Monday, December 30, 2019

Surviving an injury in dental school

At the sound of three bones breaking in perfect sequence as my ski-boot-covered foot slammed onto the ground, my adventure day at Squaw Valley turned disastrous. I was never the student to break the “no skiing, no snowboarding” rule of dental school. Now, one surgery later, I found myself in excruciating pain and unable to walk.

Major injuries can pose many challenges, but the additional pressure of dental school makes balancing everything seem impossible. While my injury put me out of commission for months, I found five ways to survive an accident while in dental school. 

1. Work with your administration early.

In the time I had to miss school, I missed nine finals and three practicals. I wanted to downplay the injury as much as possible, but I found myself overwhelmed by the amount of work I needed to finish.

The best thing you can do is have your doctor write a letter to the administration at school detailing the extensiveness of your injury, the typical recovery time, pain levels and what will be within your ability during recovery. Work with the administration on your individual needs.

You may feel tempted to rush and finish the work, but remember that you are in school to learn. Take your time and honestly communicate to faculty where you are. After all, you are paying to be there. My biggest mistake was trying to wing my schedule. I regret not making a schedule early and then studying accordingly. Schedule early and prevent the looming sense of panic when navigating your personal and academic life.

2. Lean on your colleagues.

I did not want to be that person who kept asking for help. It was hard to remember that no one wanted me to do this alone. Almost two years out from my injury, I still remember the classmates that were there for me during a difficult time. Those are the people I know to count on and hope to someday refer patients to!

Remember that the people in dental school are studying to become health care providers. Most of your classmates will offer to help in some way, and it is OK to take them up on their offers. From grabbing extra medicine to helping carry your stuff, this will strengthen your bond with your peers.

3. Manage your pain.

Proper pain management is essential to recovery. The first thing that may come to your mind post-injury is mobility, but I found that pain is much harder to manage. Factor in your need to ween off pain medications if prescribed them, factor in how you will carry your medications around and plan what regimen you will stick to. Put yourself back in the doctor’s shoes: What would you want your ideal patient to do?

Pain can be debilitating. It will make it hard to focus, and it is downright exhausting. Often it’s not just the injury, but how your body is adjusting to new methods of mobility that will be one of the biggest challenges. Plan plenty of time for rest and recovery from the pain of each day.

Try not to be discouraged by the pain because it eventually helps with patient management. I found that the medications I was prescribed mirrored my own patients’ regimens. Patients feel relieved when their doctors understand what they are going through.

4.  Find someone going through the same thing.

While it was unfortunate that I and another ASDA member had similar injuries, it was nice having someone to commiserate with. We both shared our frustration with not being able to attend lobby day or even sharing our day-to-day struggles. It was always fun to swap tips on managing clinic one-legged, too! There is a reason peer groups are so effective, and an injury should never preclude you from one.

5. Redefine your purpose.

The ups and downs of dental school will always challenge your “why.” An injury will rock that “why” to its core. If that injury prevents you from doing dentistry, it can make it even harder to get through the recovery process. Maybe you went into dentistry to help people, maybe you went into dentistry to fix problems. Whatever the reason is, examine it from many angles to reshape your new life to your values.

If you are having trouble remembering, read your personal statement, talk to a faculty mentor or ask your family and friends. All of these insights are important to remember your “why” and finishing off this injury better than you started.

~Alysia Mascolo, Pacific ’20

ELSA: Promoting change for children with dental congenital anomalies

This past April, as part of the ADA Dentist and Student Lobby Day in Washington D.C, 1,000 dentists and dental students went to Capitol Hill to lobby for the Ensuring Lasting Smiles Act (ELSA), legislation that would help children with congenital anomalies. First- and second-year dental students learn about dental congenital anomalies such as ectodermal dysplasia, cleft lip and palate, skeletal and maxillofacial deformities, hypodontia and enamel hypoplasia. Third- and fourth-year students may even have the opportunity to treat patients with these anomalies.

Despite the prevalence of these congenital anomalies in the population, a lack of insurance coverage often prevents these patients from receiving oral maxillofacial care. Many families with children with congenital anomalies are often denied insurance coverage for corrective procedures, as insurance companies consider them to be cosmetic. ELSA would help change this.

This past February, Senators Tammy Baldwin (D-Wis.), Joni Ernst (R-Iowa), Sherrod Brown (D-Ohio) and Lisa Murkowski (R-Alaska) reintroduced this bipartisan legislation. ELSA requires health insurance plans to cover medically necessary services resulting from congenital abnormalities. It also stipulates that such coverage includes services and procedures that functionally repair or restore any missing or abnormal body part that is medically necessary to achieve normal body functioning or appearance, and clarifies that this includes adjunctive dental, orthodontic or prosthodontic support.

Read the rest of the article in the November/December 2019 issue of Contour magazine.

~Patrick Campbell, Marquette ’20

Wednesday, December 18, 2019

How pass/fail grading can impact the dental school experience

During my undergraduate years, I would dwell on my grades. Getting an 89% on an exam would leave me feeling defeated and frustrated — I was so close to an “A,” after all! Now that I am a third-year attending a pass/fail dental school, I feel as though I’m able to perform at the best of my intellectual abilities with minimal academic stress. This can be considered one of the biggest benefits of attending a pass/fail dental school, but are there drawbacks, too?

Several students at pass/fail institutions say that this particular grading system seems to halt competition between peers because everyone is working toward a common goal.

Taylor Fisher, a D3 at LECOM, feels the benefits of a more universal assessment measure is exemplified through the pass/fail grading system. She explains, “It allows for a more cohesive and supportive class.” The fixation on obtaining every point possible on an exam or practical can be mentally draining. The pass/fail grading system can help ease this worry.

