OMFS vs Orthodontics

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D1Bound

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I'd like to hear people's opinions on this. For money, lifestyle, what comes out on top, OMFS or Orthodontics? Which one would be good for early retirement or semi early retirement?

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I'd like to hear people's opinions on this. For money, lifestyle, what comes out on top, OMFS or Orthodontics? Which one would be good for early retirement or semi early retirement?
Maybe don’t pick the one that finishes training at age ~32, requires sleeping in the hospital, has you deal with hospital politics, requires you to hold a screaming pager, and will involve life and death emergencies at any moment. Does that sound cushy to you?

You wanna retire early? General is easily the best way to do it! No extra tuition, path to quick ownership, ability to delegate, etc.
 
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Maybe don’t pick the one that finishes training at age ~32, requires sleeping in the hospital, has you deal with hospital politics, requires you to hold a screaming pager, and will involve life and death emergencies at any moment. Does that sound cushy to you?

You wanna retire early? General is easily the best way to do it! No extra tuition, path to quick ownership, ability to delegate, etc.
In terms of post training, private practice.
 
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In terms of post training, private practice.
You won’t make it through post-training if you’re looking for comfort. Financially speaking, investing in OMS just to retire early is a terrible decision. Same could be said for Orthodontics. If you want to get out of the game early, pick the path with the shortest training.!
 
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the data is out there, but I agree. Do not do OMFS for the money. You’ll be miserable.
 
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You won’t make it through post-training if you’re looking for comfort. Financially speaking, investing in OMS just to retire early is a terrible decision. Same could be said for Orthodontics. If you want to get out of the game early, pick the path with the shortest training.!
Not in anything JUST for the money or early retirement, but dental students cannot gloss over the fact that OMFS are clearing over a million dollars a year. Students can't ignore this. GPs may have a head start, but a surgeon has personally told me that OMFS "wins every time." You would catch up in earning potential super quick. But heck what do I know. Not much honestly
 
Not in anything JUST for the money or early retirement, but dental students cannot gloss over the fact that OMFS are clearing over a million dollars a year. Students can't ignore this. GPs may have a head start, but a surgeon has personally told me that OMFS "wins every time." You would catch up in earning potential super quick. But heck what do I know. Not much honestly
Sounds like you've made your decision.

If you've spent enough time on sdn .... you'll know that "currently" OMFS is the glam specialty and ORTHO has been in the dog house. Years ago ...... hands down .... ORTHO was tops. No answer for what the future holds.

OMFS and ORTHO are two totally different specialties. Seems like alot of time, work and effort just to do something to make alot of money and retire. Make sure you will like what you do. The new retirement is not to retire, but to work less at something you enjoy doing. ORTHO historically can be practiced for a long time.
 
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Sounds like you've made your decision.

If you've spent enough time on sdn .... you'll know that "currently" OMFS is the glam specialty and ORTHO has been in the dog house. Years ago ...... hands down .... ORTHO was tops. No answer for what the future holds.

OMFS and ORTHO are two totally different specialties. Seems like alot of time, work and effort just to do something to make alot of money and retire. Make sure you will like what you do. The new retirement is not to retire, but to work less at something you enjoy doing. ORTHO historically can be practiced for a long time.
That's what sounds sweet about ortho. Longevity. Surgeons physically work hard.
 
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Orthos don't retire. Mainly because they don't want to, not because they have to keep working. Ortho seems to win in many categories except a few big ones.. Job security & income (all else being equal). OMFS are constantly in high demand... Orthos (especially after graduation) must work hard to find several jobs in order to fill up their week schedule, which may require traveling. Both can have a good work-life balance after residency. That being said, OMFS residency will tear you a new one while ortho residency is pretty chill.

If any of this seems inaccurate please correct me.
 
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Residency is torture. Not sure I would put anyone through this unless they really wanted it. Money isn’t everything especially if it’s pretty solid money regardless
 
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Residency is torture. Not sure I would put anyone through this unless they really wanted it. Money isn’t everything especially if it’s pretty solid money regardless
But the hardcore sdn avatar makes it all worth it
 
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This question is dumb. You can make lots of money and retire early or you can choose to practice until you die with either specialty. You need to choose which procedures you like better - glacially slow clean procedures or fast bloody procedures.

