Monday, June 30, 2014

my typical day as a dental student

I’ve been meaning to do these posts for a while! I love getting a peak of everyone’s lives and I wanted to write about a typical day in the life of a dental student. Then we started clinic & my schedule did a 180-flip. After the immense popularity of Sharon’s post, I wanted to share my last Wednesday- sans the military time. Here we go.

7:15AM Alarm goes off! On clinic days I usually get up five minutes before the alarm. It’s a combination of nerves and excitement. Catch up with parents- the time difference between Korea and here makes my mornings a perfect time to chat. Scrubs on! Penn just started mandating scrubs for clinic. Each class has its own color and everyone has her name engraved.

9:00AM Grab coffee on the way to school and arrive at dental school. Look over today’s patient files & review radiographs.

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9:45AM Morning huddle with our faculty group leader. All the juniors and our clinic faculty gather for a little bit of pep talk and review what each one of us is doing for the day. My favorite part of the day, easily. Our leader Dr. Newell talks about making mistakes- we learn only by mistakes. If you’re not making mistakes, you’re not learning.

I get one of the private operatories with a beautiful view of our courtyard. Whoo!

day 4

10:05AM First patient of the day! He’s here right on time. It’s our first time meeting each other. We go over his medical history, address chief complaint, and get to know each other. Two hours go by quick!

day 3.5

12:15-12:45PM Lunch! I learned that the secret is to pack little bites: yogurt, crackers and cheese, fruits and granola bars.

1:10PM Second patient of the day. One of my favorite patients, sweet sweet lady. I’m continuing to gather information on her so we can start treatment planning. First, I need to take a some X-ray radiographs to update her file. We take four bitewings and no caries that I can see! I take an impression to make a cast model of her mouth.

day 2

4: 45PM After the patient leaves, I head downstairs to pour up her diagnostic casts. I trim a set of casts I had poured the day before while waiting for this one to set. The yellow labstone takes about thirty minutes to harden.

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6:20PM Both models trimmed! I’m off, clocking out! This isn’t even my dog; it’s Emily’s but he makes me smile so much. His name is Nico. I eat dinner while watching an episode of Friday Night Lights.

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7:30PM Head out for my dance class! Wednesdays are SO much better with some jazz sashay’s.

9:30PM After dance, meet a friend for a long walk to the river. We catch up and laugh about dental school.

10PM Shower, finish up clinic notes, check email.

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11:00PM Then I hit the bed. Clinic days are pretty hectic. I learned that I need to make clinic my main focus on my Tuesdays and Wednesdays when I see patients. I would love to read and get some studying done but for now, ZZZZZ.

Friday, June 27, 2014

typical day of a dental student ft Sharon

I get a lot of questions asking what my typical day as a dental student is like! I thought I’d recruit my dental school friend Sharon to tell me about her day. I’ve featured Sharon on the blog before: we discussed prioritizing health & fitness as a dental student and her military scholarship with the Air Force. Here’s her typical day as a dental student at Penn Dental Medicine (aka our newly minted “PDM”). Enjoy! –Y.

0650 - Alarm goes off. I was so tired last night I passed out on my futon...before I fed my fish (I gave them extra this morning to make up for it and apologized profusely to them).

0800 - Even though I don’t have clinic until 10, I wake up early so I can watch an episode of Cake Boss, and also so I can go study for National Boards Part 1. (Y: I wrote about our NBDE preppin’ here! I also went to grab coffee and ran into Sharon so I snapped this picture.)

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0950 - Head into clinic. Before I go in I review my scheduled patient's chart, medical history, X-rays, and what has been done in the last few visits. I want to know who my patient is before I meet them. I want to understand what they need and not just quickly glance over their chart while they are sitting in the chair waiting for you. Preparation is key!

1020 - After calling and checking the waiting room, my patient unfortunately doesn’t show. It is okay since some of my classmates need chairs. I now have time to get all my paperwork up to date.

1230 - Leave clinic for lunch. Since I didn’t have any patients I help those who were running late clean up their chairs.

