So You’ve Decided to Specialise? – IC056

[Jaz]
The whole pros element, right? Multiple crowns, four rehabs, lots of general dentist do four rehabs, lots of general dentists do all on fours, that kind of stuff. So, nowadays it’s like blurred lines between, okay, what do they actually need a Prosth for? However, prosth, I think they’re very employable. However, lots of people who do an MClinDent Prosth end up being general dentist. We’re just like really good general dentists in practice and still doing checkups and stuff. I have seen that.

[Beant]
The fees are 37 and a half thousand pounds a year and they’re subjects-

[Jaz]
For a home student.

[Beant]
This is for a home student. I’m a home student.  

[Jaz]
What? How much is it for an international student?

[Beant]
60, 000 pounds.
 
Jaz’s Introduction:
I think every dentist in the world at one stage of their career has thought about specializing. And most of us never do, right? About 90% in UK anyway are general dentists or at least non specialists. Only 7% actually enter specialist fields of dentistry like perio, prostho, endo, oral surgery, you name it.

How do we decide whether specialty training is for you? There are huge sacrifices one must make both in terms of time and finances. And how can you be sure that you really want to niche and narrow your scope of practice into that one field that you might choose? Is the best time to specialize like straight after dental school? Or is it good to gain a few years experience or many years of experience before you consider specializing?

Hello, Protruserati, I’m Jaz Gulati and welcome back to your favorite on the podcast. I’ve got Dr. Beant Thandi today who’s literally been accepted just now into Perio specialist training. We recorded this a few months ago. So it probably just started his specialist training, but he’s young. He’s a new grad and he’s deciding to specialize early on.

He decided that Perio is his calling and be nice to tap into his mindset. Why is he thinking of specializing in Perio? Why not any other specialty? Why not do some more years in general dentistry? Why not do lots of courses in Perio and be good at Perio, but not necessarily be a specialist. How’s he going to finance this? Nowadays, things are getting so expensive. And that includes the fees for specialist training. Beant is one of our community members on the app. So it’s a great pleasure to host him.

Hope you enjoy this episode. Covers so many themes about specializing. Like we’ve all thought of these questions before. And you know what? I don’t think there’s any right or wrong answers. But I know for a fact, this will help you. If you’re kind of stuck and you’re thinking, is specialist training for me? This is going to help to give you some direction. Catch you in the outro.

Main Episode:
Dr. Beant Thandi, you’re about to specialize. Super exciting time. It is so great to have you, to catch you at this stage of someone’s career, because we’ve had specialists on before. We’ve had young specialists on before, experienced specialists.

We’ve had people thinking about specializing, but you’re literally in that kind of limbo period where You’re literally about to start specializing in Perio. So tell us my friend about your journey so far. And when do you actually start your program?

[Beant]
Yeah, sure. So, well, thanks for having me on. So we’ve got long story and short story. So to answer the first bit, which people want to know is I’m starting next Monday. I’m going to the Eastman Dental Hospital, do their three year MClinDent course, hopefully come out a specialist, that’s the plan. It will be, yeah. It’ll be a full time course. So I’ve had a bit of a read of the brochure.

It’s going to be like five days a week, pretty intense kind of thing. So pretty much like a job going straight into it. So excited, nervous. I think it’s a happy, nervous, excited. I think I don’t know quite what to expect, but I’m like looking forward.

[Jaz]
And so tell us, give us a flavor of what got you to this point. So tell us about your dental school training, like your very early stage in your career. And so people decide to specialize at various times. Like, for example, when I look at someone like, Reena Wadia, a well known perio specialist, who’s been on the podcast before. A bit like you quite early jumped on and she’s doing great things. Equally, I’ve seen clinicians who’ve been in the game for 11, 15 years, then they want to specialize and they’re also equally doing wonderful things. So tell us about your journey so far.

[Beant]
Yeah, sure. So my journey all started with cOVID actually. So, when I was an undergrad, it was middle of third year. So we just started seeing patients literally in the January, February started getting going. Treatment plans were done. We’re actually starting to do fillings. It’s getting excited and then bang COVID hits and we’re all sort of shelved. And I remember during that period we all went online with everything and it was all good. We’re still learning. They got us back. So I trained at Birmingham.

They got us back into clinics quite quickly, actually like credit to them. And what happened was it got to a phase where we would go to clinics, go to university, then we’d come home and that was it. Couldn’t do anything else. Couldn’t see anyone. There’s only so many video games and Netflix series you can really watch.

