Grades

[mfdope]

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[Ostracized]

Hey everyone,

Currently a D1 grinding out these last 2 weeks before winter break. Like everyone else in dental school, I was always at the top of my class in undergrad, really trying hard to get that 4.0 every semester. I'm doing okay my first semester now (couple of C's, couple of B's, couple of A's), but I've found myself not really caring about grades anymore. Like I just want to pass. Is this a normal feeling? Shouldn't I be wanting and trying really hard to those A's? It's very odd, because for the first time in my academic career, I'm extremely average and really don't care about getting A's at this point. Any thoughts? Is this feeling shared amongst others?

What do they call someone who just barely passes dental school?

A dentist.

 

[Aceofspades]

Oops, that is what the OP was talking about.

pass all classes = general dentist

 

[boxdesker]

My name is Boxdesker and I'm a recovering hard-workaholic. I feel the same way as the OP. I got really good grades in undergrad, studied my butt off for the DAT and did really well on DAT. Why? Because I had motivation... because I wanted to get into dental school. I worked hard, it paid off, and I got into dental school. Motivation, action, success.

I know I'm fully capable of getting really good grades in dental school... but why do it?

I've had plenty of conversations about this with my parents, brother, non-dental school friends, and dental school friends and I keep getting mixed answers ranging from "F it, who cares" (brother) to "Make sure to always do your best" (parents) to "Get good grades to keep your options open" (dental school friends).

The only logical reason I can think of for why most people THINK it's important to get good grades, is so you can specialize... ok great. "Specializing" means I get to:

• Experience a terrible time in dental school because I'm working my butt off to get the highest grades (as oppose to settling for Cs and at least somewhat having a life)
• Spend an extra 3-6 years of my life in more school after dental school, reading research papers and working my butt off
• Not making any money and living in a non-ideal financial situation during these times (in fact: ADDING to my tremendous debt in the process and probably paying for additional tuition)
• Putting off being able to meet a nice woman and settle down because I'll be putting my life on hold for another 3-6 years

All for what? So I can make $300,000 or let's say even $400,000 as a specialist instead of the $200,000 the average GP with their own practice makes?

• First of all, I don't even know how much more you would be making if you consider the $600,000 in lost income you could have made as a GP ($200,000/year x 3 years for average specialty program) in addition to the extra $60,000 in interest your dental school loans will have picked up (assuming $300,000 in dental school loans) AND the added tuition you'd pay for the specialty program...
• Second of all, I'd rather be young and make tons of money than put off my life, and make tons of money when I'm much older.
• Third of all, the more money you make the more your expenses go up, and you'll never be satisfied.

Pretty simple right? Here's the huge problem. I feel I'm constantly under over-achieving pressure from my peers, whether directly or indirectly... and that's why I haven't been cured yet.

• Example of direct pressure: Constant talk about specializing in conversations and the necessity to obtain good grades to do so
• Example of indirect pressure: Seeing students excessively studying and getting As to show for it, while I study very little and get Cs--makes me feel the need to prove to these students that I am capable of getting As as well.

Are there any reasons to specialize? The only reason I can think of for specializing is for the psychological understanding... knowing that I'm a 'specialist' at something, that I'm an expert in my field, that I have the most advanced training, that there isn't anyone above me.

But even then, once you get into the real world, nobody cares. Really, I would bet that most of the population doesn't know the difference between an endodontist's training and a dentist's training....

I apologize for the rambling, but this post really captured my attention, and it's something I've been thinking about a lot. Since I typed this pretty quickly, I'm sure there might be some logical fallacies. Point them out and I'd love to explain myself. But to me, it pretty much comes down to: Ideal situation except I'm not a specialist, vs. Non-ideal situation but I'm a specialist. If you were able to get through this long and boring post, please share your comments because I really need support if I am to get over this over-achieving mentality...

 

[iwannabadentist]

My name is Boxdesker and I'm a recovering hard-workaholic. I feel the same way as the OP. I got really good grades in undergrad, studied my butt off for the DAT and did really well on DAT. Why? Because I had motivation... because I wanted to get into dental school. I worked hard, it paid off, and I got into dental school. Motivation, action, success.

I know I'm fully capable of getting really good grades in dental school... but why do it?

I've had plenty of conversations about this with my parents, brother, non-dental school friends, and dental school friends and I keep getting mixed answers ranging from "F it, who cares" (brother) to "Make sure to always do your best" (parents) to "Get good grades to keep your options open" (dental school friends).

The only logical reason I can think of for why most people THINK it's important to get good grades, is so you can specialize... ok great. "Specializing" means I get to:

• Experience a terrible time in dental school because I'm working my butt off to get the highest grades (as oppose to settling for Cs and at least somewhat having a life)
• Spend an extra 3-6 years of my life in more school after dental school, reading research papers and working my butt off
• Not making any money and living in a non-ideal financial situation during these times (in fact: ADDING to my tremendous debt in the process and probably paying for additional tuition)
• Putting off being able to meet a nice woman and settle down because I'll be putting my life on hold for another 3-6 years

All for what? So I can make $300,000 or let's say even $400,000 as a specialist instead of the $200,000 the average GP with their own practice makes?