1300 - Back to clinic! I didn’t have any patients scheduled for the afternoon, but as I was walking around one of the seniors asked me to start with her patient. Saweet! I am about to do my first final impression for a crown. I read and did some of the steps in lab, how hard could this be? But first, time to hunt down a chair...

photo 1 (600x800)

1320 - Chair found! I pull up the patient’s chart and get up to speed on the patient. I then bring the patient back and begin the process of a final impression. Sounds easy, but holy smokes there is a lot involved. Two gingival retraction cords, medium and light body impression material, hunting down custom impression trays, removing the provisional, bite registration, the list goes on! It is a fun learning experience and the next thing I know it's 5:00 (luckily we finish at 4:40, just enough time to write a clinical note, clean the station, return materials, and head out for the day).

photo 2 (600x800)

1700 - Meet my friend for dinner. He was passing through town, so we catch up over some much deserved burgers.

1800-2000 - GYM TIME! Thank goodness I ate a burger since today's workout involved squats. Saying I love the gym is an understatement. 

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2100-2300 - Shower, pack my bag for tomorrow, and sit down to study for my final tomorrow morning. It's a good thing this class is pass/fail, since I am pretty much ready for bed at this point! No matter how much material I haven't covered, I always am in bed by 11. Sleep is important for recovery, so I make sure I do not deprive my body of those precious hours.

Thursday, June 26, 2014

The many emoji’s of dental school

A picture is worth a thousand words. Or, in the case of our generation, an emoji is worth a thousand texts. emojis

After a day in clinic and I’m plopping down onto my bed, I’ll send a couple of these emoji’s. It’s dental school, summed up in a picture or two. No words necessary.

When a patient is late to the appointment:photo

See patient checked in 5 minutes before the appointment:photo

Taking X-ray radiographs and the patient’s in pain:photo

See a huge cavity on radiograph extending into the pulpphoto(But on the outside I’m like)photo

Faculty makes a TMI comment (joke?):photo

Find out patient’s insurance won’t cover anything: photo

At the end of the day, patient says thank you:
(And you get to write “patient left satisfied and ambulatory”)photo

What emoji would you use to describe your day of dental school?

Wednesday, June 25, 2014

what would you do if you weren’t a dentist?

It’s crazy to think this is my life.

Scrubs and loupes on, meeting new and old patients, flipping through radiographs… You know that question, what would you do if you weren’t a dentist? (Or in our case, what would you do if you weren’t in dental school?)

How about this guy?

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When I was living in Houston I went to an Astros game and saw three hot sauces race around the field. It was hilarious.

I started working through The Desire Map this summer. Danielle LaPorte asks how you want to feel. Why do we chase the goals we set for ourselves? I love this way of thinking because this digs deep into the real reason behind we want certain things. Here’s what I mean.

- I make perpetual lists of restaurants to try & spots to check-out in Philly because I want to feel connected to my community.

- I make plans that are sometimes too specific to follow because I want to feel in control of my future.

- I make last-minute travel plans because I want to feel spontaneous.

And so on, you know. What I’m craving when I say “I want to be a hot sauce runner” is feeling fun and silly. And joyful! I don’t think I have to go out and call Taco Bell right now… but I see that being silly and fun is very important to me.

Here’s your turn: What would you do if you weren’t a dentist?
What feeling are you craving?

Saturday, June 21, 2014

our standardized patient experience

I’m not letting myself watch The Fault in Our Stars- yet. Reading the book was such an emotional experience!!! It’s the unlikeliest love story. If I tried explaining it to you (“two kids with cancer…”) I’m never going to do it justice. So read it. And watch the movie!!!

Picturegus-hazel-fault-in-our-stars-movie

Our lucky class of 2016 are the first class at Penn Dental to have SP (Standardized Patients) experiences. Perelman School of Medicine has an SP program and we hopped along on the Penn Med SP wagon. Over the last two weeks, we saw four Standardized Patients with varying medical issues & challenges such as dental anxiety, HIV status, and domestic violence.

I know that SP experiences are common in medical schools; they are almost unheard of in dental schools. So here’s how it works. Standardized Patients are given a scenario to play out with us future doctors. It’s essentially role-playing a dental visit. In the middle of the session, we can call “time-out” to essentially pause the patient and ask our facilitator/colleagues for advice and input. At the end, the Standardized Patient will give feedback and suggestions based on what he/she saw. It’s so cool because I felt like I was freezing time.

