2 year out dentist, too much free time, sharing my journey so far. AMA

[LaughingGas]

If associate salaries are so low, then isn't now the best time to be an owner? You can pretty much hire dental labor for cheap, and make a huge profit.

Not with all the headache that is going on with PPE regulations, business loan problems, limiting scope to emergency treatments, discrepancy in settlement with hygienists and if you are going to buy now, you should wait because with COVID , your income is most likely be lower than before ( I hope I am wrong on this) and you don't want to buy a million dollar practice, which with COVID, should have devalued, so buying at this moment IMO is not ideal.

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[ToothJockey]

Not with all the headache that is going on with PPE regulations, business loan problems, limiting scope to emergency treatments, discrepancy in settlement with hygienists and if you are going to buy now, you should wait because with COVID , your income is most likely be lower than before ( I hope I am wrong on this) and you don't want to buy a million dollar practice, which with COVID, should have devalued, so buying at this moment IMO is not ideal.

True that, I guess I meant more before the whole pandemic started.

Let's say there is no pandemic and offices are running like normal. An owner has a pretty big practice, and he brings on an associate. If he pays the associate 500-600/day, and the associate produces ~550k for the office working full time. The associates salary is ~140k (~25% production), and say overhead is 250k for the associate (equipment cost + an extra assistant or two to work with the associate, most of the fixed costs such as rent don't change). That means you are making a $160k profit just by employing the associate. You are pretty much making more off the associates work than the associate makes himself. I'm sure I fudged the numbers a bit but it definitely seems like a good deal for owners given how stagnant associate salaries have been.

 

[LaughingGas]

True that, I guess I meant more before the whole pandemic started.

Let's say there is no pandemic and offices are running like normal. An owner has a pretty big practice, and he brings on an associate. If he pays the associate 500-600/day, and the associate produces ~550k for the office working full time. The associates salary is ~140k (~25% production), and say overhead is 250k for the associate (equipment cost + an extra assistant or two to work with the associate, most of the fixed costs such as rent don't change). That means you are making a $160k profit just by employing the associate. You are pretty much making more off the associates work than the associate makes himself. I'm sure I fudged the numbers a bit but it definitely seems like a good deal for owners given how stagnant associate salaries have been.

Possibly. I am still early in my career and I am trying to determine whether I have the personality to own. Maybe if I am more financially driven, it will change me enough that I would want to own, but I am trying to learn the business aspect while working as an associate.

 

[laundry]

Nice! Your starting compensation was probably comparable to those who graduated in 2002/2004. Most dentists I know who graduated after 99 seem to recall starting around 500/day

The timing in your reply reminded me of Nolan's early work, a picture called Memento

 

[allDAT]

True that, I guess I meant more before the whole pandemic started.

Let's say there is no pandemic and offices are running like normal. An owner has a pretty big practice, and he brings on an associate. If he pays the associate 500-600/day, and the associate produces ~550k for the office working full time. The associates salary is ~140k (~25% production), and say overhead is 250k for the associate (equipment cost + an extra assistant or two to work with the associate, most of the fixed costs such as rent don't change). That means you are making a $160k profit just by employing the associate. You are pretty much making more off the associates work than the associate makes himself. I'm sure I fudged the numbers a bit but it definitely seems like a good deal for owners given how stagnant associate salaries have been.

That's not quite how it works (I wish it were that easy). When associates are paid 25% of collections you are practicing in a saturated market. 25% of collections is the low end in SoCal (there are associates who are paid 30% here too) although some turds will offer 20% to new graduates, but that's usually driven by HMOs and places you wouldn't want to work anyways.

Back to the numbers - 65% OH is typically for owner-occupied offices around here. If you have an associate driven office (where you don't work as a dentist) OH usually creeps up to 70% because you're not there and when you have an associate running the show you usually need a manager to keep the employees up to speed and the associate doesn't keep an eye on costs/is wasteful/doesn't clean the place up/may not want to stay an extra 30-40 minutes late to see the patient who needs a root canal etc... You also have to spend more on marketing to drive the associate run practice because the associates are not usually motivated to be a fixture in the community to the same extent that an owner would be. Yada yada. When you move out of CA you find associates are paid 35-40% in most markets, so while the average OH of the office goes down to around 55-60% there are a lot of parallels.

So if you pay your associate 25% and the OH is 65%, there's 10% left. So in the example, you provided an associate collecting 550 (I'll assume no hygienist) you'll make 55k if you're running on all cylinders and don't need to bring in an expensive temp to cover for the associate while he or she goes on vacation/takes maternity leave/etc - same for the staff.

Associate compensation is stagnant because insurance reimbursement is stagnant/declining and has been since the financial crisis so it's not a great deal for the owners.

 

[biochem5]

If associate salaries are so low, then isn't now the best time to be an owner? You can pretty much hire dental labor for cheap, and make a huge profit.

Finding a good practice to buy is another issue in itself. In my area dentists are selling to “groups” 5 years or so before they would traditionally be retiring and then they work for the group for several years after the group buys it. So when the next waive of dentists that graduated in late 1980s/early 1990s are ready to retire there will be no practices to buy.

 

[LaughingGas]

Adding some links from the dental forum. Pre-dents that are going to be pulling full amount of loans should read this imo.

USC First YR Cost of Attendance $152k 2020-2021
Dental School Finances. Debt, income, and the future of dentistry
Dental schools are ridiculous...
Is the current number of grads per year unsustainable for the future of dentistry?
With the avg dental school debt being 400k, please explain your strategy to conquering this enormous debt when the intrest atm is reaching 8%.

