer or take CE. Cheaper than a year of lost income doing a gpr, IMO.

A bit out there to say that for people who take GPR. Many people on DT rave about having a decent worth while GPR and that they would do it again. Its more common to read about people who would make the same choice again , rather than not take one at all.

 

[480640]

Why is the number of students that drop out of nyu after the first or second year high compared to other schools?

 

[bjpenn]

Why is the number of students that drop out of nyu after the first or second year high compared to other schools?

Where are you getting that info? From what I remember, my year
D1: 1 dropped out
D2: 3-4 had to repeat the year, 1 got kicked out
D3: 2-3 had to repeat the year
D4: everyone graduated

Nyu gives you tons of diadatic, even after d1 you only get a month off where lots of schools got 3. There aren't huge curves or extra credit, 2-3 regular exams and usually a cumulative final. Not much room for error. Fail your first exam, expect a lot of stress trying to dig your way out.

Bottom line: just bc u got into dental school doesn't mean you automatically get to be a dentist. Gotta work really hard bc you just have to do so much stuff in a short period of time.

 

[dentheartthrob]

2500/month for 15 years..yea i know I can't do ibr or paye. I think I was concerned about what happens in future..will your loan really be forgiven? I plan to pay all this off in the next 2-4 years.

My interests from both my loans are 7.9 and 6.8 percent from roughly a 300K loan . And I've graduated the same time as you did and I'm nearly paying the same amount as you but on a 25 year plan. tsk tsk tsk. Time for me to look into SoFi.

 

[bjpenn]

Sofi- nothing bad to say abt them. Just be ready to give them all your financial documents. My credit score is 800, and my income probably paid a big role in it. Nothing to lose by applying.

 

[Kayaker89]

Are there any federal or state loan repayment options where you work, would you recommend going through one of these programs?

 

[bjpenn]

Yes- there are federal repayment options, but it just seemed to complicated, drawn out, and uncertain for me. I would probably guess about 99% of my classmates are doing some kind of federal or state loan repayment option. I just don't like debt hanging over my head especially if my occupation is to perform a service on a human being. I want to be able to sleep at night. That's why I live where I live, why I'm living way below my means..after a while you get used to it. I see so many of my classmates buy the fancy car, clothes, or live in that tall high rise apt.

Someone said to me once: "You have status already, no need to spend lots of money on those things." What's important to me now is less stress and good health until I am able to figure out what my next move is. In the meantime, I'll be ready for my next move because I'm increasing my skillz, and saving up.

 

[Realitydentalstudent]

Thank you for doing this. I was wondering out of the non-military and students without parents as dentists, what % of your class is working cooperate right now? Are private associateship positions very difficult to get as a new grad?

 

[bjpenn]

Aside from my sister, no one else in my family are dentists. I would say about 99pct of my classmates who moved to texas are working in corporate right now. Private associate positions aren't hard to get, but the good one's aren't usually advertised. The bad ones are, those ads constantly keep coming up.

 

[jeffk805dent]

Aside from my sister, no one else in my family are dentists. I would say about 99pct of my classmates who moved to texas are working in corporate right now. Private associate positions aren't hard to get, but the good one's aren't usually advertised. The bad ones are, those ads constantly keep coming up.

This is true and in my stupidity I fell for one of these bait-and-switch private association gigs. It was so bad, I would have been better off at Aspen dental (and thats saying a lot). Best private association gigs are found through aggressive and constant networking through the local dental association and keeping the dentist updated that you're interested. I did not do this out of fear of pissing off the dentists but some of my friends at other dental schools did this and it worked.

On a side note, I find it interesting you mention 99% of classmates who moved to texas are in corporate. I always hear the "everything is bigger in TX" all the time that people assume you can find a nice private association gig in Dallas.

 

[bjpenn]

Dallas and Houston are super saturated. Tons of offices everywhere, and even if you found a spot, it would be just a matter of time other offices setting up next to you. Of course, this happens in every desirable area. With lots of competition, you just have do differentiate yourself by having really good customer service, and a well run office. After working so hard as an associate, thought of setting up somewhere with less competition seems more attractive.

 

[calpred]

bjpenn, thanks for sharing your experiences.


A. Would you say more about procedures you do? The most common ones, the challenging ones, the rare ones, ones that you may refer… do you do implants?


B. So you are fresh out of college working in a corporate office, and you get a kind of challenging


case, let’s say a prosth case. You want to do the case, but need some


consultation/mentoring over it. Is there a way to get it? Does your office provide such


opportunity to consult with experienced dentists?



Thanks!

 

[bjpenn]

I do mostly fillings/sealants. I do about 1 crown a week, and 1 endo every 2 weeks, and 1 adult extraction a week. This is a rough estimate, but I feel as comfortable as any one 2 years out of school. I refer complete bony impacted 3rd molars, but I'll extract a tooth if I can see it. Don't really do much cosmetic. i want to learn ortho and implants, but hopefully in my office one day.

