What to do after graduating?

[russ7272]

I’m currently a D2 and want to start looking at what I should do when I graduate.I will be about 240k in debt, and i am open to working for an organization that helps pay them off.

• From anyone with experience, how did you like working in a DSO, and what are some of the better companies to watch for? (Or the ones to avoid)
• Is fresh out of school too early for an associateship? Will i just be completely overwhelmed?
• Any organizations or federal programs you guys find that were good + helped Repay loans?

Any advice is greatly appreciated

---

Members don't see this ad.

 

[Let me out!]

Hm. D2 might be still too early to decide.
Residency vs. Off to work.

I didn't do residency and I am working in a DSO after graduation. I'm sure you'll learn during residency, but I decided to work right out of school. I can do CE as needed.

It depends on your skill set too, but about 3 to 6 months working in a busy clinic, you'll get used to it. You will be overwhelmed at first especially if you are from a school that sees less pt.

If I had 240k debt, and with how much I'm earning now, I can probably pay it off in a year and a half, with considering for living expenses as well.

Every DSO is different and every clinic within the DSO is different. Everyone will have different opinions. I am in one that has a really terrible reputation for mistreating dentists, but my clinic and the staff are amazing. My pay is well beyond average. Absolute joy to work here.

If you only have 240k loan, just pay it off ASAP. Even at an average pay of about 180k, you can easily pay that off in the default 10 year program.

 

[Saddleshoes]

When I was a D2 I had the same questions! (In those days I had fewer options.) A few points come to mind to share here...

1) Your first year out is your most dense learning year no matter where you go.
-----Embrace your rookie status and learn wherever you go!
2) Sadly, these days one's student debt drives all your post school decisions. You are lucky to ONLY have 240K! As a result you have more flexibility than many of your peers. Please don't feel pushed to make big bucks your first year out.
-----The loan repayment game is a marathon not a sprint.
3) These days most new graduates WILL be working for a DSO as a first job. That is just the fact of the matter. Do some research and figure out which one is best for you and your needs. Remember you are just another EMPLOYEE at a DSO not and a VIP.
-----So show up ready to humbly, work hard.
4) If knocking down the student loan is your first post-school priority, find a good DSO and hustle.
-----You will learn on the job and make bank!
5) If learning your craft is your first post-school priority find a good GPR.
-----A year at a good GPR is worth 4 years of OJT but you make 1/2 the $$$$!
6) Your first job out is NOT going to be where you spend the rest of your life. You WILL move on from it. SO I would suggest getting your "first job out" at a location as different as possible from where you have grown up. For example if you grew up on the coast go to fly-over country. If you grew up in the city go to farm country. If you grew up in the mountains go to the plains. If you grew up in the South go to the North.
-----Take some time to learn how others live and expand your horizons. (Maybe have some fun too!)

 

[Pablo Sanchez]

I graduated in May of 2022. Didn’t do a GPR. Didn’t work at a DSO. I work at two private offices. I paid off my $200k of loans in just over a year. I’m doing more procedures more efficiently than most if not all of my classmates who did a GPR. Experience is key. You need to get reps doing procedures. You have to ask yourself if you need to be in a structured environment to learn (GPR/AEGD) or if you’ll be able to do it on your own, with mentors in the field, and with CE. You’ll learn a lot in your first year working regardless of where it is. Focus on learning and the money will come. I’m personally glad I didn’t do a GPR.

But you absolutely don’t need to commit yourself to 10 years in a rural area or serving in the military to pay off your debt. Get a good associate job and you should be able to pay those loans off fast!

 

[BluntForceTrauma]

I’m doing more procedures more efficiently than most if not all of my classmates who did a GPR.

How do you know this? I mean, do you work with a bunch of your classmates or have y’all been shadowing each other since graduation?

I don’t doubt you could be skilled, and learn quite a bit in the ~18 months since you’ve joined the work force, but the above does seem to be quite the intense generalization.

 

[Pablo Sanchez]

How do you know this? I mean, do you work with a bunch of your classmates or have y’all been shadowing each other since graduation?

I don’t doubt you could be skilled, and learn quite a bit in the ~18 months since you’ve joined the work force, but the above does seem to be quite the intense generalization.

I only say this because I’m doing most procedures. I place implants. I do molar endo. I do Invisalign. I restore all on x cases. None of my friends that I’ve personally talked to who did GPRs are doing all of these regularly. Not saying there aren’t great GPR programs out there. Just stating my (biased) experience. There are many dentists who have been in practice for 20 years who aren’t doing this.

 

[dentalinthemental]

I only say this because I’m doing most procedures. I place implants. I do molar endo. I do Invisalign. I restore all on x cases. None of my friends that I’ve personally talked to who did GPRs are doing all of these regularly. Not saying there aren’t great GPR programs out there. Just stating my (biased) experience. There are many dentists who have been in practice for 20 years who aren’t doing this.

You don’t have to do all of those procedures to be successful or even “more skilled” as a general dentist. Being skilled doesn’t mean you do all 30 procedures GP’s can do. In fact, many of the most efficient & financially successful dentists just do bread & butter, or hone in on one specialty procedure, & do it well. I don’t know about you, but I’d rather go to GP that’s done 100’s of Invisalign cases & focuses in on that niche over someone who sprinkles a couple in, between molar endo, all on x restoration, & 20 other GP procedures. It’s the quality of procedures performed that matters. Unless you’re prep checking all of your GPR colleagues work & evaluating their success rates post-operatively, you really can’t make that comparison.

 

[Pablo Sanchez]

You don’t have to do all of those procedures to be successful or even “more skilled” as a general dentist. Being skilled doesn’t mean you do all 30 procedures GP’s can do. In fact, many of the most efficient & financially successful dentists just do bread & butter, or hone in on one specialty procedure, & do it well. I don’t know about you, but I’d rather go to GP that’s done 100’s of Invisalign cases & focuses in on that niche over someone who sprinkles a couple in, between molar endo, all on x restoration, & 20 other GP procedures. It’s the quality of procedures performed that matters. Unless you’re prep checking all of your GPR colleagues work & evaluating their success rates post-operatively, you really can’t make that comparison.