I am also part of different dental groups in facebook. I read a discussion regarding whether the school should give a refund (whether partial or full) for the term affected by COVID. Long story short, D3s from this school have no more clinical exposure obviously, including rotations due to COVID. When students asked for refund, one of the deans told them "well, you are paying for the degree". So, why should one go to more expensive school when at the end of the day is the same degree?. How does paying more $$ get justified when the student doesn't get that "clinical exposure" that made the school stood out more than others ( which I disagree).

 

[0Mik3cho]

Adding some links from the dental forum. Pre-dents that are going to be pulling full amount of loans should read this imo.

USC First YR Cost of Attendance $152k 2020-2021
Dental School Finances. Debt, income, and the future of dentistry
Dental schools are ridiculous...
Is the current number of grads per year unsustainable for the future of dentistry?
With the avg dental school debt being 400k, please explain your strategy to conquering this enormous debt when the intrest atm is reaching 8%.

I am also part of different dental groups in facebook. I read a discussion regarding whether the school should give a refund (whether partial or full) for the term affected by COVID. Long story short, D3s from this school have no more clinical exposure obviously, including rotations due to COVID. When students asked for refund, one of the deans told them "well, you are paying for the degree". So, why should one go to more expensive school when at the end of the day is the same degree?. How does paying more $$ get justified when the student doesn't get that "clinical exposure" that made the school stood out more than others ( which I disagree).

As a pre-dent, I’ve seen other pre-dents offer horrible advice to "live the dream" and choose the expensive school in Cali or the big city regardless of costs. I‘m curious what fraction of students going to those expensive schools legitimately understand the costs down the road. I’m actually glad COVID is forcing me to look into finances I didn’t consider before.

 

[frozenicecreamDMD]

My sample size is obviously very small but when I asked around to get paid around 800 in Los Angeles area, you had to know how to do Molar Endos and surgical extraction comfortably.
But yeah, little wage growth, excessive increase in tuition, poor ROI.

how do you prove you are comfortable doing molar endo and surgical ext right out of dental school? just how you feel about yourself or if you know you can do it in dental school with little faculty supervision?

 

[LaughingGas]

how do you prove you are comfortable doing molar endo and surgical ext right out of dental school? just how you feel about yourself or if you know you can do it in dental school with little faculty supervision?

Molar endo: This is just my personal opinion, but being comfortable with molar endo specially with maxillary molar endos is if you can find all the canals ( a lot of GPs miss MB2 on maxillary molars) and if you can do retreats.
Surgical Ext: If you can manage or extract comfortably without the possible complications: OA communication, lingual plate fracture, making sure no iatrogenic damage to nerve/vessels.
As long as you know things "not to do" such as placing an elevator from lingual, or missing MB2s on max 1st molars, it should keep you out of trouble.

 

[frozenicecreamDMD]

Molar endo: This is just my personal opinion, but being comfortable with molar endo specially with maxillary molar endos is if you can find all the canals ( a lot of GPs miss MB2 on maxillary molars) and if you can do retreats.
Surgical Ext: If you can manage or extract comfortably without the possible complications: OA communication, lingual plate fracture, making sure no iatrogenic damage to nerve/vessels.
As long as you know things "not to do" such as placing an elevator from lingual, or missing MB2s on max 1st molars, it should keep you out of trouble.

a lot of practicing GPs told me they refer all retreats out because they simply take too long to do it and they don't have a microscope in office.

and they told me their molar endo takes 30 min which is mind blowing. I do not know if this is why endodontist specialists retreat a lot of missing canals cases.

 

[LaughingGas]

a lot of practicing GPs told me they refer all retreats out because they simply take too long to do it and they don't have a microscope in office.

and they told me their molar endo takes 30 min which is mind blowing. I do not know if this is why endodontist specialists retreat a lot of missing canals cases.

At the end of the day, you have to follow the standard of care. There is a legal standard of care and ethical standard of care imo. I personally don't do molar endos because if calcified orifice, most likely I will miss the canal, variation of canal anatomy so unpredictable results in my hands. Every dentist has their own rules and ethics code. If there is a patient that has Vertucci VII canals, I know endodontists (supposely) will do better job than me. I know GPs that can do procedures just as good as specialists. Your question can be complex depending how you think about it.
Ok. You knowingly did 30 minute poor endo. Patient paid you for the procedure. Few months later or a year later comes back with PARL or symptoms. What do you do? Do you lie that the endo didn't work and give option for re-treat at specialist? Do you offer ext+implant in your office? Keep the money? refund?
I personally do procedures that even if it fails for whatever reason, I know within my knowledge I did the best as I could and the outcome wouldn't have changed if it was sent to a specialist. This is very subjective. And I know retreats increase failure rate + vertical root fracture. So why would I do a disservice to the patient?.
So only you can answer that question.

 

[thetoothguy]

$500 a day is actually still very normal in NYC. I work at a non-profit and am salaried at $125k a year, which ended up being $3,300 after taxes (bi-weekly). They cover my mal-practice, which is a nice perk. This is in past tense, because I got furloughed to 3 days a week, but even 125 a year is pretty comfortable, and I'm expecting to go back to full-time by January. I work 9-5 Monday - Friday (actually used to get off at 4 Tuesday, Thursday and Friday when I was working in the school) and only see kids, which is pretty sweet gig. My rent is $1,300 (I live in NJ), which I split with my wife (not a dentist, but still makes just under 6 figures). Anything above $500 a day will likely require longer hours or a weekend day. I can only speak for my area, but I live pretty comfortably and don't eat ramen everyday lol. Graduated dental school in 2016, GPR in 2017 and have been working ever since.

