Today’s post is full of #wednesdywisdom from Dr. Kathy Ong. Kathy was my classmate at UMSOD and has a heart of gold. 💛 Now a resident with Christiana Care Health System in Wilmington, DE, Kathy was the recipient of the 2020 Student Leadership Award presented by the Delta Dental Community Care Foundation. The honor recognizes students who have demonstrated leadership skills, commitment to public service, and outstanding service or accomplishments in the field of dentistry. I couldn’t think of anyone more deserving! Keep reading for Kathy’s clinical pearls of wisdom (there’s lots)!
If you were a D2 what advice would you have given yourself to better prepare you for clinic?
I would’ve been more familiar with the different competencies for D3 so that I could be more aware of which patients I could possibly challenge them on instead of missing an opportunity.
What is a trait that you believe is crucial for success in clinic? Why?
I believe being organized is crucial for success in clinic because it’s very easy to get lost when you look at your Rolodex (patient list) or at the many competencies that we have between D3 and D4. I would make an excel sheet for your patients with their initials, patient number, what appointments/steps you’re on, and what you have to do next for that patient such as make an appointment, prepare for your TXP, bases and rims, etc. As well, you can keep track of who you’ve co-therapied, inactivated, or transferred. It’s also helpful so you can pull it up on your phone via Dropbox if you’re running errands for that patient without having to log in to Axium all the time. Another trait I think is important is being proactive. If a D4 co-therapies a patient with you, be proactive in contacting that patient because it delays that patient’s treatment if you forget about them.
What was your first procedure? What went right? What went wrong? What would you have done differently? What did you learn from it?
My first procedure (outside of treatment plan work-up’s and prophies) was operative for my mom to restore a Class IV on #8. What went right: giving local anesthesia. What went wrong: it was hard for me to tell when I had finished removing the old composite and I was anxious about making the preparation bigger. As a result, the preparation took a long time before the restoration and I ended up going past the clinic session time. What would I have done differently and what did I learn from it: I would’ve asked my faculty for more specific help earlier in the session, such as informing them that it was my first filling on a live patient and that I didn’t know how best to tell if I finished removing the old composite. I learned that it’s important to tell your faculty what you’re struggling with because otherwise, they won’t know.
What has been the biggest lesson you learned reflecting back on your time in clinic at UMSOD?
The biggest lessons I’ve learned reflecting back are to not compare myself to my peers and to ask for help if I’m deficient in certain clinical experiences. For example, it’s easy to become discouraged your D3 year when you see others already starting dentures or crowns. However, you should focus on the needs that your current patients have and know that it’s okay to start remo in the Spring or Summer. If by late Spring you find that you don’t have any reliable patients for the minimum remo clinical experiences, reach out to faculty and classmates and ask if anyone has patients they would be willing to share. Perhaps you will have something to share to someone too, such as operative or boards patients. Each person will run at different paces in clinic, but you all will make it to the same end goal.
What would you have done differently from the time you started clinic to the time you finished clinic? Why?
I would’ve told myself to be braver in challenging competencies even if you feel you aren’t fully prepared for it or even if you’re scared to fail. I would do so because you never know when you’ll have the opportunity to challenge it again or if clinic will be closed because of a pandemic. For example, patients may change their mind and decide not to get a crown for your crown competency, or maybe there’s not enough time for you to finish disease control to start the crown. Taking the step just to try challenging a competency is a big accomplishment already and if you fail, you’re not the only one so learn from the lesson and try again.
What has been the biggest hurdle you have had to overcome in clinic? How did you overcome it and what did you learn from it?
I think the most tears that came out from me in clinic was when I was unsuccessful in one part of the mock boards. It was an existing Class III on my mom (my number one fan, haha) and it became bigger than the ideal dimensions. After I had prepared to the ideal, I misunderstood the faculty’s direction to then remove all of the remaining composite, when in fact the faculty wanted me to ask for modifications. I overcame the hurdle by clarifying the CDCA directions afterwards, asking peers if they had non-existing composite lesions to share for reattempting the mock boards with, and becoming successful with the reattempt. I learned from it the importance of clarifying directions even if it means asking three times and that I would never do an existing composite lesion on real boards.
What has been the best piece of advice you have received while in clinic?
“I would rather have a student who may be less confident, but who is willing to learn, than a student who thinks they already know everything. Confidence will come with experience.”
How did you best manage the stresses of classes and clinic at the same time? How difficult was this transition for you?
The transition was difficult for me because I felt so exhausted after a day of classes and clinic and then a lot of time was spent scheduling and planning for appointments than for studying for didactic exams. I best managed the stresses of classes and clinic by compromising, such as cutting down on volunteering, attending mainly the required 8am classes in order to catch up on sleep, and setting study goals such as determining which classes would take more time to prepare for and which I could review just a few days before the exam.
