Orthodontic Residencies Ranking Worst --> Best (Reddit Post)

[Bentley242]

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Not my ranking, found it while looking at Reddit and thought it was interesting for people applying to ortho. Reddit Post

Tier 5: Financially Destructive​

($300k to +$500k & 3-Year club)

• GSO
• NYU
• Harvard
• Columbia
• CTOR
• USC
• BU
• Roseman
• UNLV
• Rutgers
• Maryland

Tier 4: Proceed with Caution​

(30 months: $150k to +$300k)

(36 months: $100k to $300k)

• Arizona (30 months)
• Colorado (30 months)
• Seton Hill (30 months)
• Case Western (30 months)
• Oregon (30 months) moves up to Tier 3 if in-state
• SLU (30 months)
• UIC (30 months)
• Washington (33 months)
• West Virginia (34 months)
• UoF (35 months)
• Connecticut (36 months)
• University of Pittsburgh (36 months)
• Stony Brooks (36 months)
• NOVA (36 months)

Tier 3: Respectable Investment​

(27 months: Pricey)

(33-36 months: Inexpensive)

• UoP (27 months)
• Loma Linda (27 months)
• Ohio State (33 months)
• UNC (33 months)
• University of Kentucky (34 months)
• South Carolina (34 months)
• Tennessee (34 months)
• Texas A & M (34.5 months)
• University of Michigan (35 months)
• San Antonio (35 months)
• University of Buffalo (36 months)

Tier 2: Would Happily Match​

(24 months: Pricey)

(30 months: Dirt cheap)

(36 months: Free)

• University of Penn (24 months)
• Tufts (24 months) Great program too, one of my favorites for faculty and residents that I met. Very impressed, only here instead of Tier 1 because of the cost.
• Jacksonville (24 months) Tuition is less than $200k, plus can live on the beach in Florida.
• University of Detroit Mercy (24 months), bad location, could put it in tier 3 for location.
• Howard (24 months)
• Temple (26 months)
• Nebraska (30 months) Would be tier 1 if it were 24 months.
• Alabama (30 months)
• Augusta (30 months)
• UMKC (30 months) nice faculty
• Oklahoma (30 months)
• UCSF (36 months) Previously had in Tier 4.
• Montefiore (36 months)
• Moaimonides (36 months)
• BronxCare (36 months)
• SBH Health (36 months)
• Einstein (36 months)
• UCLA (36 months) Would be in Tier 1 if it weren't 36 months.

Tier 1 (Best): The Unicorns​

(You hit the lottery - All programs less than $100k 26 months or less)

• Medstar (24 months) & You get PAID (extremely rare for 24 month program)
• Eastman (24 months) & You get PAID (extremely rare for 24 month program)
• AIDM (24 months) & You get PAID (extremely rare for 24 month program), plus living in Austin Texas
• SIU (24 months)
• Indiana (24 months) (in-state) Out of state goes to the tier 2 category because it costs 2x.
• Iowa (24 months)
• Louisville (24 months)
• University of Minnesota (24 months) Dirt-cheap tuition, stipend, and outstanding clinical setup.
• VCU (24 months) Great clinical program. One of, if not the best.
• LSU (24 months) Great clinical program.
• Houston (26 months)
• Marquette (26 months)

 

[New_Vegas]

Terrible list. Indiana is one of the worst residency programs in the nation. Interviewed there and ranked that program dead last. Some of the schools on the "Tier 1" list are actually not good programs in terms of giving you solid knowledge in clinical orthodontics.

You can tell that whoever put this list together has certainly not gone through residency, and doesn't really have a good understanding of the programs either.

 

[Bentley242]

Terrible list. Indiana is one of the worst residency programs in the nation. Interviewed there and ranked that program dead last. Some of the schools on the "Tier 1" list are actually not good programs in terms of giving you solid knowledge in clinical orthodontics.

You can tell that whoever put this list together has certainly not gone through residency, and doesn't really have a good understanding of the programs either.

Why didn't you like Indiana? I had the opposite experience when I interviewed there. I really liked the faculty and residents, and it seemed like they had a great clinical experience and culture. It was in my top five, and I'm not from Indiana.

Also, I don't think the rankings were based as much on orthodontic education as on overall cost and program duration. I'd argue that cost and duration are among the most important factors given the amount of debt many of us have from dental school.