I did hold another job doing mobile dentistry in schools before this making $600 a day, with the day starting at 7 and ending around 2. There were a few drawbacks with that job - they did not cover my malpractice, no PTO / vacation, work was not always consistent - but I brought home about $4,400 biweekly if I worked a full 10 days. I got free online CE through them and had a few sick days. It was also a pretty nice job with awesome colleagues / supervisors, but I don't know if it will start back up again due to COVID.

People will say I'm underpaid but I never cared for money. Hopefully this helps current dental students / residents get an idea of salary expectations, since it's all over the place on SDN haha

 

[monkeykey]

$500 a day is actually still very normal in NYC. I work at a non-profit and am salaried at $125k a year, which ended up being $3,300 after taxes (bi-weekly). They cover my mal-practice, which is a nice perk. This is in past tense, because I got furloughed to 3 days a week, but even 125 a year is pretty comfortable, and I'm expecting to go back to full-time by January. I work 9-5 Monday - Friday (actually used to get off at 4 Tuesday, Thursday and Friday when I was working in the school) and only see kids, which is pretty sweet gig. My rent is $1,300 (I live in NJ), which I split with my wife (not a dentist, but still makes just under 6 figures). Anything above $500 a day will likely require longer hours or a weekend day. I can only speak for my area, but I live pretty comfortably and don't eat ramen everyday lol. Graduated dental school in 2016, GPR in 2017 and have been working ever since.

I did hold another job doing mobile dentistry in schools before this making $600 a day, with the day starting at 7 and ending around 2. There were a few drawbacks with that job - they did not cover my malpractice, no PTO / vacation, work was not always consistent - but I brought home about $4,400 biweekly if I worked a full 10 days. I got free online CE through them and had a few sick days. It was also a pretty nice job with awesome colleagues / supervisors, but I don't know if it will start back up again due to COVID.

People will say I'm underpaid but I never cared for money. Hopefully this helps current dental students / residents get an idea of salary expectations, since it's all over the place on SDN haha

How are your colleagues doing from school? What are their experiences like?

 

[thetoothguy]

How are your colleagues doing from school? What are their experiences like?

Pre-COVID, they weren't really doing much better than me. My daily pay came out to $480 a day, which ends up being about $10,500 pre-tax every month (assuming 22 work days in a month). At least one friend in private practice ("PP") would aim for about that much in monthly pre-tax income and a month of 12k was considered good for him, which he'd hit every other month-ish, so he definitely out-earns me. However, he also puts in more hours than I do - PP + per diem in the hospital (though sometimes he's on call, which I'm not sure what that's about) + occasional weekends. He also has to pay his own malpractice and as an independent contractor, he pays more in taxes. And working as an independent contractor is veryyyyy common, even though the legality of that is questionable by a lot of people. That's another topic altogether haha.

The income for dentists is kind of all over the place, but I'd say a good starting salary your first year out is gonna be around $110k (a little under 3k biweekly), and then it just goes up from there, because you'll end up being able to do more expensive procedures as you gain the confidence and knowledge to do so.

I choose to work a 9-5 with no weekends, call or even occasional evening shifts, so my salary will represent a lower end. However, being in a non-profit helped cushion the blow that COVID did to dental practices. There's pros and cons to each life style.

Now, I have other friends who are specialists (endo) and their daily rate is about $1,200 a day. And they easily earn their keep. But they're in a different category than us GP's lol.

 

[2thDoc11]

Pre-COVID, they weren't really doing much better than me. My daily pay came out to $480 a day, which ends up being about $10,500 pre-tax every month (assuming 22 work days in a month). At least one friend in private practice ("PP") would aim for about that much in monthly pre-tax income and a month of 12k was considered good for him, which he'd hit every other month-ish, so he definitely out-earns me. However, he also puts in more hours than I do - PP + per diem in the hospital (though sometimes he's on call, which I'm not sure what that's about) + occasional weekends. He also has to pay his own malpractice and as an independent contractor, he pays more in taxes. And working as an independent contractor is veryyyyy common, even though the legality of that is questionable by a lot of people. That's another topic altogether haha.

The income for dentists is kind of all over the place, but I'd say a good starting salary your first year out is gonna be around $110k (a little under 3k biweekly), and then it just goes up from there, because you'll end up being able to do more expensive procedures as you gain the confidence and knowledge to do so.

I choose to work a 9-5 with no weekends, call or even occasional evening shifts, so my salary will represent a lower end. However, being in a non-profit helped cushion the blow that COVID did to dental practices. There's pros and cons to each life style.

Now, I have other friends who are specialists (endo) and their daily rate is about $1,200 a day. And they easily earn their keep. But they're in a different category than us GP's lol.

Many programs are predicting 130k a year in costs. I believe Midwestern is around that number as well.. would this worry you as an incoming D1 and knowing what you do now? Are we looking at 30 years of loan repayment? Or is that if you still want more of a “dentist lifestyle?” less Or more? And I know a lot of factors depends on the individual but anything would be nice! Also would it change much if one were to specialize?

