Wednesday, August 29, 2012

A Case for Journals/ Personal Blogs


There are a lot of things I did wrong during college, but a couple of things I did right. 
Whether you're starting out as a wee freshman or embarking on your senior year,  keeping a journal or blog is important. Trust me, your memory will thank you for it a thousand times over once you're in the process of applying for dental school, organizations, or anything that requires some reflection on your end.

Need ideas for what to put in your journal/blog? Here's what I did. 
For some, it's rather intuitive - you just write what you're feeling. But for those of you who are new to journals/blogs, here's what I've kept in mine over the past couple of years.

1) A short explanation of current goals for the future. I included why I wanted to be a dentist, and paths I wanted to pursue to stay happy.
2) My current GPA, and classes I planned on taking to improve it.
3) Positive character traits, and examples of them in action.
4) Negative character traits, examples of them in action, and how I wanted to change.
5) Important events that happened and my reflection on them.

Wednesday, August 22, 2012

Extractions

  • Overview: A tooth has to be removed, sometimes because it's abscessed, or maybe just because there's crowding in the mouth. Your dentist will anesthetize the patient, and then go at it. Dentists all have their own way to go about this, especially with different types of teeth, but for the most part, they'll use a periosteal to detach ligaments around the tooth, an elevator to wiggle the tooth around, and 150/151 forceps to remove it. A lot of other instruments can be used to loosen the tooth, I'll just list them under instruments.
  • Instruments: periosteal, elevator, root tip pick, 150/151L forceps, surgical suction, syringe, anesthetic, topical, needle, cotton rolls/gauze, mirror & explorer
    • Others: east/west, golden misch + attachment, rongeur, montana, bone file, scalpel + blade
  • You: Use the surgical suction to remove blood from the tooth that is being extracted! Dass it. 

Composite/Amalgam Fillings

**This is where it can get kinda tricky. Every dentist has their own preferences for what bond/primer or etch/bond and condensers/burnishers they use, etc. Sometimes, the cavity is deep and close to the root, so they'll use a glass ionomer liner like Fuji LC or Vitrebond. Here's an outline**
  • Overview: This is what most dentists are known for - the typical drill and fill. Basically, a tooth has a "cavity" or decay on any of the 5 surfaces (I'll post about this again, but just a refresher, mesial/distal, occlusal, buccal (or facial)/lingual), and the dentist needs to remove it, and fill it with something else! Some dentists will use a diagnodent, which is a lasery thing that detects the enamel lesion in the tooth by bouncing back a certain wavelength of light is to see if it's really a cavity. Usually, the dentist will use an explorer to see if the poky side sticks to any tooth surfaces (this can indicate a cavity) and an x-ray will be taken to confirm it. The dentist will remove the decay using a highspeed handpiece, use etch/bond to prep the tooth surface, add composite material, shape/polish it, and then check the occlusion using articulating paper. 
    • Note: Most dentists don't use amalgam fillings because they contain mercury, and because they're not aesthetically pleasing. This is usually only used if the cavity is in a hard to reach area and it's hard to get a dry work space.

Scaling and Root Planing (SRP, aka deep cleaning)

  • Overview: Remember how I talked about perio charting? And how sometimes people can have very deep pockets? These pockets can be further aggravated and cause the gums to inflame, so a cavitron is used to clean beneath the gumline and remove calculus. People need to be anesthetized for this.
  • Instruments: same as a cleaning + anesthetic (lidocaine or septocaine, etc), syringe, needle, cotton rolls/gauze, floss
  • You: Same deal as cleaning; there's a lot of water, so you need to follow the cavitron with a high volume suction, and remove excess water with a saliva ejector (I'll usually just hang the small one on one side of the mouth). May also need to perio chart. 