Or be a gunner and do both. But if you're going to both, do the OMS first.
 
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If considering omfs, try taking the cbse first
 
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If you’re trying to decide between ortho and OMFS, the answer probably isn’t OMFS.

Reality is that to get through OMFS residency, you have to love it enough that you’re okay doing it at odd, unusual, and cruel hours. Otherwise, it’s a real meat grinder for 4 years. You have to be able to get excited about starting a trauma case at 9pm. You have to be stoked to run in and close a laceration at 2am. You have to tolerate getting out of bed and coming in to preround and deliver a crisp presentation to a senior resident at 6am.

After residency, you do what you want, but money generally isn’t the primary goal. A few people chase the money via perpetual exodontia, but come on, no one ever who’s willing to work ever goes broke in general dentistry, orthodontics, or OMFS.
 
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If you’re trying to decide between ortho and OMFS, the answer probably isn’t OMFS.

Reality is that to get through OMFS residency, you have to love it enough that you’re okay doing it at odd, unusual, and cruel hours. Otherwise, it’s a real meat grinder for 4 years. You have to be able to get excited about starting a trauma case at 9pm. You have to be stoked to run in and close a laceration at 2am. You have to tolerate getting out of bed and coming in to preround and deliver a crisp presentation to a senior resident at 6am.

After residency, you do what you want, but money generally isn’t the primary goal. A few people chase the money via perpetual exodontia, but come on, no one ever who’s willing to work ever goes broke in general dentistry, orthodontics, or OMFS.
Sounds fun, and easy
 
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Orthos don't retire. Mainly because they don't want to, not because they have to keep working. Ortho seems to win in many categories except a few big ones.. Job security & income (all else being equal). OMFS are constantly in high demand... Orthos (especially after graduation) must work hard to find several jobs in order to fill up their week schedule, which may require traveling. Both can have a good work-life balance after residency. That being said, OMFS residency will tear you a new one while ortho residency is pretty chill.

If any of this seems inaccurate please correct me.

I'm not gonna pretend like ortho residency holds a candle to the difficulty of an OMFS residency because it doesn't. But atleast at the accelerated 2 year ortho programs, chill isn't exactly the way I'd describe it.
 
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I'm not gonna pretend like ortho residency holds a candle to the difficulty of an OMFS residency because it doesn't. But atleast at the accelerated 2 year ortho programs, chill isn't exactly the way I'd describe it.
Definitely - ortho residency and any residency for that matter is no easy feat that's for sure.
 
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GPs may have a head start, but a surgeon has personally told me that OMFS "wins every time."
Sounds pretty biased.

I have OMFS and every other specialty kissing my butt for referrals. They get upset when I send implants out to Perio or Prosth. The biggest moneymaker for OS is running sedation during their procedures.

There is lots of money in General Dentistry. If you think specializing is your only path to money you could not be more wrong.
 
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Sounds pretty biased.

I have OMFS and every other specialty kissing my butt for referrals. They get upset when I send implants out to Perio or Prosth. The biggest moneymaker for OS is running sedation during their procedures.

There is lots of money in General Dentistry. If you think specializing is your only path to money you could not be more wrong.
Can General compete with the amount thirds ripped and implants slammed by OMS?
 
Can General compete with the amount thirds ripped and implants slammed by OMS?
No. But they can compete with the amount produced. After 4-6 years you can have enough financial and skill leverage to do a lot.
 
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I'm not gonna pretend like ortho residency holds a candle to the difficulty of an OMFS residency because it doesn't. But atleast at the accelerated 2 year ortho programs, chill isn't exactly the way I'd describe it.

If it's not chill, then let's call it busy work. So you have only 2 years versus 3 to trim all those models and trace those cephs. If you no longer trim models and just scan everything, then you must have more time now in 2 years to read papers and put together power points. Do residents still do lab work? The last few I've met know barely more than "scan and hit order."
 
