Is student debt influencing new dentists' choices after graduation?

Chris Salierno, DDS Chief Editor

Will certain practice models succeed and others fail because of student indebtedness? Let's stop speculating and go right to the source. Who better to address these questions than those who have just finished their terms on the Executive Committee of the American Student Dental Association (ASDA). These three have led the organization that represents almost 90% of all US dental students, so it's safe to say they have a firm grasp on the student perspective.

Christian Piers

Immediate past president, ASDA

University of Colorado School

of Dental Medicine,

Class of 2016

What are your plans after graduation?

After completing my orthodontic residency at UNC-Chapel Hill, I plan to buy a practice (or build one from scratch) on the Big Island of Hawaii.

How do you think student debt has influenced your classmates' postgrad plans?

About 5% of the students in my class are going directly into specialty residencies. Another 5% are going into the military, while one-third to one-half are going into general practice residency (GPR) or advanced education and general dentistry (AEGD) residencies. One student is looking to buy his own practice, and the remainder of the class is split between working as associates in private practice or in dental service organizations.

Have you noticed any trends in your classmates' postgrad plans?

Student debt has made the prospect of moving straight into practice ownership very difficult for my classmates. The pressure to pay off student loans has led many who started dental school with the goal of owning practices after graduation to apply for associate positions to build capital and secure loans for practice purchases. That same pressure has led others to pursue residencies to increase their yearly earning potentials, and diverted the paths of still others who wanted to specialize but can't afford to give up two or more years of income while allowing debt interest to accrue.

Adrien Lewis

Immediate past vice president, ASDA

University of Texas School of

Dentistry at Houston,

Class of 2016

What are your plans after graduation?

After my two-year pediatric residency, I plan on becoming an associate for a few years in a pediatric dentistry practice in the Houston, Texas, area.

How do you think student debt has influenced your classmates' postgrad plans?

About one-half of my class is going into some sort of residency or postgraduate training. About five students are going into the military. About five students are going into private practice with relatives in dentistry. For the remainder of my class, I don't know if they will be going into private practice or joining a DSO, but I have heard about five to 10 students who have contracts in progress for associateships.

Have you noticed any trends in your classmates' postgrad plans?

I think student debt has had a big impact on almost every student in my class. Whether starting a practice or joining a DSO, the mountain of student debt hanging over our heads guides our postgraduate decisions. I know some students had the opportunity to have dental school paid for and will be joining family practices, but this is certainly not the majority. Because of the high amount of student debt and fear of opening a practice right out of school without enough experience, about half of my class is doing some sort of postgraduate training, and then they have plans to associate before buying or opening a practice. The other half of the class has already started looking into associateships, but I've only heard of about five to 10 contracts in progress. I am unsure of the plans for the remainder of my classmates, but many have mentioned they will join some version of a group practice or DSO because of the guaranteed salary, free CE, and elimination of "fees" that come with owning a practice.

Niveditha Rajagopalan

Immediate past vice president, ASDA

Midwestern University College

of Dental Medicine-Illinois,

Class of 2016

What are your plans after graduation?

After graduation, I will practice part-time at a private practice and part-time at a DSO. I know the owner-dentist at the private practice, and she plans to take me on to mentor me as a junior dentist. Financial reasons concerning loan repayments are why I also plan to work part-time at a DSO.

How do you think student debt has influenced your classmates' postgrad plans?

My dental school class consists of 130 students. Of those, about 40 are going into a residency or AEGD program, and the rest are going into general dentistry. The majority of students (more than 50%) are considering DSOs. Only three students are starting their own practices right out of school. The rest of the students will be joining private practices.

Have you noticed any trends in your classmates' postgrad plans?

In speaking with my classmates, I would venture to say that student debt is the determining factor for postgrad plans for general dentistry. Being students at a private dental school in Chicago, our student loans are hefty. To expedite repayment of these loans, most students are signing on with a DSO or corporate dentistry group because of the high salary from these groups as compared to entry-level private practice salaries. For me personally, I grew up in Nebraska, and before I even applied to dental school, I had hopes to set up a practice in rural western Nebraska. I worked with this underserved community in college. But upon attending dental school and having the reality of my student loan burdens set in, I changed course and have delayed my plans to return to rural Nebraska until I'm able to pay off a sizable portion of my debt.