There are challenges, too, though. A student who did not give as much effort and got a 78% would receive the same “P” on their transcript as a student who received a 94%. Plus, a 74% is reported as an “F” on one’s transcript, as opposed to the “C” that would be reported on the transcript of a student attending a school using the traditional letter grading system.

This could fail to instill motivation, as some may only strive to pass. As future dentists, we have a responsibility to learn as much as we can and practice as much as possible, not simply get by. How do we alleviate concerns of a well-performing student who desires to stand out on their transcript receiving an identical grade to that of another student who is only technically passing? Mark Zmiyiwsky, a predoctoral and postdoctoral faculty member at LECOM stated, “For those who aim to specialize following graduation, LECOM attempts to prepare students to sit for the ADAT examination, allowing specialty program directors to attest to each candidate’s academic and clinical abilities using a numerical standardized test score.”

Furthermore, without letter grades and with the NBDE Part I and II exams reporting pass/fail results, the task of specializing can be daunting. Without letter grades and percentages, it can be more difficult to differentiate yourself as a candidate. Therefore, students with an incredibly high GPA and aspirations of specializing upon graduation may not support the pass/fail grading system.

Second-year student Stanley John is a member of the first LECOM class assessed with letter grades (its first five classes were pass/fail). As a predoctoral student hoping to specialize in endodontics, John says he’s in favor of LECOM’s transition to a numerical grading system. “It would be like applying to dental school without a GPA or DAT score,” he says. “You can do all the extracurriculars in the world, but you won’t get anywhere without numbers.”

There are many qualifications beyond grades, though, and these attributes can help one transition from student to resident. Leadership opportunities, patient interactions, research involvement and volunteerism are aspects that program directors often focus on over class rank and GPA, according the ADEA’s Charting Progress.

As a student at a pass/fail institution, I admire our class’ ability to work as a cohesive unit that consistently strives toward a common goal. I see that there is minimal competition between one another, and exam scores do not define us. I also have faith that if I choose to specialize later on in my career, it is possible. The debate of which curriculum holds more merit will continue, but I would not trade my experience at a pass/fail dental school for anything else. This alteration in grading philosophy has allowed me to make astonishing strides on my mental health, self-confidence, as well as career aspirations following graduation.

~ Lauren Cuculino, LECOM ’21

Meharry ASDA: Impacting the community in a big way

As dentists, serving the greater community through health care is not just our job but an incredible opportunity. Meharry is a historically black college located in Nashville, Tennessee, and as Meharrians, we are pilot leaders not only within our communities but globally as well. We understand that seeing someone who looks like you in a professional field matters. Every day we treat patients, but our focus is on healing the entire community, which can be affected by lack of resources and barriers to care. From volunteering at local youth centers after class to providing free dental treatment at community events, we enjoy providing quality outreach in our community and are determined to make a difference.

During ASDA’s 2019 Annual Session, Meharry ASDA received the “Outstanding Community Outreach” Gold Crown Award. One of the largest and most influential programs our student leaders have implemented on campus is our Meharry Oral Health Day. Four years ago, ASDA alumna Dr. Audrey Fields wanted to provide oral health treatment at no cost to the community. Today, Oral Health Day is one of our most anticipated events of the year. 

Servicing more than 600 patients at an event this large takes a full year of planning and about 300 volunteers from the community. The event starts at 7 a.m. each year and lasts for about nine hours, although most volunteers arrive much earlier and stay later. Our patients are medically triaged before presenting for treatment. This year during Meharry’s third annual event, the dental school collaborated with students in our medical college, as well as students from several other universities in the area. 

During Oral Health Day, a complete medical history is taken and vital signs are recorded as the patients are screened for treatment. If a patient is deemed unable to receive treatment based on our findings, we explain that the treatment is not the best option for them at this time and provide referrals to the hospital if necessary. 

Based on the patient’s chief complaint, we put them into three groups: prophylaxis, fillings or extractions. Extractions are further broken down into simple or surgical, and each patient is sent to receive their specific treatment. Because this event involves the entire community, we partner with local grocery stores, restaurants, dental offices, and a plethora of other vendors and organizations. We plan for many variables, including medical interpreters we may need, overnight security and traffic guides, inclement weather and entire meals to feed our volunteers and the community. 

At the 2018 ASDA National Leadership Conference, Meharry ASDA alumna Dr. Mirna Azer and student dentist Jordan Pierre presented “32 Problems but a Tooth Ain’t One,” which highlighted the planning of and involvement in Oral Health Day. It was an honor to be recognized at the national level and a wonderful opportunity that allowed us to help guide other students who may be interested in planning a large community event at their schools. 

As Meharry’s Fourth Annual Oral Health Day approaches and gains more national recognition, it is our hope that other chapters that have dreams of starting events like this do not feel limited by the lack of experience in the field. 

In January 2020, as a part of ASDA’s Week of Service, Meharry students will kick off activities by participating in a community service event in honor of the Dr. Martin Luther King Jr. Day of Service holiday. The remainder of the week will be filled with events targeting low socioeconomic, geriatric and pediatric populations, as well as environmentally friendly events.

As Meharrians, we support one another and are excited that we can be pioneers in dental students taking on such large feats. As we continue to matriculate through school, we are constantly reminded of our purpose. Becoming a part of something bigger than ourselves and leaving a legacy is something Meharrians take great pride in as we continue to make an impact.

~Rayna Turner, Meharry ’21

ASDA’s Week of Service is Jan. 17-25, 2020. Start working with your chapter leaders now to organize an event that serves your community. You also can participate in the national canned food drive challenge. Visit ASDAnet.org for challenge details, event ideas and resources.