questions about specialization????

[Sleepless]

Everyone is talking about specialization and percentages that do so from various schools...

I was wondering does anyone know what % specialize from UNC bc I looked on their website and was not able to find any stats.....

and also...everyone is so concerned about which school to choose in terms of % of students that specialize....doesnt that usu depend on a student themselves???

I mean in the end I believe that there are soo few dental schools and they are all working hard (esp now) to be very well rounded and provide good clinical and research based training...

If you really want to specialize and you stay on top of your game i know everyone in this forum could specialize!

anyway, thanx!!

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[Temple2007]

In the end 1000's apply for like 200 or so spots in each speciality. That is why you need a higher grade point or research or whatever to set yourself apart from the rest of the pack. I personally think that the specialist want to keep there fields lucrative so they influence the amount of seats that are available to GP dentists. I bet that there are plenty of dental students with great skills but there didactic scores dont keep them ahead of the race. So it will remain just that a race to be in the top 15% of your class if you wanna specialize that is.

 

[drPheta]

Originally posted by Temple2007
I personally think that the specialist want to keep there fields lucrative so they influence the amount of seats that are available to GP dentists.

It could also just be that the room available in the rotations isn't enough to accomodate the amount of attention needed by the residents of each program. Think about it. This is a program that shows you practically every aspect of that specialty with a limited number of cases to present. It happens very quickly and rigorously, and the programs are not just comprised of rotations. There are seminars and other academic requirements, as well.

To say that specialists fight flooding of the markets may or may not be the case. But, I think there's MUCH more to the whole picture than what you're saying.



To the OP, if the website doesn't have any information on a certain topic it's probably best to call the school up for the info immediately. They're usually very eager to send you inforation on whatever it is you need to know. These can range from a senior profile that tells you exactly where each student is going after graduation, a few sheets and pamphlets with pie charts breaking down the trends of specialty and private practice gp over the past few years, or whatever else they have on hand.

Chances are, percentages spit out on the boards are all hear say and not accurate. Ever play telephone? How often was the information at the end of the line the same as the info at the start?

 

[Temple2007]

YAh I think there is more to the picture too. I dont know why there are only so many spots for specialists. But If it is a matter of supply and demand there are alot of students who want to be specialists and there are only a limited amount of seats available. I dont think that it would be hard for dental schools to increase the amount of students in there speciality programs. They have all the instructors, clinics, and patients in place. I wonder if the ADA, some state law or something regulates the amount of speciality licences that can be given out each year??? Bottom line is I dont know but If they allowed students the option of specializing after school the market would quickly become saturated and the appeal of being say an endodontist (at least money wise) would be lost. And there would be alot of preexisting specialist that would be very upset. Just my opinion though what do you all think?????

 

[drPheta]

Well, wouldn't the limited specialty based on monetary factor rule apply to MD residencies, as well? What be the reason for there being such a few amount of spots open in the MD specialties?

While you make tons of money as a specialist, there are just as many GPs pumping out that much. It just so happens that the range of income for the GP is much broader than that of a specialist...reasons include, but not limited to:

GPs age group is much broader
GPs practice a wider range of cases
Specialists endured more training, thus can charge more for their treatment

So, I'm still not sold on the money issue. How competent would a specialist be if every student could just hop into a program? How much attention do you get as is in dental school? 100 students for what, 10 faculty members? 20 faculty members? How efficient is that learning process for very intricate and intensive procedures? How good of a GP is one when they graduate? Yeah, they can do crowns, bridges, some endo, some extractions, and whatever else they did during the 4 years. But, how much have they not done? A LOT. A GPR is said to take off 3 years worth of GP experience. That's quite a bit of experience a very intimate learning environment offers.

So, what about a resideny in Pedo? Seems like it isn't too much higher of an average income compared to GP. That can be linked to reasons including the similarity of the procedures performed with Pedo. Also, the amount of added training in Pedo isn't too much more. There could be any factor alloting to this.

Now, take a 4 year residency in OMS, the complexity of the cases within that program and tell me that you can throw 50 students into that one OMS program. How about 20? How many attendings and faculty members are there for this residency? Each one of those members has their special skill within that program to teach you. Each of them has to show that skill to 5 or 3 other students during their enrolled time, and it all has to be scheduled in a way that chronologically and sequentially makes sense to the students and harbors excellent clinical training.

