What was your experience like?

[coolguy07]

Hi! I am applying to dental school right now to start in the fall of 2020 (if I get accepted). I was wondering if anyone can share what their experience was like while serving in any of the branches. Are you assigned a base? How in shape do you have to be?

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[BluntForceTrauma]

Recommend searching the forums for this, or even Google searching "military dentist lifestyle sdn" and you will get all the info you desire.

If you still have questions after reading all these things, search again using those questions.

After steps 1 and 2, then make a new, more specific post here.

 

[Big Time Hoosier]

Hi! I am applying to dental school right now to start in the fall of 2020 (if I get accepted). I was wondering if anyone can share what their experience was like while serving in any of the branches. Are you assigned a base? How in shape do you have to be?

Serving those who put their lives on the line for you and me is awesomely rewarding. You will make lifelong friendships with many of your peers. Your skills as a dentist will waste away, as most likely you’re going to get stuck doing just exams and fillings. You may spend years of your life stationed in the absolute middle of nowhere. Many of your senior officers will be some of the most incompetent and stupid people you will ever work with. No friggin joke here. They stay in the military because there is no way they’d survive in the private sector. These people can make your day to day miserable. If you do the HPSP, GTFO ASAP. I have no regrets taking the HPSP, but it’s not always sunshine and roses.

Big Hoss

 

[Big Time Hoosier]

They stay in the military because there is no way they’d survive in the private sector.

Big Hoss

 

[coolguy07]

Serving those who put their lives on the line for you and me is awesomely rewarding. You will make lifelong friendships with many of your peers. Your skills as a dentist will waste away, as most likely you’re going to get stuck doing just exams and fillings. You may spend years of your life stationed in the absolute middle of nowhere. Many of your senior officers will be some of the most incompetent and stupid people you will ever work with. No friggin joke here. They stay in the military because there is no way they’d survive in the private sector. These people can make your day to day miserable. If you do the HPSP, GTFO ASAP. I have no regrets taking the HPSP, but it’s not always sunshine and roses.

Big Hoss

View attachment 266318

Thank you so much for your honest feedback! I really appreciate it

Thank you for your service

 

[Evistor]

Serving those who put their lives on the line for you and me is awesomely rewarding. You will make lifelong friendships with many of your peers. Your skills as a dentist will waste away, as most likely you’re going to get stuck doing just exams and fillings. You may spend years of your life stationed in the absolute middle of nowhere. Many of your senior officers will be some of the most incompetent and stupid people you will ever work with. No friggin joke here. They stay in the military because there is no way they’d survive in the private sector. These people can make your day to day miserable. If you do the HPSP, GTFO ASAP. I have no regrets taking the HPSP, but it’s not always sunshine and roses.

Big Hoss

View attachment 266318

this scares me...

Do others agree with Big Hoss?

 

[Big Time Hoosier]

this scares me...

Do others agree with Big Hoss?

What scares you more, what I wrote or having $400,000+ in student loans at a near 7% interest rate?

The money you get through the HPSP is not just handed to you. You will definitely earn it. That said, the time flies. And where I said serving those who put their lives on the line for you and me is awesomely rewarding makes up for all the crap you have to put up with. The sacrifices I had to make pale in comparison to the forward deployed Marines and Sailors. I may just be a salty vet now, but I will always be proud to have worn the uniform.

Big Hoss

 

[USArmyHPSP]

SDN

As I get ready to retire next week, I don't want to get into a Flame war with those on SDN. Here is what I tell anyone who reads (and takes seriously) what some of the old curmudgeons on SDN post.

In the Army we have about 400 HPSP dentists. It's my guess that it is about the same for the other two Services (Air Force and Navy). So, conservatively, you are looking at 1200 dentists in all three Services. They will all graduate, and usually will spend at least four years on active duty. So, over four years, you now have 1200 new dentists in the pipeline. Add to that those who take residencies, or just stay in because of a sense of duty, location, or, job security and you will at least double that. Out of that conservative 2400 dentists, let's say that 1/3 know about SDN. Again a very conservative number. So, we are now looking at the 1000 (rounding up a little) dentists across all three Services that are on active duty, all have access to computers, and again, have been on SDN at some point either prior to, during or after dental school. How come there are only 1 or 2 who regularly post and usually in the negative? OK, I even plus that up to 5, which is way huge, the question remains the same….

Over the past 35 years working for the AMEDD, I have learned is that hard work pays off. The cream rises to the top. And, life is what you make of it. I have seen some come in and from the very first day state that all they want is out (both in peacetime and war). I have seen others come in who are "going to make a change". Some do, some get beaten down and leave wishing they had expended their effort toward something else. Some come for a career, some simply for a paid education. Some want to be specialists, some want to be administrators. The military is the one true melting pot. Discrimination is not tolerated - at all levels. Sexual harassment is dealt with swiftly and judiciously. We have all colors, creeds and religions. There are those who willingly work their butt off, and others who do the bare minimum. Those of us who enjoy diversity seem to thrive in the military. If you dislike it, not so much. It's a job/career that is not for everyone. Much like some cannot be a General Dentis, while others cannot see being a surgeon.

The organization is huge, it has its own rules and it survives on those rules. Sometimes the rules go in your favor and sometimes not. It has its own systems. Some work well, others don't. Add in extra curriculars like wife, husband, significant other, divorce, kids, no kids and things can change and/or get complicated fast. Your tastes can change. One of the best pieces of advice I was given back in the 1970's came from the lying dingus of a recruiter I had. He told me to sign up for as little time as you can. There will always be a chance to sign up for more later if you want.

