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Is it the lifestyle/salary? Most people I talk to hate it..
Why is ENDO residency so competitive?
- Thread starter makohunter18
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I'm pretty jealous of my Endo specialists. There is three ways to do it:
1) 2 Chairs, 1 column with treatment at a reasonable pace 2-3 hours bookings with decent PPO/FFS fees and 1 column with consults. Minimal staff...Sub 50% overhead...4 days a week...booked out... even if you collect 500-800k...at 50% overhead you are taking home 250-400k with 2 columns and seeing 10 or so patients a day...SWEET GIG.
2) More productive 3 chair mill. Hustling and making more...but overhead goes up...and quality goes perhaps down...but money goes up to...
3) Corporate: drive to different clinics and hustle the endo $$$. Lots of patients, great pay, but hard for sure.
I think the thing is that endo OFFERS the ability to do option #1. You can't do that kind of option as a General Dentist and expect to be taking home alot of money. Endo does a "slower" pace dentistry with great money. The overhead is amazing to. You are paying for files and bleach basically and inert gutta percha. Also you don't have to deal with staff all day long. Having 2-3 staff versus 10+ in a GP/OMFS/PEDO/Ortho office is god-send. You have no idea how much of a headache staffing can be.
At the same time, I think you have to love endo. The cases they get are hard...limited opening...second molars...staring into a black <.5 mm hole all day long. I think thats pretty miserable.
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Do you think endo will always be a needed specialty? Sometimes I read people saying it's going to be less necessary or something like that.
I think endo is here to stay. Not too sure about periodontists. Prosthodontists will always have a place in dentistry as they kind of have a stronghold in dental education.
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Yes, but I do think the cases will be HARDER. Less GP will refer out the easy endo/molar endo because of competition+student loans+less patients to go around...but....GP will still refer out retreats, broken files, and crappy rcts for endodontists to clean up. Gone are the days of easy open pulp chambers....here are the days of calcified dentin blocks, broken files, and bailing out GP's.
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Maybe someone can weigh in on this. What does it take for someone to get into an Endo residency? I've heard if you practice as a GP for a while to get experience your chances go up, but what does it take to get in straight out of dental school? Are there things that can boost your chances like extracurriculars or research? I can't seem to find much info on this subject except general opinions.
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Like all specialties, it’s class rank, research, service, leadership, and faculty connections. Also, it does seem that endo to a large extent is jumping on the ADAT bandwagon, so crush that. FYI, my endo friends tell me that half of all residencies won’t take you seriously without full time experience.
Big Hoss
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So you think the amount of need and work will stay the same for an endodontist, it's just that your skills as a specialist will be put to the test every appointment?
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Periodontists like to occupy the administrative positions and like to be the "face" of the school (because they drive a lot of research activities and are in general showy people). But prosthodontists are the ones doing the heavy lifting as far as teaching the restorative curriculum is concerned.
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Not every appointment... but yes the cases are harder but you are a specialist... you are supposed to do the hard cases and fix the mess ups... it’s part of the job description.
It’s also like omfs... I’m sure they have a few easy referrals but if the teeth are partially erupted on a 16 year old... GP will do it and collect 2000, if it’s a horizontal impact next to nerve omfs gets it. With more competition and less pay to go around, all the easy cases get taken up...
You get referrals from GPs with different skill sets. Several of my referring GPs don’t do endo in their practice since they are busy with restorative, and they refer cases to me and then do build up and crown next day. Having said that after doing 1000+ endo cases and using scope, treating challenging cases becomes a routine part of your daily schedule.
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They are not many Endo programs, and each takes few residents. AAE is the best source to find the list of programs:
https://www.aae.org/specialty/education-events/academics/advanced-programs-in-endodontics/
https://www.aae.org/specialty/education-events/academics/advanced-programs-in-endodontics/
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Endo saves teef.
It's all about the higher income potential.
While there may be some who truly LOVE doing endo all day long, rest assured that if the income was not so high, that the number of applicants would not be so high.
When I finished Dental School, Pedo was considered one of the easier residencies to get into, and the 4 people in my class who went into it were not even in the top half of the class. My understanding now is that Pedo is also very competitive - due to the huge increase in income potential for Pediatric dentists.
