I Just Graduated From U Of T And Am A New Associate. Ask Me (Almost) Anything!

[cleanup]

Hi guys. Haven't been posting or even moderating very much lately, but short of answering who I am or where exactly I practice, I thought this might be fun. I get a number of PMs every day but I think having a thread might be more interesting. Hope everyone's having a good week.

[uoft2020]

How many clinical cases (endo, exo, prostho) did you end up doing during your last 2 years of dental school?

[Pauls]

Was it easy to find a job? How was the transition from school to associateship? did you feel ready for the real world after graduation? do you feel you are adequately compensated? Thank you!

[munchkin]

How difficult is it to find an associate position in Toronto? Thanks! 

[uoftdentalstudent]

How do you go about improving your skills such as learning implants, complex molar endos, thrid molar extractions, assuming you never did a GPR? How do you find time to improve your skills? Also, do you recommend a GPR in Canada?

[cleanup]

How many clinical cases (endo, exo, prostho) did you end up doing during your last 2 years of dental school?

I'm on mobile so forgive me if my formatting is a bit weird.

 

I was lucky in that I got plenty of clinical exposure. I did about 6 or 7 endos, a large number of pulpectomies (essentially the first half of an endo and it is by far the most difficult part of an endo, so I consider it just as helpful as doing a full endo), maybe 30-35 exos in clinic and about another 20-30 in rotations/Externships (not everyone will get these but you can seek them out). Prostho was a bit lacking for me. I only did 6 dentures (including all types) and I was unfortunately not able to do a bridge.

[cleanup]

Was it easy to find a job? How was the transition from school to associateship? did you feel ready for the real world after graduation? do you feel you are adequately compensated? Thank you!

At first it wasn't but that's because I started looking way too early (in December/January). People just weren't looking for associates so far in advance. I was aiming to start beginning of June. The job offers really ramped up around end of April to beginning of May. After that I was fortunate to have enough job offers that I was turning a lot of practices down in an effort to find my ideal schedule and practices. Your mileage may vary. I know of other people who have had more difficulty finding associateships. It all depends on how you present yourself as well as how picky/flexible you are.

 

The transition is still happening, but so far so good. One of the biggest learning curves is learning how to manage your time properly, and the mental hump of realizing you can't say "let's speak with the instructor" anymore when you're not sure on something. You can still ask your principal or colleagues (if you can't, then quite frankly get the hell out of there) but you need to be able to artfully manage a situation you haven't seen before, even if it means admitting you don't know in a way that maintains the patient's confidence and trust in you. 

 

So far my billings are not super high because I haven't been doing too many high yield procedures. But I think it is wise to start slow. Exams, emerg patients, basic restorative, extractions, treatment planning. Get the basics down pat; don't be jumping into the deep end too quickly, and be open to learning from absolutely everything. I am more concerned with being booked/busy than I am with making a bunch of money right away. I have only ever really had downtime one day I've worked so far, and that's because I was a) fortunate to find the practices I did and b ) interviewed well and impressed them. I was picky and prioritized being busy and being able to learn. 

 

That said, with regard to billings, I think it is wise to expect little, and maximize what you get out of everything. Spend far less than what you make, and realize that even though you will and should be making much more than when you first start out, even a brand new dentist can literally make well beyond the average income of a Torontonian on a handful of hours per week. For reference, a PGY-5 medical resident makes something like $77k a year--this is just what I'm getting from the CaRMS website, I am by no means an authority on these so please correct me if I'm wrong--and they're worked like a dog for it. I was offered an arrangement where I could have made well beyond that for doing nothing (ie. paid a per-diem base salary, or 40% of production, whichever is higher) for 4 days a week. Find me another field where you could technically make $77k a year for doing zilch (not that that would actually happen but you understand my point). I didn't take it, because it was a new startup practice and I knew that once again I was prioritizing doing things and seeing patients over money, even if for whatever freak reason I was making less than the base salary (to be frank, if you make $77k in your first year you are doing something wrong, or are being fallacious with yourself with your job selection). Quite simply, that kind of flexibility does not exist in many fields. Count your lucky stars.

 

And no, don't feel ready for the real world yet. I dont believe any dentist is completely wholly competent for anything that walks through the door, ever. There's always more to learn. I think "comfort" comes after a few years for general dentistry, and where you go from there all depends on what kind of practitioner you want to be.

[cleanup]

How difficult is it to find an associate position in Toronto? Thanks!