I don't know. I'm still fixed on the notion that quality of education is the limiting factor. Not income.

Especially since there are GPs making more than specialists, and they have the freedom to do and refer out whatever they want. Seems like a better deal to me than schooling for 3 more years. We'll see what pans out.

 

[Temple2007]

Well opinions are just that opinions I wonder if there is any literature out about this? I dont think that on average GPs make more than specialists. True there are some GPs who may make more than specialists but its not the norm. Pedo is a differnt story Gp who go into this field must like children cuz they dont make much more the Gps. I think that it is all a way to proctect the market for the entire field. To have the dental game work you need a pyramid the Gps make up the base which refer patients to the top (the specialists). The Specialists depend on there base the dentists for refferals. If you allowed the pyramid to become say a square instead. Then the whole system would fall apart. I know there is a shortage of faculty but they could double the programs or open postions (I think) and not have a big problem. Im still sold on the notion that dental school and speciality schools postions and open spots is set up to proctect the market. Which is a good thing for us GPs or specialists. The quality of the education would not change if lets say instead of 3 students in your residency you had 6 or even 9.

 

[ItsGavinC]

Originally posted by Temple2007
Well opinions are just that opinions I wonder if there is any literature out about this? I dont think that on average GPs make more than specialists. True there are some GPs who may make more than specialists but its not the norm.

You are correct. ON AVERAGE a specialist is going to make more than a GP. Of course, there are various reasons for this. For example, it might be attributed to a higher billing rate due to complexity of procedures, or it might be attributed to having a very minimal overhead (like endo?).

 

[UBTom]

Originally posted by Temple2007
I dont think that it would be hard for dental schools to increase the amount of students in there speciality programs. They have all the instructors, clinics, and patients in place. I wonder if the ADA, some state law or something regulates the amount of speciality licences that can be given out each year???

I know there is a shortage of faculty but they could double the programs or open postions (I think) and not have a big problem.

Nope... It would actually be difficult for dental schools and other institutions to increase the number of residents in specialty programs.

You have to pay the residents, and there is only so much money-- And what's worse, U.S. dental schools just lost GME funding for school-based programs last year, despite the ADA and state associations' lobbying efforts on your behalf to preserve the funding. And programs like Ortho, Endo, Perio etc. are school-based.

So in the future, be prepared to PAY tuition for specialty training rather than receive a stipend. Imagine having to pay another hundred thousand dollars of tuition for PG training on top of the couple hundred thousand dollars you already owe in earning your DDS. It IS a big problem.

 

[Temple2007]

You have to pay the residents, and there is only so much money-- And what's worse, U.S. dental schools just lost GME funding for school-based programs last year, despite the ADA and state associations' lobbying efforts on your behalf to preserve the funding. And programs like Ortho, Endo, Perio etc. are school-based.

SO your saying that the problem for limiting spots in residencies is that the schools have to pay have pay there residents. Then you say that the residents have to pay there own way due to the recent lost of GME funding. The problem of funding is solved (for the schools) if the residents have to pay there own way... right?
So why would this limit the amount of residents the schools can support.

 

[UBTom]

Actually, it does NOT solve the problem. It only passes the buck, literally, to the residents. By making the resident pay for it, one is also limiting the number of residents going into postgrad training, by making specialization FINANCIALLY VERY UNATTRACTIVE for the postgrad applicant.

If you went to a private school like USC, owed $300,000 after you graduate, then pile on another $100,000 of debt by going into a specialty program, all I can say is you are probably going to live like a dental student for the next 20+ years.

I don't care how good your GPA or NBDE scores are, but if you have to pay $4000 Every Month for the next 30 years just so you can specialize, I bet most dental students won't do it.

The problem for the schools would simply change from not being able to pay for more residents to not being able to ATTRACT enough residents, which puts a program IN JEOPARDY (Imagine a university administrator asking, "if nobody is signing up for this program, why do we bother to spend money to run it?"). Either way, the number of people going into postgrad training would remain low, whether GME pays for it or not.

