Friday, May 22, 2009

The D-3 Experience I

Amazing. Exhausting. Terrifying. Fun. These four words spring to mind after completing one week as a D-3 student. I have gotten home exhausted pretty much every day, I am amazed at how much experience I have gained in five days, I am terrified by how little I actually know, and I am having fun amongst it all. I love it. I may be a bit blinded by how much hatred I had for the last semester of D-2 year, which finally got our grades up this week and I did pretty awful compared to previous semesters. What sucks is that I was border line in every class - but where I would usually end up on the better side of that border, I seemed to get hosed in nearly every course this time. Key difference though, I don’t give shit. A ‘B’ is not a bad grade, and it isn’t a damning grade either towards any future aspirations (at least for someone who isn’t planning on specializing IMMEDIATELY after graduating if at all).

I am totally digressing though, this is not a post to whine about last year, it is to discuss initial impressions of my new found status as an upperclassmen. I know I will have bad days, I will be humbled, humiliated, ect., but I hope to learn a LOT. I see no other alternatives when you are practicing dentistry on real people every day. So far, I have really enjoyed it.

I was nervous Monday morning, had that same uneasy feeling you get when you are about to step into a new world – very similar to orientation. Once I got going, things just blazed by and before I knew it I was sitting at home with a beer watching TV.

So what is my schedule you ask? Here goes:

8-10: Dental Public Health (meets 6 times, done in July)
10 – 4:30 - Clinic (lunch is designated 12:30-1:30)

8-10 - Dental Ethics (meets 8 times, done in July)
10 – 4:30 - Clinic

10-4:30 Clinic

8-9 - Pain control II
9 – 10 - Comp care IIIa lectures
10-4:30 Clinic

8-10 - Basic Oral Surgery (but less basic than last semester)
10-4:30 Clinic

OKOK, now some of these numbers vary. Clinic time can be spent in many ways. We generally have a morning block and afternoon block of time, so we usually can’t see more than two patients a day. HOWEVER, we also have several required rotations scheduled at various times that take precedence over general clinic. Now we won’t all go through the same rotations this summer, but by the time graduation rolls around, everyone will have spent an equal amount of time in each rotation.
Generally when we have a rotation, one session occupies half of any given day and lasts a week. So when on rotation, half your time slots will not be available to schedule patients for that week.

Here is a breakdown of what I go through this summer:
Urgent Care (12 sessions) – Basically we treat the walk-in emergencies of the day. Usually end up referring to post-grad endo or OS. If we get lucky, we can do something interesting like a pulpotomy. The best part of urgent care is that you can pick up new patients with interesting cases. Most of your endodontic experience will be gained through urgent care patients. I had my first rotation this week, and picked up a new comprehensive care patient (which is great as most of my current patients refuse to call me back).

Oral Medicine (2 sessions) – We will be in here checking out oral pathologies and working on our clinical exam skills. I need to remind myself to reschedule one of these rotations as it conveniently overlaps one of my OS finals.

Radiology (5 sessions) – become cheap labor in the radiology department and take FMX and pans all morning/afternoon. I have this in 2 weeks and am glad because I need more practice.

Invisalign Training (1 day) – Get certified in invisalign in 8 hours, sounds good.

Pediatric Rotation – EVERY FRIDAY AFTERNOON FOR THE ENTIRE D-3 YEAR. Holy crap..that is a lot of pedo experience. I really hope I can learn to manage little kids by the time this is all said and done.

My only gripe is that I am missing out on the oral surgery rotation that most of my classmates seem to have. It lasts three weeks and must be completed before you can start extracting teeth without heavy supervision. Seeing as MANY urgent care patients require simple extractions, it sucks that I won’t really be able to start until I get my OS rotation (hopefully early in the fall).

All other clinic hours are meant for our patients. If a patient cancels, or you just couldn’t book anyone, you are expected to help out in urgent care, assist classmates, call patients, do lab work. You can’t just take off (although it seems like nobody would notice in the chaos that is this summer due to all the clinic shuffling). I really don’t mind doing UC when I have nothing else going on; it provides extra experience and offers the slim possibility of picking up a new patient.

Quick breakdown of courses:

Comprehensive Care IIIa – I loathe comp care. Simple as that. This class seems like it will be very similar to last semester, with a constant stream of ticky tack assignments just to bug the hell out of you. I’m not sure of the grade breakdown yet.

Dental Public Health – Haven’t had the class yet, but I doubt it will be a problem..most likely to be annoying though. 8 am still sucks for any lecture.

Dental Ethics – While this class sounds terrible, I can actually find value in it. There are plenty of really tough situations that I wouldn’t mind talking through with my classmates and faculty.

Endo Clinic I – This class is carried over a bit from last semester (I’m not exactly sure what else we do to get graded). I know if I get at least one RCT done this summer, my ‘experience’ grade will be an ‘A.’ Other than that…not sure.

Basic OMFS – very similar to last semester, some of the intstructors write absolutely dreadful multiple choice questions which pretty much makes easy tests much harder.

Pain Control II – The bad lecturer from the other OS classes is not in this one, so thank god. Hopefully the tests will actually be manageable. We get to load up each other on nitrous again at the end of the semester.

Perio Clinic I – I honestly didn’t even know this was a class until I looked up my schedule while writing this post. I assume we will be evaluated by the perio faculty for this grade.

Restorative Clinic I – Not sure how we are evaluated (performance exams most likely), but I will update when I figure it out. Hope I actually get to do some direct restorations this semester…it sure feels like all of my patients only need RPDs, Dentures, or Perio.

So that wraps up the official schedule, here are some drawbacks that will become more apparent as I get further into the year:
1.) Not enough chairs – with all the construction going on this summer (not to mention over-matriculation of international students), we are really tight on space. I am lucky if I can book a patient within a week at this point which sucks.

2.) Lack of endo – several of my peers have completed root canals already (some have done more than one). This sucks because it is pure luck if you find one through urgent care which seems to be the main avenue for RCT cases. This is also the one specialty I am interested in, so I would like to get some experience to determine if my interest stays legitimate.

3.) Lack of patients – yes I still lack a good patient pool, I know I will be getting more and more as the summer progresses, but I still have a TON of blank spaces on my calendar.

4.) D-4’s still around – I was under the impression that MOST of the D-4 students would be on rotations this summer, but it seems like they are all still around. Of course having them around is also helpful, because they can quickly offer advice/help when you most need it.

5.) Performance exams – Finding enough patients to practice, and then finding a good one to get graded on for any procedure simply sucks. I still am unaware of our actual requirements this summer, but I know it will be stressful.

6.) Not knowing what the hell you are doing – yes, believe it or not, the two years of pre-clinical training really can’t prepare you for live patients. It is frightening to be responsible for someone’s well-being when you feel so na├»ve and overwhelmed. All of the upperclassmen claim that it takes some time, but we will eventually feel pretty confident doing many different procedures. I hope so!

7.) Unclear expectations/goals – I really don’t know how we are evaluated, or what we are expected to complete.
Enough bitching! Most of that is pre-emptive bitching anyways because I haven’t had enough experience yet. Bottom line is that I am quite happy with where I’m at right now. I look forward to getting the ball rolling with my patients and actually improving their quality of life. I haven’t even thought about that yet.

Now I’m off to enjoy a three-day weekend. The nice weather has finally arrived!