Sounds pretty biased.

I have OMFS and every other specialty kissing my butt for referrals. They get upset when I send implants out to Perio or Prosth. The biggest moneymaker for OS is running sedation during their procedures.

There is lots of money in General Dentistry. If you think specializing is your only path to money you could not be more wrong.
Disclaimer; just looking for some clarification on this since I never understood it-- please, anybody, feel free to pitch in!!

In your opinion, do you think that the same ("there is lots of money in general dentistry" could be said about Ortho?

I think bc there is so much flexibility and variations of procedures within general, theres lots of room for money there
but with ortho, since theres basically one procedure with ~variations based on the case, it seems as though there isnt as much variation in price & thus money to be earned? My thought process is that although one ortho case is probably more expensive than one general dentistry case, its payment is spread out over a course of ~2-3 years so in the end it doesnt seem as though ortho would pull in as much money? So it puzzles me that orthodontists seem to earn more than general dentists?

Really appreciate all of your guys insight about this, def just trying to understand the field more bc I dont know as much about it as a student or as a patient since ive never had ortho work done before & dont know who to ask!
 
If it's not chill, then let's call it busy work. So you have only 2 years versus 3 to trim all those models and trace those cephs. If you no longer trim models and just scan everything, then you must have more time now in 2 years to read papers and put together power points. Do residents still do lab work? The last few I've met know barely more than "scan and hit order."
We scan every patient for records, but any lab work that needs to be done (hawleys, essix, nance, TPA, etc etc) requires a separate alginate impression, pour up, and fabrication on our own. We only send out stuff that can't be done on our own (like a Herbst)
 
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My thought process is that although one ortho case is probably more expensive than one general dentistry case, its payment is spread out over a course of ~2-3 years so in the end it doesnt seem as though ortho would pull in as much money? So it puzzles me that orthodontists seem to earn more than general dentists?
That’s because an ortho can see 60-100 patients per day and each patient pays him/her $120-200 per office visit. Just do a simple multiplication calculation; you can figure out how much an ortho can produce per day. Since there are not enough ortho patients to put 60-100 of them in one day, 4-5 days a week) at one office location, most orthodontists have to open more than one office or have to travel to work part time for the corp offices (or GP offices) in order to fill their week schedule. All specialists, including the OS’s, have to travel if they want to have full time work schedule and make a lot of money. To get 21 work days/month, I have to travel to work at 6 different offices (4 of them are mine and the other 2 are corp offices).
 
We scan every patient for records, but any lab work that needs to be done (hawleys, essix, nance, TPA, etc etc) requires a separate alginate impression, pour up, and fabrication on our own. We only send out stuff that can't be done on our own (like a Herbst)
You are attending a good program. I didn't think such program still exists. Those lab skills will come in handy when you start your own office or when work at corp offices that still use alginate impression material.
 
Can General compete with the amount thirds ripped and implants slammed by OMS?
No, but if that is your rationale for OS I would not recommend you take that path.

Keep in mind that GP’s who place their own implants restore them as well, and it’s not cheap. Depending on the case it can be pretty straightforward and profitable. I don’t have to deal with purchasing all the equipment for sedation. Doing IV sedation and impacted 3rds will also make your liability premiums skyrocket. I do the majority of my own extractions and grafting.

Don’t get me wrong, OS is an incredible specialty. Their knowledge and training provides them with a wide skill set. I was in awe watching some procedures they performed in the OR. But if you plan on training for an additional 4-6 years to be an overqualified exodontist for financial reasons, it’s not the right move. It’s not worth the student loan interest growth or the stress of the residency.
 
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We scan every patient for records, but any lab work that needs to be done (hawleys, essix, nance, TPA, etc etc) requires a separate alginate impression, pour up, and fabrication on our own. We only send out stuff that can't be done on our own (like a Herbst)
It's good to be able to fabricate these appliances, but hopefully you only need to do a bare minimum. It's a waste of valuable time. A 2 yr program (can't believe they still exist) is not alot of time. You have more important areas to spend your time on. In the real world .... most if not all of your appliances will be sent out to a lab. Yes. Some appliances (Essix rets) are still made in house. If you have extra time at your private office .... spend that time networking and developing referrals. That is more important than making a retainer.
 