Cleaning, Prophylaxis (Prophy)

  • Overview: Often times, hygienists will do cleanings instead of your dentist, but it's still good to know what happens. Prophylaxis is preventative care to inhibit the formation of cavities. Basically, the dentist/hygienist removes any tartar/calculus that's built up on someones teeth, that cannot be removed by routine brushing/flossing. After using the cavitron to scale, they will use scalars to hand scale (scaling is the action of removing buildup) what was missed by the cavitron. Some people will get anesthetized for this because it can be painful/sensitive if the gums are inflamed. Afterwards, they will apply a coarse paste with a prophy angle/slowspeed handpiece to polish the teeth. 
  • Instruments: mirror & explorer, perio probe, prophy angle, prophy paste, slowspeed, cavitron + cavitron attachment, scalars, gauze, floss
  • You: The cavitron is an ultrasonic scalar that uses vibrations to remove calculus. It shoots out water to keep the tooth/instrument cool and wash away debris. That means theres a lot of water in the patients mouth, so your job is usually to follow the cavitron with a high volume suction, and just suction with a saliva ejector. When they're hand scaling, you can hold out a piece of gauze (don't get poked though!) they can wipe off the yucky stuff.

General Exams/New Patient Exams

  • Overview: General Exams are an opportunity for your dentist to check the general oral health of the patient by noting missing teeth, any existing problems that need to be treated, and any restorations that have been done by previous dentists. They'll usually check the patient's gums for pockets (that's when they read all those numbers, like "2, 3, 4.. 3, 3,3... etc.". They're just reading off the number of mm their perio probe can be inserted on the mesial/distal and lingual/buccal surfaces of the tooth. If it's too deep (like 5+ mm) then the patient usually has some sort of gum problems, and will get SRP.
  • Instruments: mirror & explorer, perio probe
  • You: Usually just help with general charting (taking note of all the missing teeth, previous restorations, things that need to be fixed, etc.) and perio charting, whether on paper or on the computer. 

Research, and How to Make a Position Less Elusive



The problem is quite circular.

Labs want undergrads with research experience. Undergrads who are starting out don't have any, which is why they're looking for a position. BUT, don't give up! One of the best mentors I've had in college was my lab post doc, and working in a lab brought life to my major (as cheesy as that sounds). If research is something you want to explore, you gotta get that break somehow.

Several Approaches to Getting a Lab Position

Sunday, August 19, 2012

why I love the ED

Things I've learned from volunteering in the SFGH emergency department
  • dealing with urine and feces doesn't bother me nearly as much as my anxiety that people will think I smell like urine and feces. 
  • my broken Chinese can come in handy. But I need to improve.
  • nurses are awesome.

I've been volunteering in the emergency department at SF General Hospital for a few months now, and it's been a great experience. I volunteer Sunday mornings, so it can be pretty slow at times. I spend a lot of time cleaning gurneys and restocking blankets. But I LOVE it when it's busy. I've seen a little bit of everything - gunshot wounds, open fractures, car accidents. I've also had to perform chest compressions a couple of times.

Today was a hectic morning, but in a ridiculous way that made me laugh. The craziness probably started when an inmate from some nearby jail was brought in. He would not stop shouting things at the doctors and nurses - his voice filled all 4 zones of the ED. Out of the many shouters I've heard, he probably ranks at the top for both volume and relentlessness. Then, I heard a nurse call for help and saw what seriously looked like a zombie trying to attack her. Okay, it was really just a patient with altered mental status, but almost as freaky! Within seconds, there were 6 of us surrounding him, trying to put him in restraints. But he was very strong for a barely conscious man. Finally, I realized that the main hallway was full of patients and visitors, all watching us deal with screaming inmate guy and zombie man.

Throughout all this craziness, the staff were so calm and collected, even making jokes so that I could not help laughing myself. I love the atmosphere of the ED, where hectic moments actually bring out the best in these doctors and nurses. I love how ED doctors have to work well in a team and think quick on their feet, but know how to have fun with their job as well. I know I have awhile before I think about specialties, but what discourages me from considering EM would have to be the lack of depth in any one area of medicine. That would probably kill the nerdy science side of me. But for now, I'll just keep enjoying the unexpected and hilarious moments in the ED.

<3 kathleen

Thursday, August 16, 2012

How to Sneak Coffee Into a Library

DISCLAIMER: this post is not for those who intend to wildly splash their coffee on books in the library, or leave crumbs all over tables that are supposed to be used by others.