I was nervous “performing” in front of dental school colleagues because my empathy, my listening skills, my conversation abilities were on display- not dentistry. It’s like having an image consultant session. (Have you ever had anyone tell you something like “your leg shaking communicates a nervous energy?”) I learned some things I want to share.

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1. We can’t prepare for everything. Every patient is different. Even if we were to learn all there is to know about dental phobia, for example, each patient has their own unique experiences they bring to the clinic. In addition, they may choose to share certain parts of their lives and not the others. Be open-minded and take the time to learn your patients.

First week of clinic, I was so focused on getting my forms signed and getting things done. But I learned from my SP sessions that every minute I spent getting to know my patients was precious.

2. We can just be honest. I used my “time-outs'” to ask my dental classmates “What should I say? I don’t know how to respond.” Simple answer: tell them that! Instead of having all these thoughts floating in my head, it was better to say what I was thinking out loud. For example, I could say “I am not familiar with that condition, can you tell me more?” I could also admit, “I don’t know what to say. I hope I’m not offending you.”

How do you communicate effectively? How do you listen well? I’d love some pointers.
Are you going to watch TFIOS this weekend?

Thursday, June 19, 2014

deciding to live alone & live near dental school

I took one step inside the apartment and it felt like home. It was above my budget but this was the apartment. After a few phone calls with the parents and some discussion about my finances, I signed the lease on my first grown-up apartment. Living alone.

In college, I always had roommates/suitemates/housemates. Although in my gap year, I was not technically living alone (all I had to do was walk down the steps of my garage apartment and I had a whole gaggle of kids running around the backyard), this shoebox was my own.

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Moving to Philadelphia (in the city!) I figured it was safer to live with someone. I certainly didn’t want safety to be a big worry when I knew dental school was going to be the entrĂ©e on my life plate. So I decided to room with someone I had never met before. It turned out fantastic. (I dug up this post from when I first moved in and was all excited. Bonus: a pic of me without braces!) I had an easy friend and saved tons of money.

Ever since we wrapped up our didactic classes and pre-clinic laboratory this spring, I began working from home a lot. Making patient phone calls in private (HIPAA respect) and being able to put my phone not on silent are small but huge luxuries! And my room began to feel pretty small. Besides, turning 25 was huge for me and as a career woman in her “late” 20’s, I wanted to live alone. As simple as that.

It was another decision to live near dental school.

I am a huge believer in creating nourishing environments that make the right decisions easy. Even in the laziest of mornings, I’m more likely to go to class when dental school is only ten minutes away. I’ve been able to hop into dental school and ask insurance questions on my off-clinic days because it’s just so easy for me to drop by, living around the neighborhood.

Yeah, separation between school and play is very important to me, but I’ve learned there are other ways to do that besides physical distance. I would have to give up some space to live in Center City by myself.

In the end, I thought about space/cost, safety, and convenience. As long as my friends don’t make me read scary things on the internet, I think I’ll be okay.

Do you prefer living alone or with a roommate?
Do you have any awesome/OMG roommate stories?

Sunday, June 15, 2014

gift not a burden

I’ve been unwinding after dental school by watching Friday Night Lights. It has an ensemble cast of really interesting characters (including the greatest female role model I’ve seen on television, Tami Taylor played by Connie Britton) and features football in Texas.

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In a scene where Eric and Tami try to figure out day care for their newborn, Eric says this:

“This isn’t a burden. It’s our gift.”

I immediately thought about our starting clinic… because I get stressed about seeing patients and everything that goes along with this, but it’s a privilege to have this problem.

Also… as the typical dental student I noticed Aimee Teegarden has the cutest teeth. She has prominent central incisors that make her look years younger.

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Where do you get your (unexpected) wisdom bits from?

Saturday, June 14, 2014

first day in clinic, real live patients

This week I learned how to swim in the ocean. I saw my first real patients. Guys, I’m a real (student) dentist!!!!

It was crazy, hectic, so perfect. It was the most exciting week of my life. HIPAA is for real, guys, so no details about my dental patients there. But we can talk about me.

beauty

The night before clinic, no, the entire weekend before clinic, I had a bottle of aspirin on my desk all week. These moments of confidence I wrote about came and went away in waves. If you were to ask me what I was nervous about, I would not have been able to tell you. Helen asks if there’s like a winner or a prize we’re all fighting for. Um… no.

