JACOBI MEDICAL CENTER

Department of Dentistry/OMFS
Division of Continuing Dental Education

Residency Selection
Information

Peter M. Gershenson, DDS

Director, General Practice Residency Program

Director, Dental Continuing Education

Jacobi Medical Center

Bronx, NY

Copyright 2018
How will you decide which residency programs to apply to in the following
months? There is very little information available about individual programs on
the web, which means you will be vulnerable to opinions posted on social media,
special interest websites, and trolls planting misinformation.

You have spent four years in college, perhaps some additional education after that,
and you will soon be in your last year of dental school.
All that tuition…and when it finally comes to selecting your first job as a
dentist….very little help. Sadly, it will fall on you to come up with a strategy to
determine what you will do once you have your diploma. Some of you will go
directly into private practice. This is the way things used to be, in what was called
the “golden age of dentistry”. Few insurance plans, little oversight, and an
abundance of caries to treat with a limited number of modalities.
Welcome to the 21’st century. Dentistry has come a long way since cast gold
veneer crowns and silver amalgam. Treatments are more and more complex and
aesthetically driven. We are expected to be competent in all of these modalities in
the same four years as our fellow clinicians who graduated in the 60’s with far
fewer choices. The 60’s, before composite, endosteal implants, cone beam scans,
digital impression scanners, CAD-CAM, laptops, cell phones…you get it.
This is where a General Practice Residency Program comes in. It is a year of
training, where you will be able to practice and refine techniques you have learned
in dental school, while adding new and more advanced techniques to your
treatment armamentarium. A quality training program will prepare you to enter the
private sector with the skills most sought after, and the confidence to perform these
procedures.

How will I identify the program best suited for me?

If your dental school has an Office of Career Development, that may be your first
stop on this journey. Typically, these offices can provide assistance with your PS,
and some advice on the PASS application process. No such office at your school?
The question should be raised to administration…”Why not?”. That is what your
student government officers are for. A straight forward discussion with top
administration about the future of the class and what help the school will provide
toward this end is both reasonable and demonstrates a real interest in the wellbeing
and ultimate success of the class. Not entering into this conversation leaves your
future in your own naïve hands, with little guidance.
This may also be the time to discuss with administration what type of business,
marketing, and accounting courses they might want to provide, as dentistry is a
business. Since many of the dental schools are affiliates of large universities, the
business school with some of these answers may simply be around the corner.
With collaboration the new buzzword in dentistry, it should be easy for the dental
school to enlist some business faculty to teach seniors some “real” business tools,
not the anecdotal stories of some dental school faculty with a private practice.

Approaching administration with new, novel formulas for education may at once
seem both intrusive and invasive. On the other hand, the squeaky wheel gets the
oil, and you will not know without trying. The beneficiaries will be yourselves.

LOCATION
If you search on the ADEA PASS website, you will see that the majority of the
post-doctoral training programs are concentrated in the Northeast. That is not to
say that there are not many excellent programs in other parts of the country, but
this is the area with the greatest concentration of dental schools. One must also
consider that the states in this area have traditionally had an ongoing Medicaid
programs with strong pediatric and adult dental components.

The Bronx, where my GPR Program is located, has the most post graduate
residency seats of any city in the country. A large section of the Bronx is
designated as a federally qualified underserved dental area, allowing it to benefit
from numerous government grants. Some of the greatest minds in post grad
dentistry head up these institutions, and keep expanding services.
City vs. suburbs vs. rural
There are programs in each of these areas. Do you want to live in a large urban
environment with the inherent crowding, noise, expense, public transportation,
cultural opportunities, nightlife, and density of newly graduated young adults?
Do you want the more family friendly suburbs, with the surrounding parks, good
school systems, necessity of a car, mall shopping, and other families to make
friends with?
Do you prefer the quiet rural setting? Providing care to an underserved population,
lower volume of patients, slower pace of life, and becoming part of a community.
There are good reasons to select any of these choices, and I have not commented
on going to a program close to home and family. Each of you will have your own
reasons.

