Tuesday, June 29, 2010

The D-4 Experience I

A little over half-way through my first semester as a D-4, shall I elaborate? I summed up the major feeling of fourth yearness in my “lords of the idiots” post – so just go back three posts and poof.

The curriculum at this point is one giant garbled mess. We have the most useless course in the world still chomping at my toes (comprehensive care IVa). I seriously need to explain the evolution of the comprehensive care class. I have had it EVERY semester. So this is my 9th go around. The class has progressively gotten more and more useless each and every semester. At the beginning it was great – it focused heavily on all of our pre-clinical perio and restorative, the kind of stuff we need to know. Now it has simply turned into a stereotypical college level class that revolves around regurgitating paper after paper that do not stimulate any sort of joy – but rather decreases your brain matter as your bullshit your way through one double-spaced, font twelve, times new roman page to the next.

Case in point – I am required to right a progress plan for June that discusses all of the things we have been doing reports on since last year. Things like production, unpaid treatment, unapproved notes, ect. OK. Fine. I can do that, not a big deal. But we have to do ANOTHER one that is due 4 weeks after the first. I am on rotation (and MANY others are as well). This means I will be in the clinic seeing patients a total of eight days (prosth exam and holidays account for weird number) before the next one is due. How much do you think will change in these 8 days? Will I somehow increase my production by 5k? Will I end up having tons of unapproved entries? Will the same dead patients that didn’t pay before, magically come in and pay now? I’ll probably see about 10 patients and six will fail/cancel. Not much to write about there.

We have some “delivering bad news” presentation later this week as well as some other portfolio assignment that I haven’t looked at yet.

Now in our restorative class – we have to write some silly paper that involves, you guessed it, EBD. Thankfully it is short and we simply fill out a template provided.

None of these assignments are bad on their own – they just snowball when you add it to the massive pile of crap I already have flooding into my summer free time. Gets really tough to keep everything straight.


Getting my GPR application put together through PASS (letters of rec, personal statement, transcripts, etc)

Going on rotation for 2 weeks a month

Studying for NBDE II (failure rate about 30% last year due to random increase in difficulty)

Attempting to schedule all my requirements around my rotations (implant cases, limited ortho cases)

Doing TONS of lab work

Practicing for prostho exam

Scheduling performance exam patients and praying they don’t fail

The list goes on

Apparently, based off of what one of the head honchos told us today at our ‘town hall meeting,’ the comp care class will be obliterated in the new curriculum. So I guess this point will be irrelevant to the entering classes.

We also have a mock mock prosth exam next week. Why two mocks? Because the real mock exam is September. We have to prep #9 all ceramic, and a 3-5 bridge (3 as FGC and 5 as PFM). The catch? There aren’t enough manikin heads and equipment to go around so we can’t all practice at the same time. The problem? A lot dental students are assholes and will hang on to the equipment for way longer than necessary – screwing others over in the process. I am taking this test next week and I hope to practice this weekend…assuming I can actually check out the right stuff. I haven’t cut a plastic tooth in a LONG time, so I feel like at least one practice attempt is mandatory.

OK, enough bitching. What do I like about D-4 year? I like knowing the end is near. I like that the faculty in general treat you with a lot more respect. I like going on rotation and being treated like a full-fledged dentist. I like feeling extremely confident with tons of dentistry.

There isn’t much more to it. I’ve entered my 7th week of studying for boards and I have increased my correct percentage from 50% to around 70% which should pass (yay me). I’m taking the test in early august so I still have plenty of time.

I just am tired overall. Obviously deciding to take boards has destroyed any semblance of “summer” very much like part I did oh so long ago. I don’t regret it though. Assuming I pass – my life in the last two semesters will be just a wee less stressful.

What else can I address? I have become a little more jaded on our society in general the last two years. I see so many people that want something for nothing. People that are single, have no job, have five kids from three different fathers, and get pissed at you when their free insurance doesn’t cover the cleaning and they have to pay a whopping thirty dollars. Then they get on their blackberry in their SUV and speed off blabbing to all their friends about how shitty this clinic is. Their free insurance that MY taxes pay for essentially rewards the socially and financially irresponsible sect of this country whilst punishing the responsible. Now granted this is an extremely generalized statement and abuse of the system goes both ways no doubt. I’m just getting wearied by it all, especially as I see my debt piling up. I won’t even pretend like I know anything about our current healthcare system or politics in general – but I have noticed my interest and knowledge base slowly increasing – which can’t be a bad thing when I am so close to graduation.