Do you have any insight on how to best have access to chairs and make appointments? If you do, what advice would you give people who are seeking the most efficient way to obtain chairs?
Scheduling patients with the right faculty for the right day and time is a struggle for everyone. My advice would be to know your patients’ preferred appointment times, which patients can be more flexible, and which patients can come with shorter notice so when the chairs go out, you can book efficiently. You can also trade a chair with a friend if you feel you desperately need that session. As well, you can politely ask the front desk a week before for the chair that you would like or keep an eye on the schedule in case someone drops the spot. Lastly, you can ask the specific faculty if they would be willing to accept an overbook or not.
What aspect of clinic did you find to be the most time consuming and how would you recommend a student go about being more efficient?
For me, the most time consuming in D3 were TPWs (treatment plan work-up’s) and preparing for TXPs (treatment plan presentations). TPWs were time consuming because you have a lot to do and you’re trying to maximize the patient’s time to finish the TPW in 1-2 sessions. I would recommend that you try to get at least these three done in the first session of a TPW: radiographs, impressions, and photos. With those three items, you can get a good idea of what kind of treatment plan to formulate and to review with your faculty before the TXP. You can check your findings again and finish perio charting at the beginning of your TXP, and if you know your patient may qualify as a perio case or if they may need any consults, you can ask to get that done during your TXP appointment. The most time consuming in D4 was dentures. To make your denture appointments more efficient, plan and review ahead so you have goals to accomplish during each session.
What resources did you use to prepare you for Boards Part II?
Mastery App, Tufts Pharmacology
What tips worked for you in getting patients to say “yes” to your proposed treatment?
I would recommend finding out your patients’ goals and presenting risks/benefits/prognoses of each option in layman’s terms. Sometimes it would also help to relate my own dental experiences or one of my family member’s, such as why I got orthodontic treatment or how implants helped replace missing teeth for my mom.
What skills/techniques for certain procedures did you find particularly helpful when beginning clinic?
At the beginning of clinic, you’ll often find yourself without an assistant so it was helpful to get a computer with the keyboard close to my side so I could perio chart on my own. As well, I used to dread putting on dental dams and had gotten used to the technique of placing the clamp on the tooth and then the dam in pre-clinic. However, I learned from my classmate to place the winged clamps on the dam before placing it on the tooth, so that made it a lot easier and quicker. Bite blocks can also be your best friend.
Are you going into GPR or AEGD? If so, which one and why? What was the biggest contributing factor that led you to gaining admission to your program? What advice would you give someone with interest in gaining admission to that program?
I’m going to a GPR at Christiana Care because I heard a lot of great things about the program from my friends who went there and hope to gain more experience in working with medically complex patients in a hospital setting as well as mentorship from faculty. Also, you have an opportunity to sit for the Delaware licensing exam as a resident. I think it helped me to speak to previous residents about the program to learn what the program offers and ask specific questions during the interview based on what they experienced. If interested in the program, I would ask past residents about their experiences or perhaps schedule a visit to the program.
Do you listen to any dental related podcasts? What are your favorite ones and why?
I haven’t listened to podcasts, but I’ve been watching dental seminars through the Pankey Institute, Dawson Academy, and Aspen Dental websites.
Did you attend a clerkship? If so, which one and what has been the biggest benefit you had from being a part of it?
I was part of the pediatric dentistry clerkship. I think the biggest benefit was being able to assist residents on complex cases in mornings, when no one else was on block except for the clerks. Observing the residents helped me to learn strategies in approaching kids and their parents.
What did you do that you feel gave you an advantage in patient selection for boards?
I helped screen D1s and D2s in searching for boards lesions and was able to find one during the screening that would help another classmate for the boards exam. In the end, I was lucky that my patient for Class III came through and was grateful to my friends who shared their patients with me for Class II and perio.
What was something that you did differently from your peers that you feel benefited you in clinic and that you will be able to carry on in private practice/residency?
Unfortunately, I didn’t know about this during clinic, but during the time off due to the pandemic, I was exposed to occlusion seminars through the Dawson Academy. I feel that every dental student should watch these seminars so you can apply the principles during clinic as you check occlusion after almost every appointment. The seminars helped me to better understand what we should be looking for when checking occlusion, what exactly is canine guidance and group function, and the consequences of occlusal disease, all of which I will carry on to residency and beyond.
For more clinic tips, be sure to check out #wednesdaywidsom from Dr. Laura Rojas. What clinical pearls of wisdom can you pass along? Comment below!