Wednesday, December 30, 2015

HPSP Laptop Rental

My blog tends to be about me.  Stories about what I'm doing or what I'm going through.  I tie that in together with details about the Air Force (as much as I am allowed to divulge) and particularly the HPSP scholarship.

However, as a "regular" practicing Air Force dentist now, I don't have much more to say along the way other than updates about how things are going in clinic and information that can help you along your HPSP path, whether that means talking you into or out of the scholarship (which I've done many times both directions!) or giving you tips along the way.  My 5 year track record of being one of the only active HPSP student bloggers online and the many hundreds of emails I've received since this all began, gives me some unique insight into what HPSP students are doing and thinking about.  So what's my point?

One unknown aspect about the HPSP scholarship is this weird option in there to rent a laptop and have the military totally cover the rental.  These days, people aren't usually thinking about renting a laptop (vs buying) and the logistics of renting electronics is less and less appealing.  On the other hand, it would be nice to take advantage of this free offer from the military and be able to rent a high quality laptop for the few years you're in school.  This would prevent wear and tear on your own machine and your dollar would go further to buy your own laptop for yourself once school is over.

I think I've only heard of a few people actually utilizing the laptop rental reimbursement but that may change very soon.  A company called Laptops for Military Docs is getting straight to the point.  This company will give you step by step instructions on how to rent a high quality laptop from them hastle-fee.

Now I must admit, this company is very new and I have no personal or financial stake in this whatsoever.  Obviously with them being so new, I did not personally rent a laptop through them (or anyone, actually).  But every once in a while something comes along that I feel compelled to let my readers know about.  This is one of those times!  This company is clearly set up for specifically this reason and I have to believe that by focusing solely on HPSP students, they will be able to help you, too.

Technology is changing rapidly so consider a rental reimbursement during dental school to save yourself some money!  It's an option that's free to you as long as you're willing to do the legwork and Laptops for Military Docs is there to make it easy.

I'd love for some of you all to give this service a try and let me know how the process was for you!

Sunday, October 18, 2015

Overseas

We got Alaska.

So it's been a while since my last post and I wanted to let the dust settle, per se, before I posted again.  My residency is over and we have been at Eielson AFB for almost 2 months now.  I started seeing patients a few weeks ago.  Eielson is considered overseas for somethings and not others, so it's a weird mix of both!  My assignment is only 3 years like an OCONUS assignment, not 4, but I'm not actually overseas in a foreign country (for example).

First off, I'll talk about the AEGD now that I have some perspective.

Not a lot more I have to say that I haven't already, to be honest.  I will say that the personnel at your location can make or break the experience in a given specialty and you really have no way to know what each base is going to offer.  People are moving all the time!  Having said that, I don't see how you could survive as a brand new Air Force dentist without doing a residency.  There so much "Air Force" stuff to learn that it would be really hard to learn on the job if you came straight out of dental school. With that being said, if you absolutely do not want to do a residency then think twice about the HPSP at all!  You are now required to not only apply for, but also accept, a spot in an AEGD residency.  That's right, no longer optional!

My AEGD was good, and the location was incredible.  The Academy was a beautiful place to be!  However, there were aspects of the residency that were less than ideal while other aspects were very well executed.  It certainly wasn't a traditional educational environment like dental school but more of a "learn by doing" situation but the faculty all see their own patients most of the time.  It had a tendency to feel somewhat disorganized at times with lectures being fit in where they could be and not a real over arching theme or long terms goals, except when outlined by each specialist as they saw fit.  Syllabuses for different specialties either didn't exist or were usually incomplete, and there was a tendency for contradiction in lectures or between faculty that made things frustrating at times as someone trying to learn.  It's something you have to embrace as part of the unavoidable nature of the constant movement of parts and pieces in a very large Air Force system.  As someone who really likes to make their own way and be as proactive as possible, I encountered a surprising amount of opposition to that style and found it more beneficial to "go with the flow" most of the time.