Every CODA-accredited orthodontic program should prepare you to become a competent orthodontist. In my opinion, where you train probably matters less than factors like cost, program fit, and your own effort during residency. I share the same opinion about dental school: you should attend the least expensive dental school possible to limit debt.

 

[New_Vegas]

Why didn't you like Indiana? I had the opposite experience when I interviewed there. I really liked the faculty and residents, and it seemed like they had a great clinical experience and culture. It was in my top five, and I'm not from Indiana.

Also, I don't think the rankings were based as much on orthodontic education as on overall cost and program duration. I'd argue that cost and duration are among the most important factors given the amount of debt many of us have from dental school.

Every CODA-accredited orthodontic program should prepare you to become a competent orthodontist. In my opinion, where you train probably matters less than factors like cost, program fit, and your own effort during residency. I share the same opinion about dental school: you should attend the least expensive dental school possible to limit debt.

I would really disagree with that notion. In my residency I did over 10 surgical cases, had a bunch of impacted canine cases, did 2 cleft palate cases, started over 100 cases.. placed a handful of tads, did MARPEs.. i've talked to people who went to other residency programs who didnt do a single surgery case in residency. I would be sh*tting my pants if I tried to do a surgical case in practice without having done it in residency. same goes with impacted canines, and other tough cases.

At the time I went through residency, Indiana didnt even have a 3D scanner. My co-residents who interviewed at Indiana also put it at the bottom. I could go on and on about that program.

I'll be honest, some of the residency programs out there don't really expose you to any of those tough cases and leave you hardly even competent at doing ortho.

 

[D1Bound]

Keep in mind, that Austin institute program is designed to run you 6 days a week of labor. It is a DSO dressed up as a dental school. You’re going to get reps, but you’re going to be laboring. All I’ve done is look at their website, so I don’t know exactly how it is, but that’s what the hours of operation are. Residents don’t really have rights per se that I know of. At least, definitely not in the same way as employment. It’s the only legal way you can be worked for infinity hours for as little pay as possible, and you’re not going to speak out. No chance. Because you’re afraid of retaliation.

 

[Bentley242]

Keep in mind, that Austin institute program is designed to run you 6 days a week of labor. It is a DSO dressed up as a dental school. You’re going to get reps, but you’re going to be laboring. All I’ve done is look at their website, so I don’t know exactly how it is, but that’s what the hours of operation are. Residents don’t really have rights per se that I know of. At least, definitely not in the same way as employment. It’s the only legal way you can be worked for infinity hours for as little pay as possible, and you’re not going to speak out. No chance. Because you’re afraid of retaliation.

6 days a week, but getting paid $40k a year for 2 years vs 5 days a week paying the residency $250k doesn't sound like a bad deal. New program though so we will see what comes of it and what residents and graduates say about it.

 

[D1Bound]

6 days a week, but getting paid $40k a year for 2 years vs 5 days a week paying the residency $250k doesn't sound like a bad deal. New program though so we will see what comes of it and what residents and graduates say about it.

Oh for sure it’s better in that aspect 100%. No further debt is huge.

 

[FeralisExtremum]

Not sure how accurate this list is. For example, Texas A&M paid us a stipend that exceeded the tuition.

I also think that this list is a little too focused on cost/time efficiency. There's a lot to be said about the quality of education, instructors, cases, and clinical experience in a residency program that can't be captured by a list like this.

 

[Bentley242]

Not sure how accurate this list is. For example, Texas A&M paid us a stipend that exceeded the tuition.

I also think that this list is a little too focused on cost/time efficiency. There's a lot to be said about the quality of education, instructors, cases, and clinical experience in a residency program that can't be captured by a list like this.

Yeah, that's the hard thing about a list like this.

No one is really going to know the differences in training between programs. Really hard to compare all the programs' training unless you went through them.

 

[charlestweed]

It doesn't matter where you get your ortho certificate from. You'll gain the skill and experience from treating patients.....a lot of patients....in the real world. The more offices you travel to work at and the higher volume of patients you see per day, the better (and more efficient) clinician you will become. The cheapest and the shortest ortho programs should be the top ones on the list period.