You’re totally right! You can be a very successful GP in so many different angles. There’s no one best way to run a dental practice! You could argue that if a dentist is able to have systems down and focus on just simple restorative and do so in a way that’s super productive and efficient, they are a successful dentist. Success comes in a lot of different colors.

I find my patient population where I am prefers to go to one provider rather than being passed around to different specialty offices. We do great quality work in an efficient manner.

If you read my entire initial post, you’ll see that I was encouraging the OP to look internally to find out if they’re more the type who would prefer a more structured environment, like a GPR, to get reps and experience in, or if they’re the type to be able to do that out on their own. There’s nothing wrong with GPRs. But for me, personally, I’m glad I didn’t do one because I was able to make a lot more money than my GPR classmates made that year, pay off the entirety of my student debt, and get great experience. You can be a very successful general dentist without a GPR.

 

[throwawayacc2]

To tack onto this- how do we know whichever is best for us? Residency or associateship? I've heard that those who don't go to residency are "basically un-hirable", but obviously some of you have been able to get jobs. Does it really come down to the amount of procedures one does at their school; as its to my knowledge that different schools offer different amounts of procedures within their education, thus different experience levels.

 

[Pablo Sanchez]

To tack onto this- how do we know whichever is best for us? Residency or associateship? I've heard that those who don't go to residency are "basically un-hirable", but obviously some of you have been able to get jobs. Does it really come down to the amount of procedures one does at their school; as its to my knowledge that different schools offer different amounts of procedures within their education, thus different experience levels.

Everyone who graduated from my class without a residency was able to find a job. That’s not difficult. The amount of procedures you do in school isn’t really relevant either.

It’s are you comfortable learning from experience on the job. You’ll do more procedures in a couple days of practice than in school. But are you comfortable with failing on the job. That’s how you’ll learn. You’ll try a molar endo and perf. Then you’ll never make that mistake again. If you aren’t comfortable with that, then do a residency. But it is called a dental practice for a reason. The more practice you get, the better you’ll become.

 

[Let me out!]

To tack onto this- how do we know whichever is best for us? Residency or associateship? I've heard that those who don't go to residency are "basically un-hirable", but obviously some of you have been able to get jobs. Does it really come down to the amount of procedures one does at their school; as its to my knowledge that different schools offer different amounts of procedures within their education, thus different experience levels.

Who said that?

Graduating from NYU, I've known hundreds of grads and with the exception of not working by choice (some rich bastards) I have never seen a grad who couldn't get a job right out of school.

It's not the matter of being hired or not. Some students do a poor job as a student and slack off with procedures and seeing patients. Oh they will get hired somewhere. It's a matter of how much you can produce.

And yes, some schools will train students better and more mainly with access to so many patients like NYU, but as many have said, once you start working and giving 6 months or so, you're all fine. You'll do more work with patients outside in a month than you did the whole 4 years in dental school. (At least it was for me anyway...)

I would say, if you want to learn some cool advanced treatments, don't want the full responsibility right off the bat, and you are still on the younger side, sure, go ahead and do some residency. Take another year for learning process.

If you aren't really sure about doing advanced procedures (which you can learn with CE btw), you did an OK job in clinics in dental school and seen quite a number of patients, and/or on the older side, working right off is fine.

 

[SnozzBerry]

Everyone who graduated from my class without a residency was able to find a job. That’s not difficult. The amount of procedures you do in school isn’t really relevant either.

It’s are you comfortable learning from experience on the job. You’ll do more procedures in a couple days of practice than in school. But are you comfortable with failing on the job. That’s how you’ll learn. You’ll try a molar endo and perf. Then you’ll never make that mistake again. If you aren’t comfortable with that, then do a residency. But it is called a dental practice for a reason. The more practice you get, the better you’ll become.

lol this dude is legit saying the patients he’s working on are guinea pigs…you sound like a kid in my class (I’m 7 years out). He jumped into everything including implants, apicos, hard molar endo, etc. Talked a big game, opened up his own practice. The guy makes a lot of money, or so he says. However for awhile he also worked at an office my buddy worked at too (corporate office). His work was well below a specialist’s standard, how could it not be? He was doing a plethora of specialty cases within a year of graduating..unsupervised. There’s a reason specialists train in one area for years. You don’t know what you don’t know. Lots of cowboys in dentistry.

 

[Pablo Sanchez]

lol this dude is legit saying the patients he’s working on are guinea pigs…you sound like a kid in my class (I’m 7 years out). He jumped into everything including implants, apicos, hard molar endo, etc. Talked a big game, opened up his own practice. The guy makes a lot of money, or so he says. However for awhile he also worked at an office my buddy worked at too (corporate office). His work was well below a specialist’s standard, how could it not be? He was doing a plethora of specialty cases within a year of graduating..unsupervised. There’s a reason specialists train in one area for years. You don’t know what you don’t know. Lots of cowboys in dentistry.

Never said anybody was a guinea pig. Patients are patients and all deserve the best care. But it’s an undeniable fact that the more experience you have, the better you get. When you graduate, whether it’s dental school or residency, you have limited experience and no experience practicing in the real world. You get better as a clinician as you get that experience. Luckily I don’t work unsupervised and have some great mentors who have helped me develop my skill set to be able to provide excellent care to my patients.

You have to know when to send the case the the specialist and when not to. Again, something you learn with experience. If you think you graduate from dental school as a perfect dentist, you’re wrong. You develop the skill with time and practice.