I work in a group practice, so there's always someone to ask. These days you can even show pics to your classmates/colleagues and they can give you advice.

My biggest case was a 10 unit anterior case. That was pretty cool.

 

[Bifenthrin]

Do you feel confident doing Invisalign cases? I know we graduate NYU certified in Invisalign, but certified doesn't always mean confident in the procedure. If you do feel confident in it, do you do it in the office? And if so, how much does the office you work for charge patients for it?

Trying to figure out if I should seek out Invisalign cases while I'm in clinic to get good at it, because if it brings in a lot of revenue, it might be a good selling point on my resume and good when I open my own practice a few years down the line.

 

[bjpenn]

No I don't feel confident in invisalign cases. I work in a medicaid office, and most patients cant afford braces, and we have an ortho on hand does usually does conventional braces.

I doubt as an associate you will get to be in an office where you will be able to do invisalign on your own. By the time you open your own practice, you will have forgotten how to do invisalign. I spoke to an invisalign rep a while back, and I wanna say the lab fee is $1500. I think offices charge 4-5k in it. Case selection is key though especially if you're working on a pt that can pay that much.

You know whats a good selling point on your resume?
1. able to extract 3rd molars
2. molar endo.

 

[ajj70]

Yes- there are federal repayment options, but it just seemed to complicated, drawn out, and uncertain for me. I would probably guess about 99% of my classmates are doing some kind of federal or state loan repayment option. I just don't like debt hanging over my head especially if my occupation is to perform a service on a human being. I want to be able to sleep at night. That's why I live where I live, why I'm living way below my means..after a while you get used to it. I see so many of my classmates buy the fancy car, clothes, or live in that tall high rise apt.

Someone said to me once: "You have status already, no need to spend lots of money on those things." What's important to me now is less stress and good health until I am able to figure out what my next move is. In the meantime, I'll be ready for my next move because I'm increasing my skillz, and saving up.

This should be the header on this board. Something for everyone to remember....yes, you are going to be a dentist and make a good living, but you still need to pay your dues and get your feet under you. Unless you are walking into a family practice right out of dental school, just about everyone could learn from your viewpoint. Give a a few years, get your skills down, pay off your debt, get some money into the bank, then when you are more settled, you can buy that dream car or whatever...keeping in mind that you still have bills to pay.

 

[docrogers777]

Do you know if the loan repayment is considered tax deductible if you own your own practice as opposed to being an associate? I would imagine that it could be considered a business expense. I've been looking into this for a while and haven't gotten a definitive answer.

It's not tax deductible.

 

[FlyingSky]

how does it feel to make your own clinical decisions?
do you sometimes feel the need to ask something to someone (like in dental school), but you cant, you are your own boss no one looking after you?
Did you memorize all the epinephrine contraindications/limits?
Did it ever happen to you to have a patient taking warfarin and you werent sure if you could treat the patient that day?

Do you consult your books sometimes? What books are most useful to buy during dental school that could help me in my practice later?

 

[aspiringdds02]

Were you given a salary guarantee or strictly percentage of production?
You mentioned your first year salary was over 200k, are you projected much higher this year?
How aggressive are you being regarding loan payback? Can you provide figures if you don't mind? I want to be as aggressive as possible when I finish school.

 

[irishmom]

Did you memorize all the epinephrine contraindications/limits?

I'm a hygienist currently. I will be attending tOSU Dental School this fall. I have my anesthetic license. In my anesthetic class they gave us a chart of all the epi/limits per pound on a laminated sheet for quick reference in the real world. Hopefully they do the same for those in Dental School. If not...I have mine...lol. Also they gae us a color-coded illustration of where each injection would numb.

 

[FlyingSky]

I'm a hygienist currently. I will be attending tOSU Dental School this fall. I have my anesthetic license. In my anesthetic class they gave us a chart of all the epi/limits per pound on a laminated sheet for quick reference in the real world. Hopefully they do the same for those in Dental School. If not...I have mine...lol. Also they gae us a color-coded illustration of where each injection would numb.

Congrats on your acceptance!
I have many papers like this in my old classes notes (like pharmacology class with lot of infos), but finding them is another thing lol! I even downloaded a file from a poster a while ago... but they are not laminated... I have a hard time remembering drugs, if you guys have any files you'd like to share I am a taker for sure
Like I have some papers on antibiotics for parodontal diseases, others for endodontics, others for pediatric, others for pregnancy meds, analgesics for pediatric, analgesics for endodontics, it never ends

Hoping that while studying for the NBDE I will find all my papers... I need to make a dossier with all the important papers!