• First of all, I don't even know how much more you would be making if you consider the $600,000 in lost income you could have made as a GP ($200,000/year x 3 years for average specialty program) in addition to the extra $60,000 in interest your dental school loans will have picked up (assuming $300,000 in dental school loans) AND the added tuition you'd pay for the specialty program...
• Second of all, I'd rather be young and make tons of money than put off my life, and make tons of money when I'm much older.
• Third of all, the more money you make the more your expenses go up, and you'll never be satisfied.

Pretty simple right? Here's the huge problem. I feel I'm constantly under over-achieving pressure from my peers, whether directly or indirectly... and that's why I haven't been cured yet.

• Example of direct pressure: Constant talk about specializing in conversations and the necessity to obtain good grades to do so
• Example of indirect pressure: Seeing students excessively studying and getting As to show for it, while I study very little and get Cs--makes me feel the need to prove to these students that I am capable of getting As as well.

Are there any reasons to specialize? The only reason I can think of for specializing is for the psychological understanding... knowing that I'm a 'specialist' at something, that I'm an expert in my field, that I have the most advanced training, that there isn't anyone above me.

But even then, once you get into the real world, nobody cares. Really, I would bet that most of the population doesn't know the difference between an endodontist's training and a dentist's training....

I apologize for the rambling, but this post really captured my attention, and it's something I've been thinking about a lot. Since I typed this pretty quickly, I'm sure there might be some logical fallacies. Point them out and I'd love to explain myself. But to me, it pretty much comes down to: Ideal situation except I'm not a specialist, vs. Non-ideal situation but I'm a specialist. If you were able to get through this long and boring post, please share your comments because I really need support if I am to get over this over-achieving mentality...

wow great insight. i know i may be getting ahead of myself here...but what about just doing a GPR or AEGD? I mean yah its not as difficult to get into as a specialty but don't you still need above average grades for that? any thoughts on this?

 

[ski.bum]

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[ski.bum]

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[boxdesker]

You would be way better off investing the time into extracurricular courses to be able to do a lot of what specialists do. My brother and I rarely refer out. I spent about $20,000 while I was in school on implant courses and ortho courses, and I spent one evening every week at a free clinic just doing extractions...and I went on a dental trip with my friend's dad where I extracted over 1,000 teeth over the course of a week. Why would I spend the extra time and money to be an orthodontist (and ONLY get to do ortho) when I can do braces myself, when I want? Obviously if I find something too difficult I'll refer it out, but most basic ortho and extractions and endo I can do myself without referring out, because I took the time to do extra training. Now I can get the money for performing procedures of specialists without being limited to one scope of dentistry. Don't worry so much about grades unless you want to specialize (which really can be a waste of time if you get what I'm saying above), and spend the extra time really learning about applicable dentistry instead of the 50 year old methods they teach in school. With this method though, you have to be humble enough to decide how far your training can take you. In my experience though, there hasn't been much that I wasn't totally confident in.

This is EXACTLY my thought-process, EXACTLY what I needed to hear, and EXACTLY who I needed to hear it from. Reassurance is good. You think quitting smoking or drinking is hard... try quitting feeling the need to over-achieve.

Sorry to OP, didn't mean to hog your post, but since you have my same 'symptoms' of lack-of-motivation I'm guessing you're under the same thought-process as I am, even if subconsciously

 

[allstardentist]

I completely agree and feel the same way as well.

 

[Gentledental1]

I'm only a D2 so the words of someone who is already in practice have much more weight than mine. However, I shadowed 10 dentists and 5 specialist prior to coming to dental school and this was MY experience. 9 of the 10 GP's told me to specialize as you work 3-4 days/week and make about 100,000 - 200,000 more per year (or waaay more). each of the specialists I shadowed were very passionate about what they do and all of them were extremely happy they'd chosen to specialize. Their reasons weren't about money, but the fact that all their business came from referals, they didn't have to go out looking and struggle to maintain a patient base. Also, they had fewer working hours and more family time. All 14 of the 15 said that when looking at your whole career of 40-45 years, a few extra in residency is a drop in the bucket, just a few more years of delayed satisfaction. Its nothing compared to the number of years you've put in already. As far as the debt load goes, there are quite a few residencies that pay you (albeit it a rather small salary), espcially the hospital based ones like OMFS, GPR, Oral Path... And if they don't, and you're overly concerned with debt load, theres always organizations who will help you pay (military, indian health service corp, state organizations...)

So my advice to you is at least leave your options open. Look at it three ways. One, you work really hard in dental school and then decide that you don't want to specialize. Great, you're a better, smarter practitioner, dental school is over, time to make some money!!!! or two: you work really hard, decide that you really like a certain aspect of dentistry and specialize. Great, you've left your doors open and you have options that your other classmates don't. Or thirdly, don't work hard in dental school, just do enough to get by. You haven't utilized your very expensive dental education to its full potential, you have no options other than to be a GP regardless of what you want to do. I think the difference between getting C's and high B's/A's is negligible. Ok, so you put in an extra few hours a week, its not that big a deal. I still go to all the same parties on the weekends that my friends who don't try hard go to, I still spend a ton of time w/ my girlfriend throughout the week, I still watch dexter, always sunny in philidelphia, the office and the league every week. I even slip in the occasional joint . The only difference that I can tell is around finals and midterms I give up a saturday or two before the test to get ahead in my studies. Again, the difference in social life is negligible, I have a 3.9 gpa, i'm ranked 7 out of 100 and still a great social life. I would keep trying hard, its in your nature anyways.

