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COVID-19: Memoirs of a recent graduate

17 September 2020

Dr Monica Farrelly
 on transitioning from university to the dental profession and how to manage being a new practitioner in our rapidly evolving industry.

Graduating from university coincides with great feelings of joy, but also uncertainty as we advance into the profession as qualified dentists. For me and my colleagues this sentiment was universal as we navigated our own expectations, accepted our first job and commenced work as independent practitioners. 

The first six months of 2020 have been extremely difficult for all dental practitioners, with new graduates suffering from the clinical and financial implications of COVID-19. But this period has also proved our resilience and resourcefulness as employees. Looking back on my time, I hope to share some information that would have made the transition easier and my days “less stressed, more blessed”.

The bridge – university must do's and job seeking

Transitioning from university to clinical practice is not exactly smooth sailing. The first day is unnerving. You are left alone in the clinic with your new dental assistant, half-filled books and questionable clinical competence. Dental school, however, has prepared us effectively for clinical dentistry and the responsibility now lies in our hands to develop the soft skills that transform us from ‘good’ to ‘great’ dentists.

Becoming a great dentist starts at university. University is not just about completing mandatory clinical hours, but also developing technical and soft skills as a practitioner. The dentists who work in clinical and academic roles have a wealth of expertise, with unique knowledge and experiences. If you strike a collegial relationship with a particular supervisor, seek out opportunities to clinically observe them or for clarification on topics of interest.

I had an extraordinarily helpful mentor on my penultimate placement who discussed my weaknesses and strengths with me. This experience provided insight into my future employability and the type of dentist I wanted to be in the short and long-term. My supervisor’s expertise also sparked my interest in the business of dentistry, directing me to accept my first job as an associate in my current practice.

Interviewing for and accepting your first job is a stressful process. Do not feel pressured to secure a job as soon as possible. Attend numerous interviews, consult with several practitioners and observe different practices to construct an informed opinion of the best match for you as an individual. During this process, I realised that you cannot market yourself unless you have a strong personal ethos and a view about your future direction.

Interviews consequently require some level of personal emotional intelligence to determine your compatibility with the clinic’s ethos and your principal dentist.

The relationship between a new graduate and their mentor is important. Mutual understanding is required to ensure new graduates are comfortable seeking help: you are interviewing your employer as much as they are interviewing you! Do not be disconcerted by this and do your research. Look up online reviews and the practice website, and speak to past employees if possible. Prepare answers to common interview questions, which differ significantly in public and private dentistry.

Securing an interview, however, is the difficult first step. Appoint time to invest in your resumé and cover letter in detail as this is the first representation of you as a potential employee. Outline your key skills and strengths, experience in practicals and any part time or volunteer work. Get involved! Most employers do not care if you are a straight 7.0 GPA student. They are more concerned about your communication, interpersonal and organisational skills. Personally, my experience working in university student associations and part-time as a dental student exhibited these soft skills. 

Employers are also interested in your clinical areas of interest and experience. Endodontics, prosthodontics and oral surgery are the more challenging dental disciplines for new graduates, with some experience paramount. Good knowledge on paediatrics and orthodontics is also significant. Private practices and public health facilities look favourably upon practitioners who are enthusiastic to treat children. Pay careful attention to this seemingly ‘easy’ university content as developing good relationships with children is a unique practice builder.

Clinical practice – managing patient expectations, finances and rapport

Soft skills, namely communication, time management and teamwork are the steepest learning curves for dental graduates in both private and public practice. Speaking to other graduates, our greatest struggle is often not creating a posterior contact on a five-surface restoration (although this is very challenging!), but communicating to patients the importance of preventative dentistry and the finances involved.

Dental school did not provide sufficient education on complex treatment planning, making it extremely difficult for new graduates to confidently plan and advise patients of the multidisciplinary dental treatment required. Investing time in your communication skills, workflow in emergency and new patient exams is priceless and makes day-to-day life easier. Standard operating procedures and reviewing your books a few days beforehand in order to clarify complex procedures or treatment with senior clinicians is advisable.

Observing your principal dentists and specialists in the community also provides invaluable knowledge. Practising on extracted teeth and completing CPD in the areas of occlusion, prosthodontic materials and molar endodontics will prepare you well for daily practice. Repetition of procedures will translate to confidence when communicating the intricacies and finances of treatment with patients. New graduates tend to over-explain procedures in an effort to provide informed consent; however, mastering concise and clear explanations translates to higher patient acceptance.

Many patients have limited dental knowledge or motivation but new patient exams provide us with a unique opportunity to positively influence this. Increasing patients’ dental knowledge prompts them to take responsibility for their health and inadvertently results in increased treatment plan acceptance. Treatment plans should be patient specific, with their limitations and motivators considered for an individualised treatment plan to be provided.

Nevertheless, COVID-19 has resulted in noticeable patient health and financial concerns. Numerous patients are both unwilling and unable to complete preventative and maintenance dental treatment. Maintaining good rapport with patients through open and honest conversation is essential to manage these concerns. Altering treatment plans and scheduling may also be necessary to ensure our patients remain supported during their dental treatment.

Patient management has personally been the most difficult part of the transition from university to working life. As young practitioners, we are enthusiastic but less experienced in dealing with patients. It can be difficult learning to cope with dissatisfied patients and undesired clinical outcomes. In the workplace, patient management is primarily our responsibility, while at university the ‘blanket’ of the student clinic protected us from adverse outcomes.

Patients can be quick to form assumptions based on our age, gender or race and may use it to inadvertently question our competence or knowledge. This scenario can be challenging and demoralising, but having the support of your peers and mentors is invaluable and can help you navigate these difficult conversations. Moreover, processing this information as constructive criticism is a more useful outlook, as we will all be in this position at some point in our first year and it is arguably the rite of passage as new graduates.

A final word

The transition from final year student to recent graduate is an enjoyable rollercoaster, filled with great successes and disappointments that teach us resilience. Prioritising yourself, building a strong support network and investing in your soft skills will equip recent graduates for the arduous journey.

Being a dentist is the utmost privilege and a momentous achievement. COVID-19 and the significant implications it had on the dental industry reiterated this. Policy, procedural and clinical changes were wearying, but we should rest easy knowing this time has passed. I for one will never take my triplex or surgical handpiece for granted again!

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