Just curious...what are your school's clinical graduation requirements (# of crowns, class II amalgams, dentures, extraction, root canals etc.)? Which schools are competency based instead?
What are your school's clinical graduation requirements?
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When I graduated in 2012 Maryland required a minimum of 12 crowns, lots of restorative (no real way to calculate minimums), 18 extractions, 6 units of dentures, 3 RCTs (at least one of which was a multi). Most students well surpassed the minimums of restorative and OS. Dentures you could if you wanted to, but RCTs/crowns were relatively harder to come by.
Thank you for sharing. Anyone else?
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http://forums.studentdoctor.net/showthread.php?t=617482
Getting an input on the clinical requirements is harder than extracting impacted 3rd molars.
Getting an input on the clinical requirements is harder than extracting impacted 3rd molars.
I wonder why that is...
Ours is based on a point system where each procedure is worth a certain amount of points, however in the most simple form the amounts below are a good estimate. As most 3rd/4th years know, sometimes you are fortunate to get a lot in one category and just make the minimum in other categories. IMO, dental school is what you make of it so you can strive to destroy any minimums if you really want. We are given patients by our coordinators, then we are 100% responsible for bringing them in and getting everything done. The amount of patients trying to get admitted into our system is huge, so since I've been here you can dismiss a patient for missing appointments and you'll have a replacement soon after. Here's the minimum for 3rd/4th year to graduate.
Operative: 100 fillings
SU/FPD: 16-18 crowns/FPD retainers
CD/RPD: 8-10 units
Endo: 3 anterior, 3 molar
Perio: 5 perio pt's, 2 that must have 3-4 quads full SRP (the other 3 can be 2-4 quads limited SRP)
Peds: Hard to give exacts, but pretty much Class II fillings/SS Crowns/Space Maintainers/pulpotomies/EXT's
OMS: 75 EXT's
Ortho: N/A
Operative: 100 fillings
SU/FPD: 16-18 crowns/FPD retainers
CD/RPD: 8-10 units
Endo: 3 anterior, 3 molar
Perio: 5 perio pt's, 2 that must have 3-4 quads full SRP (the other 3 can be 2-4 quads limited SRP)
Peds: Hard to give exacts, but pretty much Class II fillings/SS Crowns/Space Maintainers/pulpotomies/EXT's
OMS: 75 EXT's
Ortho: N/A
Thanks for sharing! 75EXTs seem like a lot...
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Wow.... I don't see how this is possible in 2 years. Your school must use a completely different clinic/ pt care model than U of L.
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Ds is a taxing time. There is not much of interest left for those enrolled.
I don't see how that's possible for everyone to graduate unless over treatment is involved.
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From what I hear the 150 extractions are easy to come by, especially with all the removable that we do. For the fixed requirements I think they see how we do after 3rd yr and set individual goal/requirement/"essential experiences" for us to have in the 4th yr. I guess we don't do a ton of gigantic composit/amalgams with 20 pins. If the restoration is gonna be too large (more than 1/2 the intercuspal width) we just do a buildup/post if needed and crown. 3rd yr we do 10 crowns and then end 4th yr with 30-40 under our belt?
I guess it's the only way I know, and I'm not sure how other schools only get a few crowns. I imagine costs are the same (500 buildup crown)
I guess it's the only way I know, and I'm not sure how other schools only get a few crowns. I imagine costs are the same (500 buildup crown)
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It has nothing really to do with the cost of the treatment. It has everything to do with the location of the school in proximity to needy patients.
Baylor sees, at a minimum, twenty 'emergency extraction' patients daily. It is first come, first served, and patients line up as early as 1am to ensure a spot for the day.
I would say that BCD is middle of the road to conservative as far as treatment goes. We do turn away quite a few patients. I had a whole week of screening during the summer, and we turned away all 6 patients I screened. One case was too easy, and the other five were incredibly difficult cases.
SLM is correct in that we do have tons of extractions due to the sheer amount of removable we treat.
8 extractions with aveloplasty, Mx tuberosity reduction, and bilateral Mn tori removal - also known as one patient on a Friday afternoon.
One other way BCD is able to corral so many patients is our Patient Advocates. They keep our schedules full. They are constantly calling patients, reminding them of appts, finding other patients that can fill cancelled slots, etc. If we the students had to keep up with that, there is no way we could see as many patients as we do.
To recap, it is all about location and our Patient Advocates.