As difficult as you want it to be. There are plenty of jobs. Are there a lot of good jobs? That depends on your level of flexibility. But the further you go from the city the better it will be in terms of clinical quality, busyness and general lack of red flags. No I don't mean North York or Scarborough. Even places like Oshawa and Aurora and etc are saturated, and new practices are popping up all over Simcoe County, Niagara, etc.. People are being pushed further and further out. You will have to make sacrifices on one side or another for the good jobs. Either move to a small town or be okay with driving--a lot of driving.

[cleanup]

How do you go about improving your skills such as learning implants, complex molar endos, thrid molar extractions, assuming you never did a GPR? How do you find time to improve your skills? Also, do you recommend a GPR in Canada?

I recommend a GPR for people who a) want to specialize and see a GPR as an "in" especially if it's at an affiliated school or hospital to the program you're aiming for and b ) people who aren't comfortable jumping into practice out of school. I felt fairly confident out of school and though my initial experience has been humbling I feel like I can expand my clinical and theoretical knowledge on my own. A GPR is great for getting a bunch of learning, skills and even certification in a safe, valuable manner. But the downside is you will probably also be learning some things you don't enjoy or aren't interested in, and generally GPR life can be difficult. However, I am of the firm belief that if you want to learn, do it early while you're young.

 

[Edit] I just realized I didn't fully answer your question. You can further your learning through continuing education; it's essentially a requisite anyways since you have to do it in order to maintain your license. The upsides of this are that you can learn what you'd like, at your own leisure, and there are a multitude of options available to you. The downsides are of course cost (popular or high-yield courses can be 4-5 figures), lost productivity (you have to take time off work, while in a GPR you'd be learning things AT work) and the fact that these learning scenarios aren't always done in a setting you're used to (ie. clinical/academic).

[Nachoolibre]

From your graduating class, do you know roughly how many people got into specialty programs?

[cleanup]

From your graduating class, do you know roughly how many people got into specialty programs?

 

Around 8 or 9 I think immediately. That number will go up after people finish GPRs, or do general practice for a bit. I have really smart, hard-working classmates.

 

That said, do not take some sort of off-the-cuff statistic to try to predict how likely or easy it is for U of T grads to specialize. It varies person to person, class to class. In the end, it's the people who actually want it who get it. I'd say most people are capable of working hard, getting the grades, accolades, recommendation letters to get into a residency, but if you don't want it badly enough, none of that matters.

[cleanup]

I've made a few edits to posts to flesh out my ideas/points better. Sorry for the crappy responses so far, I am on mobile and will be for the rest of the day.

[enamelbro]

Are you happy? Would you go through dental school again knowing what you know now?

[OralG]

Are you happy? Would you go through dental school again knowing what you know now?

[uoft2020]

I'm on mobile so forgive me if my formatting is a bit weird.

 

I was lucky in that I got plenty of clinical exposure. I did about 6 or 7 endos, a large number of pulpectomies (essentially the first half of an endo and it is by far the most difficult part of an endo, so I consider it just as helpful as doing a full endo), maybe 30-35 exos in clinic and about another 20-30 in rotations/Externships (not everyone will get these but you can seek them out). Prostho was a bit lacking for me. I only did 6 dentures (including all types) and I was unfortunately not able to do a bridge.

What about root canals?

[DDSER]

By endos he means root canals

[cleanup]

Are you happy? Would you go through dental school again knowing what you know now?

 

Sorry, I was out all day.

 

Yikes. That's a bit of a loaded question. Am I happy? Of course. But I think the key is to be happy with whatever you do. Am I happy with my choice of dentistry? So far, so good. I can't say I don't rarely wonder "what if" I went to med school, but I don't regret my decision the slightest. Also I think I'd have similar feelings had I gone to med school as well. I don't know what the future bears; you have to stick to your guns.

 

If the question is about choosing between the two, I don't think you can go wrong. But you should go with your gut; no point in trying to be pragmatic/technical about it... that will just engender a decision you probably won't be sure about.

[cleanup]

By endos he means root canals

 

Strangely, uoft2020 also used "endos" to refer to them in his original question.

 

Yeah "root canal" as a term to refer to the procedure itself is a bit of a misnomer. "Root canal therapy" is the more correct term. "Endo" and also "RCT" are just colloquial terms used by practitioners amongst each other. Otherwise 'root canal', despite being a pretty terrible bastardization of the whole thing, is still the term that patients understand; unfortunately it also has a lot of negative connotations.

[Haribo7173]

Basic question but...when you were considering dentistry, did the very hands-on nature of the profession ever "scare" you or were you looking forward to the challenge?