The second part of location regards the actual dental facility. As the discussion is
limited to General Practice Residencies, that will be the benchmark.
Is the dental clinic/center within the hospital?
Is the dental clinic/center in an adjacent building to the hospital?
Is the dental clinic/center off site, some distance from the main hospital?
The answer to this question may be of some relative importance to each of you. If
you want the “hospital experience”…being part of the house staff, interacting daily
with other doctors from other services, treating and consulting on inpatients, quick
access to the Emergency Department and the main OR’s, the answer is obvious.
An off-site clinic/center may have more of the feel of a private practice, which may
be attractive to some applicants.
Being on campus but in an adjacent building to the main hospital may provide the
best of both worlds.
It will depend on who you are and what you want.
 CLINIC

The quality and design of the dental clinic may have a great impact on the quality
of your experience as a resident. Nothing is more frustrating than working in an
environment where the chairs do not function properly, there are insufficient
instruments and supplies to properly perform procedures, and the delivery of
patient care cannot run smoothly due to inherent design flaws which impede
natural flow.
Are there sufficient operatories so that each resident has a space to treat appointed
patients?
Are the residents sent to overly long, non-dental related off service rotations in
order to free up chair space? There are some mandated off service rotations, such
as Emergency Department and Anesthesiology. Spending 6 weeks on Internal
Medicine may be too long, and the reason for this needs explanation.
Is the equipment modern, functional, and maintained?
Working in an updated environment sets the tone. The hospital values the dental
service and makes sure it is on par with the rest of the ambulatory clinics. The
dental staff makes use of new technology and equipment, which identifies a group
of attendings who are current and knowledgeable. Old broken equipment often
comes with associated old school thought and practice.
Ten years ago an EDR and digital radiography were enough to categorize a clinic
as state of the art. Now you must have a cone beam, digital impression capability,
and a variety of lasers.
Applicants often overlook the small things that make a year in residency more
enjoyable. Does the hospital have adequate employee parking? Is the on call room
in a safe location, and is it reasonably clean? What are the public transportation
options near the hospital?
 STAFF
It is almost impossible to objectively evaluate the attending staff at any
residency. CV’s and Google info can only relay so much. Visits to the programs
are a snapshot of what will occur during the other 364 days. The truth is you
entered dental school as a D1 not really knowing much about your future
professors and row instructors. You went on faith.
Instead of going on faith, try and talk to the PD when you are on a visit. He/She is
ultimately in charge of the way the program is run, and the culture of the program.
Does the PD practice dentistry privately, or is this their only job?
This is a very opinionated question on my part, as I do both. A PD who also has a
private practice is still chairside for many hours a week, and knows what it is to
have difficult cases and patients. They may be more empathetic to your problems
and dilemmas.
A PD who solely administrates the program may not be that helpful in the clinic
when the chips are down, and a case is going poorly. The roll up your sleeves and
let’s get to work PD is going to be there for you when you are stuck, lost, or just
can’t get things to work.
You will have some minimal contact with all of the attending staff during the visit.
Remember to be on courteous/good behavior. Also keep in mind that you have
spent the last 17-18 years in school and you did not like all of your teachers. You
don’t have to.
Hygiene and assisting staff should be present and working. The front desk staff
should appear calm and busy. Take a look around and imagine yourself in scrubs
and an ID being a part of this clinic.
 CURRENT RESIDENTS

During a visit to any residency program, it is imperative to speak with the current
residents. They are in the program, have experienced the day to day workings of
the institution, and will be generally forthcoming with whatever questions you ask.
Reasonable Questions:
1) What school are you from?
Programs with a diverse national class or at least not from a one school majority
can indicate students will relocate to this program because the training is deemed
worthwhile.
2) Where do you live?
Knowing that most of the residents live about a 45 minute commute from the
hospital might be info you need to know. If the living conditions around the
institution are not desirable, you will at least be aware of the 1.5 hour two way
commute you are entering into. Some hospitals have on site resident housing for a
deeply discounted rent. This is also important.
3) What types of dental procedures have you done?
This is a deal breaker question. If you hear what you like, you are in the right
place. If not, you have crossed this place off your ROL. Visiting in July and early
August may not yield any valuable answers. Try to visit in early June, when the
residents are finishing up the program and have experienced all the rotations.
4) How is it working with the PD?
Most PD’s do not care if they are popular or not with the residents, as it is only a
12 month gig. On the other hand, most PD’s are committed to fairness and high
quality training. If the residents feel that the PD is there for them, and has their
best interests at heart, you are in the right spot.
5) Is there adequate attending coverage?
Working alone is not your goal first year. There should be enough attending
coverage so that you are always able to ask for guidance. Attendings that spend
the day surfing the web and not supervising the clinic need to look for dental
school jobs (LOL…poor attempt at sarcasm)