Sounds pretty biased.

I have OMFS and every other specialty kissing my butt for referrals. They get upset when I send implants out to Perio or Prosth. The biggest moneymaker for OS is running sedation during their procedures.

There is lots of money in General Dentistry. If you think specializing is your only path to money you could not be more wrong.
This is the area that I had no idea about when I specialized. The always tenuous referral relationship with GPs. The whole process of "begging" for referrals. This process is easy when you are young and full of energy. If you are a people person. Out going. I remember my routine of meeting a few new dentists every week for lunch. What a hassle. My success rate of then receiving referrals was pretty low. As a specialist ... not only are you going to have to kiss a**, but you will need to treat that GP's referral patients like they were VIPs. One bad situation with a GP's patient ,,,, means you need to call that GP and explain the situation. If not. Potentially lose that referral source. So exhausting. This is the ONLY bad part of specializing imo.

As a GP. You are the gate keeper. You get to pick and choose who to refer to.

There have been a few weak moments in my career where if I could have changed anything .... I would have been a GP in a small, rural town. Not an orthodontist in a saturated city.


Nahhhh. Happy to be an orthodontist.
 
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If it's not chill, then let's call it busy work. So you have only 2 years versus 3 to trim all those models and trace those cephs. If you no longer trim models and just scan everything, then you must have more time now in 2 years to read papers and put together power points. Do residents still do lab work? The last few I've met know barely more than "scan and hit order."
ya that's basically all ortho residency is, you just trim models and trace cephs and make powerpoints. nothing to it!
 
You can retire early as an OMS, ortho, or GP dentist. Any earning differences between them is diminished by taxation. ie; the net earning difference between 300k vs 400k is only ~50k after taxes. The disparity gets worse the more you make. Living lean, and earning money earlier, will help you retire early more than specializing.
All this to say, it's better to do what you enjoy so that if early retirement doesn't work out, or your specialty gets nerfed financially, you can at least enjoy your profession. Ortho and OMS are different enough that the choice should be clear once you've looked into both of them.
 
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ya that's basically all ortho residency is, you just trim models and trace cephs and make powerpoints. nothing to it!
Especially since the peds residents will see the patient with the poky ortho wire who's been waiting in the emergency department for the last 5 hours. Nothing like waking up at 1:00 AM to go clip an ortho wire!

Big Hoss
 
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ya that's basically all ortho residency is, you just trim models and trace cephs and make powerpoints. nothing to it!
Compared to an Oral Surgery residency, yes. I mean you can make it through ortho residency and get your certificate without giving an injection. One ortho resident brought me an injection syringe when asked to anesthetize a site and reported it was broken. Well of course it is not going to work if you placed the anesthetic cartridge in the wrong direction by 180 degrees.

After dental school and a GPR, ortho residency was a joke. I had so much free time.
 
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Especially since the peds residents will see the patient with the poky ortho wire who's been waiting in the emergency department for the last 5 hours. Nothing like waking up at 1:00 AM to go clip an ortho wire!

Big Hoss

Let's add "handing out wax" to the list of very important ortho residency procedures because this patient definitely should not have been sitting in the ER.
 
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Compared to an Oral Surgery residency, yes. I mean you can make it through ortho residency and get your certificate without giving an injection. One ortho resident brought me an injection syringe when asked to anesthetize a site and reported it was broken. Well of course it is not going to work if you placed the anesthetic cartridge in the wrong direction by 180 degrees.

After dental school and a GPR, ortho residency was a joke. I had so much free time.
That is extremely sad. If you cannot place a LA cartridge in correctly that is very alarming. They probably went to a dental school that was very weak clinically-usually the Ivies.
 
