School and class year: HSDM, 2020
Hometown: New York City
What was the last book you’ve read?: An Ember in the Ashes by Sabaa Tahir
What is your favorite food?: Kale (...just kidding, it's quesadillas)
What is your favorite hobby?: Reading silly teen novels that I'm too old for
Where do you think you would want to have a dental practice?: Some place that isn't too humid year-round
What is your favorite ASDA event you’ve attended?: All the mixers!
What is a fun fact about you?: When I was on the Today Show playing Christmas music with my bell choir in 9th grade, I met Keanu Reeves and have been hopelessly in love with him ever since
Anything else you want to add: I'm obsessed with manatees and hope to one day meet one
As a 4th year student, I am strongly against the live patient exam of CDCA or WREB – on many levels. However, the largest problem I see is with the ethics of the exam. During my white coat ceremony, I took an oath. This oath was crafted by many of my classmates and was shaped around the Hippocratic oath. One main tenant is that we do no harm to our patients. Live patient exams inherently create an environment in dental schools that directly contradicts this principle. The exams are comprised of a portion in which a student sits and practices on a patient performing several different types of dental restorations: a class II restoration and a class III restoration. In order to complete this restoration, one must first diagnose the necessary lesion by taking bitewing and periapical radiographs.
Now, the hardest part, the perfect lesion. You need one that is, as goldilocks would think, not too big… not too small… just right. This perfect lesion must be right at the DEJ. This is the delineation between the enamel (the hardest part of the tooth) and the dentin. If the lesion is too small, the tooth is not likely cavitated and would not be clinically indicated for a restoration. If the lesion is too large, there is a possibility that the lesion could extend to the pulp and create pulpal involvement.
The hunt for the perfect lesion creates the ethical quandary that many dental students face. If this lesion is indeed perfect and meets right at the DEJ or just barely short of it, do I: A) discuss with the patient that this active disease lesion would qualify for my licensure exam that is in March (even if March is several months away), which means we are waiting to treat active disease or B) discuss with the patient that they currently have active disease occurring in their oral cavity and that we need to treat this now? Let’s take a moment to stop and ask ourselves. I have active disease in my patient’s oral cavity – do I treat it now, foregoing the opportunity to have this lesion for my licensure exam, risking that I’ll find another perfect lesion, or do I ask this patient to wait to have their tooth treated until my licensure exam?
This is going on throughout the country. Not only am I, a student, contemplating this ethical quandary, but many faculty members are as well. As a third year, my faculty would not think twice about this perfect active disease lesion needing treatment because it is indeed, active disease. They would instruct us to treat it. But, as a fourth year, with my licensure exam in several months, “this would be a good licensure lesion. Think about holding on to this,” one instructor mumbles. This is an instructor, who is also a licensed practitioner, discussing with their student and future healthcare provider to wait to treat active disease because of the licensure exam.
I’d like to leave you with this last thought about this irrational double standard that future dentists are held to.
Imagine if a live patient licensure exam was in place for a medical physician to graduate from a surgical residency. A surgeon would need to find this perfect lesion. Too small, no we can’t operate. Too large, we need to operate immediately. Just right, let’s see if it will stay the same size in a couple months for me to operate in order to challenge my licensure exam. Does the circumstance change that much? Is the surgeon’s situation really that different? Or is it because a surgeon looking for a mass could be life or death for a patient while for a dentist it’s well… just a tooth? These are the questions we should be asking.
Last month, I had the unique opportunity to testify at the State House in an effort to bring an end to live patient exams as part of dental licensing in Massachusetts. Alongside four recent dental graduates from Tufts and BU, we expressed our concerns with the current licensure model to the Joint Committee on Consumer Protection & Professional Licensure.
Our message was simple: live patient exams are unethical, and have no place in medical training. Our concerns included the common practice of deferring treatment so that patients can qualify for licensure exams, coercion and extortion of dental students on this stressful day, and the overall immorality of using human subjects for the purpose of discovering dental student incompetence.
In fact, dentistry is the only medical profession that still requires a live patient component as a condition of licensure - but this has been gradually changing across the country. In 2011, the American Dental Association passed a resolution pushing for the elimination of this component by 2015. Although we still have a lot of work to do, a handful of states – including New York, California, Minnesota, and Iowa – have already adopted this change.
When we consider that nearly 350 students graduate from dental school in Massachusetts each year, it emphasizes the volume of patients that are affected by this yearly.