Take a step back, and think. If you were working for a large organization like GM or Northrup Grumman. You may walk into your dream job, and 7 years later hate your boss and what the job has become. It's all very personal. Those of us who have been around a while can remember the good ole days when the last conflict was so far in the rearview mirror it was a distant memory, money was free for the picking off Uncle Sam's money tree - take all you want. There was no chance of war. Yep life was good. Yet even then people complained basically about the same stuff they complain about now plus now we have the very real possibility of war...

The honest to God truth is that nobody really knows where military medicine is going. In the last 35 years I've seen many changes and we always persevere. When they closed Fitzsimmons, Army medicine was doomed. Well, that didn’t happen.

The HPSP is a financial boon for dental school, AEGD and if picked up residency. The absolute worst is that there are not enough residency slots (of your personal choice) to go around and when the music stops you're standing instead of sitting. You do your internship, pay back the four years, and take a great CV to apply to the civilian match a little later. You still have little to no debt while those around you in that later residency will be eating peanut butter and Raman noodles. Flip side is that you will be four years behind some of those you graduate med school with. Is it worth taking a roll of the dice? Up to you.

So, if you have taken the time to read all this, please take away that the military offers an education, and compensation. What you make of it is entirely up to you. However, I strongly suggest you sign up for a little as possible - you can always sign up for more later if it suits.

And now it is very honestly, seriously and heartfelt, that I thank you all for your service and wish you all the very best.

Art Covi
US Army HPSP Program Manager

 

[Blueshirts]

SDN

As I get ready to retire next week, I don't want to get into a Flame war with those on SDN. Here is what I tell anyone who reads (and takes seriously) what some of the old curmudgeons on SDN post.

In the Army we have about 400 HPSP dentists. It's my guess that it is about the same for the other two Services (Air Force and Navy). So, conservatively, you are looking at 1200 dentists in all three Services. They will all graduate, and usually will spend at least four years on active duty. So, over four years, you now have 1200 new dentists in the pipeline. Add to that those who take residencies, or just stay in because of a sense of duty, location, or, job security and you will at least double that. Out of that conservative 2400 dentists, let's say that 1/3 know about SDN. Again a very conservative number. So, we are now looking at the 1000 (rounding up a little) dentists across all three Services that are on active duty, all have access to computers, and again, have been on SDN at some point either prior to, during or after dental school. How come there are only 1 or 2 who regularly post and usually in the negative? OK, I even plus that up to 5, which is way huge, the question remains the same….

Over the past 35 years working for the AMEDD, I have learned is that hard work pays off. The cream rises to the top. And, life is what you make of it. I have seen some come in and from the very first day state that all they want is out (both in peacetime and war). I have seen others come in who are "going to make a change". Some do, some get beaten down and leave wishing they had expended their effort toward something else. Some come for a career, some simply for a paid education. Some want to be specialists, some want to be administrators. The military is the one true melting pot. Discrimination is not tolerated - at all levels. Sexual harassment is dealt with swiftly and judiciously. We have all colors, creeds and religions. There are those who willingly work their butt off, and others who do the bare minimum. Those of us who enjoy diversity seem to thrive in the military. If you dislike it, not so much. It's a job/career that is not for everyone. Much like some cannot be a General Dentis, while others cannot see being a surgeon.

The organization is huge, it has its own rules and it survives on those rules. Sometimes the rules go in your favor and sometimes not. It has its own systems. Some work well, others don't. Add in extra curriculars like wife, husband, significant other, divorce, kids, no kids and things can change and/or get complicated fast. Your tastes can change. One of the best pieces of advice I was given back in the 1970's came from the lying dingus of a recruiter I had. He told me to sign up for as little time as you can. There will always be a chance to sign up for more later if you want.

Take a step back, and think. If you were working for a large organization like GM or Northrup Grumman. You may walk into your dream job, and 7 years later hate your boss and what the job has become. It's all very personal. Those of us who have been around a while can remember the good ole days when the last conflict was so far in the rearview mirror it was a distant memory, money was free for the picking off Uncle Sam's money tree - take all you want. There was no chance of war. Yep life was good. Yet even then people complained basically about the same stuff they complain about now plus now we have the very real possibility of war...

The honest to God truth is that nobody really knows where military medicine is going. In the last 35 years I've seen many changes and we always persevere. When they closed Fitzsimmons, Army medicine was doomed. Well, that didn’t happen.

The HPSP is a financial boon for dental school, AEGD and if picked up residency. The absolute worst is that there are not enough residency slots (of your personal choice) to go around and when the music stops you're standing instead of sitting. You do your internship, pay back the four years, and take a great CV to apply to the civilian match a little later. You still have little to no debt while those around you in that later residency will be eating peanut butter and Raman noodles. Flip side is that you will be four years behind some of those you graduate med school with. Is it worth taking a roll of the dice? Up to you.

So, if you have taken the time to read all this, please take away that the military offers an education, and compensation. What you make of it is entirely up to you. However, I strongly suggest you sign up for a little as possible - you can always sign up for more later if it suits.

And now it is very honestly, seriously and heartfelt, that I thank you all for your service and wish you all the very best.

Art Covi
US Army HPSP Program Manager

Thank you for your service and commitment to helping all of us young folk on SDN as well, Sir.

 

[coolguy07]

SDN

As I get ready to retire next week, I don't want to get into a Flame war with those on SDN. Here is what I tell anyone who reads (and takes seriously) what some of the old curmudgeons on SDN post.