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You can retire early as an OMS, ortho, or GP dentist. Any earning differences between them is diminished by taxation. ie; the net earning difference between 300k vs 400k is only ~50k after taxes. The disparity gets worse the more you make. Living lean, and earning money earlier, will help you retire early more than specializing.
All this to say, it's better to do what you enjoy so that if early retirement doesn't work out, or your specialty gets nerfed financially, you can at least enjoy your profession. Ortho and OMS are different enough that the choice should be clear once you've looked into both of them.
OMS you could buy a private island easier though
 
It's good to be able to fabricate these appliances, but hopefully you only need to do a bare minimum. It's a waste of valuable time. A 2 yr program (can't believe they still exist) is not alot of time. You have more important areas to spend your time on. In the real world .... most if not all of your appliances will be sent out to a lab. Yes. Some appliances (Essix rets) are still made in house. If you have extra time at your private office .... spend that time networking and developing referrals. That is more important than making a retainer.
It helps when you first start your office and it is super slow. Spending time to make the ortho appliances should help keep you busy and relieve the stress of having to sit around doing nothing due to lack of patients. Sure, you can spend the free time to do marketing and to meet the referral GPs….but this only takes a couple of hours a day and a few days a month to do…and there are 365 days in a year. As your office gets busier, you can use your lab knowledge to train one your assistants to make appliances for you so you can focus more on patient treatments.

Not having to depend on the outside lab to make appliances for you is very beneficial. If you can make your own expander, you can deliver it the next day or a few days later and not having to worry about the separators falling out. Being able to deliver the appliance whenever you want is very helpful, especially when your newly built office is not opened a lot of days (due to lack of patients) and you have to work somewhere else to supplement your income.
 
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This is the area that I had no idea about when I specialized. The always tenuous referral relationship with GPs. The whole process of "begging" for referrals. This process is easy when you are young and full of energy. If you are a people person. Out going. I remember my routine of meeting a few new dentists every week for lunch. What a hassle. My success rate of then receiving referrals was pretty low. As a specialist ... not only are you going to have to kiss a**, but you will need to treat that GP's referral patients like they were VIPs. One bad situation with a GP's patient ,,,, means you need to call that GP and explain the situation. If not. Potentially lose that referral source. So exhausting. This is the ONLY bad part of specializing imo.

As a GP. You are the gate keeper. You get to pick and choose who to refer to.

There have been a few weak moments in my career where if I could have changed anything .... I would have been a GP in a small, rural town. Not an orthodontist in a saturated city.


Nahhhh. Happy to be an orthodontist.
Very true! As a specialist, you need referrals from the GPs. If you are not willing to go around meeting the referrals GPs, you shouldn’t specialize. It’s also true that when you are young, you have more energy and time to do whatever it takes to make the referring GPs happy. My wife used to visit the GP offices very often when she was in her early 30s. She taught the GPs how to take impressions and restore implants. She helped the GPs to deliver and adjust the stayplate after the immediate extractions and implant placements etc. As soon as she stopped marketing, the practice has lost a lot of patients. It used to be opened 3 days a week. Now, it only has enough patients to stay opened 4 days a month. Her office manager now becomes my full time office manager:). That's ok because my wife needed more time to take care of our kids and my ortho offices have gotten busier. One good thing about ortho is you can market your practice directly to the public. And your ortho patients also refer their friends and relatives to your office. OS, endo, perio all have to rely on the GPs for getting new patients.
 
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Compared to an Oral Surgery residency, yes. I mean you can make it through ortho residency and get your certificate without giving an injection. One ortho resident brought me an injection syringe when asked to anesthetize a site and reported it was broken. Well of course it is not going to work if you placed the anesthetic cartridge in the wrong direction by 180 degrees.

After dental school and a GPR, ortho residency was a joke. I had so much free time.

That’s pretty funny. We’ve already given trigger point injections during our TMD rotation. I’m placing a couple TADs next week. The experience you get in an Ortho residency just really varies
 
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That’s pretty funny. We’ve already given trigger point injections during our TMD rotation. I’m placing a couple TADs next week. The experience you get in an Ortho residency just really varies

Trigger point injections, that is cool. This combined with the lab work, your program sounds impressive and I'm saying that in a not sarcastic way. If you're in a 2 year program, you really hit the jackpot then. TADs, well everyone should be placing those in residency now. Orthodontists still try to get away with the "super strong topical" when placing TADs to avoid the injection.
 