Baylor sees, at a minimum, twenty 'emergency extraction' patients daily. It is first come, first served, and patients line up as early as 1am to ensure a spot for the day.
I would say that BCD is middle of the road to conservative as far as treatment goes. We do turn away quite a few patients. I had a whole week of screening during the summer, and we turned away all 6 patients I screened. One case was too easy, and the other five were incredibly difficult cases.
SLM is correct in that we do have tons of extractions due to the sheer amount of removable we treat.
8 extractions with aveloplasty, Mx tuberosity reduction, and bilateral Mn tori removal - also known as one patient on a Friday afternoon.
One other way BCD is able to corral so many patients is our Patient Advocates. They keep our schedules full. They are constantly calling patients, reminding them of appts, finding other patients that can fill cancelled slots, etc. If we the students had to keep up with that, there is no way we could see as many patients as we do.
To recap, it is all about location and our Patient Advocates.
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When I was at UCLA more than a decade ago:
- 4 RPDs, which is the hardest clinical requirement to fulfill.
- Lots of dental fillings. A student must take and pass 5 class II amalgam filling competency exams.
- 5 endos. I only did 3 and they still let me graduate.
- Lots of scaling and root planning.
- No OS requirement. It can be as little as 20 extractions or as many as 200 depending on where the student picks his/her OS rotation. I only extracted 17 teeth.
- 13 crowns
- 2 bridges
- 2 perio surgeries. The student provides the patients but the perio residents (or perio instructors) perform the surgical procedures. The student just sits there and assists.
- The student must earn 2000 points to graduate. An occlusal Ag filling = 3 points. A gold crown = 12 points. Assisting your classmate = 3 points etc.
I prefer going to a dental school that doesnt have tough clinical requirements so I can graduate in 4 years. And UCLA is that school.
- 4 RPDs, which is the hardest clinical requirement to fulfill.
- Lots of dental fillings. A student must take and pass 5 class II amalgam filling competency exams.
- 5 endos. I only did 3 and they still let me graduate.
- Lots of scaling and root planning.
- No OS requirement. It can be as little as 20 extractions or as many as 200 depending on where the student picks his/her OS rotation. I only extracted 17 teeth.
- 13 crowns
- 2 bridges
- 2 perio surgeries. The student provides the patients but the perio residents (or perio instructors) perform the surgical procedures. The student just sits there and assists.
- The student must earn 2000 points to graduate. An occlusal Ag filling = 3 points. A gold crown = 12 points. Assisting your classmate = 3 points etc.
I prefer going to a dental school that doesnt have tough clinical requirements so I can graduate in 4 years. And UCLA is that school.
Are those emergency extractions free? Are Patient Advocates volunteers? Do your students get a say in scheduling/pt management?
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The emergency extractions are not free, though nearly. Each of the patients pay for a screening, pano, and the extraction.
The patient advocates are a paid position. There are six that are in charge of our class of 104.
Patients assigned to the student, stay with that student until the treatment plan agreed upon by the student, the faculty, AND the patient is complete (or the student graduates). The treatment plan is sequenced and for the most part followed to completion (barring any immediate type of treatment). The student puts in patient appointment requests, telling the patient advocates how long of an appt is needed, the clinic needed, and what procedure is planned that day. What is even easier is walking the patient after an appt straight to the patient advocate for scheduling.
Baylor requests that patients be able to come at least twice a month. They drop patients for missing three appointments or not giving 24 hours notice of canceling the appt. They turn away patients that only want single composites or crowns when they have many more pressing or additional treatments that need done. For example, I screened a patient that only want an esthetic crown on #8. Did not want to do anything about the decay on the molars, Class II mobility, and generalized perio. The school strives for 'comprehensive care', not a single filling and turn a bombed out mouth back out on the street.
I feel extremely lucky to have been accepted to BCD. I do feel that they are preparing me well.
The patient advocates are a paid position. There are six that are in charge of our class of 104.
Patients assigned to the student, stay with that student until the treatment plan agreed upon by the student, the faculty, AND the patient is complete (or the student graduates). The treatment plan is sequenced and for the most part followed to completion (barring any immediate type of treatment). The student puts in patient appointment requests, telling the patient advocates how long of an appt is needed, the clinic needed, and what procedure is planned that day. What is even easier is walking the patient after an appt straight to the patient advocate for scheduling.
