Here's a list of key questions that you should consider asking yourself or others as you go through the process of choosing specialty program. By clicking on the "+" sign, you find an answer that has been provided by people that have gone through the same process.
It can be daunting and even overwhelming to think about training as a specialist when you haven’t even finished dental school. Luckily, you can decide to specialize at any point in your dental career. General information about specialty training and programs follows in this section.
Although it’s true that as a general dentist there is no limitation on the scope of practice, there are several reasons why someone may choose to specialize:
- You have developed a passion for something and want to follow it.
- You may decide to specialize because as a child you had a great experience with a dental specialist, such as an orthodontist or pediatric dentist, and you want to pay it forward—or perhaps it was a not-so-great experience and you want to change that experience for another child.
- As a specialist, with advanced training and especially with a Master’s degree, you may have broader career options, including teaching.
- Specializing in a particular field allows you to become extremely proficient as you dive deeply into that area. This sort of expertise is hard to develop as a general practitioner, especially early in your career.
Although some organizations may see emerging trends that paint a pessimistic view on the future of dental specialties, the wisdom of mentors and specialists in the field suggests that in some geographic areas the market is saturated with both specialists and general dentists; but there is still a definite market for the various dental specialists. Currently, it is well accepted that large urban centres and cities that have dental schools are well-serviced by specialists. However, you don’t need to travel too far outside of these centres to realize that there is still a need for specialists in many other communities. Additionally, the demands and needs for specialty services will differ for each discipline. As an example, there is a shortage of dental public health specialists in both rural and urban areas.
Further, given that many students graduate from dental school having limited experience in certain procedures (e.g., molar endo, placing stainless steel crowns on a child, extracting wisdom teeth, etc.) these same dentists may prefer not to perform these procedures in private practice and refer them to specialists.
Doing your own research will help you assess whether one specialty program is better for you over another. However, the criteria that you choose for this assessment is just as important. Some of these criteria may be location, tuition fees, reputation of the program director and other teaching staff, and type of program (e.g., 2-year, 3-year, mandatory research project, Master’s or PhD). Current residents of the program are a wealth of information and can give you insights about their experiences. You should also consider the examination and licensing requirements of the province you will eventually want to work in and whether or not your specialty credentials will be accepted.
The focus between programs may differ based on the vision of the program director. Some programs may involve more self-study while others are research-based.
Completion of a residency program looks favourable on an application and CV, especially in the absence of real world dental experience.
Hospital-based residency post-graduate programs are usually Pediatric Dentistry, Oral Medicine, Oral Pathology, and Oral Maxillofacial Surgery as the majority of clinical work is performed in the hospital setting including the operating room. Most of these programs will pay the graduate students a resident’s salary as well.
CaRMS is the Canadian Resident Matching Service. This is a “MATCH-like” program related to medicine and medical residents only. But this is completely unrelated to the dental MATCH program used for GPRs, AEGDs, and dental specialties.
Specialty programs must follow a certain formula as set out by the accreditation commission. Although there is heavier focus on clinical patient-based care, there are also didactic and research or teaching components. Typically, classes or seminars are held before clinic sessions in the morning or at lunch and clinical sessions constitute the majority of the work day.
Because of the small class sizes, residents collaborate and work together. This builds a long-lasting comraderie which will last beyond school. The environment is different from dental school where it can be very competitive.
In addition, you will have to register for the national MATCH program through this portal. This helps applicants and specialty programs find their ideal “match” after the application and interview process has been completed. There is a contractual obligation on both parties’ part to comply with the results. The downside with the MATCH process is that because not all programs participate, some candidates who have applied to non-MATCH schools may withdraw from MATCH if they receive an offer prior to the release of MATCH results.
In Canada, currently, there is no PASS portal although there may be plans to create a Canadian version in the future. As such, you must apply separately to each program. However, it is best to check with the program you are interested in since some Canadian programs (eg. orthodontics) may be included in the US MATCH.
If you are applying to both US and Canadian specialty programs, you may need to consider the timings of the non-MATCH and MATCH schools and rank your choices appropriately.
The Application Process
Once you’ve made the decision to pursue a specialty, it is wise to plan ahead to make the application process as smooth as possible.