 

[bjpenn]

how does it feel to make your own clinical decisions?
do you sometimes feel the need to ask something to someone (like in dental school), but you cant, you are your own boss no one looking after you?
Did you memorize all the epinephrine contraindications/limits?
Did it ever happen to you to have a patient taking warfarin and you werent sure if you could treat the patient that day?

Do you consult your books sometimes? What books are most useful to buy during dental school that could help me in my practice later?

Making clinical decisions all day, everyday is pretty routine for me.

I show cases, and ask questions pretty frequently. Since I work in a group practice, I've been able to ask the pedodontist tons of questions. My sis has been practicing one year longer than I have, so we talk to each other pretty often.

As far as the epinephrine goes, I try not to give crazy amounts, but yes the most common things to watch out for are pregnant/HBP/heart dz patients.

If I feel like patients are medically compromised, I always get a medical clearance. No need in trying to do something if you feel there will be post op complications after.

 

[bjpenn]

Were you given a salary guarantee or strictly percentage of production?
You mentioned your first year salary was over 200k, are you projected much higher this year?
How aggressive are you being regarding loan payback? Can you provide figures if you don't mind? I want to be as aggressive as possible when I finish school.

I have a base salary and a pct of collections. My base salary is pretty good compared to dentists working in a big city, but I make more than the base. It's just there as an insurance policy.

Loan payback- I hope to pay off around 100k this year.

 

[greengreengreen]

I'm choosing between A.S.D.O.H. and N.Y.U.. I just want to choose the best program without factoring in money (tuition seems pretty close, would just be housing differences but AZ needs a car anyways).
Any advice on how to choose between A.S.D.O.H. and N.Y.U.?

Thanks!

 

[1passbbsSHAVE]

freaking awesome read here. can we revive it?

 

[longhornpride]

I'm two years out now and have a very similar experience to BJpenn. Basically, if you're graduating with 300-400k debt, skip the gpr/aegd unless it's at a competitive VA where you do 500 surgical exts and place 30+ implants. If you want to make good money, it will be hard to do that as an associate at a private practice. I work at a private practice but it's basically run like a corporate chain. Lots of volume and very stressful. 99% of my buddies out here in Texas are working corporate/medicaid chains. It's hilarious how this has become the norm. Basically graduate, get worked to death as an associate, get paid **** (25%) for procedures. Do this for 2-5 years, make a lot of money, pay off your debt... then bounce and open your own practice. I dream of the day I walk into my office middle fingers blazing yelling I quit. As an associate, most bosses have their own interest. They will push you to do treatment you don't feel comfortable doing and sometimes what isn't best for the patient... this is where you need to stand your ground. They don't value or appreciate you. The types of patients you work with don't appreciate you and are so damn rude. The staff will always side with the owner bc he is the one that writes their paychecks. Just this past year, I made sure to clear my schedule for new years eve by 6 pm so I could make dinner with my gf and her family. My boss booked his schedule till 9 pm on new years eve. As I'm about to head out at 6, he stops me and says that he's going to head out and I'm to see the rest of his schedule. I'm still not sure how i was able to compose myself and not bitch slap him right then and there. Unfortunately... 99% of my friends hate their associateships too. Sorry... didn't mean to go on a rant but my advice is to get a job, build your speed, pay off your debt and open your office where you can run it the way you want. And when you're the owner, appreciating your staff and doing good by your patients will go a long way.

Also, since salary is the most frequently asked question... most of my buddies that work hard and are these corporate chains are all making good money ranging from 200-400k a year. Just keep in mind, how much they work you to death and how much you have to produce to bring home that amount. It's honestly depressing and takes a toll on you mentally and physially. My first year, I was putting in 50-60 hour weeks working 6 days a week. Now that my debt is manageable, I'm down to 40-45 hours working 5 days a week. I'm hoping to cut it down to 4 days next year.

 

[jackjackson1121]

^^must be rough man. Work hard a few years to make 200k-400k a year. While people in all other aspects of life are working that to hopefully someday break the 100k mark after 20 years of service.


Sent from my iPhone using SDN mobile app

 

[re2pect]

@longhornpride: Also, since salary is the most frequently asked question... most of my buddies that work hard and are these corporate chains are all making good money ranging from 200-400k a year. Just keep in mind, how much they work you to death and how much you have to produce to bring home that amount. It's honestly depressing and takes a toll on you mentally and physially. My first year, I was putting in 50-60 hour weeks working 6 days a week. Now that my debt is manageable, I'm down to 40-45 hours working 5 days a week. I'm hoping to cut it down to 4 days next year.[/QUOTE]

Do you make around 400k working 6 days a week?