 

[dentalinthemental]

Never said anybody was a guinea pig. Patients are patients and all deserve the best care. But it’s an undeniable fact that the more experience you have, the better you get. When you graduate, whether it’s dental school or residency, you have limited experience and no experience practicing in the real world. You get better as a clinician as you get that experience. Luckily I don’t work unsupervised and have some great mentors who have helped me develop my skill set to be able to provide excellent care to my patients.

You have to know when to send the case the the specialist and when not to. Again, something you learn with experience. If you think you graduate from dental school as a perfect dentist, you’re wrong. You develop the skill with time and practice.

If all patients deserve the best care, then the best care would undeniably involve not performing procedures you are not confident you can perform predictably.
Idk about you, but if my mom or dad needed molar endo, I wouldn’t feel comfortable “perfing and learning on the job,” less than 1 year out of school because that wouldn’t be the best care available to them.
To OP, you won’t be able to perform quality, predictable dentistry in every discipline of dentistry 1 year out of school, and no one expects you to.

 

[Pablo Sanchez]

If all patients deserve the best care, then the best care would undeniably involve not performing procedures you are not confident you can perform predictably.
Idk about you, but if my mom or dad needed molar endo, I wouldn’t feel comfortable “perfing and learning on the job,” less than 1 year out of school because that wouldn’t be the best care available to them.
To OP, you won’t be able to perform quality, predictable dentistry in every discipline of dentistry 1 year out of school, and no one expects you to.

I do perform predictable treatment. We all have to start somewhere. Nobody graduates from dental school or residency a fantastic dentist. If you think you did, you’re a fool. The difference between us is I’m humble enough to admit that I’m not perfect, and I have made mistakes. What’s important is that you learn and grow. Had I never attempted my first molar endo, I’d never do one in my life. I do successful endo every single day, all thanks to my willingness to attempt my first one, admit I’m not perfect, learn from my mistakes, and GROW. One must have a growth mindset to be successful. If you refuse to try anything new out of fear, you’ll never be great. Take good CE. Find a good mentor. GROW.

Looking at your posts you haven’t even practiced a single day in a private practice. Cases don’t always go according to plan. You’ll learn that soon enough, and I hope that you grow every single day as a provider as I continually do.

 

[dentalinthemental]

I do perform predictable treatment. We all have to start somewhere. Nobody graduates from dental school or residency a fantastic dentist. If you think you did, you’re a fool. The difference between us is I’m humble enough to admit that I’m not perfect, and I have made mistakes. What’s important is that you learn and grow. Had I never attempted my first molar endo, I’d never do one in my life. I do successful endo every single day, all thanks to my willingness to attempt my first one, admit I’m not perfect, learn from my mistakes, and GROW. One must have a growth mindset to be successful. If you refuse to try anything new out of fear, you’ll never be great. Take good CE. Find a good mentor. GROW.

Looking at your posts you haven’t even practiced a single day in a private practice. Cases don’t always go according to plan. You’ll learn that soon enough, and I hope that you grow every single day as a provider as I continually do.

You’ve edited this like 4 times. Lol
I stand by everything I said- perfing and using patients as guinea pigs is not the way to grow. CE or residency and gradually trying harder cases so you can predictably provide results for paying patients who are trusting you with their care, yes. You can’t even evaluate if your molar endo, implants, all on x restoration, invisalign and whatever else have been successful and ‘predictable’ because odds are you did your first one 6 months ago.

 

[SnozzBerry]

Everyone who graduated from my class without a residency was able to find a job. That’s not difficult. The amount of procedures you do in school isn’t really relevant either.

It’s are you comfortable learning from experience on the job. You’ll do more procedures in a couple days of practice than in school. But are you comfortable with failing on the job. That’s how you’ll learn. You’ll try a molar endo and perf. Then you’ll never make that mistake again. If you aren’t comfortable with that, then do a residency. But it is called a dental practice for a reason. The more practice you get, the better you’ll become.

No I am not comfortable failing on the job, I hope I never get there. Best of luck to your poor patients…

 

[Pablo Sanchez]

You’ve edited this like 4 times. Lol
I stand by everything I said- perfing and using patients as guinea pigs is not the way to grow. CE or residency and gradually trying harder cases so you can predictably provide results for paying patients who are trusting you with their care, yes. You can’t even evaluate if your molar endo, implants, all on x restoration, invisalign and whatever else have been successful and ‘predictable’ because odds are you did your first one 6 months ago.

We are in total agreement here! CE, mentorship, and residency are all great ways to grow as a dentist. Gradually trying harder cases so you can predictably provide results IS THE WAY. That’s exactly how I did it! I would never advocate purposely messing up. You shouldn’t be taking on a case if you don’t feel like you won’t do an excellent job.

But failures occasionally happen. It’s called a bad day in the office. Bondings you put on chip. Onlays you put on a clencher/grinder fracture. A root tip snaps off of a non-restorable endo treated tooth you’re extracting and you struggle to get it out. A tooth you thought was restorable, it turns out wasn’t, so when you excavated the decay during your root canal, you perfed into the furcation. My point in that example was to help the OP see that it’s OKAY if things don’t always go to plan. It’s going to happen in whatever environment the OP ends up practicing in. Residency. DSO. Private practice. Learning and growing from those rare instances is what is important and makes you a better clinician.

No I am not comfortable failing on the job, I hope I never get there. Best of luck to your poor patients…

There’s no need to be rude here. Read the above. I’ve been lucky to have good mentors practicing alongside me and helping me grow as a clinician. I’m happy to hear you’re a perfect dentist.

To the OP, I was in a similar situation as you. I graduated with debt with just a dental school baseline set of skills. The debt was large enough in my eyes to make me feel like I had no time to waste. I jumped right into private practice as an associate. A GPR can also be wise. Working for a DSO can also be wise. It can be overwhelming at times, but you’ll grow as much as you want to grow. I’m now a year out, debt free, making more money than I ever thought I would, providing my patients with reliable, predictable results. Believe in yourself, don’t be afraid to ask for help, and it’s OKAY if things don’t always go according to plan. You’ll learn. You’ll be okay. Don’t listen to the people who tell you they’re perfect and never made a mistake. Believe in yourself, and trust your gut. Good luck!