If you are fortunate enough to know during dental school that you would like to pursue a career in a dental specialty, start investigating your chosen specialty early. This may begin as early as 2nd year, but more realistically, likely once you have started your clinical rotations and work in 3rd year. The rationale for this is that you want to know and understand as much as you can about a discipline before you apply, to help determine whether you will like all aspects and if it’s truly the best fit for you in the future.
The application process usually begins during the summer between 3rd and 4th year. Most of the applications are due in July, August or September when you are entering 4th year. You will likely require a letter of reference from the dean’s office or academic dean of the dental school and/or dental faculty members. Conduct yourself professionally at all times and manage your relationships well.
The interviews are held in the fall of 4th year depending on the program. It is important to realize that you may have conflicts with interview dates/times which may force or help you to rank the programs that you want to attend. Prepare well for your interviews by doing research on each program, its strengths, what it is reputed for, research that comes out of the programs etc. Dress respectfully and address your interviewees respectfully, at all times.
If you have an opportunity to shadow and observe graduate students or specialists during your downtime or holidays, it is well worth your time. It will also show initiative and may result in a letter of recommendation in the future. It is important to be respectful, show genuine interest and know that you are privileged as an observer can be a potential disruption during a clinical day.
NB: We live in a digital age. Realize that your private life on social media is accessible to everyone. Manage yourself accordingly.
Yes, the process is the same. There are many advantages to applying to a specialty after practising. You have seen more, done more and likely have developed a passion for certain aspects of the specialty discipline you’ve decided to pursue.
The only difficult adjustment, at times, is that you’ve become accustomed to earning a good income and now, you may have to return to a “student lifestyle”. However, with some foresight and planning, the opportunity cost may not be so high especially since the return-on-investment after finishing your program can be handsome. (Specialty fees in Canada are usually 25% higher than GP fees.)
If you are applying after working as general dentist, ensure that you maintain good relationships with your colleagues and perhaps, instructors from dental school as you will still be required to submit letters of reference and a letter from the dean. References may include, referring dentists and colleagues, representatives from dental organizations or associations that you participate in.
Specialty programs are very competitive so good academic marks are usually the first “test”. Some schools may set a baseline of a 3.4/4.0 GP and if you have attained this baseline GPA, your application may be accepted for further scrutiny. The letter of intent, the quality of your reference letters and your curriculum vitae will determine whether or not you will be interviewed. As a practising dentist, your GPA may not be as important as your letters of reference and letter of intent. However, when there are so many applicants to programs, as mentioned above, marks are often the easiest way to initially screen candidates.
It is important to know that some programs will have more competition than others based on the sheer number of applications it receives and/or the number of programs and positions available for students. Be realistic about your chances of earning a spot in a program and have a back-up plan in the event that you are not accepted into a program right away.
The most important factor for program directors and interviewers is that you are honest and sincere about your desire to attend their program and the specialty. The ideal candidate possesses confidence, initiative, a longing to learn as well as enthusiasm.
Your letter of intent should make you stand out—don’t be another “black suit/white shirt” applicant in your letter of intent or during your interview. Express clearly why this certain school has the program for you and if possible, share a personal story or experience that will illustrate your desire to enter this specialty. But be sure to be forthright as the dental community, and especially the specialist community, is quite small. The letter of intent allows you to showcase yourself, but the key is to remain humble and likable. Find a way to make your letter stand out while you let the evaluator know why you are interested in this particular program and why they should consider you. Also, let the reader see that you are familiar with this school, what the program offers and what the strengths of the department may be. Do not overlook the importance of proper spelling, punctuation and grammar either as it shows a lack of attention to detail in a detail-oriented profession. Make sure you have others inside and outside of the profession review your supporting documents.
Ensure that your reference letters are current and relevant. Often, reference letters can make or break an application even if the grades are not up to par. The person who writes your reference should know you well and be able to speak positively and confidently about your skills and abilities. This highlights the importance of cultivating relationships throughout your professional career.
During the interview, be respectful in the way you address your interviewers and other colleagues, residents. It is helpful to have a close mentor conduct a “mock interview” with you to prepare you for questions that could be asked during the interview process. Additionally, investigate each program you have applied to and see what research is coming out of the school. Be prepared to answer questions such as:
- What was the last book you read?
- What was the last journal article you read and what did you think of it?
- How many programs have you applied to and why is this program the best fit for you?
- What will you do if you do not MATCH or get accepted this time around?
