Thursday, May 7, 2009

The D-2 Experience VI

It has happened, I never thought this day would get here but it finally has – I am a D-3. FINALLY. Time usually flies in dental school, but the tail end of this semester has just dragged on and on. This year was without question, more difficult than the D-1 year. Anyone that argues otherwise is probably above average with their hands and hates studying basic science. Yea every school is different, but the basic route is still about the same – first year is essentially all books, second year is essentially all pre-clinic, and 3-4 is all patient care. Granted, the curriculum at UIC is getting a face-lift – but I really feel that this will mainly affect the D-1 portion of the curriculum. You still have to learn all those pre-clinic skills and PBL or whatever the hell they are calling it will never replace the bulk of the pre-clinical requirements.

The year in general was a rollercoaster. Every semester had a different feel to it. There was the Summer Semester of Waste, the Fall Semester of Saturdays, and the Spring Semester of Bull. I will elaborate on these personalized names right about now:

Summer Semester of Waste:

Waste, truly the best descriptor I could concoct to describe how I felt about the Summer. It was a shorter semester (about 12 weeks as opposed to the fall/spring 17 week marathon), but it still felt pretty long. Overall, the course load was manageable. We had comp care IIa, Intro to pediatrics, Path II, Pain control, and Dentures (this class started in July). We spent a lot of time with the comp care course learning how to use composite as well as preparing class III/IV teeth. We also did inlays and onlays towards the end. I remember the restorative portion of this course being really frustrating because they never really teach you how to polish anything here; you just have to sort of figure it out. Yea, it isn’t that hard to do – but there are a few tricks that would have been beneficial to know AHEAD of time. Perio was mostly lecture based, with a few clinical sessions. EBD was blah as usual. I suppose the true interesting aspect of this course was that we began assisting in the clinics. This was beneficial a few times but was also boring and useless on other occasions. Basically if you got stuck perio charting, you didn’t learn much (except that the perio instructors are VERY anal about EVERYTHING.)

Pain control was a standard 1 credit course, but of course STAB LAB stole the show. It was not nearly as scary as people made it out to be. The only drawback is that I haven’t done an IAN since last August…watch out next patient that needs mandibular work. Path II was the same as path I, lectures simply way to long.

Pedo was an interesting course. The tests were made impossible because each lecture covered around 200-300 slides of material and we had 2 lectures a week. Try keeping up with 600 slides PER week. However, the director gave out extra credit like candy and if you did all the lab work – you most likely got an ‘A.’ However; I do remember some of those lab days dragging on forever. Learning how to bend wires into a lingual holding arch was bad, but it could have been worse. Soldering and polishing was actually pretty interesting although I probably won’t be doing it very often.

OKOK, so the course load during the Summer of Waste really wasn’t all too bad. The kicker is that I took the National Board Dental Examination Part I in August right after the Summer of Waste ended. You know what that meant of course, I spend pretty much all of my evenings and weekends deep in study.

I call this the Summer of Waste because it truly was a wasted summer. The weather never got insanely hot, perfect breeze, and there wasn’t an inordinate amount of rain. The biggest treat I had all summer long was getting to sit on my deck and study for the boards. OK, maybe I’m embellishing a little, but not by much. I am sad to think back on how little ‘fun’ I got to have, but it’s all part of the game. Plus, I have this next summer to look forward to (the schedule looks AWESOME..more on that later).

The Fall of Saturdays:

The name is self-explanatory. I am NOT exaggerating either; I was in the school at least 14 out of the 16 weekends. Most of my classmates did their extra work during our Tuesday afternoon board study time, but I found that day to be too crowded because the D-1s were always doing something in the pre-clinic or wet lab. So I started the unfortunate tradition of coming in on Saturdays…every Saturday. Time was variable, but I would say the average was 3-4 hours.

Course load:
Compcare IIb: restorative, perio, communications, and clinic components (actually got a few of our own recall patients).
Fixed Prosthodontics I: Hardest class of the semester
Removable partial dentures
Complete Dentures
Pre-clinical Endodontics
Oral Pathology

The list may not be that long, but each and every one of those classes was a monster in terms of time/work involved – particularly Complete Dentures, Endo, and Fixed.

I spent so many hours groping my way through disgusting jars of extracted teeth, finding maybe 1 in every 20 to have any potential use, x-raying them, finding only 1 in 3 of these to be useful, mounting them in stone, and x-raying them again. This was all just to prepare for the course. That doesn’t include actually performing endodontic therapy on these teeth – which takes a LOT of time in itself. This class was my Saturday class for the first half of the semester. Afterwards the shift was towards Fixed and Dentures. What made endo stressful was that I had no extra teeth for practice. It wasn’t like fixed where I could go to the window and buy 10 plastic teeth to prepare crowns on – I could only use what I had, or what I could get via the mooch/trade with classmates. Not only did I not have to remediate, but I averaged an ‘A’ on the performance exams which was a true lift to my dentistry morale considering how poorly I did in fixed.