Baylor requests that patients be able to come at least twice a month. They drop patients for missing three appointments or not giving 24 hours notice of canceling the appt. They turn away patients that only want single composites or crowns when they have many more pressing or additional treatments that need done. For example, I screened a patient that only want an esthetic crown on #8. Did not want to do anything about the decay on the molars, Class II mobility, and generalized perio. The school strives for 'comprehensive care', not a single filling and turn a bombed out mouth back out on the street.
I feel extremely lucky to have been accepted to BCD. I do feel that they are preparing me well.
25 rct, 10 must be molars
30 CD, 50 RPD
1000 ext
100 crowns (10 can be CADCAM)
50 bridges(10 " " ")
10 implants (must place and restore 5 cases, other 5 can be either placing or restoring)
40 quads srp
8 comprehensive ortho's
Miscellaneous: 5 apicos, 10 quads surgical perio, 3 retrievals of separated files, 5 implant supported fpd or cd, 2 BSSO's
30 CD, 50 RPD
1000 ext
100 crowns (10 can be CADCAM)
50 bridges(10 " " ")
10 implants (must place and restore 5 cases, other 5 can be either placing or restoring)
40 quads srp
8 comprehensive ortho's
Miscellaneous: 5 apicos, 10 quads surgical perio, 3 retrievals of separated files, 5 implant supported fpd or cd, 2 BSSO's
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Only THREE separated file removals? Must have a damn good endo program at your school.
They lowered the graduation requirements greatly since your time. Unlike you, I am of the belief that requirements should be a bit tougher to make sure the graduates are of decent quality. Frankly, many of my UCLA classmates I wouldn't give a nod for their clinical skills.
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When you got your first job, did you feel you were ready? Since you think UCLA has weak clinical requirements, do you feel your skills are not as good as the one who graduates from the dental school that has tougher clinical requirements?
A weak dental student will continue to be a weak dentist once he/she gets out even if he/she attends the school that has 3 times as many clinical requirements as UCLA. An extra year of GPR probably won't help this person much either. The UCLA's easy requirements also allowed the students to have time to travel for their interviews for specialty programs and to screen patients for the state board exam. No one wants to pay extra tuition for staying behind and has to miss the state board exam.
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How does Western compare to UCLA in its clinical requirements?
yeah, I felt like I was ready. however, I do NOT credit UCLA for this but rather the fact that I was a non-trad student who has been around and can handle stress. a lot about dentistry is the ability to handle pressure, talk to people, and management of resources. having said that, though, from a first-hand perspective its hard for me to envision NOT benefitting from more clinical experience during school. after all, you are paying the humongous $$$ to work under the bubble and supervision of the instructors there. I certainly would have been better off doing a few more bridges, had the luxury of restoring more implants, an done more molar endos. as it is, I had to learn these on my own in private practice. i can easily imagine someone who is less daring and prone to break under pressure falter under my conditions.
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I think the majority of your classmates felt ready like you when they graduated. I dont know about your class but mine had full of smart, highly motivated, and hard working individuals. There are, of course, always 1-2 students in every class who continue to struggle after graduation. UCLA, like other dental schools, simply teaches the students the basics and prepares them for the licensing exam. I think you agree with me that because of UCLA, you were able to earn your dental license and to get to where you are today. You learn dentistry not only from treating the actual patients but also from several didactic and pre-clinical classes.
If you have a chance to go to a cross town rival school, USC, you will see that you were very fortunate to be at UCLA. Not only do the USC students have hard times finding patients, they also fight for chairs to take the competency exams. And the instructors there are very strict at grading these exams.
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Yeah, but I have heard time and time again that USC grads are prepared like none else. Though I'm not sure that justifies their outrageous cost....
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In view of the economy, lowering the clinical requirements was the only alternative ds had.
I will never know how I will fare at another school unless I happen to chance upon myself in a parallel universe, but barring that knowledge I can say that I didn't like UCLA very much. Here where I work I am exposed mostly to grads from UT San Antonio and Baylor. From talking to them, they did a hell of a lot more than I did in dental school: 35 crowns, 20 root canals, tons of surgical extractions....things I wish I had been exposed to. We pay the schools not only for their didactic but also for the opportunity for hands-on training in a bubble, shielded from real world litigation risks. I have done a lot over is past year and I consider myself a very strong dentist now, but a lot of the hard cases I handled could have gone horribly wrong and my license at risk. Dental school certainly does not teach you every hing, but any experience you get is useful to grow you to become a good dentist.
