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It is with a sense of numb relief that I mark the completion of dental school in this space. My final check-out meeting was this morning, graduation is this Friday. I started four years ago, on a hot August day. I lived elsewhere then. Mykala and I weren’t married. I had no idea what I was in for. It’s no understatement to say I was a different person.
Despite my idea that I wasn’t going to write more about it, I might as well record this thing for posterity. I’d like to describe in detail, both for myself, for my wife, for my future children, what it was like to survive “the worst hazing in all of medicine.”
The first thing you must understand is the way that licensing works. Licenses are doled out by states, and certain fiefdoms have been established around the US where you have to take a certain test to practice dentistry there. So, you do not receive your license, that is, your legal permit to do the job of a dentist, from your dental school. You receive it from the state in which you plan to work. Thus, upon graduation, you receive your school’s diploma and then you submit materials to apply for a license. I think that all of us working in Minnesota will apply for “Licensure by Exam”. That requires the following:
I actually started crying for joy last night, jumping up and down and hugging Mykala. I had my hand up in front of the screen for a few seconds after I’d logged in, hoping for the best and bracing for the worst. We took a closer look at the numbers… and then called to confirm them this morning, which is when I finally let the last adrenaline-fueled knot in my chest uncurl. I don’t know if I’ll write more about it because, frankly, I’m ready to be done tagging things “dental school”. But, the news: I passed my final FINAL final set of boards. Worrying, waiting, for four years… I finally got to say to Mykala and my parents today: “I’m out of the woods.”
“A patient of yours just checked in, has no appointment for today, and axiUm says the chart is checked out to you.”
This was not the voicemail I wanted to hear this morning during breakfast. I sighed, closed my laptop, and hurriedly biked down the hill to school to see the patient.
We are five days away from my final final final (final) board exam: “Central Regional Dental Testing Service, Part IV & V”. In this one, I spend 9 hours at the school working on patients, proving that I can do selected procedures at an acceptable clinical level. Doing the procedures isn’t hard, it’s the proving that you can do them that can be tricky. There’s a lot of paperwork, and a lot to coordinate.
Before I was a senior dental student, I used to pull up their schedule online just so I could jealously admire it. “What must it be like,” I wondered, “to no longer have to go to class and just to show up in clinic each day?”
Now, I know — it. is. awesome. Through all those days and nights of studying and stressing, I’d tell Mykala “but hey, fourth year is really great!” At the time, she was understandably skeptical. But hey, this year has definitely lived up to expectations; the decrease in day-to-day stress is unbelievable. As students, we’ve started to get more leeway from our supervisors, in part because we’re rapidly talking and opining more and more like doctors and less and less like students. When people are working under your license (as we do with the dentists at the school), I’m sure it’s easy to give an almost-doctor more wiggle room than an overwhelmed second year student. So that’s nice.
That is a tooth, with its friends milk and carrot. I think that sums up why I love Sesame Street.
Mykala and I teamed up and made these the Sunday before my big malocclusion presentation at school. They are cake + frosting + stick, dipped in Guittard semi-sweet chocolate, sprinkled, wrapped, and individually tied. They’re delicious.
This morning, we went right down the line and took out three tricky teeth on a very nice fellow who didn’t speak English. Mykala picked me up for lunch (we’ve been lunching together a lot lately) and I shared a miniature revelation.
“I think I know why most surgeons have big egos.”
177 days 16 hours 35 minutes until graduation. It’s actually getting close, now. This week, I’ll wrap up my oral surgery rotation. Then, 7 weeks of outreach over the next few months. They’re running out of hoops to make me jump through.
Someday, just one and a half seasons from now, I’ll post some pictures of a very happy version of me graduating.
We had three trick-or-treaters this year. Down from four last year. Next year, I suppose things’ll be different. We might live in a different house. I’ll be working instead of going to school. I’ll have patients of my own, instead of patients of the school’s.
I don’t know, exactly, how it will be different. But I know it will be different. Exciting and scary.
My hands trembled as I opened the letter today. PASS. With an 84, exactly the score Mykala had guessed I would get. (Boards are scored 49-99, 75+ is pass, and I haven’t talked to anyone who got over a 90). All the studying, drilling, worrying are behind us (I’ve given Mykala 42 of my 84 points).
“Tell me about your patient.”
“I, uh, well. She’s here to get #30 out. Uhh. She has hypertension and is taking medication for it.”
“Like?”
“Hydrochlorothiazide.”
“Which is?”
“Err… a loop diuretic.”
“Nope.”
“A potassium sparing diuretic.”
Doctor and Patient - The Hidden Curriculum of Medical School:
“Don’t worry about missing that class,” our teacher said when we sheepishly relayed the reason for our breathless arrival. “You can’t learn ethics or compassion. You either have it or you don’t.”
14 hours are left until day one of my two-day hell-test sponsored by the Joint Commission on National Dental Examinations. And when I say “sponsored” I actually mean “questions written to mess with me” because I still had to pay $360 for the privilege of taking this thing. My wife has made every food (all the foods) in the kitchen for a delicious dinner tonight:
Yesterday, I reviewed 1000 flashcards in 3.8 hours. The day before, around 900 in 4.1 hours. I’m to the point where, as I’m going about my day (especially when I awake), random words and phrases pop into my head. I’m not kidding, here are some examples: Sturge-Weber angiomatosis. LD50 for fluoride is 5mg/kg. Necrotizing sialometaplasia. Canalicular adenoma.
I’m 96% done with the 1440 NDBE Part II study cards I assigned myself in August. I’ve scheduled exam on October 10 and 11. I feel nervous — I think I’m on schedule, but I don’t know for sure. I’ve typed up almost 2000 digital flashcards into the Anki system. By transferring the information from the study cards to electronic cards, I can use the spaced-repetition algorithm to make my final weeks of studying extremely efficient. There is so much information: I feel I am trying to carry a gallon of water in my hands.
When I see a patient, they generally need a dental device that fits with a tolerance of microns. “How does that feel?” I’ll ask. To check, they bite down once. After that, two things can happen. If you got it right, they’ll nod. You live for that nod — you spend hours in lab for that nod. I’ve spent entire afternoons separating stone from mould just to get the nod. I’ve redone impressions, asked for third opinions, agonized over silly little things, for the nod. The only thing better is when your instructor comes by and you get to show them you are, in fact, not an idiot and here, look, there’s physical proof of it — see for yourself, they’re nodding.
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