As just mentioned, fixed was terrible during the Fall of Saturdays. I averaged a 71% on the two performance exams(had to remediate one of them) and generally felt like I sucked at everything. I just couldn’t find a good technique for making a provisional and many of the labs had us doing very important things that I already can’t remember how to do (cast/post and core with biscor build-up for example). If not for my absolute domination on the final exam, I would have gotten a ‘C,’ which is the bottom-line goal I had coming in grade-wise – no C’s, D’s, or F’s.

Complete Dentures was not too bad until we got to setting the denture teeth. We had to use mounting jigs to get these things set on our articulators (a facebow transfer would work in a real patient). The jigs were pieces of crap and essentially created an extra 5-6 hours of work for me. My original mounting was off; I simply had no inter-occlusal space to set the teeth. So instead of suggesting a remount, every instructor had me grinding the base plate and the teeth for HOURS trying to make room. I FINALLY decide to try remounting after measuring the space on a few classmates (we all use the same jig)…so I pry the thing off, remount and voila, I have another 5-6mms of space. Turns out, I used one of the ‘crappy’ jigs. Bullshit I say. There was so much theory involved and not enough hands on in the mouth experience. Some things were simply not taught like how to pour up your final impression using the plaster/pumice box technique – I still have no idea what a clinical re-mount is and in all honesty, have no clue how to properly do a facebow transfer. So I guess this will be trial by fire in the most literal sense of the phrase.

So while the Fall Semester of Saturdays was the toughest, labor-intensive semester of dental school at this point, I still probably enjoyed it the most out of all three during the D-2 year. You simply learn a TON of dentistry, and that is what I am in school for.

Now for some crap, the Spring Semester of Bull. This past semester was probably the worst out of them all (with the possible exception of D-1 Spring). Hmmm, maybe the spring semesters just suck? It wasn’t ‘difficult’ per-say…it was mostly just complete bull. I had to do so many random projects and other filler-material that made me realize UoP graduating dentists in 3 years probably IS more feasible than I once thought assuming you trim the fat – like having to sit through 18 EBD presentations (9 of them during finals week).

Comp care was more spastic and all-over the place than usual. We had a clinical component, a portfolio to write up, and the implant course. The aforementioned sections were how we got graded. However, there were a billion pass/fail sections. Radiology, Pediatrics, Perio, Endo, Urgent Care rotations all had to be completed (many of them requiring little write-ups to prove attendance). I don’t know how many root canals I could watch while coming up with an interesting “what did you learn today” response. Ummm, watching root canals is perhaps the most boring thing I have ever done in my life? I would love to actually DO the root canal…ahhh maybe next semester. We also had to tape-record ourselves during a patient interview and play the recordings during a communications rotation which was blah..then of course we had to write the obligatory reflection paper. There was a bunch of other random crap to do as well, but I’m not in the mood to sort it all out. The bottom line is that I felt completely stretched thin in this class, every time I thought I would get a little break in the action, some new and annoying project or paper would randomly appear. It was one thing after another.

The implant portion of Comp care was valuable in the sense that I actually did learn a TON. However, the quizzing and final exam were complete jokes. Case in point – we had three lectures given by three different specialists (prosth, OS, and perio). EACH one gave a different number for surivival rates of maxillary implants. So go figure, this exact question appeared on the exam. Guess what? ALL three numbers appeared as answer choices. Give me a break. The lectures were NOT organized and the teaching was often haphazard at best. However, the labs were beneficial and again, I learned a TON despite my previous bitching. I also give this course a little lee-way because I believe we are only the second class to have it..hopefully things improve for the future.

Pharmacology was the biggest waste of time/effort this semester. I will sum it up: “Here is a massive list of drugs. Memorize everything on this list even though you will maybe prescribe 1% of them and can easily look the others up as necessary because there is no way in hell you remember any of this.” I will not even dignify its presence with further comment.

Ortho also turned into a class I dreaded going to. The lectures were insanely long and ended up repeating themselves over and over towards the end and the tests covered things we weren’t exactly taught. I learned a lot, but have officially been turned off to ortho as a future career route. Far too much theory and guessing for me. Not a huge fan of working on kids either.

OS and Endo were standard lecture classes, not much else to say. Treatment planning was somewhat useful but as mentioned in previous posts, I probably could have used this class earlier in the curriculum.

Fixed II was easier than last semester, but that doesn’t make it EASY. I magically developed skills with acrylic during our winter break so that is something to be happy about.

The best part of this semester was that I finally started getting my own patients and have seen a few of them already. I look forward to seeing lots of patients in the VERY near future.

The Spring Semester of Bull, aptly named because there was so much random crap to do, felt as though we took a significant step back in our dental education when compared to the intensity of the fall semester. It was a lighter semester in terms of work, but motivation was definitely a struggle.


I found the D-2 year to be one hell of a challenge – both mentally and physically. I truly did enjoy it more than the first year though because everything was FAR more relevant. My small taste of the clinic life has made me realize just how little I actually know about dentistry and just how different real people with not-so-ideal problems compare with plastic teeth.

I am nervous about treating live people, but I am definitely ready to get started. No amount of pre-clinical practice/study can compare to real experience – and that is something I hope to get a lot of in my final two years of dental school.

Wow, I am officially half-way through. I can only imagine how insane things will be two years from now when I am two days away from graduating…

Now it’s time to enjoy my week off!