Disappointing GPR experience

[voticelli]

I have been reading the forums for a few years now and have posted a couple of times, but decided to create a new username to maintain my anonymity.

I am currently doing a GPR and my experience has been very disappointing so far. I have done only two crowns and not a single RCT up to this point. Yes, you read that right.

My co-residents are having very similar experiences. The other three have between one and three crowns completed. Only one person has done two anterior endos. We are doing plenty of removable, new exams, recalls and prophies, and some direct fills.

I am planning to stay in general dentistry and thought that the GPR will be a good opportunity to learn some new things, tackle few complex comprehensive cases, and gain more practice. It has been the complete opposite. This has turned into a backward step from my dental school experience, where I did molar endo, restored implants and did about 20 units of fixed. My speed is decent, about 3-5 direct fills in 1-1.5 hr.

Part of the problem is the program director. He is a very nice, well-meaning guy, but he lacks any desire to make this a good learning experience for us. He shies away from complex cases. He focuses on simple restorative (direct fill, single units) with his own patients. He doesn't do endo. Patients are cherry picked and those with good insurance coverage or ability to pay out of pocket are pulled into his practice.

The other issue is the patient pool, which is mainly medicaid. Most of the patients cannot afford to endo/crowns/implants. I have good rapport with patients and get positive feedback from them with letters of appreciation, etc.

I never thought it would be this bad. The previous class had done about 10-15 crowns and 10 or so endos per person. I knew it was not going to be as good as a VA program, but this has turned into a very poor experience. I have a few crowns and one endo planned, but now we are heading into medical rotations which will cut away a big chunk of our clinic time.

I thought about quitting but decided against it. I have already spent (wasted) six months, hoping things will pick up, and I might as well finish the program and get the certificate. I'd like to go into teaching at some point, perhaps part-time. Also, it will allow me to get licensed in a few more states, although I am not planning to move to any of them immediately after the program.

The residents don't want to ruffle feathers with the director because we will need a job reference. The assistants say that the administration is aware of the situation but are looking away because they can't find another director. We are joking with my co-residents that we will seek legal recourse for the lack of advanced experiences and the financial losses

My advice to those heading into a GPR/AEGD is talk to the current class and make sure there are specialist on hand to help with cases. Also, apply to the VAs because it's not all about grades/scores, but keep in mind not all VAs are the same. There are good programs outside the VAs. Choose wisely and you will learn a lot.



Please feel free to PM or write here with your thoughts or advice. Also, please share if you are or have been in the same situation via pm or this thread.

We want to change things but are not exactly sure how to go about it. And thanks for reading... I think I needed to vent.

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[Saddleshoes]

Part of the problem is the program director. He is a very nice, well-meaning guy, but he lacks any desire to make this a good learning experience for us. He shies away from complex cases. He focuses on simple restorative (direct fill, single units) with his own patients. He doesn't do endo. Patients are cherry picked and those with good insurance coverage or ability to pay out of pocket are pulled into his practice.

Does CODA (American Dental Association's Council on Dental Education) know about this issue? I think there might be a ethics/legal issue going on here.

 

[Shunwei]

This is why I think that gpr and aegd are a waste of time. A lot of gpr will try to rope in warm bodies using the enticement of implants to provide cheap dental care under the guise of experience. Honestly, if one is a good student in dental school, is confident, knows his limits, it is much more beneficial to just associate for a few years and then plan on possibly opening his own office. I went to private practice straight out of school and in less than six months have done over 200 crowns and 40 bridges, and about 90 endos over 50 of which are molars, along with a dozen dentures requiring full mouth extractions and a number of implant restorations, plus the usual operative and stuff. It's about finding the right opportunity in the right place and knowing your limits. Knowledge of IV sedation is of marginal value since very few dental cases will require this and there is increased liability involved; if a pt needs this it is most likely a highly complex case medically that I'd much rather delegate to a specialist. The only thing I consider of value in a gpr would be implant placement, but there is no telling how many you can do and whether it is there or not. Much better to spend to spend some money in a CE course and slowly expand with selected cases.