 

[Buckethead]

Agreed. I was premed my freshman and sophomore years with the intent to get into an excellent medical school and match into dermatology. This is equivalent to saying "with the intent to marry my bedroom, workdesk, and teaching hospital for over a decade." Anyone who is OK with the idea of putting life on hold for over 10% of its length, in my eyes, is fatally shortsighted, and I admit that I was a victim of overachievement for two years.

There is an enormous gamble inherent within any preprofessional education. The "pre" education is focused on science and generally useless to the preprofessional because most tend only to want to do medicine, dentistry, law, etc., not professional science. Assuming entrance is gained to a professional school, the preprofessional will have only a vague idea of what it is like to be a doctor/lawyer/dentist from shadowing. After several years of professional education, the student will know fairly well whether or not a good decision was made with respect to obtaining a usually useless undergraduate degree and attending a school that prepares you for only a single career.

Remaining "in the game" for longer than is necessary, I think, is a terrifying prospect. When it's all over and you've spent around 12 years after high school obtaining credentials to work ONLY A SINGLE JOB, you have around 35 years of work left in you and several hundred thousand in debt to pay... before your first mortgage. If I were to spent a third of my entire life (half of my physically functional life) preparing to be something as incredibly specific as, for example, an endodontist, I had damn well better love my job because I won't be qualified to do anything else (unless I would want more school, but at that point I would be a bit tired of it.)

The fact is, though, you won't know if you'll love that job from day 1 in undergrad, but some work as though they know they will, assuming their efforts will be worth it. This is the plight of most doctors (and premeds) and one of the major reasons I opted out of premed and in to predental. Every doctor I shadowed said the education wasn't worth it, the time vs. money sliding scale was disproportionate, and the primes of their lives were squandered. I couldn't agree more.

Do yourself a favor and aim to become a competent dentist while in dental school because a dentist who knows every intermediate in T-cell mediated apoptosis or how to identify S. mutans by its colony morphology is a dentist who missed the point. This is field of tangible skills, so make the intangibles secondary and prioritize the physical skills first, especially if you want the big paycheck. Read books on management and business skills and investing rather than microbiology.

Your financial success is dependent on your production and business acumen, not your GPA. Your personal success is dependent on having meaningful relationships with others and yourself. Spending over a decade buried in books and journal articles is a fantastic way to lose sight of who you were before you became so unidimensional and who everyone else was before they got on with their lives and successful careers 8 years before you did.

 

[boxdesker]

I'm only a D2 so the words of someone who is already in practice have much more weight than mine. However, I shadowed 10 dentists and 5 specialist prior to coming to dental school and this was MY experience. 9 of the 10 GP's told me to specialize as you work 3-4 days/week and make about 100,000 - 200,000 more per year (or waaay more). each of the specialists I shadowed were very passionate about what they do and all of them were extremely happy they'd chosen to specialize. Their reasons weren't about money, but the fact that all their business came from referals, they didn't have to go out looking and struggle to maintain a patient base. Also, they had fewer working hours and more family time. All 14 of the 15 said that when looking at your whole career of 40-45 years, a few extra in residency is a drop in the bucket, just a few more years of delayed satisfaction. Its nothing compared to the number of years you've put in already. As far as the debt load goes, there are quite a few residencies that pay you (albeit it a rather small salary), espcially the hospital based ones like OMFS, GPR, Oral Path... And if they don't, and you're overly concerned with debt load, theres always organizations who will help you pay (military, indian health service corp, state organizations...)

So my advice to you is at least leave your options open. Look at it three ways. One, you work really hard in dental school and then decide that you don't want to specialize. Great, you're a better, smarter practitioner, dental school is over, time to make some money!!!! or two: you work really hard, decide that you really like a certain aspect of dentistry and specialize. Great, you've left your doors open and you have options that your other classmates don't. Or thirdly, don't work hard in dental school, just do enough to get by. You haven't utilized your very expensive dental education to its full potential, you have no options other than to be a GP regardless of what you want to do. I think the difference between getting C's and high B's/A's is negligible. Ok, so you put in an extra few hours a week, its not that big a deal. I still go to all the same parties on the weekends that my friends who don't try hard go to, I still spend a ton of time w/ my girlfriend throughout the week, I still watch dexter, always sunny in philidelphia, the office and the league every week. I even slip in the occasional joint . The only difference that I can tell is around finals and midterms I give up a saturday or two before the test to get ahead in my studies. Again, the difference in social life is negligible, I have a 3.9 gpa, i'm ranked 7 out of 100 and still a great social life. I would keep trying hard, its in your nature anyways.

