Value of residency vs private practice?

[Empathetic Dreamer]

I'm a 4th year dental student choosing between applying to a residency or working at my dad's practice. He’s got an office in a low income neighborhood and he sees a high volume of patients and there are other associates that work there, so I figured that there could be potential there to learn. At the same time, I honestly find it difficult to learn from him at times, which worries me a little bit, and I have doubts about settling back in my hometown. On the other hand, I haven’t started the process of applying to residences yet, and am not sure if it would be too late to start. Do you think it’s even worth doing one, if I end up working for a year in a private office (or is the quality in experience even comparable)? If I worked with my dad, I could see my self trying to move maybe after a year of getting experience, but I hear that doing residencies can be a good way to network and get a job as well. However, I figure it would not be worth applying to a residency after already spending a year out working, (or do you think otherwise and that there is foundational training experience unique to a residency that would be hard to get in a private office)? I am hoping that with appropriate CE that they might be comparable, but I don’t know if that’s just wishful thinking. Lastly, if I were to apply now, would it be too late? I actually haven't started the application process yet due to some personal life circumstances that I was dealing with earlier in the year, and don't know if it's even worth putting an application out there at this point in the first place. I appreciate anybody's thoughts on this matter.

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[carabelliscusp]

You're talking GPR/AEGD correct? Keep in mind the opportunity cost is ~100k lost

 

[odontoblaster90210]

I'm a 4th year dental student choosing between applying to a residency or working at my dad's practice. He’s got an office in a low income neighborhood and he sees a high volume of patients and there are other associates that work there, so I figured that there could be potential there to learn. At the same time, I honestly find it difficult to learn from him at times, which worries me a little bit, and I have doubts about settling back in my hometown. On the other hand, I haven’t started the process of applying to residences yet, and am not sure if it would be too late to start. Do you think it’s even worth doing one, if I end up working for a year in a private office (or is the quality in experience even comparable)? If I worked with my dad, I could see my self trying to move maybe after a year of getting experience, but I hear that doing residencies can be a good way to network and get a job as well. However, I figure it would not be worth applying to a residency after already spending a year out working, (or do you think otherwise and that there is foundational training experience unique to a residency that would be hard to get in a private office)? I am hoping that with appropriate CE that they might be comparable, but I don’t know if that’s just wishful thinking. Lastly, if I were to apply now, would it be too late? I actually haven't started the application process yet due to some personal life circumstances that I was dealing with earlier in the year, and don't know if it's even worth putting an application out there at this point in the first place. I appreciate anybody's thoughts on this matter.

Depends on the specific gpr/aegd. Some are very good experiences and some are barely better than dental school. Ask around to find which ones are worth attending. Typically the ones worth attending are more competitive to get into.

 

[todentornottodent]

Depends on the specific gpr/aegd. Some are very good experiences and some are barely better than dental school. Ask around to find which ones are worth attending. Typically the ones worth attending are more competitive to get into.

Any GPR/AEGD come to mind that most would consider worth it? i.e. worth giving up a year of private practice income.

 

[Boat on the Chesapeake]

Sounds like you don’t want to work with your dad or in your hometown. It’s ok to come to terms with that as an adult. Regardless, does your dad have a clinical skill set that you want to emulate? Whether that’s peds, surgery, implants, etc? Do you know what parts of dentistry you like and want to focus on? Developing your skills independently at a GPR or different private practice might be what you’re looking for.

A good GPR will give you a great foundation and earn back more than $100k over your career (better quality work, more specialty procedures, etc). Knowing whether a specific GPR is good or not might take some connections or going to their interview day though.

Doing a GPR *after* a year of private practice is probably less useful and just go heavy on CE at that point.

 

[yappy]

Any GPR/AEGD come to mind that most would consider worth it? i.e. worth giving up a year of private practice income.

San Antonio VA.

 

[todentornottodent]

San Antonio VA.

That’s the one that keeps coming up haha. Any besides that?