Some people will point to the following as pros of GPRS and aegds, but I don't see the advantage as being worthwhile the time and salary opportunity costs:

1) GPR provides experience: you gain experience anyways in private practice. Know how to find a good position in the right place and you can gain plenty of relevant experience. Gprs do not teach you the dynamics of private practice and financial management.
2) GPRs train you in medical workups: Sure, you might see more oddball cases in a gpr, but how relevant is this to real life practice? For 99% of patients out there, there are only certain allergies or medical conditions you need to know and as a dentist the number of meds you need to prescribe are limited. As mentioned before l for those rare pts with special needs it is much better financially and legally to refer them to specialist for care. Why take the risk?
3) GPRS teach you implants: as mentioned before, maybe maybe not. A lot of GPRS use this as a carrot to rope in people but you have to realize that OMax residents will always get the cream of the picks. Restoring implants is not hard after you do a couple of real life cases hands-on.
4) New Grads don't know anything: I would disagree with this because if you don't know anything you should not have been graduated. You should know enough to start being a professional dentist. The key is to know your limits, refer when needed, slowly expand your boundaries, and learn continuously. Who's to say that a year of gpr would automatically transform you into a competent dentist?

Having dealt with the academia for a very long time and knowing how these folks think, I personally see GPRS and aegds as cheap ploys by the government and academic institutions to get new dentists to provide dental care for them. If you are a confident new grad whose ultimate goal is private practice, don't feel pressured into doing one. For all intents and purposes its a 5th year of dental school living under a bubble with supervision and having to deal with the usual school politics.

 

[gryffindor]

I would stop trying to make this a better experience. Just show up, do what's required, collect your paycheck and go home. Since you are doing plenty of removable, get good at that. People in private practice don't want to do removable because of a combination of an annoying procedure and awful insurance reimbursement. But there are still people out there who can't afford implants and need a good partial to give them some front teeth. Start looking for a good private practice experience now - one that will have you busy, not one that will have you doing exams and buccal pits because like your GPR, there are really bad associateships out there too.

I wouldn't quit because you never know when that certificate can come in handy with regards to licensure in other states if you ever do move or do a residency. If you ever do decide to specialize, it won't look good that you quit a GPR.

 

[Pleonasm]

I know it's disappointing, but stay with it. Just 6 more months. As the OP points out, you may get better experience with a good associateship. The problem is that in a tight job market, it's an employer's market. Many employers, especially the better practices, require either a gpr/aegd or 2-3 yr experience or both. The assumption is that you should have more/better experience than someone who's just exiting DS. Depending on where you did your gpr, this may or may not be true, but this is the perception.

 

[voticelli]

Thanks for the replies. I am not planning on quitting at this point. I have a few months left and I will use this time to make sure I find a good associateship.

@Saddleshoes:
CODA doesn't know about patients being pulled into his practice.

@Shunwei:
You make some great points. It seems you have found a fantastic opportunity that is keeping you busy. I am afraid that is not always the case. I have talked to classmates and many are spending their days as employees doing simple fills with an occasional crown.

I do think that there are about 15-20 GPR/AEGD programs which offer a great learning experience, and those are pretty well known around these forums. The rest could be a decent place for those who lack speed and confidence coming out of dental school. I had classmates who in the spring of their senior year would need almost an hour for a two-surface fill.

 

[Shunwei]

Voticelli:

You are right about not every associateship being good, which is why I mentioned location as key. Many dentists insist on practicing in super competitive areas like NYC and LA/SF, and in these settings if one is fortunate enough to even find an associateship it is likely a crappy one involving leftover crumbsfrom the owner dentist. However, in other places, such as suburban areas an hours drive from a metro center, there are still great opportunities to be had for new grads. It is all about realizing what you are (a new grad) and being willing to make some sacrifices for greater overall long term gains. Very few new grads, if any, can come out, have their cake, and eat it too.