6) What is the culture of the dental department?

All large groups, corporations, and organizations have a culture. Sometimes the
culture is that there is no culture…read: no direction.
An organization with a positive culture promotes the growth of the people within
the organization. Encouraging excellence, allowing people to pursue their goals,
and understanding that while everyone is learning and perfecting their techniques,
insufficient or poor outcomes may occur.
How poor outcomes are dealt with is very important. Root cause analysis and
continuous quality improvement are the gold standard. Old school raised voices,
casting blame, and finger pointing should not be tolerated.
7) Is the current class happy?
You will feel the tone, vibe, etc. of the resident class. You know when people are
okay/happy in their environment and when they are walking around like the living
dead, or scared of their own shadows. Some residents may be more content than
others. Perhaps their selection process did not account for what was the true nature
of the residency they ended up in. Some may be going through a personal issue
which is not due to the program. Many of you will know a classmate who is
unhappy, not due to school, but outside circumstances preventing them from being
at their best. There are many factors which contribute to resident discontent. You
can’t please everyone. We are all trying our best.
CAUTIONARY NOTE:
The visit can help and hurt. You will get a birds eye view of the program.
You must be on your best behavior with the staff, attendings, and residents.
They will all talk about you once you have left, even though this was not an
interview.
Be polite and say as little as possible. Don’t ruin your chances before they start.
 THE INTERVIEW

You have submitted your PASS application and have been called for an
interview. Most business schools training future MBA’s have classes and seminars
dealing with the interview process. Most dental schools do not. Once again, all
that tuition….
Like any other important process, you should attempt to prepare for the upcoming
interview. Some of the specialty social media sites like SDN have entire blogs
devoted to past interview questions. It’s worth a look, but the posted answers to
these questions are another story. Come up with your own. Run them by your
professors/peers.
There are lots of books about corporate interview techniques, sample questions,
sample answers, and strategies. They are worth a look. Going in cold, relying
solely on your charming personality may put you at a disadvantage. You are not
starting D school anymore, you are finishing. A certain amount of professional
demeanor and acumen are expected. Answers to interview questions should be
thoughtful and meaningful.
Dress in business attire. Clothing should appear clean and pressed. If you end up
at a residency in a Level 1 trauma center, and you have been up on call for 24
hours, you are allowed to look a little unkempt. Not at the interview.
Know as much as you can about the program and the PD, but do not ask non dental
questions of the PD, even if he/she was once an Indy car driver or a professional
wrestler.
Keep in mind that this is the only moment you will have to put your best foot
forward. The PD and the attending staff are deciding if they want to work with
you for a year…or more. You have made it through the first step; the admissions
committee or PD thinks that you could fit into their system. Now it is up to you to
make it happen.
Sample Questions:
What is it about you that will make you a good resident?
Why did you apply to this institution?
Where else did you apply? (Tricky if all other places are remarkably different.
Have reasons for your application choices.)
Why should we accept you over a similarly qualified candidate?
How would you describe/rate your dental school education?
What do you have to offer that only you can bring to this program?
How do you describe your decision making style?
How do you cope with stress?
What factors would lead you to rank a program highly?
What is your favorite part of dentistry? Second favorite? Least favorite?
If you were not already a dentist, what would you be?