So I couldn’t verbalize this pervasive sense of anxiety. That I was going to mess up? Then it was going to be embarrassing. I was going to be a disappointment to my colleagues, my patients, and my faculty… What? Slippery slope down to the dental school pothole right there.

First week happened and of course I messed up. I left equipment lying around and did not submit the right forms. I grabbed upperclassmen for help on filling out forms, getting patient signatures, and taking radiographs. (Thank you thank you thank you) I called my friends, sent long emails, and bombarded my big with questions.

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And I am so proud of myself. I had been chatting with Dabel about my first day of clinic, about the need to pep talk myself. He remembered that when he played football, coaches "hyped us up so much, we felt like we could do anything." Like we could do anything.

I may not have started the week off feeling that way, but I feel pretty good. It’s not the belief that I’m going to rock everything because I know I am going to make more mistakes. But that sounds… okay. It’s my first week, my first month, first year in clinic. I just read about aiming for progress and not perfection. That’s what I need, just progress. Baby steps. Let’s take it easy and take it slow.

Do you remember your first day in clinic? Your first patient?
Do you have a clinic mantra?

Thursday, June 12, 2014

intro to NBDE Boards Part 1

Here at Penn dental, we get one month off between our second and third year to study/take the NBDE Boards Part 1. The 8-hour-exam itself has 400 questions from the following areas:

  • Anatomic Sciences
  • Biochemistry, Physiology
  • Microbiology, Pathology
  • Dental Anatomy, Occlusion

Candidates take this 8-hour-long exam at Prometric testing centers around the U.S. Some key information about the NBDE Part I and II (adapted from ASDA’s Member Resources site)

  • Each state has own licensing requirements. The NBDE Exams fulfill the written requirement for all of the licensing boards. The practical part is the regional licensing exam (WREB, NERB, and the like)
  • Part I tests basic sciences learned in dental school.
  • Part II tests clinical dentistry.
  • The two parts will soon be combined into one Integrated National Board Dental Examination. It will affect the class of 2017 and beyond. Read more about this change in this post on ASDA’s Mouthing Off.

The Member Resources Taking the NBDE Part I & II page also has a list of commercial resources. I’ll be studying with Dental Decks. ASDA also sells released versions of previous exams.

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Taking exams is never fun (especially when it’s as big of a deal as the BOARDS) but at least the P/F takes some weight off. Our medical school friends taking the USMLE Step 1 are suggested to study 6 weeks for 10 hours a day.

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Am I the only one who thinks this is ridiculous? Schools suggesting you put together a study schedule that remembers eating, sleeping, personal grooming? (Oh wait, this happened at MIT…) I know my med school friends have said this was the hardest exam they’d ever taken. But some things like self-care should take priority.

My test date is end of July! The focus of my summer will be clinic and NBDE Part 1 studying, with ice cream and sunny runs peppered in between.

Wednesday, June 11, 2014

Pennsatucky teeth

Is anyone else loving Orange is the New Black? I got my Netflix account back just to watch Season 2. One character I am just fascinated by is Pennsatucky. She is a white-supremist, crazy religious, former drug addict. She is portrayed by Taryn Manning who really cleans up nicely.

In season 1, I noticed a big part of her character is her awful teeth. She’s a former meth addict.

Okay, spoiler alert.

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After she gets beat up by Piper & is left out on the snowfield, we see her face bleeding everywhere. Well guess what? She goes to the oral surgeon in Season 2 and gets a brand new set of beamers. Pennsatucky starts smiling A LOT. And it’s not so creepy. Everything else about her character (skin, hair, no makeup) is the same. Her perfect teeth made all the difference.

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What goes on in my dentist mind is this: Did she get everything extracted? And then dentures? Full arch implants? Some implants and a partial denture? Are we going to discuss her treatment plan?

I also came upon this Buzzfeed article: before and after pictures that prove good teeth can change your face. The photos were really cool but what really caught my eyes is this: someone in the comments section wrote that not everyone who can afford these treatments. Someone else noted that they are conscious about smiling with their teeth because of their teeth but don’t have the money.

Better teeth = more confidence? Definitely true for Pennsatucky who got the prison system to pay for her teeth. Look how happy she got.

