8 Year Recap Post, FAQ, and My Future

This is an ambitious post. My goal is to make this post a very concise summary of my experiences over the last 8 years and answer some of the most common questions I receive via email, as well as an update on my future plans.

Before dental school

Recruiters
If you have even the slightest inclination that you might want to pursue the Air Force HPSP (Health Professions Scholarship Program) for dental school, contact a recruiter. There is a link on the right side of my blog, or you can find it HERE and select "Healthcare Student or Professional".

Unfortunately, the recruiting system gets a bad rap for being unresponsive and often unhelpful, so if you're having trouble getting in contact with a recruiter in your area, start looking outside your area and contact one of those instead. They can probably help you get in touch with your actual recruiter who isn't returning your calls and emails.

Application process
Everything flows through the recruiter. You need to be in decent shape, have excellent grades and DAT, and nail your interview.

For the interview, focus on all the generic questions (strengths, weaknesses, etc), but be prepared for additional questions like: Why do you want to be in the Air Force? Why do you think you would make a good Air Force officer? What leadership experience do you have?

You're an officer candidate, not just a potential Air Force dentist.

Choosing a school
Go to the school in the area with the cheapest cost of living! Your stipend does not change based on where you live, and you'll devour the stipend if you're living in Los Angeles vs living in Oklahoma. I spoke about this on the Choose FI podcast, episode 99R at minute 57:40.

During dental school

Money!
You get paid about $2,000/month during school, and the Air Force will pay all your other required bills directly. Some things (scrubs, loupes, books) will be on you to buy, and then you will submit some reimbursement paperwork to the Air Force. You should have some information of some contacts at AFIT that can help you out.

Military obligations
You don't have any! Yay!

After dental school/AEGD-1

COT
The timing of COT depends on your school summer schedule and when you commission, but most dentists go after dental school. You may find the COT Survival Guide helpful, but keep in mind that it was written in 2014. Also, check out the newest Air Force PT Test Score Charts to get an idea of where you'll land and start training for this test during dental school! Here's a good pushup and situp video to help you out, but remember, the official Air Force guidance on fitness is found here at A5.3 and A5.4.

AEGD-1
Unfortunately, my AEGD-1 experience was not all that great, but most students love their experience. Having said that, despite my misgivings about the training I received, the year itself was very formative for me personally and the experience was one that I count as one of the most pivotal in my life. I certainly must recommend the AEGD-1 for the sheer fact that it's going to be difficult to operate as an Air Force dentist without this advanced training, since the Air Force has their own system to "allow" you to do certain procedures (called "credentialing"). Even if you did a procedure in dental school, a residency may be required to do it in the Air Force (restoring implants, for example).

You are required to apply for, and accept, an AEGD-1 now. Not everyone will be accepted by the Air Force, but there's enough spots for most applicants. Plan on going.

As far as what base you get, you'll fill out a preference sheet just before your 4th year of dental school, but they could send you to any of the 12 or so AEGD bases. I don't really have any insight as to why they send people where they do.

Specializing
I get asked this question a lot, and it's a bit of a moving target. Some specialties do allow you to apply right out of dental school, while others want you to have a few years of experience (or an AEGD-1) under your belt first. Your AFIT contacts should have this information.

After residency/Being a dentist in the Air Force

Where will they send me?
Assuming you do an AEGD-1 like most Air Force dentists, you'll get a list of bases (in February-ish of your AEGD year) that need dentists and you'll get to rank them based on where you want to go. Unfortunately, while you do get a say, you're not guaranteed a top choice. I got my 16th choice, but it ended up being the best thing for me and my career.

I got to go to a small and remote base that was in dire need of organization and streamlining, as we were updating and planning for the arrival of a new F-35 squadron in the coming years. Previous officers hadn't systematized the clinic functions, but instead just relied on the people to run the place. When those people left, so did their ideas and processes, and the clinic was constantly starting over on processes when people would leave! I stepped into some roles that most young Captains don't get to experience, and got to hone my organizational and systematizing skills that would ultimately prove very valuable for my life and career.