If one can make these realizations and finds a good associateship, there is no doubt in my mind that private practice is superior to gpr/aegd, unless teaching is the ultimate goal. In my opinion, it is no coincidence that the current states requiring gpr/aegd happen to be the ones that offer the worst job prospects. In these states, competition is so fierce so new grads are forced into these "holding" patterns for one or two years before a viable opportunity presents itself, often maybe not even this; I personally know several residents who have done multiple GPRs, because they either can't find a good opportunity or they have lived under the bubble for so long that they'd be lost going without it. My advice is to focus on opportunities themselves and not being too dogmatic on where you should practice. There are plenty of good places to live in this country.

 

[dr37]

Shunwei ""less than six months have done over 200 crowns and 40 bridges, and about 90 endos over 50 of which are molars, along with a dozen dentures requiring full mouth extractions and a number of implant restorations""



Where is that practice??

 

[Shunwei]

Suburban area in TX. Having a good time.

 

[gryffindor]

Suburban area in TX. Having a good time.

How did I know that after all of your bragging that you were going to say Texas...

 

[voticelli]

It seems there is strong interest in this topic. More than 1,500 views of the thread, but only nine responses. I am very curious to hear other people's experiences. Also, people who have dealt with this in the past, please share your stories and how you handled it. I shared my story hoping others would step up and tell about their experiences.

 

[iLuvDAT]

GPR/AEGD is a huge scam for new grads. All the programs pay you minimum wages and give you lots of crap while saying "we are training you". Haven't we had enough of this in dental school? Just grow a pair of balls and go work for a chain or an underserved area. No job is worse than general residency. All of my friends who are doing GPR are regretting their decision and want to quit. They can't believe why they'd spend thousands of dollars on PASS, traveling around the country to apply for a crappy job back then. Once you get into practice you will soon realize that you are not much different from someone who just graduate from dental school, or has been working in private practice. GPR experience is way overrated.

 

[Romas]

GPR/AEGD is a huge scam for new grads. All the programs pay you minimum wages and give you lots of crap while saying "we are training you". Haven't we had enough of this in dental school? Just grow a pair of balls and go work for a chain or an underserved area. No job is worse than general residency. All of my friends who are doing GPR are regretting their decision and want to quit. They can't believe why they'd spend thousands of dollars on PASS, traveling around the country to apply for a crappy job back then. Once you get into practice you will soon realize that you are not much different from someone who just graduate from dental school, or has been working in private practice. GPR experience is way overrated.

Couldnt disagree with you more. I'm a little over halfway through my GPR, and it's been an incredible experience in general dentistry, prosth, omfs, perio surgery, endo, oral medicine, peds, sleep medicine, and medical anesthesia/head and neck oncology that built on what I learned in dental school. And I feel that I went to a very good dental school at that, and felt prepared for private practice upon graduation. But for me, gaining more advanced and esoteric skills in a residency seemed to make more sense financially and time wise than CE or hoping to luck out on a good associateship. And its already proving to be helpful in the job hunt, since my particular GPR program and d-school have good name recognition and because employers seem responsive to hiring grads with the skills detailed above. The reason grads looking to work in major metropolitan areas of the U.S. steer towards residency is because the standards for those good jobs out there are so high compared to those in flyover country, owing to how saturated the market is and how some of the best dentists - the ones you see lecturing all over the place with multiple degrees - practice in places like NYC, SF, etc. Personally, I think working in Texas is ideal because it means fewer younger DMD/DDS getting taken advantage of in medicaid mill type scenarios when they cant find a good practice to associate in. But i would argue that even then, the residency experience can bring even new skills that may be easier to implement w/out competition in places like suburban TX.