 

[CheesyCheeze]

We are in total agreement here! CE, mentorship, and residency are all great ways to grow as a dentist. Gradually trying harder cases so you can predictably provide results IS THE WAY. That’s exactly how I did it! I would never advocate purposely messing up. You shouldn’t be taking on a case if you don’t feel like you won’t do an excellent job.

But failures occasionally happen. It’s called a bad day in the office. Bondings you put on chip. Onlays you put on a clencher/grinder fracture. A root tip snaps off of a non-restorable endo treated tooth you’re extracting and you struggle to get it out. A tooth you thought was restorable, it turns out wasn’t, so when you excavated the decay during your root canal, you perfed into the furcation. My point in that example was to help the OP see that it’s OKAY if things don’t always go to plan. It’s going to happen in whatever environment the OP ends up practicing in. Residency. DSO. Private practice. Learning and growing from those rare instances is what is important and makes you a better clinician.

There’s no need to be rude here. Read the above. I’ve been lucky to have good mentors practicing alongside me and helping me grow as a clinician. I’m happy to hear you’re a perfect dentist.

To the OP, I was in a similar situation as you. I graduated with debt with just a dental school baseline set of skills. The debt was large enough in my eyes to make me feel like I had no time to waste. I jumped right into private practice as an associate. A GPR can also be wise. Working for a DSO can also be wise. It can be overwhelming at times, but you’ll grow as much as you want to grow. I’m now a year out, debt free, making more money than I ever thought I would, providing my patients with reliable, predictable results. Believe in yourself, don’t be afraid to ask for help, and it’s OKAY if things don’t always go according to plan. You’ll learn. You’ll be okay. Don’t listen to the people who tell you they’re perfect and never made a mistake. Believe in yourself, and trust your gut. Good luck!

Funny how everyone who drives outside their lane has “good mentors”. Reality is you are not performing to the standard of specialists and neither are your mentors. Money is what drives you both

 

[Pablo Sanchez]

Funny how everyone who drives outside their lane has “good mentors”. Reality is you are not performing to the standard of specialists and neither are your mentors. Money is what drives you both

Many of my mentors ARE specialists…

 

[SnozzBerry]

We are in total agreement here! CE, mentorship, and residency are all great ways to grow as a dentist. Gradually trying harder cases so you can predictably provide results IS THE WAY. That’s exactly how I did it! I would never advocate purposely messing up. You shouldn’t be taking on a case if you don’t feel like you won’t do an excellent job.

But failures occasionally happen. It’s called a bad day in the office. Bondings you put on chip. Onlays you put on a clencher/grinder fracture. A root tip snaps off of a non-restorable endo treated tooth you’re extracting and you struggle to get it out. A tooth you thought was restorable, it turns out wasn’t, so when you excavated the decay during your root canal, you perfed into the furcation. My point in that example was to help the OP see that it’s OKAY if things don’t always go to plan. It’s going to happen in whatever environment the OP ends up practicing in. Residency. DSO. Private practice. Learning and growing from those rare instances is what is important and makes you a better clinician.

There’s no need to be rude here. Read the above. I’ve been lucky to have good mentors practicing alongside me and helping me grow as a clinician. I’m happy to hear you’re a perfect dentist.

To the OP, I was in a similar situation as you. I graduated with debt with just a dental school baseline set of skills. The debt was large enough in my eyes to make me feel like I had no time to waste. I jumped right into private practice as an associate. A GPR can also be wise. Working for a DSO can also be wise. It can be overwhelming at times, but you’ll grow as much as you want to grow. I’m now a year out, debt free, making more money than I ever thought I would, providing my patients with reliable, predictable results. Believe in yourself, don’t be afraid to ask for help, and it’s OKAY if things don’t always go according to plan. You’ll learn. You’ll be okay. Don’t listen to the people who tell you they’re perfect and never made a mistake. Believe in yourself, and trust your gut. Good luck!

I am not a perfect dentist. It’s just a scary thought that someone should be comfortable “failing on the job”. I do fail, not often, but I do. And it makes me uncomfortable every time.

People like you always talk about mentorship. Are these “mentors” standing over your shoulder during hard cases, are they in the room next door readily available if you ever fall into trouble? Are they specialists who go over cases on a regular basis? Do they look over your lab work whenever you ask? Do they help you with it if asked? Probably not, since they are at the same office to make money and produce. They have probably similarly learned through trial and error how not to screw things up.

That’s not how it is during any good residency. You learn with specialists guiding you, like actually over your shoulder or vice versa. You discuss cases before and after. You always have someone highly competent to bail you out if you need it. You have lectures by specialists and learn from them and their mistakes and triumphs.

If you are being truthful and you have a full complement of specialist mentors at your office who take the immense time to guide you on specialist procedures then that’s great. But the reality is I’m sure that’s not the case. Specialists are very busy in private practice because their time is highly valuable. They aren’t going to consistently mentor some new grad for no reason. But if you are in this unicorn of a situation, recognize it’s a unicorn and don’t guide people to do what you did. Because it’s a pipe dream for most.

 

[CheesyCheeze]

Many of my mentors ARE specialists…

Yeah okay.. so they share an office with you? Directly supervise you do cases every day?

 

[Pablo Sanchez]

I am not a perfect dentist. It’s just a scary thought that someone should be comfortable “failing on the job”. I do fail, not often, but I do. And it makes me uncomfortable every time.

People like you always talk about mentorship. Are these “mentors” standing over your shoulder during hard cases, are they in the room next door readily available if you ever fall into trouble? Are they specialists who go over cases on a regular basis? Do they look over your lab work whenever you ask? Do they help you with it if asked? Probably not, since they are at the same office to make money and produce. They have probably similarly learned through trial and error how not to screw things up.