What's a normal day like?
It depends on what base you go to, but a fresh Captain out of residency will usually be doing dentistry about 80% of the week. The rest of the time is set aside for training, PT time, or lunch. Expect to do a lot of restorative, with some single unit crowns sprinkled in as the mission permits and requires, and exams. If you did an AEGD and have the training, you'll probably be doing some IV sedation and restoring implants as well! Elective procedures (anterior crowns, veneers) will depend a lot on what the mission of your base is, and how well staffed the clinic is to suit your desires. I did almost no esthetic work at my first assignment, but a dentist at my new base is doing lots of anterior crowns and veneers because the mission is much less strenuous here.

What's the best part about being an Air Force dentist?
This depends on how you look at it. The normal answer is that you get to do dentistry without being pressured to produce a certain level of $, while having a nice slow pace to the day and getting lots of vacation time (as compared to a typical civilian corporate job). I think the "bad" things are actually good, and I detailed them a bit more in this post.

As far as vacation days go, you get 30 days per year that accumulate at a rate of 2.5 per month. It depends on the base's specific rules, but this 30 days usually does count the weekend.

If you leave on a Friday and come back Monday, that's 4 days you have to take off. Monday-Thursday would also be 4 days. Your "leave" days start and end in your local area. The definition of "local area" depends on your base's rules.

What's the worst part about being an Air Force dentist?
Again, this is going to be very personal, but I think the worst part is the slow pace and the lack of incentive to produce. However, there are lots of dentists that love this part of the job and would consider this a benefit, since they can take their time on their dental work and typically don't have to work any harder than they want to. You just need to know what Air Force dentistry is like and weigh your personality against it.

(If you didn't notice, I cheated here by using the same answer -- no pressure to produce -- for best and worst part, which leads me to...)

How is Air Force dentistry difference than civilian/private practice?
*These are my opinions from having worked in 2 civilian practices during my time as an Air Force dentist*

-Quality of work - I believe the Air Force tends to have higher work quality than most civilian providers. We don't have time pressures or too many cost pressures, so we typically get to spend as much time as we need to get things done the right way. Also, most of our dentists are a few years removed from a 1 year AEGD, which lends to even higher quality knowledge and care.

-Patient experience - I'll give the edge to private practice. I think most Air Force bases do not put enough emphasis on customer service, and our outdated charting system results in far too many records errors. However, there's a host of different ways this is managed on the civilian side, but at least on the civilian side, a dissatisfied patient can choose to take their business elsewhere. This is where the Air Force slips behind: our patients don't have options so we aren't incentivized to give them a good experience and we too frequently miss the mark.

-Clinic organizational structure - Unbelievably, I give the edge to private practice here, and it's not even close. One of the most surprising things to me about Air Force dentistry is how disorganized the organizational and accountability structure is at the clinic level. There's usually some holes in accountability and organization at some level that lets a litany of small problems leak through constantly. There's very little focus on creating good systems. Instead, most clinics rely on strong-willed individuals to run large portions of the clinic that end up suffering mightily when they depart for a new base. It seems there's no real training on "systems thinking" that would alleviate so much of the constant stress and little mistakes that occur daily in military dentistry. Everything I've learned about how to lead people, implement systems, and build/design a clinic has come almost exclusively from books I've chosen to read on my own. The military doesn't teach you this.

The biggest problem here is that, contrary to popular belief, there's just no incentive to be organized in the military because our patients are walking through the door and our appointment books are filled no matter what we do. Most are content to do "enough" and never really get to the point of optimizing and organizing things so they actually run as smoothly as possible. Things run satisfactorily, and that's all that matters to most.

For example, both bases I've been at didn't even have a consistent system to ensure the same items were reordered properly each time something ran out! There aren't even consistent locations for some items to be stored, so if they're out, it's impossible to know what was there without consulting someone who had the room memorized. (This is one area I've worked on at both of my bases to eliminate waste and confusion. It's usually just as simple as placing the order number and item name on standard containers and ensuring that 100% of items coming into the clinic have a permanent location, that everyone agrees on 1 method for altering the Logistics person that an item is low, and items don't just get tossed on a shelf or into a room.) If a certain person out for the week, good luck.

Often, an item would run out and there would be no accountability until the clinic was in an "emergency shortage" and had to rush order the item to the clinic. Fortunately, we have all the time in the world to do dentistry so typically these errors just result in rescheduling the patient or doing some less efficient procedure to get the job done. The minimal consequences of being disorganized tend to perpetuate the "good enough" mindset.