In the Army we have about 400 HPSP dentists. It's my guess that it is about the same for the other two Services (Air Force and Navy). So, conservatively, you are looking at 1200 dentists in all three Services. They will all graduate, and usually will spend at least four years on active duty. So, over four years, you now have 1200 new dentists in the pipeline. Add to that those who take residencies, or just stay in because of a sense of duty, location, or, job security and you will at least double that. Out of that conservative 2400 dentists, let's say that 1/3 know about SDN. Again a very conservative number. So, we are now looking at the 1000 (rounding up a little) dentists across all three Services that are on active duty, all have access to computers, and again, have been on SDN at some point either prior to, during or after dental school. How come there are only 1 or 2 who regularly post and usually in the negative? OK, I even plus that up to 5, which is way huge, the question remains the same….

Over the past 35 years working for the AMEDD, I have learned is that hard work pays off. The cream rises to the top. And, life is what you make of it. I have seen some come in and from the very first day state that all they want is out (both in peacetime and war). I have seen others come in who are "going to make a change". Some do, some get beaten down and leave wishing they had expended their effort toward something else. Some come for a career, some simply for a paid education. Some want to be specialists, some want to be administrators. The military is the one true melting pot. Discrimination is not tolerated - at all levels. Sexual harassment is dealt with swiftly and judiciously. We have all colors, creeds and religions. There are those who willingly work their butt off, and others who do the bare minimum. Those of us who enjoy diversity seem to thrive in the military. If you dislike it, not so much. It's a job/career that is not for everyone. Much like some cannot be a General Dentis, while others cannot see being a surgeon.

The organization is huge, it has its own rules and it survives on those rules. Sometimes the rules go in your favor and sometimes not. It has its own systems. Some work well, others don't. Add in extra curriculars like wife, husband, significant other, divorce, kids, no kids and things can change and/or get complicated fast. Your tastes can change. One of the best pieces of advice I was given back in the 1970's came from the lying dingus of a recruiter I had. He told me to sign up for as little time as you can. There will always be a chance to sign up for more later if you want.

Take a step back, and think. If you were working for a large organization like GM or Northrup Grumman. You may walk into your dream job, and 7 years later hate your boss and what the job has become. It's all very personal. Those of us who have been around a while can remember the good ole days when the last conflict was so far in the rearview mirror it was a distant memory, money was free for the picking off Uncle Sam's money tree - take all you want. There was no chance of war. Yep life was good. Yet even then people complained basically about the same stuff they complain about now plus now we have the very real possibility of war...

The honest to God truth is that nobody really knows where military medicine is going. In the last 35 years I've seen many changes and we always persevere. When they closed Fitzsimmons, Army medicine was doomed. Well, that didn’t happen.

The HPSP is a financial boon for dental school, AEGD and if picked up residency. The absolute worst is that there are not enough residency slots (of your personal choice) to go around and when the music stops you're standing instead of sitting. You do your internship, pay back the four years, and take a great CV to apply to the civilian match a little later. You still have little to no debt while those around you in that later residency will be eating peanut butter and Raman noodles. Flip side is that you will be four years behind some of those you graduate med school with. Is it worth taking a roll of the dice? Up to you.

So, if you have taken the time to read all this, please take away that the military offers an education, and compensation. What you make of it is entirely up to you. However, I strongly suggest you sign up for a little as possible - you can always sign up for more later if it suits.

And now it is very honestly, seriously and heartfelt, that I thank you all for your service and wish you all the very best.

Art Covi
US Army HPSP Program Manager

Thank you for your service!

 

[FutureDent020]

this scares me...

Do others agree with Big Hoss?

Big Hoss and I have a pretty similar outlook on the military although I am Navy, not Army. So yea, I second everything he says.

But truth is, there are a ton of benefits to being a general dentist in the armed forces. It’s just not as advantageous for some as it is others. If you are great with patients, like patient care and want to be the best provider you can be, the military will hold you back and frustrate you. I would still do it all again though. It made me very competitive for residency, I have zero debt, and have not worried about finances once. If you are doing the HPSP you should feel good about it.

 

[Big Time Hoosier]

I wish my experience had been as rosy as yours, @USArmyHPSP. I really do.

Over the past 35 years working for the AMEDD, I have learned is that hard work pays off. The cream rises to the top.

FAR TOO OFTEN I’ve seen hard work go unrecognized, my case included. This stands for both officers and enlisted. The system is set up to reward those that “play the game,” and this is not limited to military medicine. But, don’t take my word for it:

“It would be easy to dismiss Nagl’s story, except you hear it almost every time you talk to a vet. In a recent survey I conducted of 250 West Point graduates (sent to the classes of 1989, 1991, 1995, 2000, 2001, and 2004), an astonishing 93 percent believed that half or more of ‘the best officers leave the military early rather than serving a full career.’ By design, I left the definitions of best and early up to the respondents. I conducted the survey from late August to mid-September, reaching graduates through their class scribes (who manage e-mail lists for periodic newsletters). This ensured that the sample included veterans as well as active-duty officers. Among active- duty respondents, 82 percent believed that half or more of the best are leaving. Only 30 percent of the full panel agreed that the military personnel system ‘does a good job promoting the right officers to General,’ and a mere 7 percent agreed that it ‘does a good job retaining the best leaders.’

“Is this so terrible? One can argue that every system has flaws and that the military should be judged on its ultimate mission: maintaining national security and winning wars. But that’s exactly the point: 65 percent of the graduates agreed that the exit rate of the best officers leads to a less competent general-officer corps. Seventy-eight percent agreed that it harms national security...