On a positive note, I got to do quite a few IV sedations and 3rd molar surgeries as well as perio surgeries.  I got to do far more root canals than I did in dental school, and I got fairly proficient in whats known as a "cuspal coverage amalgam", something you have to see to believe!  I felt like I was adequately exposed to all the specialties enough to help me decide if they were something worth exploring further as a specialty. The general feel of the residency all seemed geared towards serving the Air Force population, and many of the skills I learned will serve me very well at my new base, even though I won't use many of them if I choose to leave the Air Force some day.


Second, Alaska!

Being on my own is really nice.  It was weird at first, and still very much is, but you'll be amazed how much faster you can work when you're doing 1 or 2 fillings and there's an hour set aside to do it without faculty looking over your shoulder.  You just sit down and crank it out.  For me, it hasn't been all that difficult of a transition for me.  I've always worked pretty fast so this doesn't seem that bad!  I do feel a little rushed sometimes but considering this is my first experience out of an educational setting, I'm really pleased with it so far.  This is a small clinic and was designed for a couple more dentists, so we have a lot of room.  Having an office is nice too!  I'm not sure what to put in it quite yet other than trail mix and extra paper.  Very official.

Eielson AFB is not a very desirable location but to be honest, I really like it here so far.  The people are very nice and for being a smaller city, they have a lot!  Amazon still delivers here so I think we'll survive after all.  We had to get our cars "winterized" but so far, we've only had 2 snow storms!  It was actually quite nice out today and my wife and I went on a walk with our dog.



That's all for now!  I'd love for some comments or emails with some ideas about what I should start posting about now!  This is kind of the end of the road in terms of my journey from the end of dental school when I started this blog.  I'm here, I'm done with dental school, done with my residency, and now a full blown real life Air Force dentist!

So let me know what YOU want to hear about and I will gladly, within the limitations of what I'm allowed to talk about, let you know!




Saturday, May 23, 2015

Off We Go

The first 3 words of the Air Force song pretty much sum up the last 5 months of my life.  I've severely neglected to post as frequently as I intended but that was partly due to the lack of particularly interesting things to talk about since January.

Not anymore.

The residency is coming to an end in a couple short months and the last 5 months have gone by about as fast as 1 month seemed to go back in the fall.  Finally getting in the flow of clinic, understanding expectations a little better, having more freedom in clinic, a new oral surgery rotation schedule, Spring Break, some federal holidays, better weather, and some fun courses have all contributed to the increase in moral and the perceived increase in speed of the residency.

My wife and I were able to hit the ski slopes for the first time in March (I seemed to be on-call for most of the prime opportunities in the fall) and we took a road trip through a good majority of the state of Colorado for our 5 day spring break.  It was the trip of a lifetime and I highly recommend it to anyone!  Email me if you want information on where we went; it was incredible.

If you follow my on twitter, or read the tweets off to the side on my blog, you'll know that we got our base list not long after my previous post with all the bases that had openings.  We had lots of great options but we were disappointed to find many of the bases we wanted were not available.  However, we were still able to put bases on our "dream sheet" that were not on "the list" just in case an opening popped up.  Surprisingly, it seems that many AEGD residents from around the country put bases high on their list that were not available (apparently) but ended up going there.  To be honest, I have no clue what the list we got was all about because it seems like people went to lots of bases that weren't on "the list". So who knows!  Maybe they just make their best guess at which bases will be open, I have no idea.

We got our #15 choice and I'll reveal what base that is once we get there.  There's been a pretty heavy crackdown on information and things lately in the military as a whole so I'm going to try to walk the line of being transparent and safe with this information.  For comparison, 2 of my classmates volunteered for their assignments, another got their #1 and another their #9 (I think). So overall, very good!

A month or so ago we had a meet up with all the AEGD residents across the country at Lackland AFB in San Antonio.  It's something they want to try to do every year and it was a really fun experience to meet everyone and talk about some Air Force stuff.  Every base was off the entire week (except us) so most of you doing an AEGD will get to be out of clinic for a week and hang out in San Antonio with all the other residents.  We did go out a couple nights and it was a pretty fun time.