 

[New_Vegas]

It doesn't matter where you get your ortho certificate from. You'll gain the skill and experience from treating patients.....a lot of patients....in the real world. The more offices you travel to work at and the higher volume of patients you see per day, the better (and more efficient) clinician you will become. The cheapest and the shortest ortho programs should be the top ones on the list period.

The more offices you travel to? It seems the offices that are only available one or two days per month tend to be the ones that are most dead. It's just so difficult to build momentum when the offices are never open. The offices that are open more days per week tend to be the more successful and busy ones. So I'd argue that on average the orthodontist who travels less is probably working at a busier and more successful clinic, thus seeing more patients and gaining more experience.

That being said, if you have not had exposure to certain difficult cases in residency, how are you magically going to be tackling those cases in private practice? How could someone who has never done a surgical case confidently present a treatment plan in a new patient consultation? how could they answer a patient's pressing questions when they've never done one? patients can tell from a mile away if you aren't confident or don't really know what you are doing.

 

[charlestweed]

The more offices you travel to? It seems the offices that are only available one or two days per month tend to be the ones that are most dead. It's just so difficult to build momentum when the offices are never open. The offices that are open more days per week tend to be the more successful and busy ones. So I'd argue that on average the orthodontist who travels less is probably working at a busier and more successful clinic, thus seeing more patients and gaining more experience.

That being said, if you have not had exposure to certain difficult cases in residency, how are you magically going to be tackling those cases in private practice? How could someone who has never done a surgical case confidently present a treatment plan in a new patient consultation? how could they answer a patient's pressing questions when they've never done one? patients can tell from a mile away if you aren't confident or don't really know what you are doing.

It's the opposite. The offices that are open more days are the ones that don't know how to treat patients more efficiently...don't know how to keep the overhead low. Why open more days, pay higher electricity bills, pay higher staff salaries for treating the same number of patients? Why see 20-25 patients per day, open 5 days/wk when you can easily see 80-100 patients a day and only need to work 3-4 days/month? Why make your life harder?

I only treated 2 surgical cases in my ortho residency program. Currently, I am working on 8 surgical cases in my practice.. Surgical cases are actually easier to treat than doing non-surgical compromised cases. It's easier to decompensate and let the OS fix the skeletal discrepancy surgically than trying to treat the case non-surgically through extractions and camouflage.

 

[New_Vegas]

It's the opposite. The offices that are open more days are the ones that don't know how to treat patients more efficiently...don't know how to keep the overhead low. Why open more days, pay higher electricity bills, pay higher staff salaries for treating the same number of patients? Why see 20-25 patients per day, open 5 days/wk when you can easily see 80-100 patients a day and only need to work 3-4 days/month? Why make your life harder?

I only treated 2 surgical cases in my ortho residency program. Currently, I am working on 8 surgical cases in my practice.. Surgical cases are actually easier to treat than doing non-surgical compromised cases. It's easier to decompensate and let the OS fix the skeletal discrepancy surgically than trying to treat the case non-surgically through extractions and camouflage.

The ones i'm talking about are seeing 80-100 patients per day, open 4 or more days per week.

I have never seen that or even heard of it at an office that is open a few days per month.

Its not always easy to decompensate. Trying to get the incisor angulation correct while having both canine and molar in class 1 occlusion with proper overjet on a class III case is one of the more difficult things you can do. Unless, of course, you are just lazy and leave the patient with very proclined maxillary incisors then send them to surgery.

 

[charlestweed]

The ones i'm talking about are seeing 80-100 patients per day, open 4 or more days per week.

That's 1500-1600 active patients. That's $4+ million /year in gross production. Good for them. I am happy with 1/3 of that...currently have around 600 active patients......all 3 offices combine.

Even busy corp offices don't have that many patients. They send me to work at 4 of their office locations. I currently travel to 8 offices: 3 are my own, 4 are corp offices and 1 is at my friend's private office.....for a total of 17 work days per month.

I have never seen that or even heard of it at an office that is open a few days per month.

This ortho went to the same ortho program with me. He's a year behind me. He has 8 office locations. Locations – Yeh Orthodontics

Its not always easy to decompensate. Trying to get the incisor angulation correct while having both canine and molar in class 1 occlusion with proper overjet on a class III case is one of the more difficult things you can do. Unless, of course, you are just lazy and leave the patient with very proclined maxillary incisors then send them to surgery.