There may be a social event planned the evening before interviews are held. It is strongly recommended that you try to attend these events. This is often used as an informal tool for current residents in the program to meet you and see if you fit the culture of the program. This is especially important because sometimes, the current grad students have a voice in the selection of the incoming students.
There is usually a tour of the facility the day you are invited to the interview. This is usually the only time you will have a chance to visit and speak to residents, auxiliaries and attendings as programs do not carve out time to entertain visits during the year. (The only exception is for regularly scheduled externships.)
In addition to the oral interview, you may be asked to write a written test, do a wax-up etc. as part of the interview process. Do your homework as much as possible on the program you are applying to so that you will be well prepared.
After you’ve been accepted into a specialty program, you will receive formal communication from the program and perhaps a contract. You will receive or may need to request appropriate documentation to obtain a work visa in the US. Usually, for most Canadians, a TN visa is adequate and can be obtained at the US border. Although the visa can be obtained when you are crossing the border, it is advisable to plan ahead and ensure the visa officer will be available to mitigate any delays or challenges.
You are generally required to be at the program by mid- to late-June to allow time to orient yourself to the program, university and city (if you are relocating). You may also need to open a bank account and obtain a Social Security number if you are relocating to the U.S.
You may have an easier or harder time finding employment, depending on where you decide to practice. Upon graduation, you may find that you work in multiple locations, in a specialist’s office or even in a general practitioner’s practice. This will allow you to gain experience, confidence and speed. You will also build relationships with your GP colleagues and specialist colleagues, alike.
The opportunity to work in a large GP practice is advantageous as you will not be competing with the general practitioner, but will have access to a solid patient base, in-house referrals with a low start-up cost.
There are also specialist corporate entities that will employ specialist associates. Additionally, as the demographics and lifestyles of dentists changes, there may be opportunities to have 2 part-time specialists and/or dentists sharing hours or cost-sharing a location.
After graduating from one specialty program, some individuals decide to return to do another complementary specialty program (e.g., ortho-pedo, ortho-perio).
Although there are some specialty group practices, presently this is not a common model. More often specialists will open a practice autonomously. Partnership models may exist, often in situations where the specialists are married. As mentioned earlier, the multiple practice ownership model is on the rise where one senior specialist opens several practices in different locations and hires specialist associates.
The freedom that is given to the specialist will likely depend on the contract that the two parties have entered into, but there will be usually be some room for negotiation. In the end, it is in the best interest of all parties to have a collegial and fruitful relationship.
Costs & Logistics
Once you’ve decided to train in a specialty program, you may wonder about the costs, logistics and details about the program. This following section helps you gain a better understanding of some of these essential things.
Currently, the cost of the NDSE is $6,500. More information about fees can be found on the NDSE website.
Being a specialist allows you to have a good work-life balance, as typically most specialists do not work evenings or weekends. However, in the current market, specialists do have to market themselves just as general dentists. Also, while the income for a specialist can increase at a higher rate than that of a general dentist, there is an opportunity cost since the general dentist started working three years earlier than his/her specialist colleague.
Graduate students may have the opportunity to work as a general dentist outside of the program, but this will depend on the individual, the demands and potentially rules of the program. However, program directors and graduates, alike, feel that there is great value in “moonlighting” while in a specialty program. It helps you keep in touch with the profession, keep your skills sharp and realize how your specialty training fits into the grand scheme of oral health and well-being. Working in your off-hours during the last year of specialty training may also help build connections with dentists, staff and patients and help you find full-time hours more quickly upon graduation.
This is something that is specific to programs and universities. Please inquire with the specific program you may be considering.
Once enrolled in a specialty program, the biggest issue you may face is balancing your personal and professional needs or demands. The best advice is to seek out advice and support from your loved ones, trusted friends and colleagues and mentors. Any problem that arises should not preclude you from completing your program and should be discussed and dealt with sooner than later with your director or mentor.
Most programs are 2 to 3 years in length. The U.S. has more 2-year options available.
Remember, it is everyone’s goal to graduate on time. Be wise in selecting your research supervisor. Pick a supervisor who has experience and time to guide you to finish your research on time.
Look for a topic that aligns with your interests. In some schools, you may not have the opportunity to choose the project as your supervisor may have opinions on what it should be.
The information for licensing as a foreign-trained specialist and the DSATP is available on the NDSE’s website. It can be a challenging path to follow and there are not many spots for foreign-trained specialists in Canada.