Having specialty programs at your dental school: Good or Bad

[dentist95757]

Hey Guys,

I had a question about schools having extensive specialty programs, and whether or not that benefits the dental students

When I interviewed at schools that don't have specialty programs, they always stress that their pre-doctoral students get to handle all of the difficult cases, and gain more hands on experience

I was just wondering whether or not schools blow this out of proportion, or if it's a legitimate concern that you won't feel as comfortable doing certain procedures upon graduation because many of the cases are given to the residents

Thanks!

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[MicroDent]

Great question. I too would like to get a couple different views on this from current dental students.

 

[Regmata]

Probably a good thing. If you want to specialize, you want the specialty programs there to give you the opportunity to get more extensive experience and exposure. Your courses are often taught by the various members of each specialty department, this is certainly a benefit of having a specialty program in place. Also, you get the opportunity to spend time with a program and get a letter of recommendation from a member of the field.

You could make a case either way if you aren't looking to specialize. Having specialty programs at your school could possibly cut down on your numbers in clinic, depending on the depth of the patient population. If the patient population is strong, then there are more specialist level cases to keep the program busy and consequently, more student level cases to keep students busy. Having a program in place likely also draws more referrals and patients to the clinic. As for the difficulty of cases that you would see, I doubt that the abscence of a specialty program would allow you to see much more difficult cases. A case above a students skill level shouldn't be given to a student simply because there is no specialty program at the school. Thus, I would guess that for the most part, you wouldn't lose difficult cases to the program, because you wouldn't have gotten to them in the first place. I am sure there are outliers and some faculty are willing to walk students through difficult cases, but this likely isn't the norm.

 

[Doc Smile]

Hey Guys,

I had a question about schools having extensive specialty programs, and whether or not that benefits the dental students

When I interviewed at schools that don't have specialty programs, they always stress that their pre-doctoral students get to handle all of the difficult cases, and gain more hands on experience

I was just wondering whether or not schools blow this out of proportion, or if it's a legitimate concern that you won't feel as comfortable doing certain procedures upon graduation because many of the cases are given to the residents

Thanks!

Hmm. I think that might not be true. At IUSD, we have almost all the specialty programs and while we might not be the primary provider for each case, we get to do a lot more. It is very very common for D3's to have 2 or 3 ortho cases that are 'theirs.' A ortho resident will work with them on everything but it is still their case. Same goes with perio, endo, prosth, etc. Even oral surgery, when we do our Regenstreif rotation at the 4 hospitals downtown, is pretty extensive.

So, I would say that the more specialties your school has, the more experience you get with each one and the greater there is for an oppurtunity to take some of their more run-of-the-mill procedures!

 

[keeneye]

there is a reason specialties exist. Cases range from standard to difficult and treatment planning various patients might be one of the most difficult aspects followed by actually completing the procedure.

For example, a patient may come in with lingering pain and all other obvious signs of irreversible pulpitis. In this case, you can diagnose it and treatment plan the patient for endodontic therapy. But, if this is a premolar with two roots and ligual bifurcats or a second molar which are difficult, a dental student who has done 1-3 RCT is not qualified for this case.

It's my opinion that working with specialties throughout your dental career only comes as an advantage for you. You get the opportunity to see how a very knowledgable resident practices and then you can use this experience to make yourself more competent.

 

[DavesNotHere]

It's good.

If you want to specialize you can entrench yourself with the program for an experience and resumé builder.

If you want to be a GP you can learn what cases need to be elevated. You learn how to use specialists for treatment plans youve constructed. You get to avoid doing cases youd never touch in private practice...like RCT on a 3rd molar.

As long as you go to a school with a good patient base it will only benefit you. And you can always (and should) do a GPR after d school anyway if youre going to do GP.

 

[HMI]

Hey Guys,

I had a question about schools having extensive specialty programs, and whether or not that benefits the dental students

When I interviewed at schools that don't have specialty programs, they always stress that their pre-doctoral students get to handle all of the difficult cases, and gain more hands on experience

I was just wondering whether or not schools blow this out of proportion, or if it's a legitimate concern that you won't feel as comfortable doing certain procedures upon graduation because many of the cases are given to the residents

Thanks!