*Caveat: Most military clinics are far larger than civilian clinics, and the disorganization is far more obvious the bigger you get. Small civilian clinics can often survive (and typically do) just on the personality of the lead dentist, with little regard for attempting to imagine the business as a prototype model for a franchise (a la "The E-Myth"), but this fails in a military setting because there's always more than 1 dentist. Large civilian clinics that are poorly organized simply can't maintain their business structure and end up closing or restructuring. Large military clinics, on the other hand, stay open no matter what. In my experience, the larger the civilian clinic (if it's been open for a few years), the more organized it is vs a smaller 1-doctor civilian clinic.

-Employees - This is a touchy subject, so I'll tread lightly. I'm calling this one a tie. Here's why.

In the military, we sometimes get people that just flat out don't want to be in the dental field. Some have personalities and skillsets that are more well suited for some non-medical field. These kinds of people probably wouldn't last long in private dentistry (but to be fair, they would have never wanted to work there in the first place!). But, in the civilian world, you have an outrageous 60% (or more) of dentists that will be subject to embezzlement at some point in their career. That sucks! Civilian employees are no more saints than the military employees that don't care about their job but at least the military ones aren't stealing money from you.

Here's a huge positive with the military side: sometimes you get outstanding coworkers that have big dreams and aspirations and they understand that their performance in whatever job they have is an important stepping stone to the life they want. These are true gems and a total win for the military. Many civilians aren't thinking about the next thing, but in the military, some are constantly focused on learning and growing and getting to the next step, and it makes them valuable assets to your clinic.

In the end, people are people, including dentists. If you don't want to worry about hiring and firing, but also can't cultivate the team you want, the military is the way to go. If you're able to have those hard conversations, listen to your employees, facilitate their personal growth, and have studied and practice leadership and management, private practice is the way to go because you can create the office culture you want with the people you hire vs using the people you're given that may not want to be there. It's up to YOU as the dentist (and the officer) to create the culture you want and use the strong ones as your pillars while you build a new culture (military) or team (civilian).


Are you going to stay in the military? Why/why not?

I'm not staying in. I have a lot of personal reasons for this, but here are the top 3:

1. I believe that my experiences and skills can better serve humanity in a civilian setting

The Air Force is great, but it has its limitations. I can't run a clinic how I want to, I can't hire and fire, and I can't do the dentistry I want to do. Promotions happen in a stepwise manner, and your leadership skills don't really have any bearing on how quickly you can get into a command position. It has to do with your rank, which has to do with your time in service. I'm not a huge fan of the "wait and get promoted" style that the military uses to choose their leaders. Even if I could get into a command position, I don't get to choose who works at the clinic, and that can be a big hindrance to the development and progression of a clinical mission.

At the end of the day, I have a strong will and lots of leadership experience that is just going to take me far too long to manifest in the military setting. The limitations of the military also come with a lot of safety nets that suit many dentists very well, but not me. If they would make me commander of a clinic and double my pay, I'd think about it ;)

2. More time freedom

Notice how I did not say "more money". That's not a typo. I don't necessarily want more money, but what I want is more choices.

One "benefit" of the military is getting 30 days paid vacation every year plus a lot of federal holidays. But you know what? I still have to come to work 5 days per week, do a lot of non-dental stuff, and generally spend a lot of time doing dental work at a slow pace that I could accomplish in half the time. Lots of dentists in the military do less dentistry than me (and many do more), but we all still have the same schedule.

I could walk out right now and work 3 days a week and easily make the same amount of money. Or, I could work 5 days/week and make 2x as much as I'm making now. So what's the big deal about all these "days off" in the military? It's a logical fallacy in my opinion.

Which one is better -- making more money or working less? It's personal. It's about having the options.

Right now, my plan is to leave, buy a practice, implement my vision and systems, maximize productivity and systematize an outstanding patient experience using new technology and beautiful office esthetics, serve my community well, and have the freedom to work far less than I do right now.

Time is the currency of life. Don't let someone in the military use the "days off" argument as a way to convince you that you have more time freedom as a military dentist, because it's not true. Your skills have an extremely high value in the civilian world that, when leveraged properly, is far more valuable than what the military can offer you.