As far as USC, I don't know too much about them, but I can't imagine them suffering as much as us in regards to patient pool. I wouldn't go there simply because of their ridiculous price tag.
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It is completely understandable why most don't like their own dental school. The instructors are picky, perio dept doesn't clear your patients for restorative work, the people who work at the sterilization station disrespect you, you are forced to give up your endo case to grad endo….the list goes on and on.
In my opinion, doing 6-7 crowns under someone's supervision should be enough. Doing 30-35 crowns at a dental school and having to go to different instructors to beg for the approval signatures….no thank you.
I honestly doubt 6-7 units as being enough, but to each his own I guess. And as for your earlier claim about most in my class feeling ready, I think that is far removed from reality in my class. Most were visibly insecure and even said so outright. My opinion is that they are being brainwashed by the faculty to thinking that to be 'ready' they must do a residency of some kind, and being in that glutted market certainly doesn't help either when every 'new grad' job wanted experience of some kind. I never doubted that I was ready; being older helped and not buying into the academic koolaid helped too.
I don't think highly of UCLA for many reasons, it's not a blind dislike. Clinically, it's weak. Price-wise, it raised tuition every year I was there and can no longer be considered cheap. Board scores wise. . . . Well that doesn't matter anymore does it? About the only thing going for it is the possibility of research, but one can do any crappy research project anywhere and still put it on the resume. And most of my classmates were annoying. . . . but then that's probably going to be the case no matter what given the nature of dental students.
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So in your opinion, how many crowns the instructors need to "baby sit" the student before that student can be ready on his own? Sometimes, a rookie dentist needs to take risks in order to improve his/her skills. The risk of losing the license, the risk of losing money (from having to redo), the risk of losing the reputation, and the risk of losing his/her associate job are things that help the dentist to perform with the best of his/her abilities.
A good dentist should be able to apply what he/she learns in both the classroom and clinical settings. Theories, rules, concepts, diagnosis and tx planning are just as important having good hand skills. My wife never restored an implant during her DDS and perio trainings. And now, she is teaching her referring GPs how to restore the implants that she places…from taking the impression to crown delivery. She learned from reading books/journals, the weekly perio/proth conferences, and observing the prosth residents.
These, again, are the similar problems that most students are facing, not just at UCLA. I don't know of any dental school that keeps the same tuition for the entire 4 years. UCLA and UCSF are raising their tuitions every year but they are still the 2 cheapest schools and the best option for CA residents. I always tell my patients (since many of them want to be an orthodontist) to go to the cheapest school even if that school is perceived by many as a weak clinical school.
I am of the opinion that one should do as many of everything as possible before leaving school. That's part of the package we pay these schools. As far as taking risks, it is part of the game but I think it is hard to argue against being safer with more experience. Someone who's done 20 molar endos will probably have an easier time starting them in private practice than someone who's done one or two. Same goes across all categories. I don't think schools should simply be a diploma printing machine. You sound like you advocate a dental school to merely graduate their students without regard for their clinical quality. I obviously disagree with this, but to each his own. Most of my classmates were woefully insecure about their own skills and prospects and wished they had done more relevant dentistry instead of the hated RPDs, which I consider to be borderline obsolete.
USC is watered down now. Very easy to graduate on time. I imagine that they put pressure on the administration to change things. I don't like USC, but I also don't think I would like UCLA. If I wanted to learn how to be a physician, I would have gone to medical school. To me, all of the dental school in California appear to be run very badly, and are expensive.
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Ha 35 crowns at Baylor...yes, 20 endo...no. We just need 4 to graduate and they don't have to be molar. They don't really let us do many molars or retreats unless you show some potential and beg for the molar. Most go to grad endo.
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If you read all of my above posts, I am sure you know that thats not what I am advocating. I believe that all dental students have the self-taught abilities in them. Dental students today are a lot smarter than us, older dentists. Getting accepted to dental school isnt as easy as it was 10-15 years ago. In my opinion, a person can improve his skills faster if he is on his own. When there are no helps (ie the clinical instructors), he is forced to look things up himself such as reading about certain drug interaction, or asking the pharmacist about the drug dosage, or reading the instruction on how to retreat the molar endo etc. A child will never learn how to ride a bike if his parents never remove the training wheels.