I do like to counter-balance negativity with positive stuff. There have been plenty of ‘feel-good’ moments. That one smiling kid, grateful parent, or patient that brings you a sponge cake are all great things. Experiences like these make me thankful for the opportunity to be a part of the profession. I only keep my fingers crossed that there will be more of these to come in the future and less of the ‘other.’

Life is just helter-skelter right now. I am bouncing from one thing to the next with little time to breathe. This post obviously reflects my current scatterbrained thought process (and it wouldn’t be the first time). That is why I sometimes like posting when I am completely exhausted or frustrated or exasperated. I capture that pure emotion in this little time capsule and can read back on it years from now and think…daaaamn was I strung out! Or wow, look how ignorant I was about THAT. I would also like to emphasize that my life is great and I really am a whiny bastard for complaining at all. I have been lucky with my life – great family, great relationship, great friends, great profession, great everything. Anything I manage to gripe about can’t really stack up to that at the end of the day. How’s that for inspirational? Did I mention I have to write tons of bullshit papers where you just make stuff up that sounds good? Lots of good practice.

Kidding, kidding, kidding!

And holy crap, the scary part about summer in Chicago is that I cannot tell the difference between fireworks and gunfire – but there is definitely something going on by my house!

Time to hit the MOSBY review again with my 12 year old glen Fiddich. Still got to have some luxuries right?


Wednesday, June 16, 2010

19 Weeks and Counting

I started my 2x2 rotation on Monday. I have just finished my third day and am a just a wee bit less exhausted than the first two..maybe I'm adapting.

I am paired with a classmate, so for the most part, we will both be at the same site (rockford being the exception). However, my partner got trapped on the east coast due to flight cancellations over the weekend and I had to go solo on monday. He didn't know about the cancellation until Sunday..so monday was booked as if he would be there. Nothing like getting thrown into the deep end right? Everything went great though and I'm having a good time so far.

Did I mention this clinic is inhabited solely by women? The dentists are all women, and ALL other staff are as well. I probably need to get used to that though since most practices have a similar ratio. Not that I have anything against women - far from it. However, anyone knows how the dynamic of a lunch room changes when it is all ladies as opposed to guys - and if you are the sole member of the opposite sex surrounded by these swarms, it can be an interesting social experience to say the least.

So I have probably accomplished in three days on rotation what I did in maybe 4-5 months of pedo at the college. Remember that I only spent 1/2-1 day a week in the pedo clinic during my D-3 year. The work load is absolutely overwhelming at first. You bounce around doing the POE check-ups and then run back to the nitrous room to do 3 fillings on a screaming 3 year-old in a papoose.

I have plenty of learning and adapting to go - but wow, the experience curve is amazing. Perhaps even more importantly, is learning to work with assistants. Some of them are amazing, others not so much. I still am getting used to ordering them around because I honestly have never been in a position of such authority in my entire life - as in pretty much the boss. Granted, I am still a student, but the assistants are supposed to treat me like any of the other dentists in the clinic - and they do...and it takes some getting used to.

I have no interest in pediatrics as a specialty, but I feel like this sort of rotation really really ramps up my comfort level. I mean, if you are OK with nitrous and a papoose board, you can deal with a HUGE percentage of the child population.

Complaints? The unit set-up. You can't sit at 12:00..ever - which makes the maxillary teeth a living hell on my back because I'm trying to learn new mirror angles. Why can't you sit at 12? Because the nitrous stuff and all the handpiece motors are right there...bleh. I also don't like the bur selection. Pretty much a huge block of 330s and round burs is all you get. I need a longer guy for those damn boxes...and I really really am sad they don't have enamel hatchets. But it's ok - you adapt...and fast because there really is no choice. My final, and perhaps biggest gripe is the gloves..they are slippery as hell. I have dropped my handpiece TWICE (thankfully never while running) and I honestly don't feel like I ever have a good grip on it because of it's awkward position in the operatory.