People like Gentledental1 are what push me towards relapse. I'm trying to convince myself that the GP path is the best path using sound reasoning and logic, and Gentledental1 comes along and says the opposite, also using sound reasoning and logic.
I would debate a few things though:

• There are definitely geniuses out there in dental school that can perform very well with minimal time input, but for most students the difference between a C and a B and from a B to an A is major in terms of time commitment and overall stress level. I know it would be for me at least.
• Isn't relying on referrals from GPs as a specialist perhaps equally as stressful as relying on yourself as a GP to develop a patient pool?
• A few years is a drop in the bucket compared to a long life, true, but I feel that these few years are the PRIME years of your life. If I could sacrifice the ages of 45-48 to specialize that would be great, but unfortunately it would be my (and most people's) 20s on the line. It is a drop in the bucket, but I think you're dropping something heavy into the bucket...
• Not getting As would not necessarily mean not utilizing your expensive dental education. It would mean you don't dedicate as much time learning the non-applicable aspects. I have a lot of trouble figuring out a lot of the things we learn in gross anatomy is relevant to dentistry. Or how about biochemistry and its relevance to dentistry... spend two weeks learning about hemoglobin... really hemoglobin? Spending hours and hours waxing up a molar... when you should have a lab do all that anyway...

Anyways, I think this is a great topic and it would be great to hear from practicing dentists/specialists (in addition to dental students)

 

[ski.bum]

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[askadds]

The D2 (sorry, as I'm typing this can't remember your sn) has valid points. HOWEVER - the most important thing to remember is, if you want to specialize because you love it, do it. I don't like endo or ortho or prostho enough to do those EVERY DAY, ALL DAY. A GP can do all of the above, plus some, at his/her leisure.

Furthermore - dentistry is about 10% dental skill and 90% business acumen. There are many terrible terrible business people out there and many failing dentists. Sorry that's rough news, but it's the bottom line. Yeah, if you're a specialist, the business part may come a bit easier. But will you really be happy doing endo the rest of your life just because you're too lazy to develop a practice? My guess is that most GPs who aren't satisfied or wish they specialized aren't very good business people, or they don't have the energy/business acumen to keep up in today's competitive dental arena.

Don't get me wrong, we definitely need specialists. But, unless you have this strong desire to specialize, don't do it for the money and definitely don't knock yourself out in d-school. Most of the first two years is crap anyway.

Lots of people on here are prone to embellish. I'm going to tell you that I'm not embellishing right now, and you can take it or leave it, I don't care. To give future GP's hope though, my brother came out in 2005 and did a start-up. Two years later he bought another practice out (that I currently run). His gross last year was 1.8 million. Now, don't get me wrong, I am not even CLOSE to that, which I'm ok with. The economy hasn't hurt him a bit...because he is a brilliant, shrewd, business person, as well as being an incredible dentist who has been featured in AACD journals. My point is, a GP can be successful. Don't waste your time specializing and make d-school a miserable experience trying to get 4.0s, unless you really really want to and LOVE a specialty. Money can be had anywhere, you might as well spend your time becoming a better business person than memorizing biochem stuff for the millionth time.

I love my job, and love being a GP, if you can't tell. I'd go nuts doing the same stuff everyday. General practice gives you variety. And you get to have fun arguments with the state boards when you advertise you do ortho as a GP...haha.

Good luck whatever you decide to do!

very nice..

 

[Ostracized]

Yeah, if you're a specialist, the business part may come a bit easier.

Are you sure? Specialists are highly dependent on referrals. Patients don't just show up at the endodontist's office when their tooth hurts. Heck, maybe their GP dentist will be skilled enough to do the endo him/herself.

Specialists need to worry about GPs improving their skills. My dad's been in the business for 32 years and he never refers out any extractions, ortho, endo, prostho/implants. He only makes use of a periodontist, in-office.

Also, considering that incoming dental students are getting older (I was 25), it does get really hard to keep your life on hold for so long. I don't want to be 32-33 when I start my career - I don't care about the financial benefits.

 

[Gentledental1]

All of you guys make very strong arguments and all the considerations are stuff I have and still do struggle with. By the way, I am in no way a "genius" that gets good grades easily, i just work moderately harder than most. One more point to consider is that for anyone who is just starting dental school, you should look at where the future trends are going in dentistry. As our scope of practice begins to encompass more and more (such as a simple thing like the advent of implants) it is inevitable that just like medicine, we will be required to have a minimum of a 1 year residency. There are already a few states that require PGY-1 anyways, New York, delaware, et... That is the trend, in the next four or five years it will probably be all states that require residency. In 1995, the Institute of Medicine called for the creation of a number of graduate dental
education residency positions sufficient to accommodate all graduates by 2005. In 1999, the Journal of Dental Education published a series of articles in a special issue that set forth a focused and compelling rationale for a mandatory, post-graduate year of dental residency education (PGY-1). The most recent call for a PGY-1 was in December 2006 at the ADEA Summit on Advanced Dental Education. The ADEA is actively considering it as a practical possibility for the near future. Delaware has long required
a residency before a dentist could begin practice in the state. Beginning in 2007 the state of New York requires a PGY-1 for initial licensure.