 

[schmoob]

Kings Country GPR

I personally didn’t do a GPR but that doesn’t mean my learning atopped. My first job was private, high volume, lots of good cases, and I had the mentorship there for when I needed help with a molar endo, tough ext, or the occasional hot tooth.

I also took lots of CE so I had lots more implant annd 3rd molar ext experience. A few years later I was much more clinically prepared than many of my peers who did a GPR, even those who have been practicing longer.

It all depends on the program, the job, and the money.

 

[Saddleshoes]

I'm a 4th year dental student choosing between applying to a residency or working at my dad's practice. He’s got an office in a low income neighborhood and he sees a high volume of patients and there are other associates that work there, so I figured that there could be potential there to learn. At the same time, I honestly find it difficult to learn from him at times, which worries me a little bit, and I have doubts about settling back in my hometown. On the other hand, I haven’t started the process of applying to residences yet, and am not sure if it would be too late to start. Do you think it’s even worth doing one, if I end up working for a year in a private office (or is the quality in experience even comparable)? If I worked with my dad, I could see my self trying to move maybe after a year of getting experience, but I hear that doing residencies can be a good way to network and get a job as well. However, I figure it would not be worth applying to a residency after already spending a year out working, (or do you think otherwise and that there is foundational training experience unique to a residency that would be hard to get in a private office)? I am hoping that with appropriate CE that they might be comparable, but I don’t know if that’s just wishful thinking. Lastly, if I were to apply now, would it be too late? I actually haven't started the application process yet due to some personal life circumstances that I was dealing with earlier in the year, and don't know if it's even worth putting an application out there at this point in the first place. I appreciate anybody's thoughts on this matter.

Lots to address here...

1) You are SO lucky to have a "professional safety net" in your dad's practice. If you know you can always go there you can be more adventurous with your first steps into the dental career world.

2) It is NOT too late to start the application process. I would encourage you to find some GPR's in locations as different from your home as you can stand. (I Think people need to broaden their horizons.)

3) The Idea of working SOMEPLACE, other than for Dad, for a year to learn the ropes is wise. Working in a GPR for a year is triple wise. Even a bad GPR will give you multiple good mentors and more CE than you can ever get in an associate.

4) Working for Dad may lead to a great life and career. However, until you experienced some of the dental world beyond your Dad's office you will never know which is the best choice.

5) DO NOT look down upon a practice that serves a low-income neighborhood!!!! Some of the most professionally and personally satisfying work comes working in places like that.

 

[schmoob]

Lots to address here...

1) You are SO lucky to have a "professional safety net" in your dad's practice. If you know you can always go there you can be more adventurous with your first steps into the dental career world.

2) It is NOT too late to start the application process. I would encourage you to find some GPR's in locations as different from your home as you can stand. (I Think people need to broaden their horizons.)

3) The Idea of working SOMEPLACE, other than for Dad, for a year to learn the ropes is wise. Working in a GPR of a year is triple wise. Even a bad GPR will give you multiple good mentors and more CE than you can ever get in an associate.

4) Working for Dad may lead to a great life and career. However, until you experience some of the dental world beyond your Dad's office you will never know which is the best choice.

5) DO NOT look down upon a practice that serves a low-income neighborhood!!!! Some of the most professionally and personally satisfying work comes working in places like that.

#5 is super important! I worked in a low income practice and I saw lots of patients and did all kinds of work. You would be surprised how many implants I did and how much cosmetic work I performed. And I did TONS AND TONS of extractions which I love. I also did lots of soft and hard tissue grafting. My skills skyrocketed with this place.
Their insurance may not have covered it but when they wanted the work bad enough they found a way to pay.

 

[Thehighwind87]

The lost opportunity cost is massive when you do the calculations. Here is some random number crunching:

Average first year salary 150k.
Cost of living: 2k +1k groceries= 36k
Student loans: 500k at 7% interest = 35k

Your extra year of schooling will set you back over 200k in lost opportunity cost. The question is, do you think the extra gpr/aegd is worth that? Only you can answer that question.