For most class III cases, the upper incisors are already proclined to begin with (due to compensation). You can easily decompensate them by taking out either upper 4s or 5s (depending on the amount of crowding and the degree of the incisal inclination) and get the patient ready for surgery....it's super easy. The case will be finished with class II molar and class I canine.

The #1 student in my dental class matched to Indiana ortho. I am sure the reason he chose (ranked it high on his list) this program was the price and the short 2 yr training.

 

[New_Vegas]

That's 1500-1600 active patients. That's $4+ million /year in gross production. Good for them. I am happy with 1/3 of that...currently have around 600 active patients......all 3 offices combine.

Even busy corp offices don't have that many patients. They send me to work at 4 of their office locations. I currently travel to 8 offices: 3 are my own, 4 are corp offices and 1 is at my friend's private office.....for a total of 17 work days per month.

This ortho went to the same ortho program with me. He's a year behind me. He has 8 office locations. Locations – Yeh Orthodontics

For most class III cases, the upper incisors are already proclined to begin with (due to compensation). You can easily decompensate them by taking out either upper 4s or 5s (depending on the amount of crowding and the degree of the incisal inclination) and get the patient ready for surgery....it's super easy. The case will be finished with class II molar and class I canine.

The #1 student in my dental class matched to Indiana ortho. I am sure the reason he chose (ranked it high on his list) this program was the price and the short 2 yr training.

Getting to 4M is attainable. You just have to work hard ON your practice, and not screw around and travel to other offices the majority if the time, if you are an owner.

Its really not that easy. A lot of the time when you extract U4s on a class 3 surgical case, the maxillary incisors over retrocline. Then, you aren't able to articulate the casts with class I canine occlusion, you have to put it in class II occlusion to get the right amount of overjet. Then you have to constantly get new models and check that you finally have the right angulation before you send to surgery. So, like with all things in orthodontics, it's not easy to do things right. If you want to be sloppy, then sure - everything is easy in ortho. But if your cases look like garbage, dentists won't refer to you and you won't be busy.

 

[charlestweed]

Getting to 4M is attainable. You just have to work hard ON your practice, and not screw around and travel to other offices the majority if the time, if you are an owner.

Its really not that easy. A lot of the time when you extract U4s on a class 3 surgical case, the maxillary incisors over retrocline. Then, you aren't able to articulate the casts with class I canine occlusion, you have to put it in class II occlusion to get the right amount of overjet. Then you have to constantly get new models and check that you finally have the right angulation before you send to surgery. So, like with all things in orthodontics, it's not easy to do things right. If you want to be sloppy, then sure - everything is easy in ortho. But if your cases look like garbage, dentists won't refer to you and you won't be busy.

Like I said before....hats off to those docs who have the business skill to produce $4M in one location. Good for them. There is more than one way to skin a cat. Ortho is a wonderful profession. I don't know why you hate it so much.

Ext upper 5s instead of 4s if you think the incisors will be over-retracted. It's so much easier to burn the posterior anchorage, especially on the upper arch.

 

[New_Vegas]

Like I said before....hats off to those docs who have the business skill to produce $4M in one location. Good for them. There is more than one way to skin a cat. Ortho is a wonderful profession. I don't know why you hate it so much.

Ext upper 5s instead of 4s if you think the incisors will be over-retracted. It's so much easier to burn the posterior anchorage, especially on the upper arch.

I don't hate it. I'm just realistic about it. Its a much different profession now then when you got into it. And it's hard to think of a single thing has changed for the better.

 

[charlestweed]

I don't hate it. I'm just realistic about it. Its a much different profession now then when you got into it. And it's hard to think of a single thing has changed for the better.

The field is changing. There are more and more GPs who are providing ortho treatments in their offices. There are more new ortho programs that pump out more new grads every year. To survive, we all have to learn to adapt to the changes. It’s not just ortho. The general dentists are also facing oversaturation problem due to the openings of new schools. OS and perio are competing for the same group of patients. Endo programs are now teaching their residents to place implants etc.

