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, May 23, 2015
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!
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!
Sunday, October 26, 2014
When Learning Isn't Fun
I've got to say, one of the hardest things about being in school since I was 5 years old is getting up every morning and knowing only one thing for certain: that today I will learn something new. Unfortunately in the high-pressure environment of a dental residency, it's easy to forget that we (the other 4 residents and I) are learning and often we feel like punching bags where the fists are different tasks and questions that we aren't equipped to do or answer.
It's easy for you, the reader, to tell from that statement that an AEGD, or any residency for that matter, can feel like a beat-down at times. As I sit here and write this, I know for a fact that I'm going to feel very dumb and silly multiple times this week for either not knowing or forgetting something that someone expects me to know. However, once you come to this realization and strip away the stress that comes with chronic unpreparedness, you can start learning.
I had to figure this all out again in the last few months and coming to terms with this has been refreshing. I must do the best I can each day without sacrificing my personal health and wellbeing to perform at a high level. It's not just for me but for the future of the Air Force and I owe it to each of my faculty members and patients to constantly give my best effort. I will often fall short and I will often fail, but once you can realize that that is part of the way we must learn, it isn't so bad.
I know this is a little different than my other posts but I write it to point something out. When things seem hard, take a step back and try to understand why they seem hard. Often it's just that, they seem hard but really aren't. Perhaps it's our perspective that makes them hard. If I know ahead of time that the way they are teaching me is by asking me questions I may not know and having me do difficult procedures, then I can be totally 100% comfortable with not knowing things and failing! Because if I believe that the intentions of the residency are pure, to make me a better dentist, then I have to believe the methods are pure as well and that's ok.
It's been a hard month as we've transitioned into more clinic but I'm starting to get the hang of it. I can see improvements already and I know what the different faculty members expect. Best of all, I'm learning why they expect what they do. It isn't for their own self-pleasure or to make sure we all have a crappy time, but to improve our thinking skills and our hand skills to perform at a level that will allow us to exit in August 2015 and be able to handle far more cases with great confidence that we have never possessed before.
Because I trust the end is well intentioned, I can trust the process is well intentioned, too. And that in and of itself is why this next month will be better than the last.
It's easy for you, the reader, to tell from that statement that an AEGD, or any residency for that matter, can feel like a beat-down at times. As I sit here and write this, I know for a fact that I'm going to feel very dumb and silly multiple times this week for either not knowing or forgetting something that someone expects me to know. However, once you come to this realization and strip away the stress that comes with chronic unpreparedness, you can start learning.
I had to figure this all out again in the last few months and coming to terms with this has been refreshing. I must do the best I can each day without sacrificing my personal health and wellbeing to perform at a high level. It's not just for me but for the future of the Air Force and I owe it to each of my faculty members and patients to constantly give my best effort. I will often fall short and I will often fail, but once you can realize that that is part of the way we must learn, it isn't so bad.
I know this is a little different than my other posts but I write it to point something out. When things seem hard, take a step back and try to understand why they seem hard. Often it's just that, they seem hard but really aren't. Perhaps it's our perspective that makes them hard. If I know ahead of time that the way they are teaching me is by asking me questions I may not know and having me do difficult procedures, then I can be totally 100% comfortable with not knowing things and failing! Because if I believe that the intentions of the residency are pure, to make me a better dentist, then I have to believe the methods are pure as well and that's ok.
It's been a hard month as we've transitioned into more clinic but I'm starting to get the hang of it. I can see improvements already and I know what the different faculty members expect. Best of all, I'm learning why they expect what they do. It isn't for their own self-pleasure or to make sure we all have a crappy time, but to improve our thinking skills and our hand skills to perform at a level that will allow us to exit in August 2015 and be able to handle far more cases with great confidence that we have never possessed before.
Because I trust the end is well intentioned, I can trust the process is well intentioned, too. And that in and of itself is why this next month will be better than the last.
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