Same model holds true in medical specialties.
While there may be some who truly LOVE doing endo all day long, rest assured that if the income was not so high, that the number of applicants would not be so high.
When I finished Dental School, Pedo was considered one of the easier residencies to get into, and the 4 people in my class who went into it were not even in the top half of the class. My understanding now is that Pedo is also very competitive - due to the huge increase in income potential for Pediatric dentists.
Same model holds true in medical specialties.
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what changed about pedo to raise the income potential?
I honestly don't know.
Probably because I HATE working on kids, lol, so I have never really looked into it.
One of the guys in my class who went into pedo was a good friend. Good with people but struggled with the books, and struggled even more with his hands.
He was, however, always looking into the business side of dentistry. I can remember even 2nd year, he would be making notes on how much an office should produce per hour, etc.
He believed Pedo income would go up, and even though it was easier to get into, he didn't have the grades (they were pretty bad), so he went and worked a year as a general dentist associate for a large Pedo office (one of our professors liked him and helped set it up) and he got in a year later.
he probably graduated in the bottom 20% of our class, and is now making a great living as a Pedo dentist.
More power to him. I would have a nervous breakdown working on screaming crying kids all day.
Probably because I HATE working on kids, lol, so I have never really looked into it.
One of the guys in my class who went into pedo was a good friend. Good with people but struggled with the books, and struggled even more with his hands.
He was, however, always looking into the business side of dentistry. I can remember even 2nd year, he would be making notes on how much an office should produce per hour, etc.
He believed Pedo income would go up, and even though it was easier to get into, he didn't have the grades (they were pretty bad), so he went and worked a year as a general dentist associate for a large Pedo office (one of our professors liked him and helped set it up) and he got in a year later.
he probably graduated in the bottom 20% of our class, and is now making a great living as a Pedo dentist.
More power to him. I would have a nervous breakdown working on screaming crying kids all day.
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Higher income could be one factor, but unfortunately heavy student loans make a lot of new grads make their decision only based on annual income. They should take into account several different factors and see whether they genuinely love that specialty. Charts like this could be misguiding because they think Endo or OMFS produce more and therefore, they should pursue those specialties.
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Can you elaborate on what students can be misguided on?
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ADA publishes annual income of different specialties, and unfortunately there are times dental students don’t think about what they really enjoy doing and just look at ADA charts and how much they make by becoming an Endodontist or Oral Surgeon. Each specialty has it’s own pros and cons, and several factors is involved to become a successful specialist. I love my specialty and I am happy doing what I do regardless of my annual income.
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I agree with what you are saying.
And I think it applies even more so in Endo and possibly Perio than the other specialties.
Oral Surgery is just that, cut and dry, it and ortho are the specialties most removed from what a general dentist does day in and day out, IMHO. Pretty plain what ortho does. Same with Pedo. Pros is really just for those who enjoy challenging restorative cases, and want to be a master of restorative.
Endo in particular, where most dental students have done possibly a dozen, or 2 dozen root canals - mostly easier non-complicated cases, it would be hard to really "love" the specialty, as one has barely dipped their toes in. I think this is why most endo residencies tend to admit mostly candidates who have some time out of dental school, whether it be a GPR and/or a few years in private practice.
That being said, income IS important. Being a dentist, ANY kind of dentist, is hard work. While I love many of my patients, there are high maintenance types, and unreasonable types, and those who simply do not want to pay for their oral health needs - and those patients can take much of the satisfaction out of a typical day of practice.
After 2 decades as a general dentist, with the last decade having my income above the 75th percentile for general dentists (by those same ADA surveys - which IMO are the most accurate income surveys for dentists), I can say that if I had it to do over again I would have specialized, either in OS or Endo. Much of general dentistry is a grind, and you have to hop to produce in a typical PPO dental practice. I understand many pursue a less or insurance free model, with more cosmetic dentistry, but I have found that attracts a higher maintenance class of patient, and I have no interest in that.
I mention income being important, because at the end of the day, I get my happiness mostly from my family and time out of the office, and while dentistry has been good to me, I do find it taxing on the body, and stressful in general.