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Basic question but...when you were considering dentistry, did the very hands-on nature of the profession ever "scare" you or were you looking forward to the challenge?

 

Both. I like working with my hands, but that doesn't mean I wasn't apprehensive in the beginning just like everyone else. 

 

Hand skills, dexterity, surgical finesse is learned. Some people pick it up quicker than others, but for the most part everyone reaches a certain level of comfort. I wouldn't let it worry you. There's a reason a lot of schools couldn't give two shits about the manual dexterity test on the DAT anymore.

[munchkin]

What's the difference between being an associate vs. doing a residency in terms of experience, compensation and competitiveness? Thanks

[McMomo]

When looking for a job, what factors do you think are the most important? (Eg, Clinical experience, networking, extra-curriculars, grades)

[cleanup]

What's the difference between being an associate vs. doing a residency in terms of experience, compensation and competitiveness? Thanks

 

I'm going to assume you're talking about a general practice residency. That entirely depends on the residency you do as well as what type of associateship you have. You can have residencies where you'll just be doing a lot of surgery, dentures, basic restorative on medically and mentally compromised people. Others you might be doing implants, complex prostho cases, with or without sedation, etc. They run the gamut and you need to do your research to see which one is right for you. Similarly associateships can differ; I can tell you that in your first year of practice you probably won't be (read: shouldn't be) doing uber complex cases involving implant placement, full mouth rehab, etc., but in residency you may get this opportunity to do it under supervision. That's a huge plus obviously. Otherwise, you're apt to make a much greater income in one year of associateship than a residency, even if you're not working very hard and just doing basic dentistry. Residency isn't about its renumeration (and in my honest opinion, neither should associating be); in both I would advise you to make learning your main priority. 

 

So I'd say the following GENERALLY holds true, but once again dependant on context:

 

Residency: more exposure to high levels of theory, get to rotate through medical fields, might get to do some complex stuff, not compensated greatly (though some residencies will bundle in certifications that are worth quite a bit, but it still doesn't quite touch associateship)

Associateship: exposure to what private practice is actually like, learn a lot more about time management, business, how to treatment plan in the real world, talk to patients, etc., get compensated for what you do, but your income is up to you and the level of mentorship you receive is entirely up to your principals/colleagues

 

 

 

When looking for a job, what factors do you think are the most important? (Eg, Clinical experience, networking, extra-curriculars, grades)

 

If you're talking about finding a job and being the one they hire, none of the above. MAYBE networking to a small extent, but overall I'd say your clinical experience, grades & whatever-else-the-hell you did in dental school are all completely secondary to one single thing: your character. If you do not make an impression on and get along with the people interviewing you and the office as a whole, you will not be hired, at least not by an office that actually has an investment in its associates (and you want that, obviously). It doesn't matter if you're the top of the class, if you cured cancer, if you built a fresh-water well in Zimbabwe. One of my principals put it this way: he hires slowly, and fires quickly. You have to present yourself well. Dentistry can be taught. Character cannot.

 

That said, if they love you, hire you, and you start messing up on a regular basis, you'll be out of there quickly, but the way you carry yourself and whether or not they like the person, not the dentist, is what determines whether or not you're given the chance.

[member_225]

Do you plan on owning a practise soon? If so, what are some of the factors that weigh in when making that decision? 

[cleanup]

Do you plan on owning a practise soon? If so, what are some of the factors that weigh in when making that decision? 

 

For me, within 4-5 years, and I believe it is (at least currently) a likelihood. Main things are control (I want more of it), I believe myself to be a good leader & manager as well as business-minded. Also a sense of achievement. I feel like I'd be more invested in going to work if I knew it was my own.

 

Things slowing me down:

1. selecting a location, not so much because its a dental practice, but because I am young and single and buying/starting a practice is essentially a form of settling down.

2. Cost. It's expensive. Can I afford to do it while still being able to invest & live in other ways? 

3. Experience. When will I be ready re: clinical skillset & management acumen to be able to do this with a minimum of stress and heartache? At the moment I benefit from the reputation & image of the practices at which I associate. Once I go out on my own it's all on me.

 

It's a big decision, and not one I wish to take lightly, and certainly not one anyone else should either.  Notice how I never said I'm 100% committed to doing it. You have to be very sure of yourself before taking the plunge; otherwise you're making a costly, costly mistake if things go awry. Anyone who thinks "Oh I can definitely do this" without being fully cognizant of what's involved is doing themselves an ill favour.