Ivy leagues produce a lot of specialists because that is the culture in their school. D1/D2 students are very impressionable and mimic what they see D3/D4 students doing. If D1/D2 see a majority of their upperclassman applying to specialty programs, they will too.
Does Ivy League increase your chance at landing a specialty? Yes and no...
Yes, because with so many classmates applying to specialty school, you will have a greater probability at finding upperclassman mentors that will guide you through the game of specializing. (Yes, it is a game, and knowing how to play it helps tremendously). Not only that, upperclassman that MATCHed to a program you are applying to can speak in favor of you and really swing votes in your favor when it comes to ranking. With so many Ivy Leaguers in specialty school, the likely hood of finding an upperclassman you know at a residency is high.
Now the No. Ivy Leagues send a deluge of applicants into specialty. For Example, UPenn had over 40 applicants this year for Pediatrics, of a class size of 130. Almost 1/3 of the class applied to Peds. Residency Program Directors are going to limit the number of interview spots for students from certain schools, no matter how qualified they are. Our program, when seeing a large number of applicants from a certain school, limited the number we interviewed to 5. So lets say we had 30 UPenn applicants, we would only invite 5 for to interview.
Along with that, your application means everything in landing that initial interview. It needs to be refined, with a strong statement and strong letters of rec. Again, lets take UPenn as an example... The Pediatric chair had to write 40 Letters of Rec. Do you think he/she was able to put ample time into writing a strong letter of rec or in helping look over your application? At schools with large specialty applicants, you are just another applicant, making it hard to stand out or to receive ample attention from faculty. With that logic, it's nice going to a school where there are only a handful of applicants because there you can receive the one-on-one attention, as well as there is less competition for events that will help on your CV.
Now, how did these schools become so specialty heavy?
It is my belief, after hearing from many students from these schools, it stems from lack of sufficient clinical exposure. (And this is no fault of the students) Because these schools lack sufficient patients of the right caliber (i.e. Pts that are willing to pay for necessary dental work), students feel inadequate at being GP providers. (I have heard from too many of these ivy graduates of graduating having done only 1 or 2 crowns, and 2-3 canals, not teeth, for endo...not to mention they are not allowed to do molars or premolars, only anterior endo.....).
There are schools that do well over 30 crowns on average/graduate. Middle ground schools average 15 crowns/graduate.
So imagine being a D3, and having very minimal exposure to clinical dentistry. It's time to start thinking about post graduate plans. You don't really have any exposure performing (yourself) endo, ortho, peds, OS, perio, etc... and not much more exposure to life as a GP. You see upperclassman applying to specialties, and they share about how much they learned and how much they love it, and you equate that information as "success." So, you follow suite....the cycle repeats itself year after year, and wham! 80% of students are applying to specialty (There are alot of other factors, but not going to discuss them here)
Ivy League students (and this is a large generalization) in my discussions with them, are often times lost. They don't really know what they want to do, but they feel the pressure to specialize. You hear from them, a lot, "Oh I was thinking about doing OS.. Or I was also thinking doing Ortho.... but yeah, Im glad I chose Peds." They appear peer pressured into applying to specialty school, with no real life, hands on experiences as to WHY they are applying (i.e. I was doing a lot of ______, and I fell in love with it) They always have a shadow of doubt as to if they chose the right specialty..... (again, this is not just limited to Ivy Leagues)
My interaction with applicants from clinical heavy schools is the exact opposite. I see less of them applying to post graduate programs. It is my belief, that this is because they found the beauty of general dentistry, and feel some-what confident in working straight out of school. Schools that struggle clinically will have more PGY-1 applicants because students feel the need for more training before venturing out. Again, even those at the clinically strongest schools will need further education, but GPR/AEGDs are not always the best in providing beneficial training.
If I had to mentor a Pre-Dent, the advice I would give is the following:
1) Go to the strongest clinical school you get into. This will help you feel confident in your decision to specialize or to stay GP. There are also less specialty applicants, allowing you to take advantage of opportunities to grow-in and experience the specialty before applying.
2) Forget above if you get into a school that is cheaper and will save you >$80-100k
3) If deciding between expensive schools, go the strongest clinical one, regardless of name.
Kids are awake. Santa time. Merry Christmas!