 

[Pablo Sanchez]

All I can speak of is my personal experience. I did not do a GPR and went straight out and worked. I learned a TON in my first year. I now do molar endo, place implants, do clear aligners, surgical extractions, etc. You don’t need a GPR to be able to do that. I have mentors. I’m making more than I ever thought I would. I’ve paid off my loans and know how private practice works. Some of my friends who just started working after their GPR are struggling with the pace of private practice.

The opportunity cost is massive. If you’re the type to be motivated to learn on your own I would highly recommend you avoid a GPR and start practicing. It’s not like your learning and development stop once you work. It’s called a dental practice for a reason. You get better every day, so you might as well get paid to do so.

 

[carabelliscusp]

All I can speak of is my personal experience. I did not do a GPR and went straight out and worked. I learned a TON in my first year. I now do molar endo, place implants, do clear aligners, surgical extractions, etc. You don’t need a GPR to be able to do that. I have mentors. I’m making more than I ever thought I would. I’ve paid off my loans and know how private practice works. Some of my friends who just started working after their GPR are struggling with the pace of private practice.

The opportunity cost is massive. If you’re the type to be motivated to learn on your own I would highly recommend you avoid a GPR and start practicing. It’s not like your learning and development stop once you work. It’s called a dental practice for a reason. You get better every day, so you might as well get paid to do so.

How much are you making? Also where (as specific as you're comfortable with saying)?

 

[Pablo Sanchez]

How much are you making? Also where (as specific as you're comfortable with saying)?

I have friends on here who know who I am and would love to know how much I’m making. All I feel comfortable with saying is a lot. Way more than the published $160k or whatever they say a dentist makes. I’m nothing special either. Just willing to work hard. The shame of it is that Uncle Sam takes way too much of it.

30 minutes outside of one of the top 10 largest metros in the US.

 

[schmoob]

I have friends on here who know who I am and would love to know how much I’m making. All I feel comfortable with saying is a lot. Way more than the published $160k or whatever they say a dentist makes. I’m nothing special either. Just willing to work hard. The shame of it is that Uncle Sam takes way too much of it.

30 minutes outside of one of the top 10 largest metros in the US.

Glad to hear you’re doing well!

I too am a good amount above $160K but taxes are killing me. It’s my own fault though, I claim 0 exemptions on purpose despite having a family of 4. I would rather they take some during the year than owing at tax time and getting a much larger return as a safety net or money for a vacation or something. I also pay about $1K a month for health benefits for me and my wife and kids.

Lol I get paid tomorrow and I was expecting a certain amount, but I’m getting a lot less haha.

 

[Life of Pablo]

I think if you can get into a good GPR where you'll be slamming implants, doing molar endo and surgical extractions, then it's worth it. There are a lot of bad GPRs/AEGDs out there so just be careful.

One thing that residency allows you to do is push the boundaries a little bit and try things you're not too comfortable with. In private practice, you're going to be a little bit more hesitant/nervous to do things that you wouldn't be as worried about if you were in a residency program.

 

[Thehighwind87]

I think if you can get into a good GPR where you'll be slamming implants, doing molar endo and surgical extractions, then it's worth it. There are a lot of bad GPRs/AEGDs out there so just be careful.

One thing that residency allows you to do is push the boundaries a little bit and try things you're not too comfortable with. In private practice, you're going to be a little bit more hesitant/nervous to do things that you wouldn't be as worried about if you were in a residency program.

Majority of gpr/aegd is extra hand holding for fixed prosthodontics/operative.

