Specializing in Dental School

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daein13threat

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Hi all. I am currently a 3rd year dental student about to start my 4th year this summer. I wanted to ask for advice about specializing from those of you who are in dental school, are already practicing, or are currently training for specific specialties in an attempt to hear some different opinions. I am generally unsure of which direction to take, so I will discuss my statistics and the pros and cons of specializing/not specializing below. Please feel free to weigh in and correct me if any of my assumptions are wrong. Thanks in advance.

Pros of Specializing:
-I like the idea of being an “expert” in one field, thus meaning higher demand and prestige
-Depending on the specialty, an increased chance for higher income
-The ability to do one/limited types of procedures (more predictable) that only a small number of individuals can do
-Less competition depending on the location
-I don’t mind a few extra years of school and more tuition

Cons of Specializing (Becoming a General Dentist):
-Receiving referrals for difficult cases that some general dentist may not want/feel comfortable treating
-Only getting to do a limited type of procedures (I like the idea of no two days being exactly alike and getting to do a large variety of procedures in general dentistry)
-I love the procedures I have been able to perform during my 3rd year. A lot of my classmates who are certain about specializing have said that they don’t like what we are doing this year (fillings, crowns, dentures, etc.)
-May be busier/more fast paced than some specialties and thus more physically demanding


About me:
-I am number 18/71 with regards to class rank as of the start of my 3rd year, which may have changed throughout the year.
-I have always tried to keep my grades up as much as possible in the hopes of having the option to specialize should I want to do so, but never gave it much more thought
-I am not involved in any research and have never had much of a desire to become involved, despite it helping my application
-With regards to extracurricular activities, I am in a dental school band with other faculty and students
-My personality is not an aggressive/risk-taking one. I would rather predictability and am more than willing to accept when I do not feel comfortable with a certain treatment (a lot during 3rd year!)
-I want to see my patients enough to know them on a personal level and be able to treat a variety of ages and populations presenting with different dental issues
-My main concern that I will use to end this post is that I have not found one specialty that really stands out to me. They all seem either somewhat boring and less involved procedurally (ortho) or super tedious and high intensity (endo and perio). I would like a middle ground between these two quite honestly. I know that I should be in the process of sending out applications and applying during 3rd year summer for the following year, but I don’t want to apply to a specialty I am not certain about just for the sake of becoming a specialist. However, I also don’t want to miss out on my opportunities that I currently have. For example, one person in my class wants to be an endodontist. Because if this, he is always in their department getting to know the residents and faculty. I don’t want to miss out on this opportunity simply because I am not sure.

Thank you in advance!

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I am a general dentist approximately three years out. IMO If you enjoy being a clinician, and have the interest in a specialty, I think it is best to specialize. I don’t know any specialists who regret it.

edit: don’t worry about not being good or confident yet; that will all come with experience. Just focus on what you’re most interested in and go for it. That’s okay if it’s gp too - we need good gps.
 
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Either do a GPR/AEGD, or go work for a year. No reason to have to decide in school, and some specialties (e.g. endo) strongly prefer applicants with practice experience anyway. You don't know what you don't know while you're a student. It takes working a full dental schedule for a bit to realize what you like and dislike about dentistry. Take your time.
 
dentistry)
-I love the procedures I have been able to perform during my 3rd year. A lot of my classmates who are certain about specializing have said that they don’t like what we are doing this year (fillings, crowns, dentures, etc.)
This right here tells me you should be doing a GPR/AEGD year. If it doesn’t change, I think general is the way to go. People who specialize want to only be doing certain aspects of dentistry. If you like multiple, you’d be a fool to corner yourself.
 
Only getting to do a limited type of procedures (I like the idea of no two days being exactly alike and getting to do a large variety of procedures in general dentistry)
This might also be one of the cons of being a general dentist. It’s hard to be good at a large variety of procedures. It can only be an enjoyable job if you are good and fast and know what you are doing. It can be very frustrating to do a crown prep and take the PVS impression on #31 on a patient with a large tongue and fat cheek tissue. It can be very frustrating to perform a molar RCT at a corp office that gives a limited number of endo files and only one hour to perform. It can be a huge challenge to construct a set of dentures on a patient with collapsed VDO. These are the reasons why some practicing dentists quit their jobs and went back to school to specialize.

I am a specialist. I love my job because it’s easy. It’s easy because I have done the same procedures every day (and have become very good at them) for the last 20 years. Easy job = good work-life balance.
 
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Cons of Specializing (Becoming a General Dentist):
-Only getting to do a limited type of procedures (I like the idea of no two days being exactly alike and getting to do a large variety of procedures in general dentistry)
-May be busier/more fast paced than some specialties and thus more physically demanding

- Are you sure that you wanna do a large variety of procedures? Real world is much faster and tougher than school. The vast majority would probably wanna focus on only couple of procedures by specializing.
- Highly doubt that specialist jobs are more physically demanding than general dentist except oral surgery

 
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This right here tells me you should be doing a GPR/AEGD year. If it doesn’t change, I think general is the way to go. People who specialize want to only be doing certain aspects of dentistry. If you like multiple, you’d be a fool to corner yourself.
Not sure I’d entirely agree with this. I know plenty of residents in different specialties who actually liked pretty much all aspects of General dentistry. For myself, doing OMFS opened up the ability to do a lot of really cool things, but I certainly miss doing fillings/crowns/dentures/RCTs.

Specialty practice is very different from General dentistry in ways that extend beyond procedural variety. Each specialty is also pretty unique. Suffice it to say, an OMFS day is completely different than an Endodontist’s day, which is completely different than a Pediatric Dentist’s day.

Your definition of “difficult case” changes a lot too. Cases that are difficult for a GP often become mindless, routine procedures for a specialist who does that exact thing all the time. That said, no one is immune from getting in over their head every once in a while.
 
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There is not necessarily a rush to decide on specializing ... In fact, it's often discussed on here that endodontics depts. prefer that their residents have done AEGD/GPR or have been in practice for a couple of years, because they've had the opportunity to actually do some endo. It doesn't hurt to have an income and have saved up some money to live on before doing a residency (i.e. more loans/more school.)

If you feel like you just didn't learn "enough" and are still interested in increasing your general dentistry skill set - a GPR or AEGD sound like good options, Plenty of current specialty residents did GPR/AEGD before going to OMS/Endo/Perio etc. GPRs/AEGDs give you continued exposure to different specialty procedures and providers.

Regarding "difficult cases" - that's why you train for 2-4 extra years in a particular specialty. GPs see a broad variety. Specialists see a variety in terms of complexity. There's always going to be "simple" cases (to a specialist) referred by GPs who hate particular procedures. Some of the "complex" cases are precisely what keep things interesting.

As was mentioned before, Peds retains a ton of variety and gets extensive exposure to OR/Sedation. You don't really do dentures very often though.
Prosthodontics has tons of variety - arguably more than general dentistry. Think elective endo + crown lengthening, then post-and-core prior to a crown prep. All sorts of restoring implants, obviously, since that's kind of their thing. Some pros programs even teach you how to place implants. Fun stuff! And, it's definitely a specialty where getting to know your patient can be really beneficial.
 
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