 

[thetoothguy]

Many programs are predicting 130k a year in costs. I believe Midwestern is around that number as well.. would this worry you as an incoming D1 and knowing what you do now? Are we looking at 30 years of loan repayment? Or is that if you still want more of a “dentist lifestyle?” less Or more? And I know a lot of factors depends on the individual but anything would be nice! Also would it change much if one were to specialize?

I went to NYU and ended up graduating with 465k, which ballooned to 565k after residency (had to defer because I needed every dime from my GPR to get by). My monthly payment would have been around 7k for a standard 10 year plan. I don't know what the 30 year plan would have been, but considering I don't make 7k after taxes, and many GP's fresh out of school (my friend included), do not, then yes... expect 30 years if you want live on more than ramen and misery.

Now... with REPAYE, I pay $661 a month and that number will likely go down since that was based on making $125k a year and I'm not making that anymore. The number will likely keep ballooning to maybe 1.5mil before it's forgiven tax-free. This is important to keep in mind, because if you do income-based repayment and are NOT in a non-profit, your forgiven tax amount is taxable and you may end up owing more on forgiveness than you ever took out to begin with. If you want the dentist life-style (depending on your definition of this), then I'd plan to work in a non-profit (as odd as this may sound), however keep in mind that PSLF may change, and you can only be eligible for the terms present during the time of your loan disbursement. Working where I'm working now, it never would have mattered what my debt was or what my monthly payment would be, as it'll all be forgiven tax-free and my payments are always a function of my income, which makes them always affordable. Pre-COVID was ~$6,600 a month and only $661 went to student loans (I paid off a lot of my private ones, otherwise, that'd be a much higher number lol). Pretty nice being a 9-5 with patients I love seeing and loan forgiveness that won't bankrupt me in 20 years.

For specialty, it depends. Pedo makes their money on volume mostly, so while they also could pull in what an endodontist makes, it would require longer hours and more patients, as the procedures tend to be quicker, smaller in scope and reimburse lower (most dentists who accept medicaid are pediatric dentists). I'm applying to pedo now, but not for income. I've worked with kids for over 2 years and I just enjoy it. However, if things return to pre-COVID levels, then I'd say specialty can be worth it.

Sorry for such a lengthy response. Hopefully I helped you out but if not, just lemme know and I'll try again

 

[2thDoc11]

I went to NYU and ended up graduating with 465k, which ballooned to 565k after residency (had to defer because I needed every dime from my GPR to get by). My monthly payment would have been around 7k for a standard 10 year plan. I don't know what the 30 year plan would have been, but considering I don't make 7k after taxes, and many GP's fresh out of school (my friend included), do not, then yes... expect 30 years if you want live on more than ramen and misery.

Now... with REPAYE, I pay $661 a month and that number will likely go down since that was based on making $125k a year and I'm not making that anymore. The number will likely keep ballooning to maybe 1.5mil before it's forgiven tax-free. This is important to keep in mind, because if you do income-based repayment and are NOT in a non-profit, your forgiven tax amount is taxable and you may end up owing more on forgiveness than you ever took out to begin with. If you want the dentist life-style (depending on your definition of this), then I'd plan to work in a non-profit (as odd as this may sound), however keep in mind that PSLF may change, and you can only be eligible for the terms present during the time of your loan disbursement. Working where I'm working now, it never would have mattered what my debt was or what my monthly payment would be, as it'll all be forgiven tax-free and my payments are always a function of my income, which makes them always affordable. Pre-COVID was ~$6,600 a month and only $661 went to student loans (I paid off a lot of my private ones, otherwise, that'd be a much higher number lol). Pretty nice being a 9-5 with patients I love seeing and loan forgiveness that won't bankrupt me in 20 years.

For specialty, it depends. Pedo makes their money on volume mostly, so while they also could pull in what an endodontist makes, it would require longer hours and more patients, as the procedures tend to be quicker, smaller in scope and reimburse lower (most dentists who accept medicaid are pediatric dentists). I'm applying to pedo now, but not for income. I've worked with kids for over 2 years and I just enjoy it. However, if things return to pre-COVID levels, then I'd say specialty can be worth it.

Sorry for such a lengthy response. Hopefully I helped you out but if not, just lemme know and I'll try again

No that’s great! I’ve always been really frugal with my money and like predictable outcomes so the thought of graduating with $500k of debt just gives me anxiety. Some people say that debt is crippling while others say they have no problem paying it off. Hard to know what to expect but I do know that I don’t want to live my life in debt and want to get on top of It as soon as I can.

 

[2thDoc11]

@LaughingGas would you have a similar opinion as @thetoothguy ? I know locations can change factors and what not.. how are things for you in this realm?

 

[thetoothguy]

No that’s great! I’ve always been really frugal with my money and like predictable outcomes so the thought of graduating with $500k of debt just gives me anxiety. Some people say that debt is crippling while others say they have no problem paying it off. Hard to know what to expect but I do know that I don’t want to live my life in debt and want to get on top of It as soon as I can.