This post IS for people like myself, who are coffee-addicts, and need the caffeine to stay awake and really just need to study. I'm talking about those days when you walk alllll the way to the library from your apartment, only to realize you left your coffee thermos at home, and you're still running on only 4 hours of sleep. If this is you, this trick just may save your life, as it has mine ;)

Materials:
  • 1 delicious cup of coffee (or a latte, or tea, or an americano, whatever floats your boat)
  • 3 coffee lids (THREE, not two. You will not be happy if you only bring two)
  • A backpack with side pockets or a jacket (a coffee hiding place)

Done with Secondaries!

That's not much of an accomplishment compared to Kathleen (I think she applied to 35+ med schools), but I'm still happy :)

I only applied to 12 dental schools and I think 5 had secondaries.. UPenn, UCLA, UCSF, BU, and.. Tufts? Something like that.


Huzzah!
:) rachel

Wednesday, August 15, 2012

Overview of Common Procedures for General Dental Assisting!

I remember the mixture of anxiety and excitement as I stepped into my orthodontist's office as a volunteer for the first time.

I had no idea what anything was, what anything did, and how I could help. It took a good 2-3 visits to finally get the hang of things, and actually start observing my orthodontist in action.

This was my first exposure to the dental field, but as you may know, dental schools ask for a minimum of 40 hours of general dentistry shadowing. Specialties are great for additional experience, but not necessary.

And so, I had the privilege to shadow an amazing general dentist in the Berkeley area, and even volunteer at a free clinic. Hopefully, you can peruse my notes and it will help you learn more quickly as you shadow/assist your dentist. This list is in no way exhaustive, just some of the things I've learned over the past year! I'll include a general overview of the procedure, the instruments necessary, and what you do as a dental assistant. I also italicized any instruments that are kind of unique/more important for the procedure.

Common Procedures and Instruments Needed


These are the general procedures that you see most often while assisting, with the occasional crown prep/seat, implant, and a gum graft if you're lucky :)

Happy assisting!
:) rachel


Tuesday, August 14, 2012

medicine + media

Nonfiction books, TV documentaries, and news articles can be surprising resources to get a glimpse into the field of medicine (I'm not talking about House or Grey's Anatomy - such shows portray an entirely different kind of "TV medicine"). If you're still unsure about becoming a doctor, these resources can shed light on the profession in a way that you might not get from volunteering/shadowing. If pre-med classes are torturing you, these resources can be extremely inspirational, and remind you what you're working for. And finally, when you're writing your statement and secondary essays, these can spark your creative writing.

A word of caution: books and TV give you a just a glimpse into medicine. Don't let them fool you into thinking you know what it's like to actually be a doctor yourself.

Here are some of my faves:

Nonfiction books
- Complications: A Surgeon's Notes on an Imperfect Science, by Atul Gawande
- Better: A Surgeon's Notes on Performance, by Atul Gawande
- probably anything else by Gawande, although I haven't read any others myself
- First, Do No Harm, by Lisa Belkin
- Intensive Care: The Story of a Nurse, by Echo Heron (written by a nurse, but still my all-time favorite book about healthcare!)

TV documentaries
- Boston Med (search online)
- Hopkins (available on Hulu)
- NY Med (available on abc's website)
- Doctors' Diaries (search online) <- kind of sad because none of the doctors maintain a lasting relationship

News/articles
- New York Times, Health section
- US News Health
- Bioethics topics by U of Washington

<3 (kathleen)

Monday, August 13, 2012

med school secondaries


So I'm knee-deep in the process of med school secondary applications. I call them "letters of doom" because they flooded my inbox until I was scared to check my email every morning. Since I applied to over 30 schools, I've been writing a TON of essays, and unfortunately I'm a very slow writer.

I'm not done yet, but here's what I've learned so far...

1. Be organized. Create an Excel spreadsheet to track your progress. Or if you are old-fashioned like me, keep detailed written records. I started with a spreadsheet that my friend made, but I love my good ol' pen-and-notebook combo way better. Here's a screenshot of what I had started:

On separate tabs/pages, keep info about each med school - essay questions, letter of rec requirements, or any special requirements. 