That’s not how it is during any good residency. You learn with specialists guiding you, like actually over your shoulder or vice versa. You discuss cases before and after. You always have someone highly competent to bail you out if you need it. You have lectures by specialists and learn from them and their mistakes and triumphs.

If you are being truthful and you have a full complement of specialist mentors at your office who take the immense time to guide you on specialist procedures then that’s great. But the reality is I’m sure that’s not the case. Specialists are very busy in private practice because their time is highly valuable. They aren’t going to consistently mentor some new grad for no reason. But if you are in this unicorn of a situation, recognize it’s a unicorn and don’t guide people to do what you did. Because it’s a pipe dream for most.

That’s a good point. It does make me UNcomfortable when I fail on the job. I guess what I’m trying to say is that it is going to happen, and you’ll have to work your way through it. It might be uncomfortable the entire way. But don’t give up when it happens.

I am very lucky with my mentors. The biggest mentor is a GP who does most procedures. He is one of my bosses. He is a football coach in his free time and naturally enjoys that coaching roll. He works alongside me in the office. He was there to sit by my side during my first couple of implants. He’s bailed me out of difficult root canals and extractions. It makes him more money if I can do procedure competently, right? So he’s willing to be right there for me.

I have other mentors who are specialists. For example, a perio-prosth professor at a dental school who took me to dinner and reviewed cases with me and walked me through the all on 4 workflow with his practice. He’s guided me through the cases. Once again, it gets him business if I’m competent in restoring the case.

But the point is, there are very good mentors around. Maybe I’m the one lucky person, but they’re out there.

 

[CheesyCheeze]

Yep knew it the big mentor is a GP… it’s the blind leading the blind.

Difference is residents in a specialty are receiving mentorship from several specialists all who received the same level of training and mentorship…

A specialist right out of residency is not going to make the same mistakes you do.

 

[Pablo Sanchez]

Yep knew it the big mentor is a GP… it’s the blind leading the blind.

Difference is residents in a specialty are receiving mentorship from several specialists all who received the same level of training and mentorship…

A specialist right out of residency is not going to make the same mistakes you do.

Yes. They make the mistakes during residency. On patients. Patients at a residency program are no different than patients in a practice. It is ignorant to believe that GPs are blind or incompetent. Great way to get referrals, buddy.

 

[Ryxndek]

Let's please try to be civil and keep your comments on topic.

 

[dentalinthemental]

Yes. They make the mistakes during residency. On patients. Patients at a residency program are no different than patients in a practice. It is ignorant to believe that GPs are blind or incompetent. Great way to get referrals, buddy.

See this is where I hugely disagree.
Patients for a residency or dental school understand and consent to having their work done by learning students, understand that there is a likelihood of work failing and/or being redone, and reap the benefits of a heavily discounted procedure.
A private practice patient is paying full price, have their full blind confidence in whichever provider they visit, & are not consenting to having mistakes performed for the purposes of learning.

No one is saying GP’s are incompetent. You can with time and investment become largely competent in all of those procedures as GP. But it’s a hugely problematic issue in our profession to believe you are performing specialist-level treatment doing basically every specialty discipline of dentistry & objectively complex procedures at that, months after graduation.

 

[Pablo Sanchez]

See this is where I hugely disagree.
Patients for a residency or dental school understand and consent to having their work done by learning students, understand that there is a likelihood of work failing and/or being redone, and reap the benefits of a heavily discounted procedure.
A private practice patient is paying full price, have their full blind confidence in whichever provider they visit, & are not consenting to having mistakes performed for the purposes of learning.

No one is saying GP’s are incompetent. You can with time and investment become largely competent in all of those procedures as GP. But it’s a hugely problematic issue in our profession to believe you are performing specialist-level treatment doing basically every specialty discipline of dentistry & objectively complex procedures at that, months after graduation.

The patients at my practice sign a consent form prior to receiving treatment acknowledging that work can fail or may have to be redone. I personally explain to patients that if I get in there and have any difficulty, there is a chance that I will need to send them to a specialist. And there are times that I do send them to the specialist. A lot of the time I give patients the option of seeing the specialist or having me do it. Most of the time, my patients prefer to have me do the root canal for them because they are in pain and don’t want to have to wait a month and a half to get in to the endodontist. They pay less for me to do it than for the endodontist to do it. A lot of the time, the patient comes in asking to have the tooth pulled, and I recommend we save the tooth. So patients are fully consenting. I have taken CE. In the ONE instance where I was unable to save the tooth, we did not charge for the root canal, and gave them a discount on the implant. We do the right thing for our patients and in no way try to mislead them. We just try to help. You have not once seen the quality of my work.

When you graduate from your GPR you are free to stick to fillings and crowns. There is nothing wrong with that. I successfully perform some of these simple cases of more advanced procedures because I have slowly built up to that. I know my limits. I don’t do all procedures under the sun. I do cases that I feel comfortable with and constantly focus on learning from the people around me.

And let’s be clear. Specialists do very good work and receive very good training. They’re the experts. That doesn’t mean that a GP can’t do some of the work they do and get successful outcomes.

 

[HockeyDocOMFS]

99% of GPRs are complete and utter trash. I have a lot more friends who regret doing a GPR than those who regret going into private practice right away. There are a handful that are worth it.

If I didn’t specialize, I’d go right into practice, take CE, and find a good mentor. As a future specialist, it’s okay to struggle taking a tooth out. Just please don’t smoke the nerve or refer bail-out cases to me. Learn your limits but it is okay to push yourself - everyone starts somewhere.

 

[SnozzBerry]

99% of GPRs are complete and utter trash. I have a lot more friends who regret doing a GPR than those who regret going into private practice right away. There are a handful that are worth it.