Alot of my teachers tell us to plan on doing a residency, even if its just an AEGD/GPR just to safe guard in case before we graduate they make it a requirement. By keeping your grades up, you will be able to get into one of the stellar AEGD/GPR programs rather than take bottom of the barrel. I guess that you very well may be one of the last few to slip through without it being a requirement, but as a D1 you're cutting it close. I would really look into the state that you want to work in's legislation on that and see what direction they're probably going to move towards. I'm not saying it is a sure thing, but there is a pretty good chance that it could affect you. And, even if it doesn't affect you, remember how the public mind works. For example, in a study that was presented in one of my CDA (california dental association) journals, 82 percent of patients believed a DMD had more training and was more competent than a DDS, despite the reality that they have the same level of training. It was just the fact that the word "medical" was in their degree name confused them. In the same way, if/when a PGY-1 is required by all states, despite the reality that a GP that has been practicing for ten years has WAAAy more experience and skills, the public will still percieve those new grads w/ a AEGD/GPR to be better practitioners. The point i'm trying to make is that while you will probably graduate in four years and be done with it, and be a competant dentist, look at this time as an opportunity to stay ahead of the wave as the dental profession evolves. whats one more year of your life if you do a GPR or AEGD? you learn some pretty cool stuff during that year from what I gather and you usually get paid about $40,000 for the year.

My girlfriend experienced a similar situation. She is in a DPT (doctor of physical therapy program) but when she was thinking about applying to school she really struggled with whether or not she should do an MPT (masters) and save herself some time since both have the exact same scope of practice. However, she did some research and found out that 1. every single school is going to be switching to a DPT program by 2015 and 2. most jobs that are offered now for physical therapists value a grad who has the DPT vs a MPT greater, some won't even consider a MPT. Anyways, If she hadn't had to forsight to see where her profession was heading, she could have already been done with school, but in just a few years, she would be a lesser qualified physical therapist (despite having the same skill set). Think how the public would percieve her having a lesser degree or doctors who refer to her? Its a little different than this situation, but wouldn't it be sort of a pain if you graduated and were working private practice for a few years and then all of a sudden you're less qualified (at least in the public's eye) than the new dental graduate who just opened up shop? Just my two cents, something to consider...

 

[mike3kgt]

Always work the hardest you can in dental school... while you defining what aspect of education you wish to work at (gpa/boards/skill/business/research).

Whether it be GPA/Boards to get into Oral Surgery, Ortho or basic skills/business acumen to do well in private practice from day 1. Don't slack because you should have the philosophy that never in life will you have 2.5 hours to do a class II composite again like you can in dental school. Take this time to prepare yourself however you want to go.

I went into practice as a GP for two years, got the itch, and went back to school for prostho. I am glad I studied hard and worked hard because it allowed me to keep my "options open." Yes, many will tell you the fallacy that prostho is really easy to get in and anybody can do it... that is simply true and not true. After being here for one year and seeing the quality of applications come in for this academic cycle, you have to have shown a strong academic interest in dental school to continue on to specialty training (GPA/boards/letters). It could possibly be a terrible feeling to get out into practice for a few years and then finding out that you love endo so much you wish to specialize in it but you can't get in because you slacked off.

Don't fall into that run into thinking that person who is 100th out of a class of 100 will be as skilled and successful as the 1-10th person out of the same class. There is little correlation regarding class rank and general practice success, from either end of the normalized curve.

Work hard, study hard, practice hard. Be as prepared as possible for practice and then you will see and find success... whatever and however you will plan on defining success.

 

[ski.bum]

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[Gentledental1]

Oh and by the way, when Mid-level providers are approved for dentistry, a four year dental graduate is not really a very attractive option for the majority of the public. for those who don't know, this is when a dental hygienist gets additional training and is allowed to preform irreversible procedures such as extractions and fillings. They also do not need to work under the care of a dentist and can open up shop on their own. This is an attempt by congress/other state organizations to lower dental costs. the ADHP degree they can get in some states (advanced dental hygiene practitioner) is a masters level degree they complete after hygiene school. Other options are to study under a dentist for a minimum of 400 hours followed by Mid-level dental care licensure. This is a new model in the US that is currently opposed by the ADA but it will likely happen in light of all the health care reform that is inevitable. It is already a very attractive option to lower dental costs in other countries, Canada for instance. this happened in many other areas of our health care system, dentistry is just behind the movement. MD doctors have nurse practitioners and physician assistants that offer mid level care, who can practice on their own, and in reality are a very good and cheaper option to immediately going to an expensive physician for routine problems. The same applies to dentistry, why go to a more expensive dentist for a bombed out tooth that just needs to be extracted when you can get it done for waaay cheaper? These models are currently being tried in minnesotta and alasaka. I predict that in 5-10 years the dental profession will have the standard bachelor degree dental hygienists, mid-level master's degree dental hygienists, and then the doctor dentists who are required to have a minimum of a PGY-1 residency. Watch the trends my friends, dentistry is evolving, do you want to be cutting edge, the expert in your field, be it general dentistry or oral surgery, etc? or do you want to be someone who got stuck in limbo of deciding to go back to school or practicing as a dentist who is outdated? look at the example of DO's (doctor of osteopathy). In the 60's and early 70's they only needed a four year degree to practice, just like dentists now. But they evolved to catch up with MD physicians and now have all the exact same requirements. My brother worked for an older DO before he went to medical school and the doctor he was working for never went back to school to get further residency training. While he could still practice for the last thirty years, his scope of practice was very limited compared to his counterparts who had residency training. Things to think about guys, its not as simple as just wanting to take it easy in dental school.