 

[longhornpride]

@longhornpride: Also, since salary is the most frequently asked question... most of my buddies that work hard and are these corporate chains are all making good money ranging from 200-400k a year. Just keep in mind, how much they work you to death and how much you have to produce to bring home that amount. It's honestly depressing and takes a toll on you mentally and physially. My first year, I was putting in 50-60 hour weeks working 6 days a week. Now that my debt is manageable, I'm down to 40-45 hours working 5 days a week. I'm hoping to cut it down to 4 days next year.

Do you make around 400k working 6 days a week?[/QUOTE]

I don't make 400k... it was just a range i've seen from friends working out here. I don't remember the exact number but it was around 330 my first year out working about 5-6 days and on avg 55 hours a week. worked through all holidays... x mas, thanksgiving, new years, etc. I'm making less now that i've cut back hours a day. Still busting my ass though.

 

[longhornpride]

^^must be rough man. Work hard a few years to make 200k-400k a year. While people in all other aspects of life are working that to hopefully someday break the 100k mark after 20 years of service.


Sent from my iPhone using SDN mobile app

Salaries reflect supply/demand and having a skill. Everyone has a choice to work hard and choose the more difficult/rewarding path. 8+ years of schooling, studying, tests is no joke. climbing out of 400k of debt is no joke.

 

[bjpenn]

Debt isn't a joke at all especially when you have to pay it off with POST TAX income. Don't get me started on taxes.

 

[sjk20]

This is a somewhat strange question to ask and I'm not sure how to get around this question but, are you happy? (And that goes for all current dentists in this thread) I love these threads because I value the real and honest insight you all can give to us but sometimes I read these responses and get scared- I don't expect to love dentistry 24 hours a day/7 days a week but I would hope that the majority of the time I can say I don't hate my life. Even when I am working in a corporate office and paying off my massive debt. I'm sure thats very subjective and can depend a lot on who you were even before becoming a dentist, but do you have any regrets in the path you've chosen?

 

[Cello]

Jordan Belfort (the real guy portrayed by Leonardo DiCaprio in The Wolf of Wall Street) "...enrolled in the Baltimore College of Dental Surgery; however, he left after the dean of the school said to him on his first day at the college: "The golden age of dentistry is over. If you’re here simply because you’re looking to make a lot of money, you’re in the wrong place."[16][17]"


This was back in the 70's and dentists were saying the same thing. If the "golden age" even existed, it must not have lasted long. Dentists are still doing fine, and will continue to do fine. Go where you are needed, and you will be fine.

Source:
http://en.wikipedia.org/wiki/Jordan_Belfort

Markets ebb and flow, that is what capitalism is all about.

 

[PikminOC]

I'm way farther out than you in practice, and my car has 125k on it. You are smart to be thrifty

 

[bjpenn]

This is a somewhat strange question to ask and I'm not sure how to get around this question but, are you happy? (And that goes for all current dentists in this thread) I love these threads because I value the real and honest insight you all can give to us but sometimes I read these responses and get scared- I don't expect to love dentistry 24 hours a day/7 days a week but I would hope that the majority of the time I can say I don't hate my life. Even when I am working in a corporate office and paying off my massive debt. I'm sure thats very subjective and can depend a lot on who you were even before becoming a dentist, but do you have any regrets in the path you've chosen?

Ha- happiness comes and goes. There were a couple of weeks in april where it was actually the first time I HATED dentistry. i felt overworked and burnt out and was frustrated at things going on in the office. I need a vacation( going on a few trips actually soon), but I felt like things had to change on a day to day basis. I started doing YOGA haha. it works! really sets the day off right and helps your body recover from doing dentistry all day.

Lately we haven't been busy, but I think the thing to remember is this is a marathon not a sprint. hard to not want to sprint when you just get out of school.

 

[itsJazz]

Hi BJPenn, thanks for doing this AMA. I was wondering if you've had to deal with relatives wanting you to do free/discounted procedures/checkups on them just because they're related to you. I have a feeling some of mine will once they get wind of my career, and was wondering how you would deal with the situation.

 

[bjpenn]

Hi BJPenn, thanks for doing this AMA. I was wondering if you've had to deal with relatives wanting you to do free/discounted procedures/checkups on them just because they're related to you. I have a feeling some of mine will once they get wind of my career, and was wondering how you would deal with the situation.

I've had to deal with WORSE. I have my staff's RELATIVES come in and wanting free treatment like my assistant's cousin, or my assistant's mom's brother. What would happen is they would come into the office, get labeled as an employee and get a HUGE discount. that used to piss the hell out of me. I'd be so busy seeing patients, and didn't realize I was getting tricked by the time I finished treatment on them.

Took some time to put a stop to this, but yea. Having your friends/family ask you for free work will be the least of your worries for a long time.

 

[bjpenn]

can anyone help me change the title thread to " 3 years out of dental school AMA!" ??