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The challenges of second year

November 01, 2018

By Jennifer Garvin

Photo of Ben practicing on a dummie
Practice time: Ben takes X-rays on a practice "patient."
In November 2017, the ADA News launched Becoming a Dentist, a series of stories that follows three dental students at the University of Maryland School of Dentistry — Dan Yang, LaShonda Shepherd and Ben Horn — during their journey of becoming dentists.

Image of Becoming A Dentist graphicBaltimore — If the first year of dental school is a crash course in the basics of dentistry, then second year is all about the preclinical laboratories that help prepare the students for next year's clinics as well as developing organizational and time-management skills.

There's a preclinical endodontic laboratory in which the students learn about the operative aspects of endodontic therapy including cavity preparation and root canal treatment. A prosthodontics laboratory in which they construct a partial denture and learn techniques used in fixed prosthodontics. A pharmacology laboratory that teaches them about drug interactions and adverse patient reactions. There's even a laboratory affectionately known among the students as "stab lab" — which refers to the day they begin to learn about safe anesthesia practices in dentistry by administering different types of anesthesia on each other. All told, the students have a total of 16 classes worth 30 credit hours in the fall semester alone.

Photo of Dan getting impressions made
Patient perspective: Dan lets fellow second-year student Sarah Mahammed take an impression of his mouth.
"In the first year, it's all defined by looking at your calendar and seeing when you have to be there, when the exams are," said Dr. Howard Strassler, a longtime professor of operative dentistry at the University of Maryland School of Dentistry. "Now, for the first time, they have activities that have very, very critical time deadlines."

"We still have multiple lecture classes, but now the stress has leaned towards specific labs — trying to finish the various endodontics projects on teeth Nos. 8, 12, 29 and 19 before our practical in a few days," Ben said. "If we don't successfully finish the root canal treatment, then we can't even sit for the practical."

It all requires a lot more discipline and time management, agreed LaShonda.

"We're assigned a project and deadline; from there, it's up to us to take advantage of our lab time to get it done," she said.

Dr. Strassler described the process as a "wonderful bridge" during which faculty watch the students graduate from the basic sciences and learning the language of dentistry to putting together the skill sets needed for patient treatment.

Photo of LaShonda using a syringe
Prep time: LaShonda learns how to prepare a syringe during her dental anesthesiology class.
"I think the biggest change from Year 1 is that the school environment and pace is no longer foreign to me," said Dan. "It's less of a shock to be spending hours in lab working on a project or studying for exams. It will never be easy, and it is always tiring, but at least you are used to it, so it wears on you less."

For his classes, Dr. Strassler uses a "flipped classroom approach" where the lesson starts by having the students review patient case-based scenarios online during their own time. The students look at the instructional modules that he posts on the school's web portal so that by the time they come to their physical classroom, they're ready to discuss treatment planning.
 
With the laboratories come more hands-on opportunities to prepare for live patients.

"I am more of a kinesthetic learner that will learn much, much more once I put my hands on it," Dan said. "For instance, I think the step-by-step sort of procedural process of treatment that we are learning in endo lab is something that resonates with my personality. Overall though, I find that most D2 classes are good in that they are more relevant clinically to our career. I am looking forward to doing more and more hands-on activities as we delve deeper into this year."

Said Ben, "Overall, I feel like I am taking home less work to complete in a given night, but the days are packed full of trying to complete lab work on time. So, the stress has changed, but one thing is for sure — the stress is constant and still relentless."

Dr. Strassler said he believes these stresses actually make students better practitioners.

Photo of Ben holding his baby
New baby: Ben cradles his newborn son, Cullen, born in October.
"When people sit in the chair the first question that you ask them is, 'Is everything all right today? Do you have a problem?' [Their answer] may be something totally unexpected, but you have to work with that," he said.

He pointed out that there are many outside factors the students can't plan for but must be ready for — from how patients are feeling the day of their visit to ergonomics adjustments the future doctors need to do for themselves.

"The best part for me of students having to wait for a faculty [member's input in the lab] is that when they're standing there waiting for you, they're also hearing what you are saying to another student so you don't have to say it over and over again," Dr. Strassler said. "In fact, before you come over, they're starting to analyze it and try to understand it, which may lead to another question."

To read all the stories from the Becoming A Dentist series, visit ADA.org/BeADentist.

Editor's note: A week after his interview took place, Ben announced a happy change to his schedule: the arrival of his third child—a baby boy named Cullen.