If anything, my friends who went on to Gentle Dental, etc. right out of school wish they had more opportunity to at least experiment a little with some of the things I've gotten to see/do this past year. Not saying that they havent learned a ton in their own right, but once youve graduated dental school, even if youre a little slow at it, you should be able to prep a crown for example. You'll get to do tons of them once you start working. The point in a residency is to have a compacted experience in new facets of advanced dentistry/medicine you cant get in dental school, so that you can have the option to expand your services offered to future employers/patients. My friends in corporate dentistry and some other private offices feel that they're stuck in a rut with the types of dentistry they offer. If what you learned in dental school is all you really want to do, then I dont think a residency is necessary, per se. But it helps if you want to experience a little more than bread and butter gp work, or if you want to get better at whatever you lacked from d-school.

That being said, there are a TON of crappy programs out there in NYC for example, and in general, there are some poor AEGDs here and there too. Researching programs well in advance here is key, even if it's a challenge because obviously many programs lack transparency in terms of what they offer. A good clue is to look at the MATCH results and see which programs consistently fail to match all of their spots over the past 5 yrs or so. A lot of programs with big name hospitals/universities actually have some of the consistently worst matching programs for a reason. It's definitely not worth it to go to a residency that wont fulfill your specific needs for future practice, so it's really unfortunate the OP seems conned into wasting a year at this program.

Do you mind sharing which program it is? I'm obv not applying, but I have tons of friends who will be and would appreciate the insider advice. Best of luck. My advice would be to join local dental societies and try to network your way into a couple of good associate jobs that might be able to pick up the slack. Any chance you can moonlight during residency?

 

[mndds]

Where can you find the MATCH results for residencies?

 

[Mackchops]

GPR/AEGD is a huge scam for new grads. All the programs pay you minimum wages and give you lots of crap while saying "we are training you". Haven't we had enough of this in dental school? Just grow a pair of balls and go work for a chain or an underserved area. No job is worse than general residency. All of my friends who are doing GPR are regretting their decision and want to quit. They can't believe why they'd spend thousands of dollars on PASS, traveling around the country to apply for a crappy job back then. Once you get into practice you will soon realize that you are not much different from someone who just graduate from dental school, or has been working in private practice. GPR experience is way overrated.

Sadly, many who think that a GPR is a waste of time are often the dentists who would benefit the most from doing one. Sure, there are some junk programs out there but a good year at a good GPR is easily equal to 10 years of private practice. Those who think otherwise haven't completed a good GPR...

 

[Demeter]

I have been reading the forums for a few years now and have posted a couple of times, but decided to create a new username to maintain my anonymity.

I am currently doing a GPR and my experience has been very disappointing so far. I have done only two crowns and not a single RCT up to this point. Yes, you read that right.

My co-residents are having very similar experiences. t.

Are you at one of the Lutheran programs?

 

[fdu83]

Sadly, many who think that a GPR is a waste of time are often the dentists who would benefit the most from doing one. Sure, there are some junk programs out there but a good year at a good GPR is easily equal to 10 years of private practice. Those who think otherwise haven't completed a good GPR...

I couldn't agree more. I found my year's experience at a GPR program (and that was 30 years ago) was invaluable to my career. It was hard but well worth it. If you are in a bad program...make the most of it. I think the majority of our residents would agree, and they are doing procedures thay would never have been exposed to in dental school. They are learning different techniques from different attendings. There is no way you can equate this type of experience with working for some mill or in corporate dental office. If anyone thinks working as an associate in some private office is going to provide a rich opportunity for learning...they are sadly mistaken.

My advice to the original poster is stick it out...try to make the best of it. Find out who is over the site director and your institution and voice your concerns. Good luck!

 

[askadds]

Sadly, many who think that a GPR is a waste of time are often the dentists who would benefit the most from doing one. Sure, there are some junk programs out there but a good year at a good GPR is easily equal to 10 years of private practice. Those who think otherwise haven't completed a good GPR...

"easily equal to 10 years of private practice" LOL this is one the funniest things I've heard on this forum.