 

[Gentledental1]

No it wouldn't be a pain...because having a year or two of real world dentistry makes me more qualified than someone who was in an AEGD or GPR and only getting the patients that come to those types of clinics, schools. Most people in AEGD/GPR won't have done a sinus lift in their first year - I have. Most people won't have done a full mouth rehab in their first year - I have. If you are aggressive in treatment planning and aggressive in patient recruitment, you'll get a wide variety of patients and way more experience than what you are limited to in a residency.

Furthermore - patients couldn't care less about whether you did a residency. I can guarantee I wouldn't have patients leave my office because the new guy down the street fresh out of school did a GPR.

I'm not saying it's not a good thing for some people (there were definitely less than qualified people that graduated from my school who could have used another year of practice) but for others it's just a waste of time.

I agree with you 100%. Right now, patients could care less how many degrees you have, they can't tell the difference between a GPR dentist and a non-GPR dentist. All they know is 1. does this guy care for me and 2. how much does it cost. The point i'm trying to make is will they be able to tell the difference in 10 years? Will state and federal legislation change the defined scope of practice for general practitioners, just like it did for medicine? I don't know, its just stuff that i'm considering. And everyone remember, I'm a D2, ski bum is a doctor, so what do I know? I'm the first to admit that

 

[charlestweed]

I'm only a D2 ...... each of the specialists I shadowed were very passionate about what they do and all of them were extremely happy they'd chosen to specialize. Their reasons weren't about money, but the fact that all their business came from referals, they didn't have to go out looking and struggle to maintain a patient base. Also, they had fewer working hours and more family time. All 14 of the 15 said that when looking at your whole career of 40-45 years, a few extra in residency is a drop in the bucket, just a few more years of delayed satisfaction. .....

Gentledental1, I completely agree with all the things that the specialists you had shadowed told you. Extra 2-3 (or 6 years for OMFS) years is really a drop in the bucket. I've met so many GPs who went back to school to specialize but I have not seen 1 specialist who went back to practicing general dentistry.

Don't specialize, if you love doing everything and like to work 8 hours a day. And specialize, if you like to focus on what you like to do most...and only want to work 4-5 hrs/day, 14-16 days/month.

 

[mike3kgt]

Right now, patients could care less how many degrees you have, they can't tell the difference between a GPR dentist and a non-GPR dentist.

I'd venture to say that most recruiting dentists wouldn't be able to tell the difference between a GPR and non-GPR trained dentist with one year of private practice experience from a skill set wise.

While, on the average, I'd hire a fresh GPR grad over a fresh dental school grad, I know many of my friends and dentists who I have seen from an interview perspective who have a greater skill set after one year of clinical practice than most who graduated with a GPR. Many who have their GPR training have advanced skills in IV sedation, extractions, and medically compromised but very very few have greater skill in esthetics, complex treatment planning, and business acumen.

There are some great GPRs where you may get to do the aformentioned plus more, but it seems from those I've talked with that most are public health clinics, special-needs clinics, hospital-based pre-operative extraction services, or surgical services.

While on the flip side, there are also some great private practice experiences and terrible ones. It goes both ways.

GPR is a great way to go if you feel like you truly need 1 more year to get ready for clinical practice but in no way should we be touting to the public that GPR-trained dentists are better than non-GPR trained dentists.

 

[jay47]

I'd venture to say that most recruiting dentists wouldn't be able to tell the difference between a GPR and non-GPR trained dentist with one year of private practice experience from a skill set wise.

While, on the average, I'd hire a fresh GPR grad over a fresh dental school grad, I know many of my friends and dentists who I have seen from an interview perspective who have a greater skill set after one year of clinical practice than most who graduated with a GPR. Many who have their GPR training have advanced skills in IV sedation, extractions, and medically compromised but very very few have greater skill in esthetics, complex treatment planning, and business acumen.

There are some great GPRs where you may get to do the aformentioned plus more, but it seems from those I've talked with that most are public health clinics, special-needs clinics, hospital-based pre-operative extraction services, or surgical services.

While on the flip side, there are also some great private practice experiences and terrible ones. It goes both ways.

GPR is a great way to go if you feel like you truly need 1 more year to get ready for clinical practice but in no way should we be touting to the public that GPR-trained dentists are better than non-GPR trained dentists.

Well put. I will take this into consideration.

 

[gryffindor]

I think the GPR thing is regional. On the east coast, there are an oversupply of GPR$ and they have to fill them. How else to fill them but to make students think it is better to do one? Even better, make it mandatory to do a GPR so NY residents who want to stay in NY have no choice but to $ubmit to $lave labor for a year - this way the bazillion GPR programs downstate have a better chance of filling their slots. Compare that to southern and even western schools where there are way fewer GPR slots compared to dental school grads - 3 dental schools in Texas and only 4 total GPRs listed on PASS?

To the OP, it's OK if you don't feel like gunning for grades anymore. As long as you pass, you'll be fine. The only time it may come haunt you is if you decide to specialize after graduation at some point. General dentistry is a great career.

 

[GoldTigerPirate]

Much time has been spent by me and others on this site trying to pick the brains of dental students and professionals...This thread was by far the most insightful and helpful. Thank you all!