I am almost at the end of my third year at a CA dental school that has all of the specialty programs so I can tell you what I think based on my experience. It is great to have specialists around for consults on complicated cases, but honestly I now believe that schools with specialty programs produce weak general dentists. We cannot do any posterior (molar) endo since they all get referred to PG-endo and it is not easy to find anterior or premolar endo (I am yet to do my first endo), all we do in perio is SRP and SRP only (no crown lengthening), all extractions get referred to oral surgery (we do get to do extraction in our OS rotations but from what I hear form the fourth year students it is not enough exposure since OS residents get to do most of them and all we do is to assist) and we only get 1 week rotation in ortho. Most of my classmates are either thinking about specializing or doing GPR or AEGD because most of us do not feel comfortable to go out and do molar endo, surgical extraction or other complicated procedures. I know 1 perio residents from UOP who told me that he did 15 crown lengthening and many retreat endo before he graduted form the pre-doc program at UOP (they are also invisalign certified). So yes, I do believe if you are planning to become a general dentist then having specialty programs at your school is a disadvantage (and you do not get to work with specialist on a case as a predoc student; residents from different programs get to work on the case).

 

[DavesNotHere]

I am almost at the end of my third year at a CA dental school that has all of the specialty programs so I can tell you what I think based on my experience. It is great to have specialists around for consults on complicated cases, but honestly I now believe that schools with specialty programs produce weak general dentists. We cannot do any posterior (molar) endo since they all get referred to PG-endo and it is not easy to find anterior or premolar endo (I am yet to do my first endo), all we do in perio is SRP and SRP only (no crown lengthening), all extractions get referred to oral surgery (we do get to do extraction in our OS rotations but from what I hear form the fourth year students it is not enough exposure since OS residents get to do most of them and all we do is to assist) and we only get 1 week rotation in ortho. Most of my classmates are either thinking about specializing or doing GPR or AEGD because most of us do not feel comfortable to go out and do molar endo, surgical extraction or other complicated procedures. I know 1 perio residents from UOP who told me that he did 15 crown lengthening and many retreat endo before he graduted form the pre-doc program at UOP (they are also invisalign certified). So yes, I do believe if you are planning to become a general dentist then having specialty programs at your school is a disadvantage (and you do not get to work with specialist on a case as a predoc student; residents from different programs get to work on the case).

This sounds specific to your school...and it sounds awful. This is why im always arguing that your dental school choice DOES matter. I went to a school with all the specialties, and i had the exact opposite of your experience. I got all the molar endo i wanted, all the extraction i wanted. And we got to work with either the residents as attendings in our pre doc clinic, with res as attendings in their clinic, or assist them on our patients. I got to extern in pedo and oral surgery. When my patients cancelled i could go to PG-os and observe or help. The residents always let you do whatever you wanted. I placed multiple implants in OS and did crown lengthening in pg perio.

You went to a crappy school...like i said...where you go to school matters.

 

[Just Peachy]

I only applied to schools that did NOT have specialty programs. I'd heard that in clinic, all the molar endo and extractions go to the specialty departments - so you don't get a lot of the experiences that you could if there were no specialty programs. Since I want to be a GP, I wanted to be able to do the more complicated cases instead of them getting immediately shipped off to the specialists.

I'm a 3rd year and so far have done 15+ extractions (2 of them surgical), and 2 molar endos with 6 more molar pulpal debridements that I will be doing endo on in the coming weeks (assuming my patients come back since now they are out of pain - fingers crossed!). We have all of the specialties represented via our faculty, and you can work as closely with them as you like if you have a more complicated case. If something is beyond your level, then you and the specialist faculty discuss your options and decide together if they want to walk you through it or if you want them to treat the case.

It's a pretty good setup and I feel like I've had some great experiences that I may or may not have gotten if I had gone to a different school.