I haven’t done anything differently. Twenty+ years ago, when I first graduated, I traveled to work at multiple corp offices. And now, I am still doing the same….traveling to multiple offices. What haven’t changed in ortho are the treatment methods. The ways in which you read xrays, evaluate the malocclusion, diagnose, and tx plan the cases are pretty much the same. What makes ortho super easy, fun, and relaxing is its repetitious nature. To some, this is boring….but to me, I just want an uncomplicated job and a stress free life. Once the chairside assistants get used to how you treat your patients (your tx style and tx philosophy), you are pretty much on an autopilot mode all day.

 

[New_Vegas]

The field is changing. There are more and more GPs who are providing ortho treatments in their offices. There are more new ortho programs that pump out more new grads every year. To survive, we all have to learn to adapt to the changes. It’s not just ortho. The general dentists are also facing oversaturation problem due to the openings of new schools. OS and perio are competing for the same group of patients. Endo programs are now teaching their residents to place implants etc.

I haven’t done anything differently. Twenty+ years ago, when I first graduated, I traveled to work at multiple corp offices. And now, I am still doing the same….traveling to multiple offices. What haven’t changed in ortho are the treatment methods. The ways in which you read xrays, evaluate the malocclusion, diagnose, and tx plan the cases are pretty much the same. What makes ortho super easy, fun, and relaxing is its repetitious nature. To some, this is boring….but to me, I just want an uncomplicated job and a stress free life. Once the chairside assistants get used to how you treat your patients (your tx style and tx philosophy), you are pretty much on an autopilot mode all day.

Ortho is uniquely deteriorating faster than any other specialty. There has been an unprecedented number of new residency programs, cranking out obscene numbers of new orthodontists, and add that to GPs doing aligners. You can't pretend other specialties are going through the same thing right now, because they aren't. Ortho is graduating a staggering number of new residents compared to 10-20 years ago and is on a steep decline.

 

[charlestweed]

Ortho is uniquely deteriorating faster than any other specialty. There has been an unprecedented number of new residency programs, cranking out obscene numbers of new orthodontists, and add that to GPs doing aligners. You can't pretend other specialties are going through the same thing right now, because they aren't. Ortho is graduating a staggering number of new residents compared to 10-20 years ago and is on a steep decline.

And therefore, we all have to learn to adapt to the change. Learn to keep the overhead as low as possible.

 

[New_Vegas]

And therefore, we all have to learn to adapt to the change. Learn to keep the overhead as low as possible.

Two ways to increase your take home: increase collections and reduce overhead. Like you, I also like having a low overhead. That's why I don't use the invisalign company for aligners, and I'm going to be getting rid of my iTero scanners soon. I join buyers groups, and buy brackets in bulk, therefore I'm able to get my brackets for less than 50 cents per bracket. I 3d print and do all my retainers in house.
But, overhead can only go so low. I prefer to concentrate on increasing production, because that's where you can really increase your take home. As my office grows, my overhead actually decreases. Your fixed expenses stay the same, and they become a smaller percentage of the money you are bringing in. It's the best way to make more money - think about it - you are taking more money in and your overhead is going down at the same time.

 

[2TH MVR]

Ortho is uniquely deteriorating faster than any other specialty. There has been an unprecedented number of new residency programs, cranking out obscene numbers of new orthodontists, and add that to GPs doing aligners. You can't pretend other specialties are going through the same thing right now, because they aren't. Ortho is graduating a staggering number of new residents compared to 10-20 years ago and is on a steep decline.

Ortho tx itself is in huge demand. There will always be crooked teeth to treat. I agree with your statement that practicing ortho as a specialist is getting harder and harder. I've been saying this for years. Technology has allowed lesser trained inviduals to perform ortho tx. I work in a very crowded, urban city with hundreds of Corps providing ortho tx. Most stand alone dental offices are also providing ortho services. It's a very crowded marketplace. I honestly do not know how the smaller ortho private practices can compete.

@charlestweed grew up in this environment and he adapted. I started practice when there were only a few Corps operating and orthodontists did the majority of the ortho tx. It was very profitable back then. But .... how times have changed.

I only work 1-2 days per week now. Semi-retired.

 

[charlestweed]

Ortho tx itself is in huge demand. There will always be crooked teeth to treat. I agree with your statement that practicing ortho as a specialist is getting harder and harder. I've been saying this for years. Technology has allowed lesser trained inviduals to perform ortho tx. I work in a very crowded, urban city with hundreds of Corps providing ortho tx. Most stand alone dental offices are also providing ortho services. It's a very crowded marketplace. I honestly do not know how the smaller ortho private practices can compete.