Yea, I think the approach to the debt can definitely vary. If the goal / mindset is "take the debt out and repay all of it, interest included" then I don't think attending a private dental school is worth it (and I went to one of the most expensive ones lol). It just does not seem possible to me given what private schools charge, so just make sure you have a plan before you start and know what kind of dentist you wanna be. Private school means you're better off taking advantage of loan forgiveness plans (i.e. plan for non-profit work in a medicaid clinic) and state schools allow you to do both. It's a bit of an oversimplification but it's how I approached dental school and debt

 

[2thDoc11]

Yea, I think the approach to the debt can definitely vary. If the goal / mindset is "take the debt out and repay all of it, interest included" then I don't think attending a private dental school is worth it (and I went to one of the most expensive ones lol). It just does not seem possible to me given what private schools charge, so just make sure you have a plan before you start and know what kind of dentist you wanna be. Private school means you're better off taking advantage of loan forgiveness plans (i.e. plan for non-profit work in a medicaid clinic) and state schools allow you to do both. It's a bit of an oversimplification but it's how I approached dental school and debt

Yes I’m in North Dakota so “instate tuition” isn’t really much of an option for me as far as I know.. don’t wanna get too far ahead or be naive but as of now oral surgery holds my interest. I was premed throughout undergrad and Id love to practice a combination of medicine and dentistry and I think oral surgery has the right balance for me.
perhaps I’m wrong here but I’ve heard people saying dont get used to the idea of loan forgiveness with how everything is going.. any thoughts on that? How much would you think one has to pay and how many years until the loan forgiveness occurs? I was looking at military but you mentioned non profits for getting help. What’s expected and what kinda of packages do you receive to help out? I’d be willing to do anything if it means getting that debt to disappear lol

 

[thetoothguy]

Yes I’m in North Dakota so “instate tuition” isn’t really much of an option for me as far as I know.. don’t wanna get too far ahead or be naive but as of now oral surgery holds my interest. I was premed throughout undergrad and Id love to practice a combination of medicine and dentistry and I think oral surgery has the right balance for me.
perhaps I’m wrong here but I’ve heard people saying dont get used to the idea of loan forgiveness with how everything is going.. any thoughts on that? How much would you think one has to pay and how many years until the loan forgiveness occurs? I was looking at military but you mentioned non profits for getting help. What’s expected and what kinda of packages do you receive to help out? I’d be willing to do anything if it means getting that debt to disappear lol

The employer typically does not offer a loan forgiveness package - it's the magic trio of having (1) direct loans (which all of us do in dental school, as far as i know), (2) a non-profit job and (3) an income-based repayment plan. If you've satisfied this, you pay for 10 years (120 payments) and you should be forgiven. Ignore the news articles where 97% don't get forgiveness, because that's usually due to an applicant not having satisfied one of these major requirements, which are very clearly stated in the application. Once you have those 3 criteria satisfied and have paid for 10 years, you can apply for forgiveness, which is through the government. Now, the fate of PSLF is anyone's guess; Trump wants to abolish it, Biden has some modifications he wants to do to it, but as of now, it's still the same trio I mentioned. If they change the plan, you'd be subjected to whatever changes said president makes IF your loans are disbursed after the changes they made. I highly doubt it'll go anywhere as it didn't go anywhere when republicans held all 3 chambers of government recently (and they are the ones currently likely to abolish it, which is odd since Bush signed it into law haha).

Dentists aren't typically employed at non-profits and those jobs can be rare, so you may have to move to get one, and that's the only major hurdle I see. Politics can only affect loan terms going forward but if you take a loan out under the current terms, you'd get grandfathered in. For example, my loans were disbursed from 2012 - 2016 so no matter what, I'm eligible for loan forgiveness, even if they abolish the program altogether.

For OS (and this is unrelated to your questions, but hopefully it helps you), I'd recommend (as the time nears) looking into residencies that have you working at a non-profit, because your training can count towards the required 10 years of repayment - but if you do a 6 year program, your 2 years in med school may not count. More immediately, I'd also recommend going to a dental school that places you with med students - UConn, Columbia and Harvard are the 3 I know about - because the CBSE you'll have to take is basically USMLE Step 1 boards. If you go to any other dental school, you'll end up having to study for medical boards via a USMLE First Aid book or something and that can be tough when your dental school doesn't teach you as if you're a medical student. I also know simply saying "Go to Columbia / Harvard" is a crazy statement to make but given your DAT and grades, you'd have a good shot there (I had 22,21,20 - AA,TS,PAT and interviewed at Columbia, though they said I was "a bit below the average" and they wait-listed me haha)

 

[thetoothguy]

Yes I’m in North Dakota so “instate tuition” isn’t really much of an option for me as far as I know.. don’t wanna get too far ahead or be naive but as of now oral surgery holds my interest. I was premed throughout undergrad and Id love to practice a combination of medicine and dentistry and I think oral surgery has the right balance for me.
perhaps I’m wrong here but I’ve heard people saying dont get used to the idea of loan forgiveness with how everything is going.. any thoughts on that? How much would you think one has to pay and how many years until the loan forgiveness occurs? I was looking at military but you mentioned non profits for getting help. What’s expected and what kinda of packages do you receive to help out? I’d be willing to do anything if it means getting that debt to disappear lol

Oh I forgot to answer the payment question! So, if I made 125k for 10 years, and my payments remained at $661 per monoth, then that comes out to a little under 80k of what I'll have paid. You cannot just pay the expected 80k up front, so it is definitely a commitment - however you can leave public service and come back. It's just 120 on-time payments, but they don't need to be sequential - just make sure you do your total of 10 years of public service before you apply (either with one job or many) or you'll end up with the unfortunate 97% I mentioned lol. Compare 80k to the 465k I initially had out, the 565k it ballooned to and the likely 7 figure amount that will be written off tax free... definitely worth it! The military is also a great option, but I'd really press them, before committing to it, on whether you'd be allowed to pursue certain residencies. I don't know too much about that option of doing the military, but my dad was military and I know what kind of strong arm they can have on you, especially if they're footing the bill for your dental education lol.