It takes more work to be a leader in the civilian sector than the military sector, but it's worth it. Read some leadership books, work on your management and leadership skills, and build a practice that lets you build a life of your choosing and take off half the year if you want to. We can't get our time back.

3. Self-actualization

I've read about 100 books in the last 2 years. I firmly believe that knowledge without action is worthless, so I've put a lot of action behind what I've learned. I've completely changed my diet, my workout routine, my morning routine, my habits, my beliefs about myself, and the way I handle stress (among many other things). I've also come to the realization that the life I envision for myself is not possible in the military.

Despite my emphatic shouts of "you must do the military for dental school", I firmly believe that a 3-4 year commitment, when utilized properly, is plenty of time to wrap your head around what it is you want for your life, your family, and your legacy on this planet.

This is getting a bit philosophical, but I mean it wholeheartedly. I have big plans and visions for my life, and I personally feel I would be doing a disservice to myself and those around me if I stayed in the military at this point. What I want for my life can't be accomplished in a military setting, and I feel it's time to break free and start to build that new life.

I must admit, when I graduated from my AEGD-1 residency, I was lost. I hadn't read more than a couple books that year, I was not confident in my dental or leadership skills, I had failed part of a PT test (and had it wiped from my record on a technicality), and I was generally confused about my future and what I had to offer.

But, over the course of the last 2-3 years, I started following and listening to leaders from all walks of life and came across a common theme: leaders are readers. So I started reading again.

It became an obsession that has continued to this day. I don't recognize the lost, confused, and complacent version of myself from 2014 and 2015. I'm a new person and I have books to thank for it. Those that know me from back then would be shocked at this statement, because I've always been driven, but I had lost my personal identity on what, exactly, I was driving towards.

I can't unread what I've read, or unthink the thoughts these authors have given me. I have a new confidence in my life and in my future, and I'm excited for the next step of my journey.

It is with no bitterness or resentment that I will wave goodbye to the Air Force, but instead, give it a warm farewell for a phase of life that broke me down, reshaped me, and sent me on my way with the confidence to design a life well lived.


--
As always, feel free to email me with any questions!

Cookies, Willpower and Life Systems (How to Do More and Not Hate It)

As some of my frequent readers will know, I was the president of my dental school class for 3 years before we recently graduated.  One of the ongoing jokes among my classmates was that I had more hours in the day than anyone else.  I was often the first one in, the last one out, and the guy working on stuff while everyone else was relaxing.  (Note: This did not give me the best GPA or make me the best student in my class, but I had a reputation for being highly productive.  Do not get those confused!)

Now don't misunderstand this as me bragging about myself or trying to put others down in any way, because it's not.  I view leadership as a service to others that I take very seriously, not as a hierarchy of importance, just a hierarchy of service.  But that's a topic for another day.

How is it that I had the ability to work so hard and long while seemingly getting things done that others hadn't yet started or make study guides (with the help of many wonderful classmates) and flashcards for test after test after test?

Let me preface this by saying that some people are simply high energy while others are not.  I consider myself a high energy person but I think that comes from playing to my strengths and who doesn't like doing something they're good at?  I'm not, however, an extrovert that always has to be the center of attention and accomplish things to boost my ego, quite the opposite.

This post is about something else, something we commonly call "willpower".

Willpower is the ability to muster up the energy to do something that we otherwise might be inclined to put off until later, put off forever, or substitute something simple and more fun in its place.  It takes great willpower to workout every day.  It takes willpower to eat healthy.  It takes willpower to save money. Why?  Because there are a thousand other simpler and more intriguing options at our disposal.

Instead of working out we could:
Sleep in
Get to work a little early
Not go out in the dark cold morning

Instead of eating healthy we could:
Have some more chocolate (yum)
Eat the rest of the steak right now even though we're full
Go out to eat with our friends

Instead of saving money we could:
Get that new MacBook Air
Buy the TV that's just a little bigger than the one we wanted
Take a vacation now

What if you could hijack your own willpower and change your patterns?  What if you could say "no" to good now so you could say "yes" to great later?