So just got quite bored. It’s a bit odd, but it sounds really weird saying this, but for me, I felt dissatisfied and I couldn’t explain it. I didn’t know what it was because I was telling myself and I know it’s still the truth. I’m going to be a dentist and that’s absolutely amazing. That’s fantastic.

I’m really lucky to be on the course, like what’s going on kind of thing. And then I was quite literally sat in bed at night going to sleep. And I was like, I never thought about specializing, literally a thought in my head. And I go, hmm. It was literally like a moment like that, like went to sleep anyways, carried on.

[Jaz]
What year were you in? Was this like fourth year, fifth year?

[Beant]
So this is the tail end of third year. So start of fourth year, start of BDS four. And at this point we then, so with this in my mind, it’s like, okay, I’m going to just keep my eye out for things. I wasn’t too like diehard about anything.

I was like, okay, well I’m in a dental hospital. I’m being taught by a load of specialists. Who else better to kind of get that insight from? And so, we were going through a block during, at the time, where we do specialty modules. So we had pros, specialties, perio, endo, oral surgery, oral med, Paeds, Ortho, all sort of the usual blocks.

And I kind of just paid a, I know it sounds silly, a bit more attention to them as could I see myself doing this? Yes? No? And obviously I won’t put down any other specialties, but there were some which I was like, yeah, no, that’s not for me. I respect what they do, but I couldn’t see myself doing that.

[Jaz]
And here’s an interesting question. I have this big belief from childhood that your teachers, the character they are in your role models that you have, teachers growing up will inspire you to go down a certain route. So for example, if you have a really good history teacher and you’re like in eighth grade, you may well end up doing history at uni.

Because of that eighth grade teacher was just amazing. And so I’ve had similar moments that I wanted to, I had a great Endo teacher and so for a long time, I changed my mind from ortho entering dental school thinking I want to ortho to then endo, and then later on restorative and then now being happy as a GDP.

So do you think there was an element of that? Like did you have a great per tutors compared to perhaps Endo? Didn’t enthuse you as much as your perio ones?

[Beant]
Yes, so this is exactly sort of where it was leading to, actually. So I watched the endo, I watched some prosth, and I watched some perio. I quite liked all of it, but I think it’s as you said. So it was good for me to see the staff at the uni doing their own thing and not just on clinic, like in their zone. And it also made me realize how good it is to have a nurse. I was like, wow, this is amazing. You give you assistance. And what caught me was the Perio department at exactly as you said, I think it was the fact that when someone is so keen on something, they just love the specialty, it becomes infectious.

And that infectiousness rubbed off on me and I was like, oh, actually, I quite like this perio of business. It seems pretty good because to Birmingham, they’ve got a very intensive undergraduate perio curriculum, so you learn a lot more than just the guidelines and like the things you need for general practice.

They go way beyond that just because that’s what the uni’s like. They really enjoy it. We go, like microbiology, immunology, all the surgery, we don’t do it, but like you see the scope of it. So I was like, okay, this is a bit of me, I think, and I had a chat with one of the professors who’s a restorative consultant and I was involved with them through the student society.

They were like the staff rep and stuff. So I thought, oh, that’s like, that’s a friendly face. And I just said to them, because I knew I wanted to do perio at the time, and they’re mainly perio, and I just asked them, so what’s special? I’m thinking of maybe doing a specialty, don’t really know what, but basically what are your thoughts? I want to kind of and sort of unbiasedly, obviously they love Perio, they’re going to say Perio, but what do they think? And because he sort of knew me, he said-

[Jaz]
I think it’s good that you picked a restorative consultant who when they’re grandfathered in from that generation, assuming they’re old enough, then they kind of are on the specialist register for all of them.

[Beant]
Yep. So they were, they were a specialist register. Well, they are, I should say, on the specialist register for all three. And that’s why I thought, okay, that’s good. They’ve got like a nice view of a bit of everything. They will have to work with all the other specialties. It’s a really good umbrella one to see everything.

And they said, endo is a good one for you. I think you do well at that. They were like, what else did they say? They like oral surgery. And then of course they said perio. And then that’s where I’m like, okay, that’s cool. I was like, yeah, I think I’d like to do perio. From then it just kind of went. But in a nice way the consultants and all the departments started really helping me and it wasn’t like a oh, yeah you’re going to be special bam, bam, bam.

