Competent Dentist?

[wildshark16]

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Let us say I have no desire to specialize, just want to be a GP. To be a GP, you must have quick hand skills & be competent in a lot of procedures (more GPs doing implants and more complicated cases) in order to get a quick turnover in patients. So with this in mind, I want to attend a school that will make me a good clinician.

However, as I received testimonies from dental students, they unanimously said that "any school will make you a competent dentist". This statement is usually tied with "go to the cheaper school, any school will make you a competent dentist".

On the other hand, when I went to an interview, the Dean of Admissions stated that "what differentiates each dental school is the clinical education; specifically 1. The Amount of Cases you see 2. The Quality & Types of cases (if you see complex cases and higher residents or specialized residents do not remove your complex cases) and 3. clinical Boards passing rates)".

This is confusing to me, as logically it makes sense that not all schools are "equal" clinically. But why do Dental students claim that all schools are relatively equal (that the clinical education are not that big of a deal to consider)!?

My question is: Will a dental student be at a "severe" disadvantaged clinically (disadvantaged to handle the complex cases, whatever that may be: molar root canal, implants, etc) if you attend a "Research based school with alot of residencies taking away your complex cases" vs. "Clinically based school with no residencies".

I would like hard evidence to support whether it "is severe" or "not severe".

Potential evidence: I imagine GPs graduating from a research based schools with residencies will be "more likely" to do an AEGD or GPR to get more experience before being confident in their skills and doing various types of procedures (implants, molar root canals, etc). While at a clinically based school, their graduating residents will be "less likely" to do an AEGD or GPR and be more prepared to handle all types of complex procedures.

Key words: "more likely". I understand people who graduate from Research based w/Residency schools can be "good clinicians", but they could be the "minority" of the class. Again, I have no clue whether my "potential evidence" is true, so let me know what you guys think!

 

[Vicviper]

You wouldn't be at a "severe" disadvantage. Bottom line, dental schools gives you a set of skills that you go on to develop more through clinical practice, each dental school will give you a different set of experiences. For example, at Pitt, I felt strong in Restorative, Endo, and Prostho, but weak in OS. Other schools have strong OS experience and weak Prostho, etc - every school is different. During residency I attempted to get more experience in my weaker areas, and work on more complicated cases in my strong areas.

That said, more and more people are doing AEGD/GPR because in general you get significantly less experience than dental students did 20 years ago. There are a number of reasons for this including the rising cost of dentistry, changing curriculum etc. We had to do 8 crowns to graduate, 20 years ago it was 20-30 crowns. I've heard tales from "Research" based schools, rhymes with Marvard, of people doing less than 10-20 extractions prior to graduation. I'm not sure if these are true, however.

I think the real question you should be asking should be if you should attend a school that has more out of school externships - that's where you really get experience and learn. Many of the new dental schools focus on this. I have ASDOH students at my health center who rotate through on Externships for a month at a time, and I can definitely say they're some of the most experienced dental students I've seen. My understanding is that very few ASDOH students do AEGD/GPR, because half of their 4th year is basically a residency. Hope that helps!

 

[wildshark16]

You wouldn't be at a "severe" disadvantage. Bottom line, dental schools gives you a set of skills that you go on to develop more through clinical practice, each dental school will give you a different set of experiences. For example, at Pitt, I felt strong in Restorative, Endo, and Prostho, but weak in OS. Other schools have strong OS experience and weak Prostho, etc - every school is different. During residency I attempted to get more experience in my weaker areas, and work on more complicated cases in my strong areas.

That said, more and more people are doing AEGD/GPR because in general you get significantly less experience than dental students did 20 years ago. There are a number of reasons for this including the rising cost of dentistry, changing curriculum etc. We had to do 8 crowns to graduate, 20 years ago it was 20-30 crowns. I've heard tales from "Research" based schools, rhymes with Marvard, of people doing less than 10-20 extractions prior to graduation. I'm not sure if these are true, however.

I think the real question you should be asking should be if you should attend a school that has more out of school externships - that's where you really get experience and learn. Many of the new dental schools focus on this. I have ASDOH students at my health center who rotate through on Externships for a month at a time, and I can definitely say they're some of the most experienced dental students I've seen. My understanding is that very few ASDOH students do AEGD/GPR, because half of their 4th year is basically a residency. Hope that helps!

First point is to get semantics down:

• Internal rotations = dental student participate and observe diagnosis, planning, and treatment of patient AT the school's specialty department
• External rotations = dental student participate and observe diagnosis, planning, and treatment of patient OUTSIDE of the school (apart of curriculum)
• Externship = diagnosis, planning, and treatment of patient OUTSIDE of the school (HAVE to apply for this during school/may count for an elective)

Just want to clarify these terms before moving forward. It seems like they all just mean "an experience that increases a student's competency in whatever that specialty is."

So to understand what you are saying @Vicviper , ""Bottom line" it does not matter what school you go to. There may be some strengths and weaknesses for some procedures at various schools, but ALL schools will give you the basic "set of skills". From these basic skills, you do an externship to improve on those weaknesses & solidify those strengths. The externship could be a way to prevent an AEGD or GPR because you are already competent from the externship. Let me know if I understand you.