If I didn’t specialize, I’d go right into practice, take CE, and find a good mentor. As a future specialist, it’s okay to struggle taking a tooth out. Just please don’t smoke the nerve or refer bail-out cases to me. Learn your limits but it is okay to push yourself - everyone starts somewhere.

You sound like a first year OMFS resident…Many years of humbling in front of you.

 

[Pablo Sanchez]

99% of GPRs are complete and utter trash. I have a lot more friends who regret doing a GPR than those who regret going into private practice right away. There are a handful that are worth it.

If I didn’t specialize, I’d go right into practice, take CE, and find a good mentor. As a future specialist, it’s okay to struggle taking a tooth out. Just please don’t smoke the nerve or refer bail-out cases to me. Learn your limits but it is okay to push yourself - everyone starts somewhere.

The only acceptable answer on this thread is that general dentists must do a GPR and even then should stick to fillings and crowns. How dare you suggest otherwise!

Some people really can’t handle other people’s success.

 

[stuartn7878]

Unfortunately this thread has become personal, but there are ample opportunities to learn on the job as well as academic settings. The choice is up to the individual. Personally, I prefer to learn on the job. Some people prefer the protection of an academic setting and the structure and guidance that allows one to never feel unsafe. There are many ways to learn and develop your personal, professional, and clinical skills!

 

[HockeyDocOMFS]

You sound like a first year OMFS resident…Many years of humbling in front of you.

No, I am not. Nice try. You sound like someone who regrets doing their GPR though.

If a tooth is near the nerve, sinus, fully impacted etc, I believe the person should refer unless they’re confident in their skills. If it is a junk root tip #24, I don’t think there will be any OMFS who would complain about you taking the tooth out to get experience using a surgical handpiece. I don’t think any OMFS even want to take those teeth out, unless it is the site for a future implant.

 

[SnozzBerry]

No, I am not. Nice try. You sound like someone who regrets doing their GPR though.

If a tooth is near the nerve, sinus, fully impacted etc, I believe the person should refer unless they’re confident in their skills. If it is a junk root tip #24, I don’t think there will be any OMFS who would complain about you taking the tooth out to get experience using a surgical handpiece. I don’t think any OMFS even want to take those teeth out, unless it is the site for a future implant.

I am literally advocating for the benefits of residency with everything I said above…with your reading comprehension you must be a non cat intern lol (yes I know you’re PGY2 OMFS or are you in med school years right now?)

 

[HockeyDocOMFS]

I am literally advocating for the benefits of residency with everything I said above…with your reading comprehension you must be a non cat intern lol (yes I know you’re PGY2 OMFS or are you in med school years right now?)

I apologize if my first post struck a nerve with you. But I will say, it is pretty inconsiderate and unprofessional to bad-mouth non-cats. Plenty of them are extremely talented and smart, and they are essential for programs to run smoothly. Shout-out to non-cats.

The whole point of my original post was to state that it is okay for a practitioner to take CE courses and push themselves that route. Pushing your limits through a GPR is also fine, but there is hardly a difference between the 2. In fact, a CE course will at least guarantee you cases, whereas GPRs can sometimes provide you with false hope (aside from the couple I alluded to earlier, i.e. San Antonio GPR). They claim they do X amount of impacted thirds or implants, but you end up doing less than half of that amount.

25+ years ago during the golden age of dentistry, hardly anyone did a GPR - they are still doing surgical cases without it and aren't viewede as unethical practitioners in anyone's eyes.

To OP - if you have an interest in a GPR, reach out to residents directly. It is easy for programs to boast their numbers. If you are still uncomfortable doing cases with less supervision, then definitely consider a GPR. But if you also have the personality to push yourself through CE, mentorship, and other avenues, that might be a better option for you.

 

[Let me out!]

I am literally advocating for the benefits of residency with everything I said above…with your reading comprehension you must be a non cat intern lol (yes I know you’re PGY2 OMFS or are you in med school years right now?)

Advocating for GPR is fine, but you're also throwing in personal insults, assumptions, and you're degrading others. ...Why? This conversation could have been civil - it's a good topic to talk about.

Unfortunately this thread has become personal, but there are ample opportunities to learn on the job as well as academic settings. The choice is up to the individual. Personally, I prefer to learn on the job. Some people prefer the protection of an academic setting and the structure and guidance that allows one to never feel unsafe. There are many ways to learn and develop your personal, professional, and clinical skills!

I agree with this. There are plenty of resources out there to learn while working. GPR is not the only way to learn.

 

[2TH MVR]

Wow. This thread has been entertaining. Re: @Pablo Sanchez . I give you credit for keeping the conversation civil even though you were taking alot of hits lol.

As an orthodontist ... my comments are biased towards what generalists perceive as "good treatment". This is about typical specialist treatment. I can't speak for other specialty procedures, but I can comment on ortho. The success of any ortho tx is that it holds up over time. You could say the same for other specialty procedures. Initially the treatment can look good (straight teeth), but if the true cause of the malocclusion is not addressed, than the original malocclusion will return. An example is upper anterior spacing with a deep OB. Fail to correct the deep OB .... the upper spacing will return predictably. Aligners are not the best tools to use for deep OB correction.

Whenever the gp attempted "specialized" procedure fails. Whether in a month or in a year .... the patient ends up on the losing side of this.

As for a GPR/AEGD. Not really sure of their use in the real world. Again. Just my opinion.

Please carry on. I'm enjoying this conversation.

 

[HockeyDocOMFS]

A few posts above you literally said “99% of GPRs are complete and utter trash”. Do you see how hypocritical you’re being? I was making a slight joke about non-cats. They understand they are at the bottom of the totem pole and the ones worth their salt can take a little jest.

You’ve added less to this entire topic than I have… move along…

I do not see how I am being hypocritical. I am putting down GPR programs, not individuals (which you did). GPRs have been shoved down peoples' throats over recent years as this godsend for the graduating dental student, which I do not understand. Happy to see another specialist agree with me.