The committee seemed genuinely interested in the bill and, although it may take months before they vote, this is a major step in the right direction.
As dentists, we must uphold the highest ethical standards for our patients. It should be no different while we are in dental school.
If you want to learn more or get involved, please email me at firstname.lastname@example.org.
Name: Nahrin Veronica Ebrahimi
Class Year: 2018
Hometown: Los Angeles
What was the last book you read? Speaking Truth in Love by David Powlison
Where you think you might like to have a dental practice/future plans? General dentist serving an underserved population somewhere
What's your favorite food: Bread
What has been your favorite ASDA event that you've attended? ADA Dentist and Student Lobby Day
What's your favorite word? Marveled
A Former Collegiate Athlete’s Perspective on Dental School - Eric Ress (UConn '20, District One Wellness Co-Chair)
Before I started dental school, my life revolved around swimming – I swam growing up and then also at Indiana University. I had never really experienced school without having to worry about swim practice, so dental school as a “swammer” would be a completely new experience. Although I didn’t end my career on the terms I would have liked, I did come away with many valuable experiences. My time as a collegiate swimmer taught me skills that I have been able to apply both in and out of school. In addition to sharing my experience with collegiate athletics, I asked some of my classmates to share what they took away from their respective sports.
The first big skill I developed in college was time management. The transition from high school to undergrad was easier by being forced into a regimented schedule. I found myself making use of any free time to work ahead or participate in other extracurricular activities. Whether it was studying while traveling to meets or volunteering on weekends, my free time was spent working towards personal goals. Time management in dental school is an absolute necessity. Although I no longer spend 20+ hours a week in a pool, the volume of class and school-related work requires me to manage my time wisely or risk falling behind.
In addition to managing your time, developing good habits and routines as an athlete can help develop discipline. According to my classmate Ryane Staples, a former football player at Colgate University, “When you play a Division I sport, it's a full-time job. When you add in the academics that you have to handle at the same time, it's similar to having a 60-hour per week job. To be good at both, you have to be able to manage your time well, and you have to develop good habits and routines. The same goes with being a good student in dental school - habits and routines can drive performance”. In addition, developing good habits and routines can help develop a sense of balance. Between quizzes, exam periods and board preparation, it is obvious that the majority of your time will be spent on academics. This being said, if you establish good routines where you take time for yourself, you will often see big dividends especially when it comes to productivity and overall wellness.
One of my fellow classmates, Jessica Rudman, also swam in college at Trinity College. One of the biggest things she took away from swimming was becoming an active leader. Although swimming is an individual sport, as part of a team it is important to lead by example. She said that, “How you react to a practice, competition or team decision can affect how your teammates will react and perform.” To be a leader, you do not have to have a formal title, and leading by example can go a long way. I see this in some of my classmates who are able to have a positive outlook even when school seems unmanageable.
Navigating through dental school alone is a near impossible feat. Relying on classmates and a support system can make an extremely difficult time easier. Sam Roh, a rising second year, was on the fencing team at Duke University. He said that fencing is both an individual and team sport, and that it taught him the importance of collaboration, teamwork, and camaraderie. He explained that his success depended on his teams and vice versa. Collaborating with classmates is one of the easiest ways to succeed in school. Everyone studies in a slightly different way, but even those who study well alone can benefit from a strong social support system from classmates and friends.
Although our athletic careers are long behind us, the experiences we gained from our time in college have already helped me and many of my classmates during our first year of dental school. Obviously, collegiate athletics are not the only way to learn these valuable skills, and anyone would benefit from having them. Whether its high school sports, music, art, or any variety of extracurricular activities, applying skills from our non-academic life can make dental school more manageable.
Name: Aparna Bhat
Class year: 2019 (D2)
Hometown: Arroyo Grande, CA
What was the last book you read? When Breath Becomes Air, one of my friends recommended it to me, and it was a great read!
Where do you think you'd like to have a practice (if that's what you want)? I'm not really sure yet - I like California, but I don't know where life will take me.
What's your favorite food? I actually really love Indian food, it's what I grew up with, and I love the different spices and flavors in different dishes. But I also really love Thai and Mexican food - basically anything with a spice element, I love.
What's your favorite ASDA event you've attended? The ASDA/HSDA Community Soccer Tournament that we had in the fall of 2016. I'm a little biased, because I organized the event, but it ended up having a larger turnout than we had expected, and most importantly, everyone had a ton of fun.
What's your favorite word? Perspicacious. Because it's pretty fun to say.
Name: David Danesh