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Ortho used to be the "glam" specialty, now because of at home aligners their potential earnings may have changed. I personally think it is a matter of WHEN and not IF oral surgeons will be stripped of their right to do GA and surgery, especially with anesthesia as a specialty. If/when that does happen that will greatly change the dynamic as well. Do what you like, as long as your in dentistry the money is always there. Everything else is uncertain.
 
Ortho used to be the "glam" specialty, now because of at home aligners their potential earnings may have changed. I personally think it is a matter of WHEN and not IF oral surgeons will be stripped of their right to do GA and surgery, especially with anesthesia as a specialty. If/when that does happen that will greatly change the dynamic as well. Do what you like, as long as your in dentistry the money is always there. Everything else is uncertain.
Dental anesthesiology is a tiny specialty, and is inconsequential with regards to provision of deep sedation and general anesthesia. There are about 20-30 DAs coming out of training every year, and 230 OMFS coming out every year (with 10,000 active oral surgeons roughly).
There have been attempts to strip OMFS of their anesthesia rights-it has never happened. It will likely never happen, regardless of what people say.
OMFS is probably the most future-proof specialty, but it comes at a steep price-difficult training, high stakes procedures, and difficult to get in.

The reason that Ortho has lost its 'glam' is because fundamentally, the barrier to entry for clear aligner treatment is very low. It's just not that difficult to fabricate a set of clear aligners. Whether the treatment planning is done correctly and the results will be optimal is another story.

Its very difficult to get a deep sedation permit to administer Propofol-which is what OMFS have and Dental Anesthesologists have. This is a high barrier to entry, not to mention all the extensive surgical training that OMFS has. This really cannot be replicated by many people. OMFS will probably always be the most protected and lucrative specialty, regardless of future cuts to reimbursement.
 
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I wish I could say it only happened to me once...

Big Hoss

If this happened in my GPR, the Oral surgery chief would have yelled at all of us the next day. If this happened in my ortho residency, the Oral Surgery chair would have yelled at all of us the next day.

I can't remember where you are in your dental path but if you're an oral surgery resident, then go yell at the ortho residents. No seriously, they need to hear it. Early on in my career I had a mom heading to the ER for a poking wire but she thought to give me a heads up and call me on her way there. I didn't know it was a thing, that people would run to the ER for a braces problem. Since then, I lecture the new bondings that if a wire is poking and their kid is driving them insane on Friday at 6 pm, they are to text me first and I will figure out a solution that doesn't involve the ER.
 
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@gryffindor . Interesting take on ortho residency. I believe you also attended a hospital residency as I did. My experiences were different. Undergrad dentistry seemed easy for me. I attended a nice midwestern state dental school with that typical undergrad college football feel. It all changed when I attended the hospital ortho residency. I was one of 4 residents. There was nowhere to HIDE lol. Even though the competition was over .... I felt more pressure in the residency than I ever did in dental school. A different type of pressure and stress. I was pretty busy with my thesis, the patients, the trips to the medical school for the didactics, the presentations for the craniofacial team, trying to impress the program director, etc. etc. For whatever reason .... residency felt real and undergrad dentistry felt more like SCHOOL. The THESIS itself was extremely stressful. You had to pick a topic that was "doable" with a 100% chance of completion. The statistics. Making sure your test patients in your thesis made it to their appts. The constant stress of designing and completing a publishable research thesis. Then presenting it to the faculty. One of my fellow residents did not complete his thesis on time due to losing some of his test patients which threw off the statistics. He literally had to complete his thesis and did not graduate until about 6 monthths after we all graduated. 6 months!
 
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I can do a nighttime amphibious landing, take the island, and hoist my flag. This island is mine now.

I wouldn’t even need to be an oral surgeon, I could do it as a lowly GP.
 
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These 2 specialties couldn't be anymore different. Pick the one you prefer clinically.
 
I’m just crossing my fingers that OP gets their island.

Preferably one without wireless connection.
 
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