 

[2thDoc11]

The employer typically does not offer a loan forgiveness package - it's the magic trio of having (1) direct loans (which all of us do in dental school, as far as i know), (2) a non-profit job and (3) an income-based repayment plan. If you've satisfied this, you pay for 10 years (120 payments) and you should be forgiven. Ignore the news articles where 97% don't get forgiveness, because that's usually due to an applicant not having satisfied one of these major requirements, which are very clearly stated in the application. Once you have those 3 criteria satisfied and have paid for 10 years, you can apply for forgiveness, which is through the government. Now, the fate of PSLF is anyone's guess; Trump wants to abolish it, Biden has some modifications he wants to do to it, but as of now, it's still the same trio I mentioned. If they change the plan, you'd be subjected to whatever changes said president makes IF your loans are disbursed after the changes they made. I highly doubt it'll go anywhere as it didn't go anywhere when republicans held all 3 chambers of government recently (and they are the ones currently likely to abolish it, which is odd since Bush signed it into law haha).

Dentists aren't typically employed at non-profits and those jobs can be rare, so you may have to move to get one, and that's the only major hurdle I see. Politics can only affect loan terms going forward but if you take a loan out under the current terms, you'd get grandfathered in. For example, my loans were disbursed from 2012 - 2016 so no matter what, I'm eligible for loan forgiveness, even if they abolish the program altogether.

For OS (and this is unrelated to your questions, but hopefully it helps you), I'd recommend (as the time nears) looking into residencies that have you working at a non-profit, because your training can count towards the required 10 years of repayment - but if you do a 6 year program, your 2 years in med school may not count. More immediately, I'd also recommend going to a dental school that places you with med students - UConn, Columbia and Harvard are the 3 I know about - because the CBSE you'll have to take is basically USMLE Step 1 boards. If you go to any other dental school, you'll end up having to study for medical boards via a USMLE First Aid book or something and that can be tough when your dental school doesn't teach you as if you're a medical student. I also know simply saying "Go to Columbia / Harvard" is a crazy statement to make but given your DAT and grades, you'd have a good shot there (I had 22,21,20 - AA,TS,PAT and interviewed at Columbia, though they said I was "a bit below the average" and they wait-listed me haha)

Thank you for all that information and quick responses! I really didn’t know anything about that topic haha is working for a non profit like having a second job or is that it? you mentioned finding a non profit can be rare but is this something that is pretty common for dentists to do? if this was my plan going forward, should I have any worry that there may not be an opportunity?
I guess I don’t understand why anyone wouldn’t do this type of repayment plan but I’m sure there’s plenty who dont

 

[thetoothguy]

The non-profit would be your main job, as you need to be full-time, which is 35 hours a week. If you can still pull 50-60 hours a week, you could do another job - nothing says I can't do that, but unless I'm in residency, I'm not about that life haha.

It isn't that common for dentists to work in this field - in fact, it's pretty rare - however the jobs are not THAT rare, even if they aren't "common." There are actually several non-profits in NYC I could work at, but they require evenings / weekends and I get emails regularly of FQHC (Federally-Qualified Health Clinics) that are looking for dentists in fly-over states. I think many don't pursue this kind of work because there's a lot more independence in private practice and earning potential is much higher. Non-profits are also medicaid-heavy and though there are some pretty awesome patients with medicaid, that's not the norm. There's lots of stresses when dealing with an insurance that don't cover much of anything and patients who constantly no-show, come in late, etc.

As an OMFS, you may have more opportunities since non-profits are usually more plentiful among medical professionals and that's pretty much OS! If you are worried about opportunities, then google "OMFS jobs [insert city name]" to get an idea of what's currently available. That's kind of how I figured out if peds would be a good field, because I do see plenty of jobs in the areas I work, live and will live. The options for non-profits are pretty large by the way. It's not just medicaid clinics - working as an attending / faculty at a school that's non-profit also works. If you end up teaching at a state dental school full-time, that'll work as well! You can also work for the government (a quick google search of those showed A LOT of results, at least for GP's - Native American reservations, DC, veteran's affairs clinics).

Much like dentistry being a backwards-approach where we visualize the final product and try to figure out a treatment plan that will get us there, the same kind of thought process works well with planning out careers. Yours will take a long commitment so unfortunately, things may change along the way to getting your degree and specialty cert, so there does require a bit of guess work like "Will forgiveness be an option by the time I'm done receiving all my loans?" or "Will DSO's take over and limit my non-profit options?" and others.

 

[2thDoc11]

The non-profit would be your main job, as you need to be full-time, which is 35 hours a week. If you can still pull 50-60 hours a week, you could do another job - nothing says I can't do that, but unless I'm in residency, I'm not about that life haha.

It isn't that common for dentists to work in this field - in fact, it's pretty rare - however the jobs are not THAT rare, even if they aren't "common." There are actually several non-profits in NYC I could work at, but they require evenings / weekends and I get emails regularly of FQHC (Federally-Qualified Health Clinics) that are looking for dentists in fly-over states. I think many don't pursue this kind of work because there's a lot more independence in private practice and earning potential is much higher. Non-profits are also medicaid-heavy and though there are some pretty awesome patients with medicaid, that's not the norm. There's lots of stresses when dealing with an insurance that don't cover much of anything and patients who constantly no-show, come in late, etc.