 

[Meas]

Hi voticelli ,

Thank you for sharing with us your GPR experiences. I am in my third year dental school now and in the process of applying for AEGD or GPR program. From looking at many posts online, it seems like VA programs are very good. What are VA programs exactly?

Also, all the information that is provided on individual school's website does not say much at all. I would like to know the type of procedures that residents are given, the pay, etc. It seems like we can only get all that information when we arrive at the interview and have a chance to talk with the residents in person there. Note that every application we submit is an additional cost too. However, for applicants like me who do not know many residents from other schools and preparing for my application now, how can we get that information? Is the only way to find out is by calling the program director for every single school we apply to?

Thank you in advance for your help. Any feedback is appreciated. Application will be opening up very soon and I have many questions but not sure how I should start.

Thank you!

Regards,

Meas

 

[Sublimazing]

"easily equal to 10 years of private practice" LOL this is one the funniest things I've heard on this forum.

Says the guy still in school...please share with us your opinions on the matter oh wise one?

 

[dmdluffy]

Hi voticelli ,

Thank you for sharing with us your GPR experiences. I am in my third year dental school now and in the process of applying for AEGD or GPR program. From looking at many posts online, it seems like VA programs are very good. What are VA programs exactly?

Also, all the information that is provided on individual school's website does not say much at all. I would like to know the type of procedures that residents are given, the pay, etc. It seems like we can only get all that information when we arrive at the interview and have a chance to talk with the residents in person there. Note that every application we submit is an additional cost too. However, for applicants like me who do not know many residents from other schools and preparing for my application now, how can we get that information? Is the only way to find out is by calling the program director for every single school we apply to?

Thank you in advance for your help. Any feedback is appreciated. Application will be opening up very soon and I have many questions but not sure how I should start.

Thank you!

Regards,

Meas

VA programs are associated with the Veteran Affairs hospitals and programs. Most of the VA sites I have seen talk about your pay as a resident. Also, while this is limited to what I've experienced with one VA GPR, you can contact the program director to head down to a program that you're interested to and have a look around and chat with them.

 

[Mackchops]

The big advantage of doing your GPR at a VA, as I see it, is that your patients don't have to pay for treatment. This way I get good experience with pros, implants, perio surgeries, etc. The biggest weakness, however, is you see a very narrow slice of the population exclusively. No peds, no ortho, and limited thirds.

These are blanket statements about all VAs but each is going to have different things to offer. My recommendation would be to contact program directors and see if you can get the contact info for a resident who might be able to talk with you about their program.

Hi voticelli ,

Thank you for sharing with us your GPR experiences. I am in my third year dental school now and in the process of applying for AEGD or GPR program. From looking at many posts online, it seems like VA programs are very good. What are VA programs exactly?

Also, all the information that is provided on individual school's website does not say much at all. I would like to know the type of procedures that residents are given, the pay, etc. It seems like we can only get all that information when we arrive at the interview and have a chance to talk with the residents in person there. Note that every application we submit is an additional cost too. However, for applicants like me who do not know many residents from other schools and preparing for my application now, how can we get that information? Is the only way to find out is by calling the program director for every single school we apply to?

Thank you in advance for your help. Any feedback is appreciated. Application will be opening up very soon and I have many questions but not sure how I should start.

Thank you!

Regards,

Meas

 

[hoak]

Sadly, many who think that a GPR is a waste of time are often the dentists who would benefit the most from doing one. Sure, there are some junk programs out there but a good year at a good GPR is easily equal to 10 years of private practice. Those who think otherwise haven't completed a good GPR...

GPR or private office, in term of learning new skill, technique, etc. is all depend on the specific place that you're in. Some GPRs are good, some bad. The same goes for private practice.

But saying "a good year at a good GPR is easily equal to 10 years of private practice" is really the most ignorant, laughable claim I've ever seen in this forum.

 

[aznboi89x]

GPR or private office, in term of learning new skill, technique, etc. is all depend on the specific place that you're in. Some GPRs are good, some bad. The same goes for private practice.