One thing that going to San Antonio helped me realize were the stark differences in each AEGD program.  Some bases are set up poorly for certain things while others are set up well.  I think my base is set up well for oral surgery because we have so many young cadets, but this very thing also puts us at a disadvantage for prosthodontics.  I also assumed each resident would get similar levels of training but it seems that a lot of that depends on the faculty that are at the different locations as to how much freedom the residents will have to do certain things.  Some seemed more intent on taking it slowly getting into clinic while others emphasize clinical experience as the main mode of education. If you're interested or concerned about these things, I would try to figure out a way to contact a resident at each of the bases.  It sounds like a lot of work but it might help you figure out which program fits your personality better.

Two words of advice for everyone that does an AEGD.  First, try to understand very clearly the expectations.  I've run into trouble lately with not understanding expectations from faculty both academically and clinically for various reasons.  Sometimes it's getting vague information or mixed information from different faculty members on the exact same topic. So get clarification when you need it and never assume a low level of effort will be enough. The Air Force is a little different than a normal AEGD program because people are coming and going all the time.  So often the faculty aren't on the same page about what a resident should know or do in a particular situation so don't be afraid to ask.

Second, don't be shy to let your directors know that you want to do more of a certain procedure, or that you would prefer NOT to do a certain procedure when you leave.  If you're performing well in all areas, but don't particularly like some of it, you could get stuck going to a base that needs the skills you do well, but don't like.  So help the Air Force help you and be clear about what you hope to do when you leave the residency.

I hope to summarize my feelings about doing an AEGD once my AEGD is over and perhaps after I've been at my new base a few months and can truly appreciate what I've learned.

***FYI; I've heard from applicants and current HPSP students that the AEGD will be mandatory if you are accepted.  I can confirm that I've heard this from higher ups as well.  You are no longer permitted to apply and decline an AEGD in the Air Force.

Saturday, January 3, 2015

When Stress is Stressful (aka: The Longest Post Ever)

I'll get to the dental stuff in a second but first I want to talk about stress.  This is not a scientific or philosophical discussion but simply some thoughts from my own brain about stress as it relates to where I currently am in my life.

Stress

I moved away from home ("home" here means anything within a 50 mile radius of where I was born) for the first time this summer and at first it wasn't too bad.  Then for some reason around November things got difficult.  The sun started going down sooner (sunlight always makes me happier!), the holidays were around the corner, and I started to get homesick.  It's a funny thing when you miss people because typically nothing has changed really but you can no longer just go see them whenever you want.  Even knowing that your family is suddenly 600 miles away just feels weird.

Then, of course, there's the residency.  To be quite honest, the first couple months of the residency weren't half as stressful as the worst times in dental school.  Dental school was a real drag a lot of the time and there was a ton of stress associated with graduating on time and actually making it out.  With a residency, the worst that can happen (seriously) is that they kick you out.  Really, that's it.  You're still a dentist and though your pride might be shot, your life would not be severely altered in any measurable way unless the residency was an integral part of your future plans.

For whatever reason, I started letting things get to me.  In a recent book I read, the author commented on a concept of "thought attacks" where you let one tiny thing get under your skin and suddenly your mind just creates this totally fabricated scenario in which things go terribly wrong or you are far too upset about something you shouldn't be and it makes the whole situation seem powerful and urgent and it consumes you in a flash.  These started for me once the little criticisms began in residency.  I'd make one little mistake and beat myself up for it, or answer one question wrong and extrapolate the consequences in my head to a place they never would actually go.  Even having more "things" to do just seemed stressful even if I had plenty of time to do them.  In essence, I was letting tiny things get to me in a way that I hadn't in the first couple months of the residency.

Combine these three things, and the last two months have been the worst in the residency for me personally.  We are still new but we are treated and expected to act like full blown Air Force dentists for the most part.  For a couple weeks I knew this but couldn't figure out why this was so stressful.  It's because I had never done that before!  Many of my classmates are on their own, but I'm not.  I'm still in an educational environment so I often expect someone to tell me how or what to do.  It wasn't until just recently that I realized a lot of my stress was coming from this circle I was trapped in.  It goes something like this.