Maybe there is already a thread for this, but I couldn't find one that answered my question directly. I have been gathering information from the AAE's website in regards to Endodontic Residency programs for 2019 (I will be applying this summer). After months of emailing schools and searching the AAE's website for information, I found that there were large discrepancies between the school and the AAE's website. I am wondering if anyone has an updated comprehensive list of schools that: 1. Require a year of experience/a GPR? and 2. Require a form of secondary examination outside of the boards exam? Thank you for your help!
Good luck with your application.
Can you let us know where you are academically, in terms of class rank and board scores?
My understanding is the vast majority of residencies won't even look at most new grads, unless top 10 in their class, and have done endo oriented research, etc during dental school to show a real interest in the specialty.
Background: I graduated top 5 in my class(was on a military scholarship), did a military GPR, a few years in the military, then civilian associateships, and after a few years private practice I applied to about 6 or 8 endo programs. I was selective as I thought I would have no problem getting in. The first year I got 3 interviews. One program that only took 2 residents a year told me I was the first alternate. I was surprised at the competitiveness. In my interviews all the program directors told me they only interviewed current dental students from THEIR school, "as a courtesy". As there were so many highly qualified, EXPERIENCED applicants, they had no interest in having a resident who had only done a dozen root canals, no matter how academically qualified they were. The next year I applied again but just to the programs I had gotten an interview with. I was accepted at one.
By that time I was making over $300k as an associate, and being a decade out of school the thought of going back and being poor (and my wife wasn't working and we had 2 small kids at the time) made me rethink my options, and I ended up buying a busy practice. I had always planned on specializing, I could have had my pick in the military but my wife hated the lifestyle, and the more years from when you get out of school, IMO, the harder it is to go back.
As I've stated earlier though, if I had it to do over I would have taken that slot, so if you are a competitive applicant, you should go for it.
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What's "it"? Many people hate doing molar root canals... that's why they refer to endodontists! I happen to LOVE doing root canals. That's why there's a special subset of us who specialize in this. It's competitive because a lot more people want to specialize in endo than there are spots (generally only 2-7 per program). In addition to the decent lifestyle and strong earning potential, there's a lot of other things and practice aspects that make it a great field. Have you actually talked to endodontists?
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You were top 5, with gpr, military and pp experience and still didnt match the first year? why you think so (cause that is a very competitive app i would have imagined) and what did you do different the next time you applied? did you have research experience?
Because I didn't realize just how competitive it was, I had only applied to a small handful of programs - mostly in cities that I and my wife thought we would enjoy living in. All but one of them only took 2 or 3 residents a year. I was not "in-state" at any of them.
I had no research experience, other than the rudimentary "table clinic" I did during my GPR, and just a few hours of endo specific CE every year.
Also I didn't have any big name endodontists pulling for me. Just had letters from a couple of guys in private practice, one of my bosses in the military, and from the dean of admissions at my dental school, who remembered me well, even from our first meeting on the campus of my undergrad university 15 years prior.
Really thought all the other factors on my resume would carry me, and ultimately it was good enough to get admission to ONE program, the second time around.
Send me a private message. I got in this year to a paid Endo Residency Program and could guide you a bit.
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I second what DocJL mentioned. Schools tend to reserve some seats for their own alumni so even though they may have 4-5 seats at their programs, 2-3 were already well taken (Iowa is a good example of this).I would recommend to apply wisely and apply to many programs to ensure getting some decent number of interviews and hopefully one acceptance
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What are things to make yourself competitive from Day 1 of Dental school?
From what I can gather:
1. Class Rank (Top 25%)
2. Clinical Experience
a. Advanced endodontic experience in D3/D4-retreats, etc
3. Research
4. Externship (2-3)
5. Leadership
a. ASDA/Student government
6. Connections
a. AAE membership/Meetings
7. Shadowing/Letters of Rec
Am I missing anything?
From what I can gather:
1. Class Rank (Top 25%)
2. Clinical Experience
a. Advanced endodontic experience in D3/D4-retreats, etc
3. Research
4. Externship (2-3)
5. Leadership
a. ASDA/Student government
6. Connections
a. AAE membership/Meetings
7. Shadowing/Letters of Rec
Am I missing anything?