As an OMFS, you may have more opportunities since non-profits are usually more plentiful among medical professionals and that's pretty much OS! If you are worried about opportunities, then google "OMFS jobs [insert city name]" to get an idea of what's currently available. That's kind of how I figured out if peds would be a good field, because I do see plenty of jobs in the areas I work, live and will live. The options for non-profits are pretty large by the way. It's not just medicaid clinics - working as an attending / faculty at a school that's non-profit also works. If you end up teaching at a state dental school full-time, that'll work as well! You can also work for the government (a quick google search of those showed A LOT of results, at least for GP's - Native American reservations, DC, veteran's affairs clinics).

Much like dentistry being a backwards-approach where we visualize the final product and try to figure out a treatment plan that will get us there, the same kind of thought process works well with planning out careers. Yours will take a long commitment so unfortunately, things may change along the way to getting your degree and specialty cert, so there does require a bit of guess work like "Will forgiveness be an option by the time I'm done receiving all my loans?" or "Will DSO's take over and limit my non-profit options?" and others.

Awesome! Thank you so much, you’ve provided a lot of insight! Does working for non profits or taking other routes that count toward loan forgiveness still pay similar to what, let’s say, a Corp would pay?
I've heard that the military will payoff your loans but you’ll also make ~60k a year or something like that while working for them... similar situation in a case like yours? I gotta start doing some more digging into all of this but I wanted to see what I get for options when December comes around.. I’ve interviewed at Nebraska, Creighton, nova, Midwestern and Loma Linda so far

 

[thetoothguy]

Wow, congrats! What a nice selection. With your stats and as long as you don't come across as a Mads Mikkelsen Hannibal, you'll get in somewhere for sure haha.

Corporate dentistry pays a bit better. I believe a GP starts at 135k if I remember correctly, and are given bonuses, though I don't know how they calculate the bonus or what a typical one would be (I don't know of any classmates that went to corporate dentistry). But just know that can be draining - it's a lot like being in sales and you are constantly dealing with hitting quotas and numbers. And they get sued a lot. I don't know the starting rate for OMFS though.

As for other routes, you are pretty much guaranteed $120k in any non-profit in the NYC area and I've seen similar numbers in DC and for federal jobs / other non-profit clinics. You can actually look up salaries of public school faculty - I'd look at some of the regular faculty members of the OMFS department of a state dental school and look up their salary. I did this while considering becoming a peds faculty (if I'm good enough lol) and saw they make $130k. I dunno what it is about 120k / 130k being the norm haha. The big thing to consider is malpractice. NYC rates are about 5k a year but can be as high as 8k. These are based on zip codes and the most litigious zip codes have higher rates, which I will go to my grave yelling this to be a violation of the Geneva Conventions by forcing mass "punishment' because of a few crappy dentists lol. So even if you see a number that's lower than number, once you figure in malpractice, your overall employment package looks better.

For example, I make $125k but with my malpractice covered, it's more like I'm making $130k.

For the military, you are right. They MAY have a pay bump for dentists, but as far as I know, they get paid just as anyone else would get paid who holds the rank of 2LT, so you may even be making 60k as an OMFS. Something else to ask any recruiter trying to sell you a scholarship.

 

[2thDoc11]

Wow, congrats! What a nice selection. With your stats and as long as you don't come across as a Mads Mikkelsen Hannibal, you'll get in somewhere for sure haha.

Corporate dentistry pays a bit better. I believe a GP starts at 135k if I remember correctly, and are given bonuses, though I don't know how they calculate the bonus or what a typical one would be (I don't know of any classmates that went to corporate dentistry). But just know that can be draining - it's a lot like being in sales and you are constantly dealing with hitting quotas and numbers. And they get sued a lot. I don't know the starting rate for OMFS though.

As for other routes, you are pretty much guaranteed $120k in any non-profit in the NYC area and I've seen similar numbers in DC and for federal jobs / other non-profit clinics. You can actually look up salaries of public school faculty - I'd look at some of the regular faculty members of the OMFS department of a state dental school and look up their salary. I did this while considering becoming a peds faculty (if I'm good enough lol) and saw they make $130k. I dunno what it is about 120k / 130k being the norm haha. The big thing to consider is malpractice. NYC rates are about 5k a year but can be as high as 8k. These are based on zip codes and the most litigious zip codes have higher rates, which I will go to my grave yelling this to be a violation of the Geneva Conventions by forcing mass "punishment' because of a few crappy dentists lol. So even if you see a number that's lower than number, once you figure in malpractice, your overall employment package looks better.

For example, I make $125k but with my malpractice covered, it's more like I'm making $130k.

For the military, you are right. They MAY have a pay bump for dentists, but as far as I know, they get paid just as anyone else would get paid who holds the rank of 2LT, so you may even be making 60k as an OMFS. Something else to ask any recruiter trying to sell you a scholarship.

Thank you for all the information, I really do appreciate it! I’m in ND and my top three choices are MN, Iowa and Nebraska but we’ll see.. not really sure where I want to end up. I‘d like to stay close to family here but also hate winter haha maybe Wyoming where there is no income tax

 

[thetoothguy]

Thank you for all the information, I really do appreciate it! I’m in ND and my top three choices are MN, Iowa and Nebraska but we’ll see.. not really sure where I want to end up. I‘d like to stay close to family here but also hate winter haha maybe Wyoming where there is no income tax

Glad I could help! I hope more recent grads chime in but if not, feel free to shoot me a DM on here if you have any questions. I’ll reach out to my OS friends to see if I can get some info on starting salary and other numbers for you.