The following is a synopsis of a study I've read about countless times that changed my life.  It taught me one of the most valuable lessons in my life: willpower is like a battery, it can and will eventually run out and must be recharged! (Read: Ego depletion). We can circumvent this by setting up systems in our life that don't force us to use willpower (or use far less than normal) so that we still have willpower for later.  Here's the study, in summary:

2 groups of students are taken to a lab and seated at different desks in the same room.  1 group is given a bowl of cookies while the other a bowl of radishes.  After each group is allowed to eat from their bowl, both groups are given a puzzle to complete.  The group that ate the cookies worked on the puzzle for an average of 20 minutes longer than the students over at the table with the radishes! (Side now: the puzzle had no solution).

What does this mean?  Essentially, it takes almost no willpower to resist cookies so these students had plenty of willpower saved up to work on the puzzle.  Eating a radish is no fun and takes much more willpower and thus these students gave up easily on the puzzle since they had used all their willpower to eat the radish (and resist the cookies).

Link to full study description: https://www.apa.org/monitor/2012/01/self-control.aspx

There are some more details to the study that you can research yourself but I won't get into those today.  Hopefully you get the take away and that is that willpower is a limited resource!

So what can you do about this?

In my life I've set up systems around me that allow me to use as little willpower as possible on the daily mundane tasks so that I have more willpower for later.  Here are some things I do that help me waste less willpower:

-Leave my keys, phone, and wallet in the same spot every day (no willpower spent thinking and searching)

-Set out my workout clothes each day (when I wake up I just have to walk in, put on my clothes, and leave)

-Do a budget at the beginning of every month (I don't make daily decisions about finances)

-I keep my computer very well organized (no willpower wasted searching for lost items)

-I have a separate to-do list of things that need to be done later, that I cannot do today, in a separate list with an alarm set for the date and time I can actually do that thing (no willpower thinking about things I can't do anything about) [example: I have a form I've completed that I can't submit until July 1.  So set an alarm for July 1 and forget about it and don't put it on your normal to-do list!]

-I cook chicken once a week and put it in a container so I never have to settle for junk food when chicken is ready-to-eat in my refrigerator

-Sunday is a pretty relaxed day, so this is when I plan ahead on my week and double check that my calendar is right and that I have all the food I need for the week (during the week, no willpower wasted thinking about all the stuff I have coming up or if I'm going to run out of something mid-week)

This kind of thinking, what I like to call the "Life Systems" approach, allows your free time to be much more productive than ever before.  You haven't wasted your willpower looking for keys, stressing about how much is in your checking account, forcing yourself to dig out your workout clothes from 3 different drawers, so you have plenty of willpower left to tackle all sorts of other things in your day that do demand your attention.  These tiny tasks that drain us little by little can be the difference between getting something done at the end of the day.  I enjoy coming up with ways to automate those things in my life that are necessary but not that fun to do so that I don't waste my willpower (and time) on them.

I hope this post has helped you get an insight into my productivity and allows you to search your own life for ways you are accidentally sucking away all your willpower and wondering how hyper-productive people are able to get so much stuff done. If you'd like to read more about this idea, and other concepts that have helped me be more productive, here are some books I highly recommend:

How to Fail at Almost Anything and Still Win Big - Scott Adams
The Power of Habit - Charles Duhigg
An Astronaut's Guide to Life on Earth - Chris Hadfield

Another secret to willpower is that we will always tend to default to things we know we can do!  It's easier to get things done when we know what we're doing and adding skills to your life opens up new doors.  Setting up systems gives you time to focus your willpower to learn and grow to become better at whatever you desire.  Webucator, an online eduction company that recently reached out to me as a part of their "Most Marketable Skills" project in the Webucator Asks Project, offers many self-paced courses online including Microsoft training courses (Word 2013 course is FREE for a limited time!), as well as many others, to help you expand your knowledge and succeed in today's world.

Hope this was informative and as always, feel free to email me with any questions you might have!

Life after first semester

Seeing as it's been almost 2 months since my last post, I feel I owe my blog another update. Unfortunately, not much has changed. However, I have noticed 3 important things I'd like to share that will hopefully help someone, somehow, someway. Anyway, no new Air Force stuff, so I'll jump right in.