 

[Dr.BadVibes]

Tom, you bring up a good point, but do you honestly think people will opt for speciality programs if they have to pay for them and add to their DDS debt if they went to a private school? Is it really that worth it? Or are we going to see a trend that speciality positions will be filled with people from state dental schools who have smaller debt? Because I constantly see on this board of pre-dents choosing schools such as Penn, Harvard, and Columbia because they ahve the best speciality placement, but they are also some of the most expensive schools...

 

[UBTom]

Exactamundo!

Heck, I attend a state school and I wouldn't want to add another $100K to my debt!

 

[gryffindor]

3 years of ortho at USC is now $210,000 for 3 years of training ($70,000 * 3). This includes tuition and living. Since GME is basically gone, it is up to the incoming resident to pay that price tag.

Add that to the $250,000+ debt some of the private school students have.

But, USC's ortho program didn't have any spots open after the match, that means like 5 students in this country went for it, even with the hefty price. Their pedo program did have 1 spot open after the match, and BU's pedo program had 3 spots. Since the majority of pedo programs are still hospital based, you get a stipend at most places. Some, however, like USC & BU make you pay, so it makes sense that USC & BU would be unattractive for pedo.

Tom makes a very practical point.

 

[Dr.BadVibes]

so why are people still picking pricey private schools with a good rep of specialty placements just so they can specialize? are they just misinformed?

 

[Temple2007]

so why are people still picking pricey private schools with a good rep of specialty placements just so they can specialize? are they just misinformed?

No they are not misinformed these students know the price that they are paying and would gladly pay it. If they can get into a residency program of their choice. Even if they have to pay an extra 100 grand its still worth it, depending on the residency. Why is that you have to be in the top 5-15% of your class to get into a residency? Its so competive because so many people apply to such a limited amount of seats. You cant say that schools would turn money away from there residency programs due to a lack of interest from the students. The statistics just dont support it.

 

[UBTom]

Originally posted by Temple2007
Why is that you have to be in the top 5-15% of your class to get into a residency? Its so competive because so many people apply to such a limited amount of seats. You cant say that schools would turn money away from there residency programs due to a lack of interest from the students. The statistics just dont support it.

You don't have enough temporal data to support anything yet, because this is the first year after GME funding cutoff and the programs are in transition. In a few years one will be able to see trends developing over time, if there is a lack of interest from the students if they had to pay for it.

Remember that GME funding was available up until last year. Before that, the school-based programs DID pay the residents, but there is only so much GME money available and therefore only limited number of slots are available. That's why specialty PG programs have been very competitive.

Will the competitiveness change because of the GME cutoff? Only time will tell.

 

[Temple2007]

True True Tom you make good points. While we are on this subject Temple fills there residency spots and they have not given there residents stipends for several years now. They have required there resident students to pay full tutition. Even while most of the rest of the nation was funding there students. My cousin who was at Temple 4 years ago couldn't believe that students would go to Temple when they could get paid else where. Is this a model of the future or just desperate students who couldnt get into the paid programs?....As Tom said time will only tell....

 

[DocDrtySanchez]

With regard to funding for post-graduate programs...I will be starting my ortho training this July after graduation from dental school in May. I interviewed at 10 programs, all of which, with one exception (a primarily hospital based program with GME funding), charged tuition ranging from 10,000 per year to 45,000 (NYU). Regardless of the tuition rate, if specialty training is what you desire, then the additional time and money is certainly an excellent investment...no one in their right mind could reasonably say otherwise. I personally could not see myself practicing anything other than ortho throughout my career...so my choice to specialize was a logical step for me. After speaking with fellow interviewees during the application process, no one seemed to be particularly distraught about the cut in GME funding...basically, getting a spot was everyone's objective and if it required additional investment, so be it. I don't think the cut in GME will limit the number of individuals who specialize, although it may seem logical from the perspective of the individual who is looking forward to general practice. For those who cannot see themselves in that position and hope to get into a specialty program, the tuition won't be much of a factor in their decision. Keep in mind that GME funding for the great majority of programs was not long-standing...prior to its implementation, application rates, competitiveness of programs, and tuition rates were basically the same.