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You forgot one’s physical appearance. We live in a vain, vain world. My looks have carried me further than I’d like to admit.
Big Hoss
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adat exam in the future
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I have a little different experience, so I'd just drop my two cents: I also was in the military and had some research/private practice experience, but no way close to being top 10 in my dental school. I had almost zero endo experience to show for (I did less than a dozen root canals in more than 4 years in the military; yes, my dental experience in the military largely consisted of emergencies, fillings and prophys), and I did not do GPR/AEGD. And I did not take the ADAT either. Of 9 or so programs I applied I received interview invitations from 8 (I did not go to all), and got my top choice. There are practically less than 500 unique applicants for approx. 200 slots every year (check ADA - the total application per cycle is about 3500, and assume a typical applicant is applying for just 7 programs). Of course, some programs are inherently competitive because they offer paid salary with benefits (UCLA, Einstein, etc to name a few). If you only apply to those types of schools, well, good luck. Same goes for certain programs favor their own graduates - well if you know this fact prior to applying, you'd better make sure application is above par. On the other hand, it seemed some private schools have trouble filling their seats, scrambling to bring people in for interviews toward the end of the interview cycle (I guess due to people dropping out after they got into programs with cheaper tuition). I researched and applied both state/private programs that value military experience (there's quite a few), and every director I spoke to was more than happy to bring me in for an interview. So I guess if you have a good strategy based on your strengths, getting into A program is more than doable. Again, IMHO. BTW - if you are coming out of active duty - you could be considered a resident in ANY state as you get out.
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They are several private schools’ Endo programs that provide you solid training and you guys shouldn’t disregard them. At the end of the day you want to be an endodonist and nothing should stop you from reaching your goal. I have never seen any UoP Endo grad not doing well. They have a great program director, Ove Peters, and provide you a great training. I know several of their graduates and they do very well. Knowing about program directors helps. From top of my head Myers, Sedgley, Barnett, Replogle, Hargreaves are great mentors and you won’t regret getting training in their programs. Also, ask their existing residents whether or not you can moonlight over weekends. Best of luck to applicants for this cycle. I am very happy to see more voices for Endo specialty.
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I've heard good good things about the UOP program as well from previous applicants- it seems the residents are really happy there and getting alot of clinical experience but the only negative is the tuition cost. Plus they have a brand new clinic. Someone had told me that one of their incoming residents had actually chose to go to UOP despite being accepted to the much cheaper UCSF program, so there must be something really appealing about the UOP program despite the tuition.
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I consider schools such as UTHSCSA, Houston, Baylor, PENN, LSU, Iowa, Detroit, and Illinois are "military friendly." Obviously, the list not exhaustive; there should be more of them.
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Seeing your credentials, I am beginning to wonder if I stand any chance. I have been out in the real world for 5 years now and don't have much else to back me up other than strong letters of rec.
300k as an associate?! Where do you work?! If I don't get into endo, I want to work where you are! 🙂
Strong letters of recommendation, particularly from someone known to a particular program director, are HUGE. Also take my post as a real world example of why if you are serious about getting in, you need to apply to as many programs as is feasible, and not "cherry pick" as I did.
I'm in Vegas. But those days are long gone.
Before they passed reciprocity in 2002, this used to be the best place in the country to practice, in terms of number of pts per dentist. Prior to the number of dentists LITERALLY DOUBLING between 2002 and 2008, and the economy crashing, it was very commonplace for a good associate to be able to take home $200-240k, with particularly experienced/skilled associates often being able to make $300k plus. Keep in mind that at the time I had a decade of experience, including a military GPR and 4 years as a military dentist, and then several years of private practice associate experience, and I was producing (real/adjusted production - what the office expected to collect) close to $100k per month in dentistry (this did NOT include hygiene production, just my own work).
Just for clarity, does UoP mean Univ. of Pacific or Univ. of Pennsylvania? They both have endo programs so I can't tell which one you are talking about.
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Hate it??? Wow.
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Never.
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Pacific