Mock interviews are a good way to prepare for the upcoming real one. Some of
your faculty may be willing to help you out with this. Not all will be qualified, and
not all have done a residency. Seek out the younger faculty who have been out of
training less than 10 years. Chances are they will be more familiar with the current
trends in post grad education and can give you some guidance. For the very brave
amongst you, ask the dean or academic dean for assistance with this. They will
undoubtedly be capable, and may applaud your seriousness about the upcoming
process. The risk is coming off incompetent to the top faculty. They may use this
opportunity to teach you how to conduct yourself better, which would actually be
very useful. Alternatively, they may see you in a poor light, devaluing a previous
good opinion of you. In any case, most faculty will take a more humanistic
approach to your request for a mock interview, since it is not patient related and
demonstrates a serious professional approach.
 PERSONAL STATEMENT

PD’s actually read these, as it is a way to get to know the applicant. Most appear
to have been written on the fly, with little thought about the content. Well written
PS’s stand out. Take your time and write something meaningful.

The UCSF Office of Career Development has an excellent guide to writing

personal statements on line. Use it if you have nothing else, it will help.

Anecdotal stories of how you helped a fearful or anxious patient are not amusing
nor do they belong in your PS. That is our job, that is what we do. It is not a novel
skill or experience. Demonstrations of you determination, conscientiousness, and
ability to work in a team environment will go a longer way to your end goal. Long
term commitment to one volunteer organization is often better than being spread
out in many directions. Think about how your PS could put you in the best light
possible.
 RANK ORDER LIST

If no one has told you, the MATCH is designed to be in favor of the applicant.
With that said, the way to design a ROL is simple. Put the program you most want
to attend first. Do not try to out think the PD’s. You are not privy to the strategy
the PD is using to construct his/her list. You may have something that they want
and don’t even know it. Placing your top choice in the top position gives you the
best chance of being matched. Seems simple.

POST MATCH
The MATCH is expensive. Traveling to distant locations for interviews is
expensive. There are some candidates who think they will sit out the MATCH and
take a POST MATCH position which may be offered on the spot.
The risk with this is great. Few quality post grad residency programs do not fill up
in the MATCH and have open positions. Those spots left open are often in less
desirable programs. Even those will eventually fill and you can be left with no
spot at all.
If you decide to post match because you did not match any of your ranked
programs, or you sat out the process, be prepared on MATCH day to start the
frantic application process.
A list of open positions is published around 12 noon. You can begin faxing or
emailing applications for these programs. It is frantic because the programs are
inundated all at once with dozens of applications.
Have your POST MATCH application ready before hand. Transcript, PS, Letters
of recommendation to be sent by evaluators, and a 2x2 picture.
 LAST THOUGHTS

As a longtime PD, I have always been interested in the admissions process, but
have never put my own thoughts down in words until now. I often ask applicants
when I am interviewing them, why they would want to come to Jacobi? The
program is rigorous, and the treatments can be complex. Wouldn’t it be great to go
to an easy program? No stress, easy hours, and a certificate at the end. Wasn’t
four years of dental school hard enough? Don’t you need a rest?
We have not post matched in over a decade. (We post matched for the 2019-20
class since I originally wrote this booklet. I think the post match is much harder,
and do not recommend trying it. Interviews can be much more intense, as
decisions are made almost instantaneously). I cannot dissuade any of you from
seeking intense training. That is who we are I guess.
Some of the information I have related will be relevant to you, and some will not.
That always seems to be the case in dentistry. For those of you who I will meet
during interview season, the recipe is in front of you.
The General Practice Residency is a chance for you to gain some good experience
as a dentist…not a student. Most programs will allow you to practice with indirect
supervision, and try new and more complex treatments. It is a year to grow, make
mistakes, fix them, and foster bonds with fellow residents and attending staff.
The division between teacher and student is erased, replaced with a new
relationship as colleagues. We are all in this together.
Peter M. Gershenson, DDS
Director, General Practice Residency Program
Jacobi Medical Center
Bronx, NY
CDCA Consultant Examiner
Visit [Link] for more information about the residency programs at Jacobi Medical Center

General Practice Residency

Pediatric Dental Residency

Oral and Maxillofacial Surgery Residency

Dental Anesthesiology Residency

Dental Public Health Residency

Contact Dr. Gershenson at [Link]@[Link]