2. Start early! Ok, you are probably tired of hearing the E-word by now. But imagine this...you submit you primary and are thrilled about being able to relax a little. Then you get verified and suddenly you have 30 secondaries sitting in your inbox, eagerly awaiting your love and attention. YES, this is what happened to me. It became impossible for me to turn in my secondaries within 2 weeks of receiving them. 

I had heard people suggest looking up last year's prompts on SDN, but I did not feel very motivated to write for prompts that I wasn't 100% sure would be the same. However, I now realize that many prompts are similar enough that preparing essays beforehand would have been a very good thing to do. Trust me, a VERY good thing to do. 

3. Distinguish yourself. Secondaries are you best chance to make yourself stand out. You can choose what you want to emphasize about yourself. Think about an admissions committee reading tons of applications, and then ask yourself "what can I write that will make them want to get to know me more?" or "how can I show them I will contribute positively to their school?" Many essay prompts will ask these questions directly. But even other essays are great opportunities to weave in your answers to these questions. 

4. Take a nice photo of yourself. Many schools request one, just so if they interview you they can put a face to a name. You could be daring and submit a fun, casual photo, but I would be safe and submit a semi-professional looking one. Wear a nice dress shirt and have a friend take a photo (in good lighting) or get one taken at any place that does passport photos. It shouldn't cost too much.


That's all for now! Maybe when I'm done with this process I'll add a Part 2.

But look out for a future post featuring commons types of secondary essay prompts!

<3 (kathleen)

A Comprehensive Guide to Letters of Recommendation

Personally, getting letters of rec (LOR's, or LOE's according to AADSAS) from professors was the source of quite a bit of stress. Coming from a giant public institution like Berkeley, my science classes almost always had 100+ people, even into my upperdiv classes.

Forums/pre-dent advice sites tend to say that you should start being proactive about getting letters during your freshman or sophomore year, and honestly, I think that's a bunch of bologna. Unless you are not a science major and will not be able to get letters from a prof unless its in your first two years, don't stress yourself out too much about getting them so early. (**Also, for people who are not science majors, i know some dental schools don't ask for multiple science prof LOR's if you are not a science major, and rather, ask for a LOR from your specific major instead. It's different for every school!!**)

Why you may ask? Several reasons.

1) Whatever commentary your professor can provide about you when you were a freshman/sophomore may have completely changed by the time you're applying as a junior/senior/graduate.
2) The lower div science classes that we take as underclassmen have soo many people (I'm talking 300-400 people) that it's really difficult/stressful to get noticed. Plus, Cal is full of competitive people, and I'm sure we've all been in the awkward office hour where students are obviously trying to win their prof's favor by asking annoyingly specific/smarty-pants questions.
3) Getting a rec letter from someone when you are more advanced in your learning will probably mean a better interaction between you and your prof, and subsequently, a better LOR.

So now.. I reveal to you, FIVE SIMPLE STEPS TO A GREAT LOR. 

1) Figure out where you're going to get your LOR's as you're planning your class schedule. For example, when I was entering my senior year, I knew that I needed to get 2 LOR's by graduation, and intentionally spent more time on these classes to get the best grades that I could, and make time for that professor's office hours. I also took my PI's class so that his LOR could count as a science prof as well.

2) Do your best in that class and go to office hours. You need to give your prof's something to write about. Sometimes, it helps to ask your prof if you could meet at a separate time, just so they get a chance to remember your name/face (you can say that you can't make the office hours for that week and would like to schedule another meeting, or that you have more specific questions). Just remember, professors were all students too, and they understand the struggle you're going through. Don't be nervous/shy - just ask what you want to, and be genuine. The prof's who wrote my LOR's are all extremely interesting and insightful people, and it was a great opportunity to tap into a source of wisdom.

3) Ask for the letter. Once you feel that you know your prof well enough/your class is over, here's the chance to request your LOR. Here's an example of an email that I would send to my professors. You can just look over the points, and hopefully it gives an idea of what to say in these types of emails.

SUBJECT: Requesting Letter of Recommendation

Dear Prof. Kathleen,
I just wanted to thank you for a great semester; I learned so much about crafting and inverted spray bottles through your cerealparty.blogspot.com class (shameless plug), and am interested in studying this further in the future. After your class, I learned to approach problems with a crafting-style of thinking, which I know I can apply to my pursuits in dental school. 

