Hi, current D3 here who is interested in applying for a residency in orthodontics. I'm currently researching different programs and looking at making a list of programs to apply to this coming cycle but I was wondering how much debt is it worth going into for orthodontics? I'm seeing some programs that charge 80K+ per year (not including living expenses), so in a 3 year program that would be 300K+ debt, and that's not including the lost opportunity cost of practicing as a GP.
Assuming I have zero undergrad and dental school debt, at what point is it not worth the debt to become an orthodontist? My reasons for going into ortho are not mainly financial but more personal (my own experience with braces, being the best in a specific area of dentistry rather than a jack of all trades), lifestyle based and the longevity of the career (easier on the body). However, I don't want to make a terrible financial mistake that I'll regret for the rest of my life.
My dilemma is that should I only apply to "cheap" or stipend-paying residencies and if I don't match, plan on doing GP? Or should I go all out and try to match into ortho no matter what the cost?
My main concerns about the field from hearing all the doom and gloom are:
- What is the job market like? - Can I expect to find a full-time associate gig in a suburban-type area? Are corporate jobs readily available?
- What can one expect to make coming straight out of residency? What is an average associate salary or a corporate one? What can an owner ortho expect to make?
- What seems to be the future trend in the ortho market? - Are GPs doing most of the easy cases leaving only the difficult ones for orthodontists? Orthodontists working for pediatric dentists in a group practice? Everything going corporate?
I would really appreciate any insight from current orthodontists, dentists or others specialists!
Some people hate doing dentistry so much that they are willing to spend any amount of money to specialize in ortho. Having money doesn’t guarantee that you will get in. Ortho is still very competitive….even expensive programs like Georgia, NYU are very hard to get in. Many people have to apply for ortho more than once and some gave up after several failed attempts. 2-3 years of lost income is nothing. Since doing ortho is so much fun and easy, you never feel like you are working. You can easily work 10+ years longer than your general dentist friends and easily make up for the 2-3 years lost income. I’ve been stuck at home doing nothing for 3+ wks due to the coronavirus outbreak and I miss work already.
So if you don’t like practicing general dentistry for the next 20-30 years of your life, apply to as many programs (including the expensive ones) as possible.
1. Because an orthodontist can see high patient volume (60-80 patients) in a day, most places only hire you a few days a month. In order to get F/T 20-22 work days a month, you will have to travel to multiple offices. Corps usually offer you more work days because they have more offices to send you to work at. Some areas (ie NYC and the neighboring NJ areas) don’t have corp offices so you can only find jobs at GP/pedo offices or at private ortho offices. Some orthos have to drive/fly to work at the neighboring states that have corp offices. Traveling as an ortho is still better than doing GP works.
2. If you are not a picky person and are willing to work hard, you should have no problem finding F/T ortho jobs. If 1 corp doesn’t give you enough work days, find additional work days at different corp offices or at GP/pedo offices. Corp offices pay their associate ortho $1200-1500 a day. Some corps offer 401k and pay for malpractice insurance (but you should also buy your own malpractice insurance so you can work at different offices). Some GP/pedo offices want you start doing ortho for them and they pay you the % of the collection. So at the beginning, you may not make much at these GP/Pedo offices but if you stay there long enough and have good people skills to attract more patients, you will make a lot more than working for corp offices. The disadvantage of working at GP/pedo offices is you don’t have experienced ortho assistants to help you so you may have to many of the manual labors yourself.
You have to accept the fact that when you work for someone else you will have to deal with problems like the lack of experienced ortho assistants, the GP/Pedo bosses don’t provide you the ideal supplies/equipment that you want, working with the corp managers who only have a HS diploma, dealing with assistants who only listen to their GP boss, working on Saturdays etc. If you don’t think you can handle these downsides of working for someone else, then don’t specialize in ortho….you will be disappointed.
3. I can’t predict the future but I think it will be worse due to the openings of new ortho programs that pump out more new ortho grads every year. The same applies for general dentistry and pedo…more new schools/programs = higher new grad number = increase in competition. Right now, most orthodontists charge at least $5k a case and don’t accept low pay insurance plans….this means that most of them only target the top 20% income earners. For the future ortho grads to get more new patients, I think they may have to target the lower income population, accept more insurance plans and compete against the corp offices. Low overhead is key. I highly encourage you to work for corp offices to learn how they run their offices and how they keep their overhead low.
I don’t have the exact statistics but I’d say less than half of the GPs in my area do the traditional fixed braces in their offices. That’s because it’s not very profitable for them….they don’t have enough clinical experience and they don’t have ortho assistant to help them so they end up spending a lot of time to treat a case.