“Why is the military so bad at retaining these people? It’s convenient to believe that top officers simply have more- lucrative opportunities in the private sector, and that their departures are inevitable. But the reason overwhelmingly cited by veterans and active-duty officers alike is that the military personnel system—every aspect of it—is nearly blind to merit. Performance evaluations emphasize a zero-defect mentality, meaning that risk-avoidance trickles down the chain of command. Promotions can be anticipated almost to the day— regardless of an officer’s competence—so that there is essentially no difference in rank among officers the same age, even after 15 years of service. Job assignments are managed by a faceless, centralized bureaucracy that keeps everyone guessing where they might be shipped next...

“When I asked veterans for the reasons they left the military, the top response was ‘frustration with military bureaucracy’—cited by 82 percent of respondents (with 50 percent agreeing strongly). In contrast, the conventional explanation for talent bleed—the high frequency of deployments—was cited by only 63 percent of respondents, and was the fifth-most-common reason. According to 9 out of 10 respondents, many of the best officers would stay if the military was more of a meritocracy.“

Why Our Best Officers Are Leaving

Why are so many of the most talented officers now abandoning military life for the private sector? An exclusive survey of West Point graduates shows that it’s not just money. Increasingly, the military is creating a command structure that rewards conformism and ignores merit. As a result, it’s...

amp.theatlantic.com

From my experience in the Navy Dental Corps, the cream gets out and goes on to civilian specialty programs.

Discrimination is not tolerated - at all levels. Sexual harassment is dealt with swiftly and judiciously.

Again, wish I could agree with you here. I’d love nothing more than to give details to flame those that need flaming, but I’ll maintain my anonymity.

There are those who willingly work their butt off, and others who do the bare minimum.

Again, far too often, those that do the bare minimum in clinical work are those crappy officers who know they can’t cut it in private and know it’s impossible to get fired in the military.

Do I still recommend the HPSP? Absolutely. Would I recommend a full military career? Absolutely not. Am I proud to have served? Damn straight.

Big Hoss

 

[Lil Norkii the Supreme]

if youre going to a private school in high cost of living area military is worth it
if youre anticipated debt burden is less than 300k dont do it
most debt is manageable if youre not too picky with your job selection
and i have to fully disagree with the old sage "it's what you make of" when it comes to military experience
some will come out more saltier than others but 100% of them agree there is more too much bs to deal with in the military that does not pertain to our profession
maybe its the branch i was part of but i can objectively say my experience contradicted everything military preaches about hardwork, equal opportunity, fairness, and just
(i will not go too much into detail but i have seen discrimination, hazing, sexual harassment, hostile work environment with constant njp/court marshall threats, etc etc list goes on and on swept under the rug because perpetrators are leaderships good old puppy dogs wagging their tail at their masters command and for that reason leadership thinks there is more benefit keep them in their position so people can learn from bad examples than to actually punish them for their wrong doings)
even the top dogs admitted military its just a giant boys club
its about who know you not what you do
and dont ever think you are the one to change the military
its a stagnant rotten lake that will never change
i feel sorry for those who think theyre the neo to the military matrix because theyre just delusional
but if you are ok with grabbing your ankles until youre put in an authority position to push the same bs you went through to new junior officers than by all means military is perfect for you
btw my experience in the military does not reflect the quality of people serving
dont get me wrong there are more than enough pure garbages but most people are just nice hardworking doctors
but its the organization that forces these good people to perpetuate infinite loop of bs

 

[ShortShortsDad]

I second everything Bog Hoss stated.

That being said, I’m still glad I was able to get residency trained. Even though I feel I am doing really well there is a real chance I would not have even matched in the civilian world. So for me, even as much as I lose my mind about the military mismanagement it has been worth it for me.

For general dentists I used to think the numbers made sense for the $400k loans but now I really don’t. The cost of delaying your career 4 years can amount to 7 figures if you’re talking about buying into a practice or going in with family. It’s hard to quantify the cost of skill atrophy. For the crappy dentists who would would struggle at even the sketchiest corp job the military probably makes sense, and we see that with those who stay and take leadership positions. There is almost no path for growth though. I see my successful civilian classmates owning practices and doing Botox, fillers, PRF facials, digital surgery, sticky bone, really modern and cutting edge procedures. Now this is not everyone but really what I see it boiling down to is it’s absolutely not worth it if you were going to be successful in private practice. Nobody knows going into dental school if they will have great hand skills, business acumen, patient relations, potential for being on the cutting edge. I can see risk averse people still taking the scholarship out of fear of the unknown but looking back if I were going to be a general dentist than not only would I have still hated the military environment but the 4 year delay in starting my real career would be of negative value.

If you can’t tell I’m a pessimist when it comes to anything big govt/military but I see the DHA as the end of military medicine, at least the somewhat stable quality of life job. It’s getting worse and we’re already seeing the changes. I would only recommend joining for some specific non-financial reason like being prior service and wanting to complete an officer retirement while being a good leader or obtaining specialty training that would otherwise be unavailable to you.

 

[Lil Norkii the Supreme]

i'll add one more thing
recently top leadership at bumed said they are more concerned about dentists suturing skills in combat zones than actual dentisting skills

 

[vellnueve]

i'll add one more thing
recently top leadership at bumed said they are more concerned about dentists suturing skills in combat zones than actual dentisting skills

Probably because there aren’t many combat zone dental problems that can’t be solved with proper application of a forcep.