 

[JamesOSU]

Just stopping by and read this whole thing when I should be studying for my restorative final in 6 hours... but this is a great thread, possibly one of the most well-said, thoughtful, and civil post on SDN. I thought within the top 5 posts someone would turn this into a screaming match about academic responsibility.

Great points from all three sides (passing d-school, getting good grades, and the dentists' input). I'm currently a D1 finishing my first quarter, way too soon to be considering any of this. I'm doing very well in classes right now, but I think about half of my class is as well! I could get a 3.9 this quarter and be tied for 25th/104. But it is something to think about, hopefully I know soon whether or not I want to specialize. I feel like once you know you DONT want to specialize, dental school gets a lot less stressful.

The problem is that we are not exposed to the specialties early in our d-school careers. It will be probably a full 2 years before I get a good view on all the specialties and decide if I can see myself doing one as a specialist. So I basically have to keep chugging away until the first 2 didactic years are done! Frustrating

 

[newyorkblork]

Really great post, guys. I would like to say thanks to everyone who's put real time and thought into expressing their concerns - very helpful for a worried pre-dental student.

Looks like the advice I'm taking from this thread is "Shadow as many specialists as you can, and ask tons of questions", because specializing comes with advantages and disadvantages, but ultimately boils down to whether or not you could live with yourself doing that kind of work.

One point my GP got me to consider is that specialists get all of the headache cases. You might work fewer hours, but your cases are the extremes - you won't get to place an easy-money implant, or do an easy-money wisdom tooth extraction, because if they were easy, the GP takes them

Something I would love cleared up - are GPR and AEGD residencies very competitive? I believe they are required for practicing in NYC. Any thoughts on the matter?

Thanks again guys.

 

[boxdesker]

This is a very insightful thread and I'm learning a lot from pre-dental students, dental students and actual dentists. The problem is, I'm finding the more I learn the more doubtful I am and the more questions I have.

Regarding GPR/AEGD: Personally, I don't believe an AEGD or GPR will teach you anything that you can't learn in practice as a GP or by taking CE courses. As one of the posts mentioned GPR/AEGD residency is mostly for individuals who don't feel confident enough in their abilities and need a year to practice with instructor guidance OR individuals who want to specialize and are using the residency to make their application more competitive. An instructor at my school was telling us that she had the opportunity to remove ear-wax while in her GPR. She also said that she often had lunch with medical specialists (i.e. cardiologists) and got to discuss cool cases. These are great life experiences but I question their validity to the traditional dental practice I foresee myself having.

About whether residency will become the norm and therefore putting dentists without one at a disadvantage, I highly, highly doubt that'll be the case. A patient that comes to your office wants to know that you are competent. There are tons of ways of doing that. Sure putting an extra degree on your wall and talking about your "hospital residency" will do that, but so will lots of other things (i.e. telling patients about some very complex procedures you've performed in private practice).

Is it better to specialize or not... should I sacrifice happiness to get good grades? Much more complicated issue that I'm still very uncertain about.

 

[mike3kgt]

As one of the posts mentioned GPR/AEGD residency is mostly for individuals who don't feel confident enough in their abilities and need a year to practice with instructor guidance OR individuals who want to specialize and are using the residency to make their application more competitive.

....

Sure putting an extra degree on your wall and talking about your "hospital residency" will do that, but so will lots of other things (i.e. telling patients about some very complex procedures you've performed in private practice).

Two responses.

1. I have spoken to several people who indicated that doing a GPR did not help them get into a residency and in fact, may have worked against them. A common conception is that a GPR is a great route to take if you don't match ortho, pedo, oral surgery. Not always true... although it depends on the GPR program and the desires of particular programs. While I say that, I also know a few people who doing the GPR strengthening their application (Endo).

2. Marketing in practice that you are a "hospital trained" dentist may end up not proving effective, but again, depends on the area. Say you want to work in Southern California, it may pay off to be able to state that you "did your residency at USC." You will be MUCH better off marketing yourself, and selling treatment by having PROOF of your beautiful results (photos, testimonials etc). I wish I took more pictures during dental school and my first 2 years of practice. Trust me, it works.

GPR is a good option for some people, but you must choose it for the right reasons. If you want to become a hospital dentist, do it. If you want to get more confidence in basic procedures and you're just not ready... it may help. If you just want to hang out in Honolulu for 1 year extracting teeth... yup, you can do that too... they have a GPR there.

Furthermore, you don't know if you like Ortho before you bend some wires and trace a ceph, you can't tell me you are thinking about endo until you do quite a few RCTs, and defintely don't tell me you want to be a pediatric dentist until you have done a pulp/SSC (or something like this) on a screaming, arms flailing 5 year old.

In school, plan on becoming a great general dentist and if you find something that you KNOW you could only do every day for the rest of your life, do it.

 

[ski.bum]

.

 

[TheWiredNerv]

What do they call someone who just barely passes dental school?

A dentist.

That is wrong. You are not a dentist when you graduate dental school. You are a DDS or DMD.

You are not a dentist until you receive a license to practice dentistry.

There are plenty of people with a DDS or DMD degree who are not dentists just like there are plenty of people with a JD who are not lawyers.