It's been a long couple of days...I haven't been this exhausted in a LONG time. But it still feels great. I feel like I'm working a real job. Yea we still get prep and restoration checks (but not always) but POEs are free game. If I think we need to do an amalgam on #I, then it gets tx planned and the kid comes back.

So I have 19 weeks of rotation this year...I really feel like this will be great for my technical speed. My only big concern is going to be lack of fixed work which is already a HUGE weakness in my experience belt. We will see though...there is an 18 year old coming in tomorrow for a PFM on #19...mayhaps I get to do it!?

Well I plan to post about my various rotation experiences as the year goes on. I still have 22 more days at the Children's clinic - so we will see how things play out in the coming weeks.

Expect a D-4 Experience post in the coming weeks.


Tuesday, June 1, 2010

The Lords Of The Idiots

The title sums up how I feel to be a newly minted D-4 here in good ol' dental school. You are a king amongst morons, and that is putting it politely. Dental students in general are neurotic, obssessive, over-achieving people. You don't realize how insane they are until you see the classes beneath you. Then you realize how you were pretty much exactly the same way.

I see the D-3s going through the exact same pitfalls that I was stumbling through right at the begining of full-time clinic. Getting upset about failures, freaking out about openings, freaking out about pretty much everything.

Ah, but now I get to sit back and take it all in. It was actually quite remarkable. The day we changed to fourth year students, it seemed like the faculty in general treat you a LOT differently - and in good ways.

Faculty members I was terrifed of 12 months ago are yucking it up with me about this, that, and the other. You truly feel like the big dog....of the idiots of course. We still are students, we still have bullshit assignments, we still get talked to like little kids (by the academic departments), and we still are paying out the nose for three more semesters.

The greatest thing is the no class aspect of D-4 year. We have a total of around seven times this entire semester where we have to be at the school at 8am for good old compcare + rotation paperwork business. Other then that, my alarm is set for 8:15 and I'm enjoying the shift for every ounce of greatness that it is.

Rotations have started for the "A" group. Being in the "B" group means I go out two weeks from now. Expect some sort of post on my rotation experience after I complete the first set. Children's Clinic ahoy!

So what are my requirements this semester?
Direct peformance exam (class II, III, or IV)
Perio Maintenance/Re-eval/SRP (three exams total that need to be finished by the end of Fall)
CaseCAT - Annoying research paper that they are piloting on my class. God I love it.
Assorted CompCare Crap (ACCC) - The usual stuff I presume..although they still haven't really told us
Scary Mock Prosth Exam - Prep 3-5 bridge (3 - FGC, 5 - PFM) and #8 All Ceramic.

The big change to note is that EVERYTHING is now pass/fail. This is good in that stress of performance exams is GREATLY reduced. However, it is sort of silly because your entire grade is going to be determined by the most biased and uneven portion of the gradebook - the faculty evaluation. I'm to far along to care at this point though. Case in point - I nearly got a 4.0 last semester and my GPA didn't move - so I guess I'm stuck with what I've got. Way to many credit hours in the books to move.

Still no C's in dental school though...hope to continue the streak.

So the schedule doesn't seem terrible right? Well, remember that I am on rotation for 5 out of the 12 weeks this summer - leaving me a grand total of 7 to get anything and everything accomplished. This doesn't include all the assorted graduation reqs I'm trying to coordinate (limited ortho case, Implant case, other). Did I mention that performance exam patients love to cancel/fail appointments?

I also seem to have a TON of lab work that has just really started piling up. Despite spending ample time in the lab due to a rash of patient failures/cancellations - I still seem to be falling behind. Damn dentures.

I'm also applying to GPR programs..and getting together my recommendations and applications is just another chore.

Let's also be reminded that like an idiot, or lord of the idiots if you prefer, I decided to register for the NBDE Part II and am taking it on August 10-11....oops?

So I'm pretty busy.

Right now my only strategy is to read the MOSBY review book and do all the released exams. Updates shall be forthcoming.

So while the glories of being a senior student are nice. I still feel this mounting pressure in the back of my head that probably won't be letting up until May next year.

The pressure is also going to keep getting worse

and worse

and worse

and worse