I was also very encouraged by your style of teaching, and appreciate all of the time you spent helping me through my struggles in this class, and giving me advice for my future. 

As you know, I am applying to (dental/medical/optometry) school this coming 2013 cycle, and would be honored if you could write me a letter of recommendation in support of my dental school applications. If you are willing, please let me know when would be a convenient time to meet with you. 

Thank you again, etc. 

Best,
Rachel

4) If all goes well and your prof agrees, set up a time to meet, and bring the following documents in a folder/manila envelope:
  • Transcript (unofficial is fine)
  • MCAT/DAT/OAT scores (if you have them at the time, if not no worries)
  • Resume
  • Any forms necessary for your letter service (Career Center for Cal students)
  • A personal statement that you may have started drafting OR a document that answers some questions about yourself (I did the latter, and answered the questions listed below)
    • Contact Info (Name, email address, phone number, class taken with prof, grade)
    • Why do you want to be a dentist, and what are your motivations?
    • What makes your application "different", what do you think I need to write about that will be most helpful?
    • Briefly list your volunteer work
    • Apart from the volunteer work above, what have you done to convince the schools you are applying to that you are dedicated to your career choice?
    • Are there any ways in which your student career has been "unusual"?
    • Have you taken the MCAT/DAT/OAT, etc? If so, what was your score?
When you hand this packet to your professor, tell them that you understand how time-consuming and difficult the LOR writing process can be, and that you want to support them as much as you can by providing them with all the information possible. Let them know if there is anything specific that you would like them to address (they will probably ask you this). 

5) Follow up and check in on the status of LOR's with your prof. Use your judgement to make sure you're not toe-ing the line of annoyance when asking about it though. Ooh, and once it's in, a thank you card is definitely in order :) That's it!

These steps should help you get the best LOR possible, while making this process as painless as possible for your prof. Good luck, let us know if you need any help :) 

:) rachel

So why don't you want to be a doctor?


I get this question a lot. I used to be in a pre-health sorority, and many people assumed I was pre-med. Even into my junior year, I would get a surprised "Oh, I thought you were pre-med!", when I'd whip out my DAT book, or talk about dental schools that I wanted to go to.

So I'll start by explaining why I think the dental profession is an entire world away from medicine. 

1) There's an element of art/creativity to it, and every service you provide requires manual dexterity. So if you don't have good hand-eye coordination, this may not be the profession for you.
2) You're mainly dealing with teeth and jaws (haha if that's not the most obvious thing you've heard today..). In dental school, anatomy labs usually focus on everything above the torso.
3) You can provide immediate results - If someone has a cavity, you have the tools to fix it, allowing your patients to walk out with less pain than when they entered. 
4) Dentistry operates on a very small scale. I mean we're talking about surfaces of teeth here, so it requires a lot of precision and attention to fine detail.
5) Dentistry is both diagnostic and surgical.

Now, those all dealt with technical aspects of the profession, but as far as the human aspect goes, I would say (and I think Annie and Kathleen would agree) that health professionals all have a similar responsibility to their patients - to be as  honest, compassionate, non-judgmental, and comprehensive in their care as possible.

---

To me, dentistry is an opportunity to give someone a smile, and as corny as that sounds, I'd like you to hear me out. A smile means more than being able to cheese it up for a photo, it means giving someone the confidence to represent themselves without judgement. Working at a free clinic that sees many homeless and low-income patients, I've seen how someone's oral hygiene can drastically impact their chances for employment, or potential to move up in a job. Here's a great example: one patient had a license to be an EMT, but could not get hired. When he first came to our clinic, many of his teeth were chipped/cracked/discolored, and even missing. Over 2 years, with many extractions, fillings, root canals, and eventually, dentures, he walked out of our clinic with a complete smile. Since then, he's been hired as an EMT. 

Moral of the story? This patient could finally be judged for the quality of his work and his character, not by his appearance. 

Dentistry has the ability to impact not only how you perceive yourself, but how others perceive you.

TEETH - aka Rachel