I stand by my original comment - obviously me stating 99% was an exaggeration. I know of programs where classmates left only doing 2 crowns, and they had to assist their co-residents. It sounds even worse than dental school. Again, reach out to GPR residents directly at each program asking for their thoughts, their numbers, and if they have any regrets.

 

[dentalinthemental]

Back to the original post,
Working & residency can both be great. Contrary to the above sentiments, I’d say having visited many programs (10+) in the country & interviewed at some of the best, I can say a good GPR/AEGD is one of the best investments you can make in your self. I would respectfully put significantly more weight on talking to general dentists over specialist’s opinions regarding this.

Not one out of 20+ residents I spoke to while visiting regretted their decision. Of course, everyone has their own bias and those that didn’t do a residency seem to be very loud about their opinion and vice versa. And of course, some GPRs (and Ortho programs… & Perio programs… & dental schools, & so on) seriously suck. You have to do your due diligence on programs and speak to residents. The programs I interviewed with (& this is from residents mouths, past and present) had incredible numbers and varying strengths—- 40 implants (some up to 70+), IV sedation certification, 80+ molar endos, hundreds of thirds, etc.

When making my decision, I spoke to probably 20 pp general dentists that had been working for years (and none had done a residency). Literally unanimously, they recommended that I do a good residency.

To those that are commenting, if you graduated more than 5 years ago, your opinion isn’t up to date and doesn’t hold much weight because dental school experience has changed for new grads and some of the numbers of procedures are abysmally low.
That being said:
strong residency or incredible unicorn mentor >> working out of school at a regular gig >> bad GPR, 100%. Weigh your options.

 

[SnozzBerry]

I do not see how I am being hypocritical. I am putting down GPR programs, not individuals (which you did). GPRs have been shoved down peoples' throats over recent years as this godsend for the graduating dental student, which I do not understand. Happy to see another specialist agree with me.

I stand by my original comment - obviously me stating 99% was an exaggeration. I know of programs where classmates left only doing 2 crowns, and they had to assist their co-residents. It sounds even worse than dental school. Again, reach out to GPR residents directly at each program asking for their thoughts, their numbers, and if they have any regrets.

You aren’t totally wrong. Some GPR’s are not worth it and are bad. I have no idea on the percentage, neither do you. What I do know is if you want to hit the ground running on specialty procedures as a GP it’s almost always better to do a great GPR. It’s hard for any type of private practice mentorship/CE to compare with the efficiency of a great GPR. Slowly growing your skills over years of mentorship and CE? Absolutely. Racing through as many specialty procedures because you can and it pays well right off the bat? Recipe for disaster.

 

[Pablo Sanchez]

Back to the original post,
Working & residency can both be great. Contrary to the above sentiments, I’d say having visited many programs (10+) in the country & interviewed at some of the best, I can say a good GPR/AEGD is one of the best investments you can make in your self. I would respectfully put significantly more weight on talking to general dentists over specialist’s opinions regarding this.

Not one out of 20+ residents I spoke to while visiting regretted their decision. Of course, everyone has their own bias and those that didn’t do a residency seem to be very loud about their opinion and vice versa. And of course, some GPRs (and Ortho programs… & Perio programs… & dental schools, & so on) seriously suck. You have to do your due diligence on programs and speak to residents. The programs I interviewed with (& this is from residents mouths, past and present) had incredible numbers and varying strengths—- 40 implants (some up to 70+), IV sedation certification, 80+ molar endos, hundreds of thirds, etc.

When making my decision, I spoke to probably 20 pp general dentists that had been working for years (and none had done a residency). Literally unanimously, they recommended that I do a good residency.

To those that are commenting, if you graduated more than 5 years ago, your opinion isn’t up to date and doesn’t hold much weight because dental school experience has changed for new grads and some of the numbers of procedures are abysmally low.
That being said:
strong residency or incredible unicorn mentor >> working out of school at a regular gig >> bad GPR, 100%. Weigh your options.

I agree with this post to any dental students reading it. Lots of good advice in here.

The only thing I would hold caution to is the following.

The thing GPs do most is restorative. Crown, bridge, restorations. You learn how to do this in dental school. You just need to get the reps in. There isn’t going to be any way to get more restorative experience than working in the real world. I do believe that you’re going to get more experience doing fillings, crowns, and bridges in private practice than a GPR.

Additionally, a lot of my friends thought they were going to these great programs. Programs recommended to them. Programs where they were told they place a lot of implants. But once they got into it, it’s a very short program. What, 10 months? You’re not placing implants day 1. So now you’re a few months into this GPR before you start placing implants. They need 3-4 months to oseointegrate before you restore them. So how often are you really placing and restoring your own implant and monitoring its progress in the years following? The guidance from specialists is a fantastic aspect of GPRs when learning the implant placing process, but they’re not by your side when you graduate your GPR program. That’s something I only had from taking CE. Either way, there is going to be some degree of learning on the job. Most of my friends can count on one hand the number of implants they placed in their program. And now they’re working in a practice not placing any. So yes, they got some experience, but haven’t done it since! It’s a shame.

Regarding IV sedation certification, that’s great! 99% of dentists don’t do IV sedation in private practice. So it’s cool to learn, but how relevant is it to your day to day as a dentist?

I don’t necessarily know the answers to all these questions and my perception is as a biased individual who did not do a GPR, but something to consider.

 

[dentalinthemental]

I agree with you. Bread & butter is best learned through reps & working in practice, and those additional skills are not for everyone nor does everyone care to do those procedures. Many dentists are happy to do mostly crowns, fillings, & hygiene and refer all else out. If that is your speed (which is fine), then I can say, 100%, a residency is not worth it. Some residencies offer complex prosth opportunities, but it really just varies.