I don’t mean this in a bad way but OS is very competitive so just be ready for a lot of social sacrifices to achieve it. I’ve yet to see someone who was ethical and wanted it bad enough that didn’t make it. One of my best friends, a groomsman too at my wedding, got in after 3 cycles. I hope you get it first try but if you want it bad enough, it WILL happen lol. Good luck!

 

[LaughingGas]

@LaughingGas would you have a similar opinion as @thetoothguy ? I know locations can change factors and what not.. how are things for you in this realm?

Hi. @thetoothguy gave you a lot of good information. There are so many scenarios and things to consider. For example, military, yes the annual income may suck but if you decide to stick around, in 20 years you can "retire". There are dentist jobs that you can make 180k-200k per year working at public school, but all you do is see kids and do child prophy.
As @thetoothguy mentioned, you will see medicaid patients in those FQHC. I know I am not good fit for that patient pool. It's bad to generalize, but I did not have positive experience treating that patient pool.
There are other things you need to consider. I did not want to do prophies and fillings for the rest of my life. I wanted to learn more advanced procedures, and private practice offered that. I was not qualified for HPSP, but if I had the opportunity, I would have taken it.

 

[thetoothguy]

Hi. @thetoothguy gave you a lot of good information. There are so many scenarios and things to consider. For example, military, yes the annual income may suck but if you decide to stick around, in 20 years you can "retire". There are dentist jobs that you can make 180k-200k per year working at public school, but all you do is see kids and do child prophy.
As @thetoothguy mentioned, you will see medicaid patients in those FQHC. I know I am not good fit for that patient pool. It's bad to generalize, but I did not have positive experience treating that patient pool.
There are other things you need to consider. I did not want to do prophies and fillings for the rest of my life. I wanted to learn more advanced procedures, and private practice offered that. I was not qualified for HPSP, but if I had the opportunity, I would have taken it.

this!!! For me, doing school-based dentistry is a lot of prophys. Same with FQHC. Thanks for that reminder. Really. My school-based public dentistry would have made bank prior to COVID but I wanted more and my non-profit offered that. Now, only residency can fill that extra need. Limitations exist for those who pursue non-profits and man. That definitely reminded me why I left one form of work for another lol

 

[2thDoc11]

Glad I could help! I hope more recent grads chime in but if not, feel free to shoot me a DM on here if you have any questions. I’ll reach out to my OS friends to see if I can get some info on starting salary and other numbers for you.

I don’t mean this in a bad way but OS is very competitive so just be ready for a lot of social sacrifices to achieve it. I’ve yet to see someone who was ethical and wanted it bad enough that didn’t make it. One of my best friends, a groomsman too at my wedding, got in after 3 cycles. I hope you get it first try but if you want it bad enough, it WILL happen lol. Good luck!

Thank you! And it’s still early in the game so we’ll see where my heart lies in the end! But again thank you for all the insight!

 

[2thDoc11]

Hi. @thetoothguy gave you a lot of good information. There are so many scenarios and things to consider. For example, military, yes the annual income may suck but if you decide to stick around, in 20 years you can "retire". There are dentist jobs that you can make 180k-200k per year working at public school, but all you do is see kids and do child prophy.
As @thetoothguy mentioned, you will see medicaid patients in those FQHC. I know I am not good fit for that patient pool. It's bad to generalize, but I did not have positive experience treating that patient pool.
There are other things you need to consider. I did not want to do prophies and fillings for the rest of my life. I wanted to learn more advanced procedures, and private practice offered that. I was not qualified for HPSP, but if I had the opportunity, I would have taken it.

Thank you! Lots of things to consider for sure! If I were to specialize, that would help get away from the more basic procedures or no? Perhaps this is bad but I never really had much interest in general dentistry as far as doing the basic drill and fill procedure.. a lot of people say don’t go into dentistry expecting to specialize due to it being competitive but like most things there are stepping stones to get to where you wanna be and dental school is one of them.. I love the hands on portion but I wanna get deeper then the basic stuff. We will see if that changes

 

[LaughingGas]

Thank you! Lots of things to consider for sure! If I were to specialize, that would help get away from the more basic procedures or no? Perhaps this is bad but I never really had much interest in general dentistry as far as doing the basic drill and fill procedure.. a lot of people say don’t go into dentistry expecting to specialize due to it being competitive but like most things there are stepping stones to get to where you wanna be and dental school is one of them.. I love the hands on portion but I wanna get deeper then the basic stuff. We will see if that changes

If your mind is set, just become a gunner . Nothing wrong with that. Having a goal from start is good to push you to do better. Honestly, if I had less debt, I would have pursued specialty. I hate doing fillings...

 

[thetoothguy]

Yea if GP doesn’t appeal to you, then gun away lol. I think that advice of expecting not to specialize is often given because you wanna at least be content with GP should the worst case scenario happen - not specializing. This is surprisingly not that common because everyone I know except 1 or 2 people ended up getting into the field their hearts were at.

Just don’t trust the recent match stats too much because they claim 50% of applicants to OMFS will match but there’s A LOT of self-selection there.

 

[seakzdent]

my friends made $180k first year out. It’s all geographical.

Where?