Sunday, June 8, 2014

'Twas the night before clinic

Can you believe it? Phone calls have been made, software's learned (sort-of), appointments scheduled. I took it easy this weekend with lots of pep talk. I went to the farmer’s market and picked up these peonies. I have never smelled real peonies before and holy mackerel, these smell unbelievably sweet- honey dipped in rose sugar. My whole living room smells like hot pink summer.

peonies live

Please send me good thoughts & prayers! I am nervous but as everyone reminds me, this is what I’ve been working towards all two years of dental school. I’m ready. Let’s hustle.

How was your first day in clinic?
Or- if you haven’t started yet- are you nervous?

Thursday, June 5, 2014

adjunctive ortho lab

What I did in Dallas is this: I bent stainless steel wires into different shapes. Dental school followed me all the way home. We had to make helices and “feet” (90 degrees and loops) to gain familiarity in working with the materials first. Then we moved onto adapting wires to create different appliances.

At least I had a cute little puppy keeping me company.wirebend

And of course, my best friend who “walks in beauty”.2014-05-25 23.37.40

We also bonded brackets to our plastic mannequin’s teeth. And by “bonded” I mean super-glued.

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The nature of adjunctive orthodontics is that we do a little bit of ortho to ensure restorative results. The Nance appliance we made functions to keep the molars from drifting forward, so that there is room for the premolars when they erupt. A general dentist may do this to prevent problems further down the road.

nance

Our friends who are considering orthodontics got a good taste of working with wires and wire pliers. (I had to wonder though, if they had huge expectations weighing down on their poor callused hands as they plied these wires: “My loop isn’t perfect! Does that mean I have no future in orthodontics?”)

I had two hands full of blisters and red sharpie marks, last Friday at 2PM when we were finally done with this lab class. It was a scene from Master Chef- I worked up to the 2PM deadline and our professor walked around the lab, “hands down!”

I worked hard. I mean, I spent all of my Texas vacation working on these babies. But here’s the thing: I’d shown my work to my TA right after I got back and he had said, “great job, now let’s do it again.” Um, excuse me? But trust. And second eleventh time around, all this had gotten much easier.

Tuesday, June 3, 2014

Ethical dilemmas in clinic

As we begin clinic (next week for me!), we will face ethical dilemmas. We’ll have to make choices unmonitored by other people and choose the ethical option in each case. There is no right or wrong answer bubbled into a Scantron to be graded by a professor. It could be something as small as dropping a dental mirror and making sure to wipe it down before using it- although nobody sees it. Other situations will be more complex.

2014-05-20 08.24.58Laura sent me this picture of an owl sitting on a Saguaro, looking so darn regal.

In class, we discussed a couple of scenarios that students may be dealing/have dealt with in clinic. My friends and I often have similar discussions. Because people have different values and life experiences, these discussions get very heated. Here's some from our class I found interesting:

- A patient requests re-assignment to another dental student after the first visit. When asked why, the patient responds, "I just don't want that type of dental student providing my care." (race, ethnicity, gender, sexuality…)

- A patient complains of pain and requests prescription for opiates. When you explain the prescription and referral process, the patient threatens that he will make trouble for you unless you get him the prescription now.

One of my favorite things in JADA (The Journal of American Dental Association) is the Ethical Moment section. For each clinical scenario, we are encouraged to think about the five principles governing all our ethical decisions:

Patient autonomy
Non-maleficence
Beneficence
Justice
Veracity

Someone answers the dilemma and the following week, readers (often dentists) write in with their own responses and their own experience in similar situations. It is the conflict of these principles that makes decision difficult- complex cases twist and distort the principles in a complicated knot. Is it more important to respect patient autonomy? But what about non-maleficence? (About flippers, for example)

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I know I have a challenge ahead. These conversations can be hard because OF COURSE I’m a moral person with an ethical backbone. But the difficulty stems from the fact that the wrong choice may be so darn tempting. Extra points without the extra work. More money for procedure B and the patient does want it! So much to do, so little time, so on.

But I also know each making of these ethical decisions (within the realm of our limited present knowledge) gives us the chance to practice these principles. It’s not enough to say “I’m an ethical dentist.” I want to practice ethical dentistry.

What ethical dilemma have you faced this week?
What’s your most common excuse?
(for me it has to be time- like: “do I really have to drop off the gym towel there?”)