 

[Thaxil]

That is wrong. You are not a dentist when you graduate dental school. You are a DDS or DMD.

You are not a dentist until you receive a license to practice dentistry.

There are plenty of people with a DDS or DMD degree who are not dentists just like there are plenty of people with a JD who are not lawyers.

This is very true. I graduated on time but was not allowed to practice for 4 month after because the licensing board was reviewing my application and was going to request an interview in oct further delaying the license. Fortunately I had some connections and my application was processed although delayed

 

[mike3kgt]

...(not crap like JADA)...

I hear you on this one. It seems like the JADA has REALLY gone downhill. Every time I get it, it's got something on the cover about childhood caries control or "access to care." I was amazed at this month's journal that actually had something interesting about canine impactions. Sure beats papers that tell us how great Medicaid is. I honestly believe some in the ADA are out to brainwash us into believing some of this smut they are throwing around. There are many who are still sticking up for general practitioners, but it sure seems from the ADA News and JADA it's not the case.

You'd be much better off reading journals like J Prosthetic Dentistry, Journal of Cosmetic Dentistry, or (my favoriate) Compendium to learn new materials or skills. You're better off reading Dental Economics for business sense. Heck, you're better off reading throwaways like Dentistry Today or Inside Dentistry than JADA to get caught up on the latest.

Maybe if some at the ADA get off their soapbox and re-focus on constituents we'd all be better off!

 

[ski.bum]

.

 

[DMDreaming]

Absolutely. The ADA drives me crazy. I cannot believe they are in Washington lobbying to be part of health care reform. Uh, NO THANKS! They really could not be doing anything MORE detrimental to the practice of dentistry than trying to be part of federally run health care. I wish we could start a union like the anti-ADA. Or something.

At least the ADA hasn't officially supported the health care reform like the AMA has. Read somewhere that the AMA membership is now less than 50% because they are supporting legislation that their members aren't in favor of.

 

[Vaheb]

My name is Boxdesker and I'm a recovering hard-workaholic. I feel the same way as the OP. I got really good grades in undergrad, studied my butt off for the DAT and did really well on DAT. Why? Because I had motivation... because I wanted to get into dental school. I worked hard, it paid off, and I got into dental school. Motivation, action, success.

I know I'm fully capable of getting really good grades in dental school... but why do it?

I've had plenty of conversations about this with my parents, brother, non-dental school friends, and dental school friends and I keep getting mixed answers ranging from "F it, who cares" (brother) to "Make sure to always do your best" (parents) to "Get good grades to keep your options open" (dental school friends).

The only logical reason I can think of for why most people THINK it's important to get good grades, is so you can specialize... ok great. "Specializing" means I get to:

• Experience a terrible time in dental school because I'm working my butt off to get the highest grades (as oppose to settling for Cs and at least somewhat having a life)
• Spend an extra 3-6 years of my life in more school after dental school, reading research papers and working my butt off
• Not making any money and living in a non-ideal financial situation during these times (in fact: ADDING to my tremendous debt in the process and probably paying for additional tuition)
• Putting off being able to meet a nice woman and settle down because I'll be putting my life on hold for another 3-6 years

All for what? So I can make $300,000 or let's say even $400,000 as a specialist instead of the $200,000 the average GP with their own practice makes?

• First of all, I don't even know how much more you would be making if you consider the $600,000 in lost income you could have made as a GP ($200,000/year x 3 years for average specialty program) in addition to the extra $60,000 in interest your dental school loans will have picked up (assuming $300,000 in dental school loans) AND the added tuition you'd pay for the specialty program...
• Second of all, I'd rather be young and make tons of money than put off my life, and make tons of money when I'm much older.
• Third of all, the more money you make the more your expenses go up, and you'll never be satisfied.

Pretty simple right? Here's the huge problem. I feel I'm constantly under over-achieving pressure from my peers, whether directly or indirectly... and that's why I haven't been cured yet.

• Example of direct pressure: Constant talk about specializing in conversations and the necessity to obtain good grades to do so
• Example of indirect pressure: Seeing students excessively studying and getting As to show for it, while I study very little and get Cs--makes me feel the need to prove to these students that I am capable of getting As as well.

Are there any reasons to specialize? The only reason I can think of for specializing is for the psychological understanding... knowing that I'm a 'specialist' at something, that I'm an expert in my field, that I have the most advanced training, that there isn't anyone above me.

But even then, once you get into the real world, nobody cares. Really, I would bet that most of the population doesn't know the difference between an endodontist's training and a dentist's training....

I apologize for the rambling, but this post really captured my attention, and it's something I've been thinking about a lot. Since I typed this pretty quickly, I'm sure there might be some logical fallacies. Point them out and I'd love to explain myself. But to me, it pretty much comes down to: Ideal situation except I'm not a specialist, vs. Non-ideal situation but I'm a specialist. If you were able to get through this long and boring post, please share your comments because I really need support if I am to get over this over-achieving mentality...

Honestly, I semi-agree with you, but you should keep your options open.

And pointing to the financial issue for GPs and specialists. My brother is a GP and he makes more than double of what specialists would dream to earn every year. It matters what kind of patient care you offer.