A retrospective, 4 year NYU perspective

nyczpeter said:

beautifully written. What will be your fate after you graduate? Will you be going gpr or specialty? Whatever it is, best of luck.

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phremius said:

“We're not in Kansas anymore!”
Dorothy, Wizard of Oz.

I cannot in recent memory recall greater nervousness than that I felt greeting my very first patient. I remember clutching his chart as if it were some precious tome, standing in front of a throng of patients in the waiting area, and calling, nay, croaking out his name. The protocols, procedures, and paperwork, which seemed so straightforward during our orientation, quickly became a Gordian knot of confusion and uncertainty. Affecting a competency that far far exceeded my actual non-existent skill set, I managed to bumble through a standard recall/prophy, sort of within-reason probe some teeth, and write probably the most convoluted, amateurish progress note ever. Those first days of clinic was encumbered with a sense of WTF-ness to a degree that I had never experienced during the first two years.....

While the formula for successful completion of D1/D2 was fairly straightforward, successful completion of clinic is definitively less so. Certainly the same habits that brought you thus far --- diligence, hard work, etc etc --- will continue to carry the day, but the applicative results becomes more obtuse. For example, to meet your clinical requirement you must first procure a roster of patients who has to be reliable, financially capable of affording treatment, and possessing the appropriate dental needs; furthermore, this batch of people must be successfully managed, balanced, and retained. Yet short of generic advice which borderline platitudes such as “treat them with respect”, “establish therapeutic rapport”, how one exactly does that becomes individualized affairs, predicated on different personalities and modus operandi, resulting in varying degrees of success. When one under performs in class, one studies more. But say if one is simply not gifted with gab or interpersonal fluency, or if one has a thick accent, or if one simply due to a statistical string of bad luck does not encounter the right patients, what can one do to directly remedy the situation? These nebulous uncertainties indeed weighs heavily upon one's mind.

Performing dentistry in the context of a dental school clinic is also something of a unique creature. The attending faculties are all human, and run the gamut of pleasant to vile. While you can certainly work to develop your hand-skills to become a more proficient operator, the negotiation through a patient's treatment, often with many different faculties with diverse philosophies, opinions, and foibles can be a veritable exercise in frustration. Add to the fact that both you and/or your patient(s) might become frustrated with the mind-bogglingly slow pace of dentistry in a school setting (which given the didactic institutional nature, is a necessary evil), the clinical years can be stressful indeed, and sans any viable avenues to improve your lot.

To focus on NYU specifically, one enters clinic at the end of D2, and the students are divided into separate clinics called modules, each headed by a different director, which again run the gamut from nice to mean with varying degrees of helpfulness. There are usually 40ish students per module, mixture of D3/D4, 4 year and AP. Each clinical session (32 chairs at capacity) usually has 4-5 general dentistry faculty, and 1 specialist in each field with minor variances. Most of the time the pace is reasonable, though the days in which you wait in line for 1hr + to gather signatures and prep checks will definitely stick out in your memory. You are assigned to 2 2-hr sessions per day, either morning or afternoon/evenings, and your off-time can be either spent relaxing, studying (which seriously falls to the wayside during D3), or if you so choose working in the clinics. The clinical requirements are fair, and the patient pool is extremely large, yet the minority of students each year who does not graduate on time would probably beg to differ.

There are PG clinics in every specialty, and given the drive and time investment one can be exposed to a fairly wide range of procedures. Will you get to actually hands on perform things beyond the core curriculum? Eh, generally not, though given the size of the institution and the sheer availability the potential is definitely present. NYU is fairly implant friendly, and implant-crowns are a graduation requirement. I would say that because it's got such low fees for implant/crowns and implant-retained overdentures you can end up restoring a good number of them (from a dental school perspective) However, unless special circumstances occur, you won't get to place them, observe, yes, place? No.

I graduate in May, and have to admit that I will miss this place. I had a blast my first two years, less of a blast my third, and now that the NERBs and Part II boards my 4th year is simply awesome! I mean, you saunter into a clinic for half a day, leisurely treat 2 patients while hanging out with buddies, and then with your time off focusing on, to quote Thoreau, “sucking the marrow” out of life in the City!


I wish you all the best! As for those that will be attending NYU congrats and best of luck! Feel free to hit me up with any further questions you might have.

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