I have a procedure to do, I get to clinic, I'm not 100% prepared, I'm stressed out because the faculty want me to be more prepared, they help me through the procedure, I finish the procedure and everything is fine, I'm stressed because I didn't know what to do, because I'm stressed, I worry about the next procedure with that doctor, the next procedure comes, I get to clinic, I'm not 100% prepared... etc...

Ok so I think get it now.  This is my education, this is my miniature dental practice inside of the Air Force.  If I was in private practice I was going to have to learn all of this on my own anyway.  I was trying to walk the line between being an autonomous dentist and a student.  In reality, I need to have the mindset of an autonomous dentist who happens to be surrounded by experts willing and ready to help should the need arise.  I'm not 100% student or 100% autonomous dentist yet and so I assumed I should act a little like both.  I've started to realize that I need to fully own this, as if no one is going to help me, and allow the education to flow naturally from the areas I'm weak in rather than the areas I'm not prepared.

So my stress was coming from unpreparedness.  Also, stress in and of itself is just a response our body has to a certain situation.  Whenever we are stressed, everything seems urgent and it's hard to do things well.  November and December were hard months in the residency for me but they also went by quickly.  I've seen my family twice now (Thanksgiving and Christmas) and I realize that the AEGD is under my control.  I'm feeling refreshed and the residency itself is nearly halfway over.


Dental

Now on to the dental things.  I've gotten lots of emails lately and December was the biggest month for my blog since I started it way back in 2010. I'm going to address 2 of the more general questions now and then go into more detail on the residency.

Understand as I answer these questions that they are from the perspective of an Air Force dental resident who has been doing dentistry in the Air Force for all of 4-5 months.

How do deployments work?
As far as I understand, deployments are quite rare. Not 0% rare, but usually they are filled by volunteers.  This is also answered in the comment section of the "Got a Question?" page at the top.

Where can I be stationed?
The possibilities are far and wide!  For the AEGD, there are only about 10-12 bases with the program.  As far as being stationed after the AEGD (or right away if you pass on the AEGD), there are about 50 US bases and around 15 or so overseas bases.  I hesitate to post a map for security reasons and I'm just not 100% sure that would be ok.  You can find this information by searching for bases and then seeing if the have a dental clinic.  Not every base will be an option, they need to have a vacancy for someone to go there.  Your recruiter should have maps of the US and overseas bases.

Now for the AEGD.  Here's my halfway-point summary.

You work in a block clinic (Monday morning is Endo, Friday morning is Operative, etc.) so it can be hard to schedule sometimes.  Your patient's appointments will often be a month apart because there might be other activities or holidays that lock out certain days that you would normally have clinic.

The clinical experience depends on the faculty preferences at your location.  I've spoken to other AEGD residents who had done as many as 10 single unit crowns by Thanksgiving.  I think only 1 resident at my location had done 1 single unit by that time.  As of now, I believe a total of 2-3 single units have been delivered (I've done 0). This is simply the preference of the specialist at that base in terms of how they want to deliver cases and the style and method of teaching the different aspects of their specialty.  My guess is that those other bases probably had single units ready to go when the residents arrived where as we typically work the patient from start to finish so a lot of cases I'm doing now will be ready to deliver in a couple months.

I think the biggest benefit and downside to the residency is the variety of procedures.  I don't really feel like I'm getting far better at my core skills (fillings, crown, etc.) but I'm learning new things I never expected to do or enjoy (perio surgeries, sedations, different endo obturation methods). On the one hand that's great if you want to broaden your skills but not ideal if you wanted to do a high volume of more of the core skills.

Is the residency worth it?  I would say yes, but with a caveat.  Yes because in order to do certain procedures in the Air Force you have to be "credentialed" by staff to do them.  Simply doing them in dental school isn't usually enough but this partly depends on the base you go and what the leadership allow you to do out of the gate.  If your goal is to broaden your experience and learn to have a better eye in all aspects of dentistry then the AEGD is worth the extra year.  If your goal is to get your school loans paid and get out of the Air Force, and you have no interest in learning more about other specialities, then the AEGD might not be for you.

I hope this was an informative post and I wish you all a wonderful 2015!