But saying "a good year at a good GPR is easily equal to 10 years of private practice" is really the most ignorant, laughable claim I've ever seen in this forum.

agreed

 

[sonia.g]

Thanks for the replies. I am not planning on quitting at this point. I have a few months left and I will use this time to make sure I find a good associateship.

@Saddleshoes:
CODA doesn't know about patients being pulled into his practice.

@Shunwei:
You make some great points. It seems you have found a fantastic opportunity that is keeping you busy. I am afraid that is not always the case. I have talked to classmates and many are spending their days as employees doing simple fills with an occasional crown.

I do think that there are about 15-20 GPR/AEGD programs which offer a great learning experience, and those are pretty well known around these forums. The rest could be a decent place for those who lack speed and confidence coming out of dental school. I had classmates who in the spring of their senior year would need almost an hour for a two-surface fill.

just started reading this forum, avidly searching for those elusive "good gpr/aegd" threads. any links to those threads?

thanks!

 

[straightteeth]

Hi Voticelli, been there and done with it! One thing and only one that i gained from my GPR residency was how to deal with patients of all sort " the good, the bad and the ugly ", that's so valuable when i entered private practice. Good luck and stay calm.

 

[Newgoalsdentdoc]

Voticelli, I am hoping you are doing better in your program. Excellent post and thanks for sharing with us all. I recently taught residents at a GPR program, and I do understand how you feel. Sad to say, but the program was poorly managed and the director had the same attributes that you described in your post. My heart went out to the residents I taught. I decided to go the extra mile and help the residents as much as I could. I always encouraged them to remember that a residency is only as good as what you put into it and what you take from it. They went through months of frustration and they made it through. Needless to say, the director made my life very uncomfortable, and I ended up resigning for doing my job above and beyond. I was even awarded a plaque for my dedication and commitment to the residency. It's sad that there's so much going on with some residencies that some can't even imagine. I did a residency years ago and made it a point to master Oral Surgery and Removable Prosthodontics because that's what most of the patients needed and could afford. My certificate opened a lot of doors when I was done with the program and on several jobs I've had since completing my residency in 2004, I've been that practitioner who tackles the difficult surgical procedures. In turn, I get the bonuses, etc. (smile). So, take what you can from this residency and you'll see doors open when you're done. The four residents I taught have gone on to do well. I can't tell you how good it feels to get texts from them telling me they mastered a difficult Oral Surgery case and take time out to say thank you. I am now pursuing teaching full-time and waiting for an offer. Best wishes to you. Hang in there and complete the race.

 

[jk5177]

I do think that there are about 15-20 GPR/AEGD programs which offer a great learning experience, and those are pretty well known around these forums. The rest could be a decent place for those who lack speed and confidence coming out of dental school. I had classmates who in the spring of their senior year would need almost an hour for a two-surface fill.

What are the 15-20 GPR/AEGD programs which offer great learning experience?

 

[jk5177]

"easily equal to 10 years of private practice" LOL this is one the funniest things I've heard on this forum.

I think, at max 5 years.

 

[AU07DMD]

Sadly, many who think that a GPR is a waste of time are often the dentists who would benefit the most from doing one. Sure, there are some junk programs out there but a good year at a good GPR is easily equal to 10 years of private practice. Those who think otherwise haven't completed a good GPR...

I did not do GPR/AEGD before going into practice and then ultimately going back for specialty training, but had several friends that did. Most of their experiences were positive. I think that saying that a good GPR > 10 years private practice is a bit overblown. However, if one goes into a straight drill/fill and point and pull clinic and does this repetitively for 5-10 years, maybe a good GPR where you actually do implants, IVs, complex prosth, etc would be more beneficial as far as expanding your scope. Again, just saying maybe not definitely. Depends on the GPR and the private practice. What a GPR cannot prepare you for is being out on your own from a business and professional standpoint and I won't argue with that.