However, if a student is interested in surgical procedures, they tend to be the most expensive & involved CE (ranging from $1000-30,000 per course + travel time + days off work), so if someone is interested in things like implants, surgical extractions, molar endo, 3rds, OR cases, IV sedation, over dentures, etc (depending on program), a good residency can offer a great ROI in that way. Most IV sedation courses alone are $20,000. For me personally, that is what drew me to residency as I knew I wanted a more surgically oriented GP career.

In terms of numbers, again residencies vary heavily and some will do 0 implants…. And some will do 80. Each residency is different so if a student wants to make their residency year about implants and that is their main concern, they can find 10-20 programs that historically have 25+ placements (some with 50+), & many cases to restore from prior residents also. But again, there are tons of programs that suck, too, and that is important to keep in mind.

 

[Pablo Sanchez]

I agree with you. Bread & butter is best learned through reps & working in practice, and those additional skills are not for everyone nor does everyone care to do those procedures. Many dentists are happy to do mostly crowns, fillings, & hygiene and refer all else out. If that is your speed (which is fine), then I can say, 100%, a residency is not worth it. Some residencies offer complex prosth opportunities, but it really just varies.

However, if a student is interested in surgical procedures, they tend to be the most expensive & involved CE (ranging from $1000-30,000 per course + travel time + days off work), so if someone is interested in things like implants, surgical extractions, molar endo, 3rds, OR cases, IV sedation, over dentures, etc (depending on program), a good residency can offer a great ROI in that way. Most IV sedation courses alone are $20,000. For me personally, that is what drew me to residency as I knew I wanted a more surgically oriented GP career.

In terms of numbers, again residencies vary heavily and some will do 0 implants…. And some will do 80. Each residency is different so if a student wants to make their residency year about implants and that is their main concern, they can find 10-20 programs that historically have 25+ placements (some with 50+), & many cases to restore from prior residents also. But again, there are tons of programs that suck, too, and that is important to keep in mind.

Just playing devils advocate for the sake of it. I appreciate your willingness to engage in respectful conversation and I totally see your side of it! There’s no right answer, and one year isn’t going to make or break you when looking at an entire career. If we are looking purely from a financial standpoint:

Forgo a year of, let’s say, $200k income as an associate to do a GPR that we HOPE is one of the good ones.

Or spend a few thousand dollars on good CE (which my boss pays for anyway. It’s in my contract.) Make $200k as an associate that one year instead of doing a GPR.

If we REALLY look into it. Should you forgo the GPR and make $200k as an associate your first year after dental school. You take home $140k after tax. If you invest $100k of that $140k your first year out in the S&P500 AND NEVER INVEST ANOTHER PENNY. It grows at its historical average of 10%. By the time you’re 65 that investment is worth $4,861,051. So one could argue that the decision to do a GPR is a $5 million decision when it comes time to retire.

 

[HockeyDocOMFS]

Just playing devils advocate for the sake of it. I appreciate your willingness to engage in respectful conversation and I totally see your side of it! There’s no right answer, and one year isn’t going to make or break you when looking at an entire career. If we are looking purely from a financial standpoint:

Forgo a year of, let’s say, $200k income as an associate to do a GPR that we HOPE is one of the good ones.

Or spend a few thousand dollars on good CE (which my boss pays for anyway. It’s in my contract.) Make $200k as an associate that one year instead of doing a GPR.

If we REALLY look into it. Should you forgo the GPR and make $200k as an associate your first year after dental school. You take home $140k after tax. If you invest $100k of that $140k your first year out in the S&P500 AND NEVER INVEST ANOTHER PENNY. It grows at its historical average of 10%. By the time you’re 65 that investment is worth $4,861,051. So one could argue that the decision to do a GPR is a $5 million decision when it comes time to retire.

We’re all idiots and shouldn’t have even gone into dentistry then by your logic.

 

[artist2022]

And yet another reminder to act like the professionals you guys are supposed to be, and to refrain from name-calling/generalizations. Be civil and respectful. Some users that couldn't follow these simple instructions have been temporarily removed from the thread

 

[dentalinthemental]

Just playing devils advocate for the sake of it. I appreciate your willingness to engage in respectful conversation and I totally see your side of it! There’s no right answer, and one year isn’t going to make or break you when looking at an entire career. If we are looking purely from a financial standpoint:

Forgo a year of, let’s say, $200k income as an associate to do a GPR that we HOPE is one of the good ones.

Or spend a few thousand dollars on good CE (which my boss pays for anyway. It’s in my contract.) Make $200k as an associate that one year instead of doing a GPR.

If we REALLY look into it. Should you forgo the GPR and make $200k as an associate your first year after dental school. You take home $140k after tax. If you invest $100k of that $140k your first year out in the S&P500 AND NEVER INVEST ANOTHER PENNY. It grows at its historical average of 10%. By the time you’re 65 that investment is worth $4,861,051. So one could argue that the decision to do a GPR is a $5 million decision when it comes time to retire.

To be honest, your scenario isn’t realistic due to the fact that $200K as an associate is very much on the higher end in most desirable cities. You’re comparing a perfect associateship scenario (investing every penny of post tax income of a high-end salary??) to a bad residency.

Most of my buddies (unless* they moved somewhere rural, went to daddy’s practice, or worked 6 days a week) rarely broke $180K their first year. If you really look at 100 new grads, the median is closer to 150K, which is 110K post tax. On top of that, most residencies pay $40-65K, & as a new working associate, you have loan repayment, rent, etc so investing large lump sums is not an option for many people their first yr out.

I also think, much like those that go through additional training (perio, peds, ortho, endo, etc), you obtain that additional training by evaluating the ROI over years to come, not just that first year. Feeling proficient in even one or two of those skills (implants, sedation, endo, etc.) early on in your career can pay you back in multiples, making that first year 20K or whatever you have leftover after loans & COL to invest negligible. CE is great too… but just my opinion, in dentistry, (quality) additional training is almost always a no brainer. It’s why OMFS don’t sweat about losing 6 years of income.