While slamming implants, doing molar ends, and surgical sounds nice on paper- the end goal for your first 1-3 years out should be focused on getting up to speed on basics like filling, impressions, managing patients etc- once that is completed then take some CE and expand your horizons into harder procedures. Going from dental school to "slamming implants, molar endo and surgical" is like saying, hey- life of pablo- you just finished 1 week of swimming lessons and now we are gonna drop you off in the middle of a ocean and you need to swim to shore,

 

[Life of Pablo]

the end goal for your first 1-3 years out should be focused on getting up to speed on basics like filling, impressions, managing patients etc- once that is completed then take some CE and expand your horizons into harder procedures.

I don't agree with this. There is absolutely nothing wrong with trying to learn these things ASAP. This mentality is why a lot of grads find it difficult to make enough to even pay back their loans. In fact, the most successful new grads that are killing it in private practice are the ones that pushed themselves to do more advanced procedures earlier on - they're not the ones that say "well....let perfect taking impressions before I try to do molar endo..."

 

[Thehighwind87]

I don't agree with this. There is absolutely nothing wrong with trying to learn these things ASAP. This mentality is why a lot of grads find it difficult to make enough to even pay back their loans. In fact, the most successful new grads that are killing it in private practice are the ones that pushed themselves to do more advanced procedures earlier on - they're not the ones that say "well....let perfect taking impressions before I try to do molar endo..."

While I do understand where you are coming from, what I will say is there are plenty of practitioners that buy a simple bread and butter practice that collects 1 mil on 60% overhead and take home 400k.

One doesn’t need to do any molar endo/omfs/implant to do well. I would know as I stopped doing endo/omfs/ortho. For some practices implant/endo placement just doesn’t make financial sense as liability becomes high and instead of making 410k you might make less like 390k or something. And or your practice in surburbia might not have the patient base or amount to make it worth it. I think in my practice I see maybe 1-2 referalls for ext every 2-3 weeks which means it’s not worth my time.

Regardless you do have a good point, but I would say it’s really not extremely necessary to become successful.

 

[yappy]

While I do understand where you are coming from, what I will say is there are plenty of practitioners that buy a simple bread and butter practice that collects 1 mil on 60% overhead and take home 400k.

One doesn’t need to do any molar endo/omfs/implant to do well. I would know as I stopped doing endo/omfs/ortho. For some practices implant/endo placement just doesn’t make financial sense as liability becomes high and instead of making 410k you might make less like 390k or something. And or your practice in surburbia might not have the patient base or amount to make it worth it. I think in my practice I see maybe 1-2 referalls for ext every 2-3 weeks which means it’s not worth my time.

Regardless you do have a good point, but I would say it’s really not extremely necessary to become successful.

Yeah, no need to underestimate important parts of our profession like restoring teeth. But stuff like impressions… better to delegate that to an assistant. I think assistants are way underutilized in dentistry, but for most it’s a casual job so you can only take what you can.

 

[prinaudo]

I'm a 4th year dental student choosing between applying to a residency or working at my dad's practice. He’s got an office in a low income neighborhood and he sees a high volume of patients and there are other associates that work there, so I figured that there could be potential there to learn. At the same time, I honestly find it difficult to learn from him at times, which worries me a little bit, and I have doubts about settling back in my hometown. On the other hand, I haven’t started the process of applying to residences yet, and am not sure if it would be too late to start. Do you think it’s even worth doing one, if I end up working for a year in a private office (or is the quality in experience even comparable)? If I worked with my dad, I could see my self trying to move maybe after a year of getting experience, but I hear that doing residencies can be a good way to network and get a job as well. However, I figure it would not be worth applying to a residency after already spending a year out working, (or do you think otherwise and that there is foundational training experience unique to a residency that would be hard to get in a private office)? I am hoping that with appropriate CE that they might be comparable, but I don’t know if that’s just wishful thinking. Lastly, if I were to apply now, would it be too late? I actually haven't started the application process yet due to some personal life circumstances that I was dealing with earlier in the year, and don't know if it's even worth putting an application out there at this point in the first place. I appreciate anybody's thoughts on this matter.

If you want more information regarding an opportunity for an AEGD at one of the NYU Langone site, please send me an email to [email protected]