The Road to Specializing
Benjamin HowardAhhh the time has come to bask in the glow of 4th year! The end is in sight and a career draws near. Freedom and responsibility await. Nothing stands in the way except for a little time, a few competencies, and some ACTS days to repay the state for the wonderful education we've received. That's the carefree mindset many of us in the Class of 2008 are beginning to enjoy. For those of us yearning to specialize the story is a little different. We look forward to more headaches, more hoop jumping, more trials and tribulations. Most don't enter into this decision lightly. We were told for years and try to prepare ourselves for the challenges that residency will hold. For some, the pursuit is a practical certainty long before the first day of dental school, while for others it occurs years later. The process of getting into these programs, however, remains quite mysterious.
Whether you are one of the countless Ortho, Pedo, and OMS hopefuls or that rare aspiring Prosthodontist, much of the process remains the same. It starts on day one of dental school. For students at CU, 1st year is all about waxing teeth and preparing for boards. Board score cutoffs for different programs are a much-debated and sometimes sensitive topic. With 90+ being a common phrase that may apply to many specialty programs, it can be confusing. Within any specialty, one can find programs that only accept the best applicants. Board score cutoffs as high as 95 and class rank in the top 5-10% are not uncommon in some individual programs. This seems to be particularly true for Ortho. As a general rule, scores in the 90's and class rank of at least the top 15-30% are definitely desired. This is particularly true of Pedo, Ortho, Endo, and OMS programs. Attaining these scores can relieve a lot of internal stress and self-consciousness during the application process. However, they are in no way a firm cutoff. There are many, many competitive applicants that score in the high and even mid 80's that are granted admission into a specialty program.
Invaluable Extracurriculars
Extracurricular activities and awards can all help to mitigate the weaknesses of a lesser applicant (at least on paper) or set apart a stronger one. Obviously, unique experiences and skills offer great insights into one's character and make for great interview questions. Professional involvement, community service, and activities such as intramural sports are all important as they help to show one's values and personal breadth. Research is a great way to become more professionally involved. Independent work, publications, and representation at national meetings all serve as accolades that are viewed favorably on applications. Research is particularly important for specialty programs that lead to Master's Degrees. Overall, extracurriculars allow for one's individuality to be seen and are a key component for admissions committees.
Externships are likely the best way to gain specific information about a program. Admissions and procedural statistics are frequently made available publicly or by request. While important in the decision making process, they help little to answer the key questions of how will I fit in with this program and will I like it. For this, externships can be invaluable ? so pick them wisely. Different specialties vary widely in terms of their experience from shadowing to taking call. For some they are viewed as optional, while for others they are expected. Nevertheless, the ability to interact with the faculty and current residents is an important opportunity. Externships are particularly important for OMS as they frequently involve a large amount of hands-on training and also serve as an extended, working interview. Externships are an opportunity for an applicant to gain knowledge and experience about a program, but also very much a chance for the program to learn about the applicant.
The Application Process
Once the decision to specialize is made, the application journey begins. This part can become a little confusing. The Postdoctural Application Support Service (PASS) is a component of the American Dental Education Association (ADEA). Their goal is to help streamline the written application process by serving as a central processing organization who copies and delivers similarly formatted applications to all of one's desired programs, similar to AADSAS. There is an upfront fee and additional fees for each program (20 programs=$1030). The catch is that not all specialty programs participate in PASS and still others require the submission of additional materials. For those programs, applications must be sent on an individual basis.
Once applications have been received and reviewed, the interview invitations are sent. Receiving an interview is a good sign and should not be taken for granted. If entering a residency is the goal more so than attending one specific program, taking advantage of and capitalizing on all interview requests is important. It is a common belief that if one receives 8-10 interviews, they are almost guaranteed of matching to a program. For this reason, it is suggested that stronger applicants apply to at least 10-15 programs and weaker applicants to as many as 20-30. As with any interview, making a good impression in such a short amount of time is critical and can be difficult. Confidence, honesty, level-headedness, drive, and commitment are all characteristics for which the interviewers are looking. It's not unheard of for program directors to a leave the decision of whom to accept almost entirely up to the residents, so it is important to make a good impression all around. It is important that keep in mind that an interview can either make or break it for an applicant. Coming across as arrogant or abrasive is not a good idea.
The Match Process
Following the application and interviews, the decision-making process begins. Many specialty programs such as Perio, Endo, Prosthodontics, Oral Medicine, Oral Radiology, Oral Pathology, and Public Health require individual application and extend individual acceptance invitations. Most Ortho, Pedo, OMS, GPR and AEGD programs participate in the National Match. The specifics of the match process are somewhat intricate and complicated. Simply put, applicants submit a ranked list of programs that they would like to attend while programs submit a ranked list of their preference for applicants. Prior to entering the Match, applicants must pay a fee of $80 and sign a contract to attend the program in which they are granted admission. This information is fed into a computer at the National Matching Service in Canada and after a little calculation time, out comes a list matching one applicant to one position in a program. The goal of this process is to make the admissions process fair to applicants by preventing a single person from temporarily occupying multiple open positions. Programs that do not participate in National Match must offer acceptances prior to Match Day. This allows for withdraw from the Match, should the applicant accept an offer from one of these programs.
It is important to remember that it can be quite difficult to obtain admission into a specialty program. The cost in time and effort is great. Financially, it can run upwards of $10,000 for fees and travel expenses. The training is demanding and requires an enormous commitment. Specializing for the wrong reasons or without being absolutely as sure as possible can result in misery and a great deal of regret. As for statistics and scores, they can equate to an applicant having a greater deal of choice in program selection. They may even be needed just to get one's foot in the door, but personality can make it or break it. Persistence can overcome almost any obstacle. Additional post-graduate training, retaking boards, or work experience prior to applying may be needed, but if specializing is important, almost anyone can make it happen. Good Luck.