If above statement is true, it replaces the statement "all schools will make you a competent dentist" to a more specific phrase "all schools will give you the basic skills to be a dentist". But if this statement was presented to a clinical based school (ie. SIU, Creighton, etc); it would be a slap in the face and they would refute it!

I would have to agree with those clinical based school, as it doesn't make sense that the "basic set of skills" learned at a school like SIU (where they do everything as they don't have a specialty and have so many reqs that they don't graduate on time) is relatively equal to the "basic set of skills" at Marvard/Tichigan (where all complex cases are removed as they have all the specialties and have less reqs). That maybe that these "basic set of skills learned at a clinical based school, may mean that they don't need to do an externship or AEGD/GPR to gain further competency (they have the complex cases and amount of patients to become competent and don't have to go outside their clinic to get further experience).

I appreciate your point, @Vicviper and I do agree in the value of an externship as it gives you valuable experience. But what if I can go to a school who is clinically based with no specialties &&&&& has externships available!?! Then I will be some master wizard competent in all procedures! Or will I still be a master wizard competent in all procedures if I go to a school who is research based with a ton of specialties &&&&& has externships????? Idk lemme know!

 

[Vicviper]

Haha, I think you might be over analyzing this a bit. One way or another, graduating an accredited dental school gives you a pathway to get a license, and so I don't see anything wrong with the phrase, that all schools will give you the basic skills needed to be a dentist. It really depends on the experiences you get while in the clinical years of dental school that effect your strengthens and weaknesses. Many times, that comes down to luck. A dental school is not a factory that produces identical dentists.

For example, I got a lot of denture patients, another student got less. We both completed our requirements, but just because of the randomness of the patients I was assigned, I got more comfortable with dentures than them. The same can be said with any procedure. A big portion of it is just the luck of getting assigned a good / interesting / complicated case, and being lucky enough to have a faculty member that can mentor you through it.

One of the best things about external rotations is that you're seeing a substantially higher number of patients, and so you get much more exposure. Thus, the more rotations you do, you'll be more likely to have a broader range of comfort.

Another thing I notice is that you make it seem like an AEGD/GPR is a bad thing! It's not the remedial year you're making it out to be, haha.

Also, you may not know, but schools that don't have specialties still need to refer cases, it's not like, OK, it came in the door, we have to treat it here.

Lastly, there's nothing that says you need to be a pro in every area of dentistry. Most private practice general dentists don't do many root canals or extractions. The most important skill of a general dentist is to know when to refer. Years of experience trumps pretty much most of the differences between dental schools. You'll learn more in your first 6 months of practice than you did in 4 years of dental school. So don't sweat the small stuff.

Pick a school you like based on your feeling from the interview, how much the dental students there liked it, how much you'd like to live in that area, and the cost. If you asked me if it would be worth an extra 100K to go to a school with a better clinical curriculum, the answer would be a resounding NO, haha. There's no "best" or "better" dental school. Accept the fact that most dental students are doing AEGD/GPR now, and become better clinicians because of it. Some states even require it now, and more are considering it in the future.

Bottom line, if you get into only one dental school, then for you, that is the best dental school in the country 😉

As the old adage goes, "What do they call the worst student who graduates from the "worst" dental school in the country? Doctor."

 

[PTSD]

Go to the cheapest school you can, meaning go to public school if you have the grades. If you need to go to private school, go to the cheapest one possible. Your skills after dental school will be weak regardless and you will develop them quickly thru the corporate mill grind/mentorship as an associate/gpr. Lastly, if you want to do advanced procedures, go to a good gpr where you actually learn how to do implants, bone grafts, ect. Spend time doing complex cases with endodontists, oral surgeons, periodontists, ect. Don't pretend to learn on cow skulls at the holiday inn and pay thousands for a phony certificate delivered by a dental used car salesman. The gap between the guys on dental town who learned advanced procedures at residency (good gpr/aged) and those that think they learned advanced procedures at the holiday inn is obvious to everyone except those who learned at the holiday inn. Its actually embarrassing when the holiday inn fools post their **** work and are so ignorant they don't even know its ****. I'd laugh, but its really sad for their patients.

 

[doc toothache]

My question is: Will a dental student be at a "severe" disadvantaged clinically (disadvantaged to handle the complex cases, whatever that may be: molar root canal, implants, etc) if you attend a "Research based school with alot of residencies taking away your complex cases" vs. "Clinically based school with no residencies".

"Complex cases" are either referred to residents or to private practices because no instructor in his/her right mind would allow/encourage a D3 or a D4 to attempt cases with high likelihood of failure, not to mention that the instructor may not be able to bail the student out. Blaming residents for taking all the cases is a little bit unwarranted.

 

[Vicviper]

I would definitely caution people about going to schools with every specialty, you will get cases taken away from you and given to residents. That said, there are still cases that no instructor would do with a D3/D4.