 

[Shunwei]

I did not do GPR/AEGD before going into practice and then ultimately going back for specialty training, but had several friends that did. Most of their experiences were positive. I think that saying that a good GPR > 10 years private practice is a bit overblown. However, if one goes into a straight drill/fill and point and pull clinic and does this repetitively for 5-10 years, maybe a good GPR where you actually do implants, IVs, complex prosth, etc would be more beneficial as far as expanding your scope. Again, just saying maybe not definitely. Depends on the GPR and the private practice. What a GPR cannot prepare you for is being out on your own from a business and professional standpoint and I won't argue with that.

I never did a residency, came out straight to work, never regretted it a bit. The stuff that I want to learn like Implants and Invisalign are readily available thru CE courses and can be instituted with careful case-selection. Through just simply working I have become much more adept at all aspects of general dentistry than what I imagine I could have garnered through a supervised residency, which to me seems quite similar to an extended 4th year of dental school. And this is not to mention learning about the business aspect, which school teaches none of. What's ridiculous to me is that more and more programs are extending a GPR to 2-years. At some point in time the only way to do something and get better is to simply face the music and do them and get away from always having someone by your shoulders. I suppose in the end it is really about just how confident you are.

 

[Glimmer1991]

Would anyone happen to know anything about the GPR at UNC? Good? Bad?

 

[Eric2312]

Here are my questions.
I feel like at dental school, we (pre-doctoral) don't get to do many endo, extractions, and placing implants… and maybe complex prosth.

Is GPR/AEGD necessary to enhance skills listed above?
Can you just practice on extracted teeth (for endo), go on missionary trips (for extractions), and take CEs (for implants, it would cost tons though)?
Even if you have placed implants at GPR, isn't it up to the private practice that you work at? Some practices wouldn't have extensive toys for you to place implants?
And how common are complex prosth cases at private practices? Assuming you work at middle-class (or higher) neighborhood, does patients have that much awfull hygiene to have complex prosth? Even so, how often do you see those cases?

I'm trying to figure out if GPR/AEGD is right for me. I'm pretty comfortable doing regular drill&fills, simple prosth, etc..
Thanks everyone!

 

[shendo]

Here are my questions.
I feel like at dental school, we (pre-doctoral) don't get to do many endo, extractions, and placing implants… and maybe complex prosth.

Is GPR/AEGD necessary to enhance skills listed above?
Can you just practice on extracted teeth (for endo), go on missionary trips (for extractions), and take CEs (for implants, it would cost tons though)?

I'm trying to figure out if GPR/AEGD is right for me. I'm pretty comfortable doing regular drill&fills, simple prosth, etc..
Thanks everyone!

Eric2312- to answer your question whether or not a GPR/AEGD is right for you, it would help if you think about what scope of dentistry you would want to practice once you start working. If you are just wanting to do bread and butter dentistry, then maybe a GPR/AEGD will not be beneficial. If you want to become proficient and better in the areas you mentioned above (endo, extractions, implants, complex prosth) then I think doing a GPR/AEGD can be beneficial- but the caveat like many other posters have mentioned here is to find a program that will give you good training/instruction in the areas you want to grow in: every program has strengths and weaknesses.
You asked if you can just practice on extracted teeth and become good at endo- I definitely think the more you practice on extracted teeth, it will help but how do you know if you are creating a good access if there is no one to tell you, or how do you know how to negotiate a blocked or ledged canal if there is no one to show you hands on what to do? I am the site director for an AEGD program, and when my residents start during the first week, I spend two days with them doing a hands on endo workshop going over the basics and also showing them the pros/cons of the different rotary file systems we have in the clinic for them to try out.
Also regarding extractions, the way you approach extractions typically on a dental mission trip is very different than how you would approach extractions in private clinics where you typically try to preserve as much bone and do the extraction as "atraumatically" as possible. Alot of the instruments I teach my AEGD residents to use when approaching extractions in clinic would not be usually available on missionary trips such as the use of periotomes, surgical hand piece...

Gordon