Many of the owners of standalone GP offices hire traveling orthodontists to provide ortho tx for their patients. So there are plenty of ortho associate jobs if you don't mind the hard work and traveling part. In addition to working for corp offices, I recently started a new 2 day/month job at a very busy private dental office. The assistants there didn't know much about ortho. So I had to train them how to take and pour impressions, how to make essix retainers, how to take ortho photos etc. It's extra work for me but I can manage because of my 20+ years experience. I get paid 2x as much as this private office as what I get at the corp office.

@charlestweed grew up in this environment and he adapted. I started practice when there were only a few Corps operating and orthodontists did the majority of the ortho tx. It was very profitable back then. But .... how times have changed.

We owed $450k in student loan debt (which was equivalent to $7-800k in today dollar value) but we also wanted to have a doctor's lifestyle (decent size home in a nice neighborhood, nice cars, vacation trips etc). Therefore, working 6 days/wk was the only choice....didn't have any other choice. And traveling to work at multiple locations was the only way to get full (6 days/wk) employment. When I was ready to open my own office, the new office didn't have a lot of patients to help me pay the overhead. So I had to continue to work somewhere else to pay my office rents an other fixed business expenses.

At first, I really hated working for the corp offices because they overbooked the patients and they provided me limited number of assistants. Now looking back, I am glad I have the opportunities to work in such challenging environment. Busy schedule and high patient volume taught me how to manage the chair time better....helped me become a better more efficient clinician. Now with the experience that I've gained over the years, everything in ortho becomes so easy. I love the simplicity and the repetitiveness in ortho. I can't believe that such easy job exists in America. A job that pays very well for doing very little (the assistants do most of the hard work).

I only work 1-2 days per week now. Semi-retired.

Congrats! I am not there yet.....still have to work 16-17 days/month. I have to wait for 4 more years when my kid finishes med school and becomes self-sufficient. Then, I'll probably work 1-2 days/wk like you so I can continue to pay for my healthcare premium, which is around $2500/month. Won't qualify for cheap medicare plan until I turn 65. I think working 1-2 days/wk is perfect. You have to do something. I'd go crazy if I stayed home doing nothing 7 days/wk, 365 days/yr.

 

[JacquesVallee]

I agree with your statement that practicing ortho as a specialist is getting harder and harder. I've been saying this for years. Technology has allowed lesser trained inviduals to perform ortho tx. I work in a very crowded, urban city with hundreds of Corps providing ortho tx. Most stand alone dental offices are also providing ortho services. It's a very crowded marketplace. I honestly do not know how the smaller ortho private practices can compete.

And they're still cranking out new, expensive ortho progarms. The couple of stipend programs are a blood bath to get into. Ortho is a cool field but the younger Orthos I've talked to seem seem to have lots of regret. 400k of dental school debt followed by an additional 300k for ortho residency (remember interest is accumulating during residency) is nuts.

 

[LeagueofLigTies]

Stony brook is a unicorn. The amount of surgical cases, cleft/DFD, impacted canines, among other challenging cases is insane! Top tier attending too, I'm coming out confident on these types of cases. We do everything there. TADs, MARPEs, SARPE, custom fabricated appliances, distractors/distraction osteogenesis. The list is endless.

 

[Bentley242]

Stony brook is a unicorn. The amount of surgical cases, cleft/DFD, impacted canines, among other challenging cases is insane! Top tier attending too, I'm coming out confident on these types of cases. We do everything there. TADs, MARPEs, SARPE, custom fabricated appliances, distractors/distraction osteogenesis. The list is endless.

impressive. How many cases do you think you will complete in residency?

 

[LeagueofLigTies]

impressive. How many cases do you think you will complete in residency?

Hard to say, I haven't tallied it up yet. Honestly I may finish a lower amount of cases than other residency programs, but I don't think this is a weakness at all. Reason being is, we go into such DEPTH with our cases during treatment planning, and since they are so complex, they typically take longer than a traditional residency program lasts. Even though I may not be finishing it, I know how to and feel confident on the mechanics necessary to finish the case.