Here's a list of key questions that you should consider asking yourself or others as you go through the process of choosing a residency program. By clicking on the "+" sign, you find an answer that has been provided by people that have gone through the same process.
In four years of formal dental school training, it is difficult, at times, to develop a level of clinical proficiency or confidence in soft skills such as patient management, working within a dental team and understanding how dental practice works outside of university settings. A residency program may help to bridge some of these gaps.
Continue reading below to find out what a residency program entails and see if it’s the right choice for you.
A residency is a formal and recognized apprenticeship-type program which provides the new graduate dentist the opportunity to work with others in a learning environment while honing clinical skills and acquiring new clinical, professional and interpersonal skills. The programs are generally one year in length, however, many programs offer the resident an opportunity to stay on for a second year. A program provides a supervised learning and training environment for the resident while giving him/her an opportunity to work more independently than in the dental school environment. One can learn more in-depth complex dentistry in an AEGD (Advanced Education General Dentistry) or gain more experience in hospital, geriatrics or special needs through a GPR (General Practice Residency) program. The programs are varied and the experience gained depends on the specific program that the resident chooses.
A residency program also allows newly graduated dentists to work among his/her peers in a collegial environment which is conducive to sharing ideas, comparing treatment philosophies and encouraging lifelong learning as well as multidisciplinary approaches to patient care.
One of the biggest advantages is to be able to continue to hone clinical and soft skills (such as communication, interpersonal skills) in a learning environment without the obligation of overhead costs and with the shared responsibility of liability with your attending/mentor dentist. It’s a great opportunity to become skilled in different dental procedures, learn how to manage medically-compromised patients, interact with medical, nursing, pharmacy colleagues and/or network for the future. Additionally, this is an opportunity to build and strengthen your treatment planning skills in a group setting where you can learn from your peers and their cases.
What you get out of a residency will depend largely on the program that you decide on and the amount of effort and initiative you show. If you hope to live in a certain area or apply to a specialty program, it may be advantageous to choose a program in a city where a program is offered or where there is greater emphasis on the area of dentistry where your interests lie.
Overall, many educators and practice owners feel that a year’s worth of residency is like having 5 years of experience in private practice.
An AEGD program is most often housed in a university clinic since the intent is to provide residents with the opportunity to perform more advanced and complex clinical procedures. These may include more complex periodontal surgery, endodontic surgery, etc. This program gives those dentists who are more inclined to working in private practice or graduate school an edge.
It is best to contact each of the programs that you are interested in to see if it falls under the GPR, AEGD model or if it is a blend of both. Of the 15 programs in Canada, fewer lean towards the
AEGD model and focus more on special needs, cancer etc.
The reality is that although different residency programs may focus on different elements of dentistry, no knowledge is ever wasted because the learning will translate into the practise of dentistry at some point in time. For example, a residency that has a heavy emphasis on oral surgery could make you more comfortable and adept at extractions, minor surgery and trauma in private practice.
Generally speaking, all residents are paid during the residency year. However, there is a large variation across Canada in terms of the salaries. In Western Canada, the salary can be as high as $50K, whereas in Quebec the salaries are much lower (in the $15K range). Other programs in other provinces pay residents approximately $30K. At McGill, residents also pay tuition at McGill University. So you need to explore the various programs to get an accurate idea of compensation.
When assessing a residency program, it is important to find out whether the particular programs actually deliver on what they say in their marketing claims. The best way to do this is to visit the program before applying to it (when possible) and to speak to past and current residents of the program. Most of the residency interviews in Canada take place in early November (in the US, usually early January) and can be an ideal time to speak to current residents and attending dentists in the clinic. However, on top of the general “open house” events held by various programs, it is advisable to enquire directly with the specific program(s) you are interested in to see if they will be hosting such an event.
Some organizations like the Academy of General Dentistry (AGD) will count the residency year towards obtaining a fellowship, especially if you are a member at the time of your residency.
For the US residency programs, the American Dental Education Association’s (ADEA) ADEA PASS program will have the essential information required for applying to a residency program. There is also an online search engine for accredited US programs provided by the Commission on Dental Accreditation (CODA).
Most postdoctoral programs utilize either or both of the Postdoctoral Application Support Service (PASS) and Postdoctoral Dental Matching Program (MATCH). These two services help to facilitate the application process and match applicants to a program. Applicants must register for each service separately through the PASS portal. The applicant should verify with the program(s) he/she is interested in to find out whether it participates in PASS/MATCH.
When possible, do your own research about programs that interest you and contact the program to find additional information. It is advisable to visit the program and shadow the clinic for a day. Program directors want someone who is interested and open to learning especially since they must spend a full year with the resident(s). They must be confident that the resident(s) will be responsible, capable, a good team player and care appropriately for the patient population.
