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!