 

[Huskk]

Out of that conservative 2400 dentists, let's say that 1/3 know about SDN. Again a very conservative number. So, we are now looking at the 1000 (rounding up a little) dentists across all three Services that are on active duty, all have access to computers, and again, have been on SDN at some point either prior to, during or after dental school. How come there are only 1 or 2 who regularly post and usually in the negative? OK, I even plus that up to 5, which is way huge, the question remains the same….

Can say from conversations during my time on AD, that about 80% of officers had a similar experience to Big Hoss, myself included. The other 20% either stayed in to specialize (and usually get out ASAP afterwards), transfer their GI (retention tool), just liked the work pace, or a very small percentage just had an intrinsic call to serve.

The HPSP and GI Bill are great financial tools, but you have to be diligent to maximize your clinical experience. Even with a 1 year AEGD/GPR, unless you are the sole provider at a command, your experience will likely be very similar to those who just went straight in without delaying their payback.

 

[coolguy07]

Can say from conversations during my time on AD, that about 80% of officers had a similar experience to Big Hoss, myself included. The other 20% either stayed in to specialize (and usually get out ASAP afterwards), transfer their GI (retention tool), just liked the work pace, or a very small percentage just had an intrinsic call to serve.

The HPSP and GI Bill are great financial tools, but you have to be diligent to maximize your clinical experience. Even with a 1 year AEGD/GPR, unless you are the sole provider at a command, your experience will likely be very similar to those who just went straight in without delaying their payback.

Makes sense thank you reply, but more importantly thank you for your service!

 

[coolguy07]

I was wondering if anyone can expand upon the opportunity cost of joining the armed forces after dental school if the end goal is to own a private practice. However, I am not going to be able to do this the first day out of dental school (or residency) unless there is some crazy SBA loan out there that lends like that. More than likely I will be joining a corporate or working as an associate.

Hypothetically, if you join the armed forces wouldn't you be able to use that money as a down payment for your practice?

 

[Act0fgod]

First, let me say I've found that people are either happy in any situation or miserable in any situation.

I'm about to finish my commitment and figured I'd provide my experiences. It's my perspective and my experience. It may not be your perspective and experience. I'm Air Force (AF). The AF paid for my undergrad and a 4 year HPSP scholarship so I basically had to do 9 years before my commitment was up. I'm trying to decide if I'm going to separate or stay in. Honestly, there are some serious pros and cons to each. Typing this out is kind of helping me in the decision process so it's going to be long. I feel fortunate to be in a position where I have no debt and in fact have what I consider a healthy amount of savings. Honestly going into the military has made it so money really isn't a factor. My spouse is also military and we have no kids. Having two incomes has been nice. We live a life I'm generally very happy with.

The AEGD honestly was great. It sucks a little because you feel like your a dentist now and you should be respected and not have to work as much and do your own lab work and things like that but get over the entitlement. Rotating through operative, endo, perio, pros, OS and pedo is really valuable. After dental school you might think you know everything about dentistry and you are great...you're wrong. Now that I've had to supervise people straight out of dental school and their AEGD this is incredibly clear. You have no idea what you don't know and you haven't done anything compared to what you will see in even your first couple of months of practice. I admit you may be more current knowledge and have more clinical experience than some of the older dentists in particular procedures but if you did something in school or residency there was someone else that was really responsible who knew what was going on. You did a full mouth rehab, sure you held the handpiece but you used someone else's experience to pick the case, make sure there weren't problems and if there were problems they were there to fix them. In private practice, if you do something that goes wrong you deal with the consequences. In the military, you do something that goes wrong and it's probably someone else that is going to have to deal with the consequences. In my AEGD we had a good group of folks but it's pretty clear everyone coming out of dental school is lacking in certain areas of dentistry. From my perspective, the most valuable piece of my AEGD is the moderate sedation credentials but the surgical side of perio was also really helpful. I felt like coming out of dental school I got pretty good at removable pros, endo and the surgical side of perio while other people had no real experience. I didn't do any implants in dental school and honestly was lacking in basic operative and crown and bridge. The AEGD is a way to kind of level everyone out by giving us great experiences. It also allows you to learn the military paperwork (which is ridiculous).

I've been relatively happy with the type of dentistry I've been able to do. Here is my perspective. If you were designing a public health system where no one pays for anything and your objective is to provide dental health to a large number of people with a constraint on time and resources what would you do? Also, realize that the people you are treating come from diverse backgrounds with very different dental experiences and expectations. Personally, the most gratifying thing to me is those initial examinations and subsequent treatment on individuals who have never seen a dentist in their life. If I get out I will really miss that. That being said there are also folks who are very upset when they no longer get cleanings 2x/year, can't get ortho again after their teeth shifted a half-millimeter because they stopped wearing their retainer that their parents paid for and want whitening.

In the AF I feel like I have a good amount of control over my schedule. The only thing I have been directly restricted on is third molar cases. There are times when we have been told to shut down the in house wisdom teeth cases because our appointments were getting booked out too far, the handpieces were not functioning properly or we didn't have enough assistants to support (requires 2 assistants). Generally, I have one or two half days of exams a week where I see about 20-30 patients during the half day of exams and one or two 90 minutes to half-day of covering walk-in urgent care. Those are generally the only dentistry times that I don't have control over my schedule. I should also add sometimes other folks put things on my books just like I occasionally things on other people's books and that can sometimes cause friction.