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at what point does a budding pre-doc 'know what they don't know'? while i agree that the potential bureaucracy of clinical dental training will probably be enough to make students want to go postal, i somehow believe that simply doing fewer than ten units of a given procedure won't be enough to prepare one for autonomy once school ends.
maybe i'll be approaching my education differently. i see myself being the guy hanging around the clinic to scoop up walk-ins in the event one of my patients cancel or no-show. granted, after a half dozen class II's i might be able to do the procedure in my sleep, but that won't stop me from trying to do as many as i can just for the possibility of being exposed to their associated complications and the opportunity to get myself out of them. very recently an omfs described residency very similarly: it wasn't to learn how to do a few consults, a couple sedations, and a handful of extractions for $28k before 2PM, but to manage whatever complications may come your way during the execution of those procedures.
personally, i'd rather front-load my experience in troubleshooting dentistry while i'm under the protective umbrella of a clinical instructor a few feet away.
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I hear what you are saying. However, I still think that the sooner you get out of that protective umbrella of the clinical instructors, the faster you will learn. Youll learn a lot from your own mistakes (hopefully, you wont make a lot). If you under-reduce when doing a crown prep in school, the instructor will make you reduce more tooth structure and everything is ok. But if this happens in the private practice, youll lose time and money because you have to call the patient back to re-prep and redo the impression. And thats how you learn from losing time and money.
In the real world, there are specialists (OS, perio, endo, ortho) who will help bailing you out. I am sure the specialists dont like it but they have to do it because they need your referrals. I dont know about the other specialists. But for me, when a GP asks me to bail him out, I feel it is an honor because he trusts me enough to let me fix his mistake. And I get paid for fixing the case. Of course, neither you nor the specialist wants this to happen.
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Dental school is only meant as a preliminary vehicle to get you to competency. There is no way that only 2-3 years of clinical practice can get you where you want or need to be come graduation. Learning by lost time and money is what private practice is for.
Charles, what I am getting at is that it would be benficial for someone to do as much as possible while he is IN school. Dental school provides you with a starting point, but it still has to be a starting point. While it certainly is important to venture on one's own (and I certainly do that for myself), the more you get trained prior to doing so certainly gives you a 'headstart,' if you will. Someone who's done a lot in dental school will very likely have an advantage in clinical skills vs someone who's done a lot less. From talking to many of my classmates, it is almost universally agreed among us that the UCLA clinical curriculum is sorely lacking in many aspects of real-world dentistry and instead carry many anachronistic vestiges like RPDs. The latter was a huge waste of time.
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My impression of UCLA has always been that it's the place to go if you want to specialize. I've heard that some of the best schools clinically are UNLV, USC, Texas schools, Minnesota, and Tufts.
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Tweedy and Shunwei,
Do you feel that attending UCLA gave students there a markedly better chance to be successful in the LA are?
Do you feel that attending UCLA gave students there a markedly better chance to be successful in the LA are?
That may be the case, but you will probably get into battles with defenders of each school and get into semantics about what is a 'specialization' school and what is a 'clinical school.' My problem with UCLA is not only that its clinical curriculum is weak (you can search for another one of my previous posts for details on this), but that it is also dominated by misdirection, like obsessions with gold work and removables. Personally, I think a lot of the matter here is very subjective. If you just want a DDS and move on, some would be happy with just doing one crown and one filling. I am of the type who'd like to maximize my experience in the school, since I am paying megabucks for it, but that's just me.
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I completely agree. Practice makes perfect, and you might as well get as much practice under supervision as long as you are paying for it. I remember hearing that students were coming out of UNLV having done something like 30 RCTs. That's pretty sweet, and they were very well prepared for practice.
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Check out the COA for UCLA, UCSF and Western dent:
http://www.dentistry.ucla.edu/admissions/dds-degree/ppid/projected-cost-of-education
http://finaid.ucsf.edu/newly-admitted-students/cost-attendance
http://www.westernu.edu/financial-budgets-dentistry
I would say UCLA and UCSF are right on par with Western University (a private school) because the cost of living in Pomona is low. Wow. So CA public dent schools are now ~to private schools in price. That's crazy. Thanks, fiscally irresponsible California legislators.
http://www.dentistry.ucla.edu/admissions/dds-degree/ppid/projected-cost-of-education
http://finaid.ucsf.edu/newly-admitted-students/cost-attendance
http://www.westernu.edu/financial-budgets-dentistry
I would say UCLA and UCSF are right on par with Western University (a private school) because the cost of living in Pomona is low. Wow. So CA public dent schools are now ~to private schools in price. That's crazy. Thanks, fiscally irresponsible California legislators.
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