Working as a private practitioner outside of the residency is generally not encouraged and may also be difficult. Residents usually have on-call emergency duties and rotations. The residency year is busy and can be very tiring. Additionally, depending on the type of dental license you hold, you may or may not be able to practice outside of the residency program. As an example, Canadian dentists training in a US-based residency may not be able to practice outside of the program without a valid US dental license.
At the end of your residency year, you are more well-rounded and more confident as a clinician having had the chance to see and do things that you would not be able to do in dental school or private practice.
This will also hold true for anyone who has recently graduated from a residency program. However, the extra year of training is generally looked upon as being favourable and may give someone an advantage when looking for an associateship position.
Once the applicant has been matched to the program, a welcome package containing information about the program, supporting documentation, a letter of offer and registration information will be sent to the candidate. Additionally, it will be the responsibility of the applicant to discuss visa requirements with the program administration and arrange them prior to starting the program.
U.S. Residency Programs
Many students debate whether to do a residency program in the U.S. or in Canada. Wherever you go, the experience will be worth your time and effort. In the following section, you’ll find information that pertains specifically to a U.S. residency.
Usually, the candidate can obtain a nonimmigrant NAFTA Professional (TN) visa or other special visa (check Customs and Immigration). The TN visa can be obtained at a U.S. border crossing. It is advised that the visa be obtained in advance of actually crossing the border in order to circumvent any issues that will prevent you from arriving at your program on time. Additionally, it is best to call ahead and find out the hours that the TN visa office/officer(s) will be available before driving to the border.
This is a difficult question to answer. But YES! For anyone that has completed a residency program, it is a resounding yes. For anyone who has not chosen the residency path, the question can’t be answered with any certainty.
A residency year allows new dentists to build confidence, gain comfort level with patient management and clinical skills in a safe environment. Some programs offer a second year. Anecdotally, some past residents feel it may not be worth doing the second year unless you are finishing complex treatment plans etc., there are others who feel that there is a distinct advantage in doing an additional year. Starting the new cycle as a second year, you are already familiar with the expectations and procedures of the program which allows you to be more productive with this head start. Every year in practice is valuable experience.
Choosing a Residency Program
If you’re ready to commit an extra year to a residency program, here are some valuable tips and information to keep in mind when you decide where to go.
It is unfair to expect one year of residency to be equivalent to intense continuing education (CE) in a specific area such as placing implants, because it is one year and it is focused on general dentistry rather than a specific discipline or set of procedures.
A better cost-benefit analysis would consider comparing the amount of money and experience made in the first year of private practice immediately after graduation with the amount of money and experience gained in a one-year residency program. Most would agree that there may be a difference in earnings, but in the long run, the opportunity cost is negligible when you consider the amount of clinical experience that is gained along with speed.
The focus of the program is whatever the university/hospital/program director’s vision or mandate is. This will vary from program to program. As such, it is the candidate’s responsibility to do some research and find out how the program’s offerings will meet his/her needs.
Yes, in some programs the attendings are also seeing their own patients so they may not be readily available; however, in other programs, the attendings may be 100% dedicated to overseeing residents without any obligations to see patients. Most programs will also have OMFS back-ups for emergencies.
The patients seen in resident clinics may or may not have the ideal financial coverage. Generally, these patients are attracted to the lower fee structure, but some may still opt to have more comprehensive or complex treatment.
However, if a resident shows more interest in a particular area such as pediatrics, oral surgery etc., the program may allow the resident to do extra work or have an extra rotation in one of these areas. However, this is entirely at the discretion of the program.
Dental residents usually are 1st call and therefore, the first person called to triage and assess the patient. In situations where the patient has a complicated medical history, severe trauma etc., the resident may call the back-up (2nd call) or even the attending for assistance. Typically, most patients with minor issues may be referred back to the dental department for care the next day for treatment. If the resident on 1st call is occupied with an emergency and another emergency presents, the 2nd call may be asked to step in and assist.
Residents are usually very well-supported by their programs and the emergency room staff. The call in some programs may be very intense in terms of fielding emergencies, and if there are fewer residents, the call duty may also be more frequent. In most instances, the patients treated while on call are extremely appreciative of the care they receive.
This will, again, depend on the location and focus of the program. Most often, hospital-based residents will have rotations in areas such as anesthesia, ENT, oral and maxillofacial surgery, trauma/rehab and pediatric dentistry. On most of these rotations, the resident will only observe, but often, in anesthesia may be given opportunities to start IV lines or intubate patients.