As far as what I'm doing dentistry wise. I see patients 4-8 hours a day. I usually get to work at 630. I leave between 330-430. When seeing patients most of my time is 1 hour or 90 min operative, but also do a couple endos a month (2 hour appointment and molars usually a second 90 min appointment and I don't usually do max molars referring to either private practice endodontists or military endodontists if available), a couple wisdom teeth cases with sedation a month, 3-10 crowns, maybe a bridge every 6 months, and implant restorations probably every other month, more TMD patients than I would like (couple a month), a sleep appliance every 3-6 months, I've stopped doing gingival grafts but the first couple of years I did 2-3 a year, a couple initial or annual perio evaluations (some bases I've done ScRp myself but usually there are hygienists). I've only done 3 arches of complete since my AEGD (all army members being seen in our AF clinic for what it's worth) and have not done a single RPD since my AEGD. I've done one limited ortho case since my AEGD and have chosen to stop. I have not done any veneers since my AEGD. I have no blocked admin time but there are multiple hour long meetings I have to go to. They generally cover stuff about dental equipment, supplies, budgets and what people will be doing, who is going to be recognized, who needs to do the paperwork to get someone recognized or get new equipment and supplies... Bigger clinics tend to have more meetings because spreading information across more people is harder. The logistics are also harder in bigger clinics. We also shut down half a day for "readiness" training. This readiness training stuff is not dental related. There are also hours of computer-based and classroom-based training requirements that are not dental related. Think computer systems training, training on keeping military secrets a secret (don't worry as a dentist you won't really know anything more than what you could read in the news), sexual assault training, weapons training (how to use them and familiarity of things that could be used against you), safety training, communications training, training on how to lead, training on how to follow, training on how to supervise, training on how to communicate in the military way, lots of other things I can't remember but will be told I need to do and then last is actual dental continuing education. I figure if I were to own my own practice I would spend a lot of time on non-clinical things as well.

Honestly, it's a very inefficient process and everyone will agree we should be able to do more. Here are some of the problems:

Infection control and safety: I spent an hour typing this up and then deleted it all because really it wouldn't serve much purpose. I'm a rule follower by nature so following stupid rules (or choosing to disregard ones on my own) isn't a huge deal to me but as I progress in the military I'm going to have to enforce stupid rules and that isn't really something I can see myself doing. It sounds silly to say but having to enforce dumb rules is one of the primary motivators pushing me to separate. Some in this thread have bashed senior folks. I honestly don't feel like these senior folks are dumb or incompetent. They are probably as frustrated or more frustrated than you are but they can't let you know that. You think they have the power to make real changes...they don't. Our systems are created such that no single individual can become a dictator. The bigger the organization the more power in the organization but the more divided that power is. Also the more senior you become the greater the consequences are when you make the wrong decision so it's a lot easier to go with the safe path even if it doesn't make a lot of sense. For those that want specifics lets just say if the manufacturer puts it in their instructions you must do it that way. Doesn't matter if it makes no sense. The easiest example to explain is sterilization temperatures. If the instructions say 270 degrees for 4 minutes you need to show that's what you did or at least set your sterilizer to do. The problem is manufacturers seem to use a range of temps above 270 with varying amounts of time. No rhyme or reason. This is a logistical nightmare. These infection control and safety policies keep getting added each year and there are definitely diminishing returns on the overall safety and infection control.

Techs/Staffing: The techs/assistants run the gamut. Some are great and some are not. You don't control staffing levels and you can't fire people. To be honest, if you have someone who is bad you are seen as the failure for not being able to lead them. Most are military and they probably didn't choose to become dental techs, they were told they had to. You don't get to choose who you work with. You get one assistant and if they are military they probably aren't particularly well trained so you are going to have to train them and you probably don't know what exactly they are supposed to do (especially the case early on when you are learning about different materials and equipment). You won't have consistency with your technician. I feel lucky and the longest I've worked with the same tech is one year. There are times when I worked with a rotation of technicians with no consistency (really hard to teach them or do more than basic operative). Also, remember most of those rules about infection control and safety, the techs are the ones who are bearing the brunt of these policies and they aren't really getting more time and instead of more people, it seems like we are getting less. To make matters worse if you are the best technician you may not get promoted if you aren't doing other things. It's expected that everyone is good at their job so doing things outside the clinic is the percieved way to set yourself apart. I think there is truth to that perception as well. The techs also don't work for you they work for another enlisted member. This is a blessing and a curse. Blessing because the military supervision structure takes a lot of time, a curse because they just have to keep you happy enough that you don't convince their supervisor they are bad.

Equipment: This is a problem with government procurement. You might have some of the newest and nicest things because you bought it with money that needed to be spent before the end of the year, but you can't buy something that is moderately expensive that you use every day that is getting worn out. When things break you don't usually call the manufacturer to fix it you call the jack of all trade equipment repair person in your facility that services every piece of medical equipment in the entire hospital. When you think about it these folks are amazing. They had no experience but based on the basic entry tests the AF thought they were smart enough to provide a lot of equipment training to but sometimes (usually) they don't have the specialized skills to get it just right. It will get close and work most of the time.

Supplies: You don't control your supplies. Let's be honest as well. We don't really want to. We just want to have what we want when we want it. In private practice, if it makes economic sense or you want it you pay someone to get. If they don't keep you happy you buy from someone else. Not the case in the military. I will say in the AF we use some of the best supplies and we don't try and go the cheap route.

Computer systems: It's really hard to keep a global records system for hundreds of thousands of people across the globe. The AF actually uses the armys digital record and appointing system. The computer networks are really slow and routinely not accessible. I guess the military has to have lots of computer security but this seriously impacts digital medicine. It's really frustrating when you can't take or view xrays. In the AF we can't see digital anything from the Navy. We can see some radiographs taken at army locations, but I don't think they can see any of the radiographs we use. We enter our notes into online systems but then have to print them out because we are still a paper chart system and the big AF is not letting us have printers at our desks anymore but instead we have a limited number of multifunction copier, scanner fax things that often are not functioning properly. When people move sometimes yearly you can imagine how often those paper records get lost between clinics. There are supposed to be big changes where there is going to be a joint records system (also includes the medical side) and we will transition to digital records. We are also supposed to transition to a medical network instead of using the base network which hopefully will improve system reliability/access.