 

[lemoncurry]

my school has all the specialty programs and I really don't think it has been a hindrance. we do most of our own extractions and minor surgery cases, we can do our own perio surgeries up to a point, we have to do at least 4 endos (if 3 of them are molars), retreats can be done by us, some students do full mouth rehabs, and students can even place implants if they do all the planning. some students can do sedation cases.

As mentioned before, it all depends on where you go to school. I give lots of tours to applicants and I always try to stress that despite having 8 grad specialty programs, we still get to see a fair share of complex cases and procedures.

 

[UltimateHombre]

my school has all the specialty programs and I really don't think it has been a hindrance. we do most of our own extractions and minor surgery cases, we can do our own perio surgeries up to a point, we have to do at least 4 endos (if 3 of them are molars), retreats can be done by us, some students do full mouth rehabs, and students can even place implants if they do all the planning. some students can do sedation cases.

As mentioned before, it all depends on where you go to school. I give lots of tours to applicants and I always try to stress that despite having 8 grad specialty programs, we still get to see a fair share of complex cases and procedures.

Thanks for the perspective Lemoncurry! I was curious to what role the Dental Anesthesiology residents play at your school? Are they on outbound rotations? How do they decide what goes to the DAs vs the OMS residents?

 

[DavesNotHere]

Thanks for the perspective Lemoncurry! I was curious to what role the Dental Anesthesiology residents play at your school? Are they on outbound rotations? How do they decide what goes to the DAs vs the OMS residents?

The DAs provide anes for the faculty practice only. Im not sure what exactly you mean by what goes to DA versus omfs as the DA ressies will do the sedation, on some cases, for the os faculty. Theres no competition.

They spend 1 year in the dental surgical center, and 1 year split up between Loma Linda Med Center, the VA hospital, and another smaller hospital.

 

[dentist95757]

Hey Guys,

thanks for all of the perspectives, I'm glad we have many different views on this issue.

I guess it's an interesting dilemma. because I am considering specializing, and it seems that if you have post-graduate programs at your school, it is great for networking and letters, but it comes at the expense of potentially losing more hands on experience in your field of interest.

 

[Doc Smile]

Thanks for the perspective Lemoncurry! I was curious to what role the Dental Anesthesiology residents play at your school? Are they on outbound rotations? How do they decide what goes to the DAs vs the OMS residents?

At IUSD, One of our D4 electives is Anesthesiology. It includes a 40 hour program (taught by a dental anesthesiologist and some faculty at the oral surgery residency program), ACLS certification course, and 20 sedation cases (done by the student) at the oral surgery residency clinic (Regenstreif at Wishard Hospital). Students who do the externship can decide how involved they want to be - either do the whole thing and get your certification, or they can just take the course and not receive the certification.

 

[UltimateHombre]

The DAs provide anes for the faculty practice only. Im not sure what exactly you mean by what goes to DA versus omfs as the DA ressies will do the sedation, on some cases, for the os faculty. Theres no competition.

They spend 1 year in the dental surgical center, and 1 year split up between Loma Linda Med Center, the VA hospital, and another smaller hospital.

Thanks for the clarification. From my understanding, OMS spend an entire year learning anesthesia and sedation, so i thought there might be some type of bidding war.

 

[Regmata]

At IUSD, One of our D4 electives is Anesthesiology. It includes a 40 hour program (taught by a dental anesthesiologist and some faculty at the oral surgery residency program), ACLS certification course, and 20 sedation cases (done by the student) at the oral surgery residency clinic (Regenstreif at Wishard Hospital). Students who do the externship can decide how involved they want to be - either do the whole thing and get your certification, or they can just take the course and not receive the certification.

That is an excellent opportunity, I hope a lot of students take advantage of it.

Hombre, the typical OMFS anesthesia experience these days is 5 months, with one of those months being on pediatric anesthesia. At OSU, there is no competition between DA's and OMFS residents. DA's provide anesthesia for some of our faculty cases and in various other clinics throughout the dental school when they are not on anesthesia service in the main hospitals ORs. In our clinics, OMFS residents do their own sedations, GA for our bigger cases and sometimes for faculty cases. It is actually a great addition to our education to have DA faculty and residents around