1. Easier classes do not equal better grades

-This is pretty counterintuitive, but hear me out. Last semester I did fairly well for myself. I had a few close calls but made roughly half As and half Bs in what was touted as the 'hardest' semester. No doubt, it was VERY time consuming and quite difficult. This semester, the 'easiest' semester, is no doubt far and away less stressful and time consuming than last semester. However, at my current pace, I'll end up with darn near the same GPA as last semester. Why? I think it has to do with expectation. When we are told something is difficult, we tend to prepare for it to be so. The same is true in reverse. If we are told a class is easy, we don't try as hard (in general). So keep that in mind when you head to dental school. Just because a class is easy doesn't mean you're going to be handed the grade you want without effort. No, it's not effective to put a ton of time in an easier class, but don't walk in and not try just because of what you've heard. Not everyone will be good at the same things so just because it was easy for someone else does not mean it will be the case with you.

2. Fair = unfair?

-We recently took two exams (in different classes). For the first one, a test was given that was outdated, from last years curriculum (it's been largely condensed this year for this particular class). Most of the class did terrible on it for the simple fact that we were not even taught all of the material on it! This is obviously unfair, but since our attendance had been lacking (the lectures are recorded, so we DID watch them all), the professor deemed that it was our lack of effort rather than lack of knowledge that led to the poor scores. Huh? So in other words, us not learning what was on the test had nothing to do with the fact that it wasn't taught? For the record, I made a 58%. My worst test in dental school by roughly 20% points. WOW. There was no score adjustment.

-As for the other test, we were given two versions (half got A, half B). Version A and B contained the exact same questions, just in a different order. As it turned out, version A scores had an average of 27/36 while version B scores had an average of 29/36. Logic would lead one to believe that it just so happened that those with B happened to do better out of their own accord, not due to the difficulty of the exam (because they were the SAME). Our professor, however, decided that somehow the ordering of the questions on form A led those with form A to miss an average of 2 more questions. Once again, huh? So he awarded form A people with 2 bonus points. If you're thinking "how is that fair?", you're not alone. Long story short, someone in the administration at the College of Dentistry did an analysis and found that random distribution of students had created a situation where a disproportionately high number of highly ranked students happened to get form B. Well duh, right? In the end, both versions got 2 extra points.

-The moral of this story (or stories) is that you control your fate. Study hard and do well enough so that when these crazy and weird situations arrise, they have a much lower effect on you. In the first case I was sitting at a very high B going into that test. Needless to say, I dropped quite a bit. Luckily, I ended with an 82% in the class (it only lasted half of the semester) so in the end, it didn't matter to me. Others who were counting on this test to pass the class didn't have that luxury. So even if you don't want to specialize, or just don't feel like studying all that much, find it within your self to try your best so that you don't get stuck in one of these situations. (As a side note, neither of the professors work directly for the College of Dentistry. They are professors that work in other departments that come and teach our science material.)

3. Enjoying dental school has very little to do with dental school

-This is just an option I hold, but I've found that those who have something to look forward to OUTSIDE of dental school tend to be happier in dental school. It seems that those who get caught up in 1 point here and there, a procedure in clinic, etc., tend to be the most stressed out. Relax and do your best, and it will all work out. Oh, and have something you can look forward to every night. Whether it's going home to your spouse, eating some chocolate (guilty), or playing with your dog, don't make dental school your life. It's a part of your life. The way I see it, happiness is 10% your situation, 90% your attitude.

Other than that, things are smooth sailing right now. I work as a tutor for about 7-9 hours/week, depending on the week. I'm also on the lookout for a place to move sometime in August. If I haven't said already, I currently live with my dad about 25 minutes from school. We're selling our house and he'll be getting remarried so it's time to move on! Hopefully it's also time to move closer. Being 25 minutes away from school isn't bad... until you do it every day.

For those looking for just an ounce of Air Force in this post, I'll say this. Each day that goes by I am more and more pleased with my decision to take the scholarship. I can't tell you how much I love being able to sit back and not worry about going into debt. It's nice to even be making some money to do what I want. I'm pretty frugal so I'm trying to save as much as I can just in case, but money stress is something I don't have and don't plan on having ever again. Between the scholarship, my tutoring job, and getting paid to mow a few lawns, this dental school thing is turning into a decent gig! In this economy with school getting more and more expensive, I'm more than happy to trade 4 years in the military for 20 years of paying off loans.

As always, feel free to email me (and follow me on twitter!) if you have questions about the Air Force HPSP, the DAT, dental school, or whatever. I get about 1 email per week from a new person with questions so keep them coming!