Production: It's one of the measurables we have. No one really talks about it but everyone talks about it. There is a value for every procedure based on how we code the procedure. No one really audits what we put in and no one really teaches you how to code. I've seen under coding but more frequently I've seen over coding, to include what would be fraud if our notes were submitted to insurance. I think the over coding usually starts of innocently enough. You see someone used a code for a procedure you didn't know existed so you start using it. The problem is it happens a lot and the codes are a little different so you use both, then you start to use some that aren't what you are really doing and then the codes move to legit fraud. This one is weird because it doesn't really matter but it totally matters. No one has told me production numbers matter, in fact I've had many people tell me it doesn't matter but it is a number that is included in evaluations and awards. It is a number used to determine how to allocate resources, I believe it's used to come up with the total cost of DOD healthcare. It's used as a quick judgment on our overall worth but really it doesn't show the big picture especially since it's entirely inconsistent. In private practice doing high dollar procedures is how you make money but in the military sometimes a multisurface amalgam is better than a CAD/CAM onlay or inlay. I can't come up with anything better though.

Socialist system: I really do think the military is the best social welfare system in the US. Unfortunately, social welfare programs can breed a cycle of entitlement and laziness. I see it happening to me, to be honest, and don't like it. You see someone else and you perceive they aren't doing as much as you but get the same or more. I say perceive because you never know the whole story. The only thing I know is I get paid regardless of whether I see 1000 patients or 1. You don't get paid extra for working through lunch vs re-appointing someone. You don't get paid extra for coming it at 2am vs telling them to show up at 7am for sick call. On the flip side there is no real consequence for the person who makes and then skips 6 straight appointments or who calls you at 2am because they chipped their front tooth on a beer bottle.

Deployments: This is more my wife. She is deploying frequently. I was asked to deploy once. It was right after my wife got back from a deployment and we were apart for a year so I said I wasn't interested. In the AF there aren't many dentist that deploy and someone else volunteered. I have asked to deploy at times when my wife gets deployed and I've been told no.

So why am I considering staying in? As I said I have a generally great life. Paid vacation. Not having to worry about my patients when I'm not there. There is no financial stress. It's so safe. If I stay in 20 years my wife and I will each have a pension so we will get paid over 100k starting in our early 40's for doing nothing with some form of very affordable healthcare. I actually enjoy the type of dentistry I'm doing. I personally have no interest in doing the money-making esthetic work and in fact I'm disappointed with the trend of advertising in dentistry such that commercials for clear aligners or implant-supported dentures are everywhere on TV and billboards.

 

[AmericanHero]

You need to think of this like an adult and recognize that the most important thing about HPSP is EDUCATION and financial freedom. You absolutely should do the 1 years AEGD and learn everything they teach you. It’s so much better than any civilian CE or GP residency you will ever find. (Most people who have a hard time clinically in the Army, are those who went straight into payback.) Then use your 3-4 year commitment to practice what you learned without a fear of malpractice and continue to learn from the specialists around you. Now get out and use those skills you acquired to open your own practice and provide top notch care that can offer specialty procedures and not just basic drill and fill.

You will learn that people who graduate from dental school are in incredible amount of debt and will not spend the time doing CE courses or a GPR residency and will go straight to work. You simply can’t understand at this point in your career how little they actually teach you in dental school. The real money in dentistry is in owning your own practice. You will never make money being an associate, with 300-500k in debt trying to pay down those loans for 10+ years. Those who you hear about that graduate and open their practice 1-2 years out of school are either coming from wealthy families, have dentists in the family, or are simply financially illiterate. What kind of dentistry can you provide in your office straight out of school? How long will it take you to pay off 1mil+ you just took out a loan on for your education and practice? Congratulations, you just bought your self a job that you have to pay 10k in monthly interest for the next 20 years on.

So is 4 years of your life worth spending in a setting that will allow you to learn and have zero dental school debt worth it? Absolutely. Even to those who were unfortunate enough to get placed in terrible duty stations, I think the fact that you have no loans, saved up money while paying back your commitment, and can now have GI Bill to pay for a residency, plus all the special government loans for your future house and practice are absolutely worth it. Money speaks for itself and if you are having doubts, write down the numbers on a piece of paper and ask your parents what they think the right move is.

 

[IdleKoala]

You absolutely should do the 1 years AEGD and learn everything they teach you. It’s so much better than any civilian CE or GP residency you will ever find.

I've heard mixed opinions on this. If you aren't considering specializing is there really a point in doing a 1 year military AEGD when you most likely will just be doing exams and restorative work for the next 4 years regardless? I personally am undecided regarding whether or not I want to specialize. If I don't specialize, it doesn't really seem wise to do an AEGD if I will most likely be doing the same procedures if I hadn't have. Does anybody do a civilian AEGD/GPR after they get out? Does the GI Bill cover all civilian GPRs?

 

[FutureDent020]

I've heard mixed opinions on this. If you aren't considering specializing is there really a point in doing a 1 year military AEGD when you most likely will just be doing exams and restorative work for the next 4 years regardless? I personally am undecided regarding whether or not I want to specialize. If I don't specialize, it doesn't really seem wise to do an AEGD if I will most likely be doing the same procedures if I hadn't have. Does anybody do a civilian AEGD/GPR after they get out? Does the GI Bill cover all civilian GPRs?

There are mixed opinions because there isn’t a right or wrong answer. It depends on the individual. I’ve expanded on this question multiple times so I won’t get into the details. You won’t need to do an AEGD or GPR when you get out though. DM us if you have more detailed questions.

 

[isittoolate]

To be honest, my only motivation for taking a 3 year AF HPSP scholarship was financial.

I was in the last class that had a choice for AEGD- I chose to attend and I am very glad I did.

Straight out of dental school, here are some individuals (NOT the majority) with enough knowledge, handskills and experience to be successful and practice a decent range of dentistry (simple implants, molar endo, clinical crown lengthening, etc). At the end of dental school I knew my surgical skills were lacking and I simply did not have enough experience with molar endo.

Biggest takeaways from the AEGD was IV sed and enough 3rd molars to know what to keep and refer, molar endo, endo retreats, CEREC (mostly full coverage), and implants with direct and indirect sinus lifts. Good additional skills to have but "school" mindset- emphasis on quality, not speed. Not all of these skills will translate to private practice for many reasons that I won't get into now.

However, my current clinic limits me to mostly exams and fillings. It is a constant fight to schedule CEREC, molar endo, and any perio surgeries; access to care concerns and inability to schedule appointments over 1 hour. My skills are definitely deteriorating, as well as there is no opportunity to practice running multiple chairs and/or speed. All I can hope is these procedures are like riding a bike.

Highly unlikely that you will want to take an AEGD or GPR after the end of your service when the time comes. You may be able to take CE, but again you will have to make time for it and $$.

If you are sure that you want to be a general dentist, I do not think there is a one year residency that matches what the military provides. If you may want to specialize, probably matters less and you can get out one year sooner to use your GI Bill. Who knows if my answer will change after I transition to private practice. Good luck!

 

[midds2022]

To be honest, my only motivation for taking a 3 year AF HPSP scholarship was financial.

I was in the last class that had a choice for AEGD- I chose to attend and I am very glad I did.

Straight out of dental school, here are some individuals (NOT the majority) with enough knowledge, handskills and experience to be successful and practice a decent range of dentistry (simple implants, molar endo, clinical crown lengthening, etc). At the end of dental school I knew my surgical skills were lacking and I simply did not have enough experience with molar endo.

Biggest takeaways from the AEGD was IV sed and enough 3rd molars to know what to keep and refer, molar endo, endo retreats, CEREC (mostly full coverage), and implants with direct and indirect sinus lifts. Good additional skills to have but "school" mindset- emphasis on quality, not speed. Not all of these skills will translate to private practice for many reasons that I won't get into now.

However, my current clinic limits me to mostly exams and fillings. It is a constant fight to schedule CEREC, molar endo, and any perio surgeries; access to care concerns and inability to schedule appointments over 1 hour. My skills are definitely deteriorating, as well as there is no opportunity to practice running multiple chairs and/or speed. All I can hope is these procedures are like riding a bike.

Highly unlikely that you will want to take an AEGD or GPR after the end of your service when the time comes. You may be able to take CE, but again you will have to make time for it and $$.

If you are sure that you want to be a general dentist, I do not think there is a one year residency that matches what the military provides. If you may want to specialize, probably matters less and you can get out one year sooner to use your GI Bill. Who knows if my answer will change after I transition to private practice. Good luck!

Any chance you'd ever moonlight to try and hold on to some of those skills? To be 100% honest, my choice for the HPSP was similar, with the added benefit of doing some moving before settling down, but if I could hold onto some skills by moonlighting 2-3 days/month then it might be a good deal, plus pay back that 1 year of dental school a little quicker.

 

[isittoolate]

Any chance you'd ever moonlight to try and hold on to some of those skills? To be 100% honest, my choice for the HPSP was similar, with the added benefit of doing some moving before settling down, but if I could hold onto some skills by moonlighting 2-3 days/month then it might be a good deal, plus pay back that 1 year of dental school a little quicker.

I'd love to moonlight, but since it has never been done at this base I have been shut down previously. Currently submitting again for approval with a contract offer in hand, but due to COVID likely no chance again.

Depending on your leadership, you may be able to get approved. One of my co-residents was approved at his base, so it can be done as a general dentist. Lots of specialists are approved, but there seems to be the understanding that they are sacrificing more income therefore it is more logical to approve them.

Worst case, 6 months at a corporate office before I feel like I have taken the training wheels off. Seems like the trend of recent graduates...

 

[Big Time Hoosier]

My friend spent some serious cash to get a certain state license to try and moonlight, only to get shot down by the Command.

Big Hoss

 

[bird2youth]

I'd love to moonlight, but since it has never been done at this base I have been shut down previously. Currently submitting again for approval with a contract offer in hand, but due to COVID likely no chance again.

Depending on your leadership, you may be able to get approved. One of my co-residents was approved at his base, so it can be done as a general dentist. Lots of specialists are approved, but there seems to be the understanding that they are sacrificing more income therefore it is more logical to approve them.

Worst case, 6 months at a corporate office before I feel like I have taken the training wheels off. Seems like the trend of recent graduates...

Do commanders change frequently per base, every year or so? I'd love to moonlight as well.

 

[Lankers]

Are you able to get the bonus for being a dentist while you are paying back your four years for the HPSP scholarship. Also, I have read here and there it is more common to get into OMS right out of dental school in the Army. What would you all say to this statement?
Thanks