It was just oh, do you want to come along? I’m going to do this cool surgery come have a look and for me because I was actually enjoying it just on my days off because I don’t know how other dental schools were. But often you’d have like a half day or a day off here whenever it aligned I’d go watch some surgery or something and I was like, okay. Yeah, like this is pretty cool. I could see myself doing this.

[Jaz]
Sorry to interject, but this is a really important point that I don’t want people to miss is this is a recurring theme in a podcast where we’ve had someone who’s excelled into implants. They were as a student going in and say, let me see this being done.

Let me go on the Hypodontia Clinic, right where we’ve had people excel or have this, I guess, affinity towards orthodontics in their time. They were in the cleft clinic and they went on the Hypodontia Clinic or they were in the ortho clinics, basically, and so you have this element of being a proactive learner.

And then, the easy thing to do when you’re a student is just play FIFA and that’s it. And just not do that extra stuff. It’s a small percentage of people that do that extra stuff. Credit to you to do that. And then also it kind of like is like work experience all over again. You’re still gauging whether this is still right for you.

[Beant]
Yeah, exactly that. And, I mean, don’t get me wrong, disclaimer, I played a boatload of Call of Duty during my time at uni. But it actually made me realise, and if there’s students there, you do have a lot of time, downtime, don’t get me wrong, when exams come, that’s a different thing. But when you have those half days or day offs and you just go home, I would just sit in a clinic, and because it’s not timetabled, and the lecturers were quite, please, someone’s watching them do their thing.

If I said, quite honestly, oh, I’ve got to go, I’m meeting a friend, they’d be like, yeah, no worries. Like, thanks for coming to watch. It’s not like timetabled clinics where you have to stay. Those horrible clinicians who make you stay, like, right to the end. Well, not horrible, but they make you stay right to the end until everyone’s finished.

[Jaz]
There’s flexibility.

[Beant]
Yes, exactly.

[Jaz]
And what this creates is this environment of whereby the educators, once they get a whiff that, you know what, this person has this spark in their eye, they’re interested, they’ll give you more because they’re seeing that you’re a sponge. They’re seeing that you’re willing to absorb and you’re willing to have these conversations. As an educator myself, when I see a student like that, if you’d like, when I see someone who’s got that hunger, I love it. And I want to put on a buffet for them.

[Beant]
Yes, and that was literally what happened. So it was this, from this professor, I started watching more period at uni, so I was watching sort of some of the consultants, some of the staff grades. We even had some people who were registrars at the time doing, and I presume we’re going to maybe a bit later or whatnot, but they were doing MClinDent part time, which we can talk about, and they were working at Birmingham, so they gave me another view. And all of this coming together is like, okay, I’m seeing sort of the more hardcore, super researchy side.

I’m seeing the people who are doing. more sort of specialist stuff. And then from there, I started watching like BSP lectures. And again, I think the nice thing was there was no pressure to any of this. There’s no exam at the end of it. There’s no one testing me. It was all just my own curiosity carrying me through.

And one of the things which happened was that I don’t know if you were there was at the time, it’s called the Manchester Undergraduate Research Society, or something like that. The Manchester undergrads, they do a conference every year, and it’s designed for undergrads, and there’s a range of speakers.

One of the classes was a perio class, and it was how to use hand instruments and stuff. And I just went up to the guy who gave a talk, and I was just like, oh, hey, nice to meet you. This is who I am. And from there, he was like, hey man, like, it’s cool you’re into perio. Why don’t you come watch me in practice?

And I went down and that was another thing. So I got to see perio in practice because hospital dentistry in real life practice sometimes can be very different and it all sort of painted this picture together. I was like, okay, this is pretty cool. I quite like this. At the same time, I’m obviously doing my BDS training to become a dentist, so I was very aware, very, very aware at the same time, not to let anything else slip, because I didn’t want to, like, you could say, almost fly before you can even take your baby steps as a dentist. I wanted to make sure I understood how to do those root canals, how to do my removable prosth the things, I think. It’s fair to say most graduates struggle with-

[Jaz]
And stay grounded as you did. And I think if you go back to like, some people might be thinking, oh, this guy is too young to specialize. And you hear that sometimes, right? You might have been having those thoughts in your mind, right? Maybe someone said it to you. I don’t know. Has anyone said that to you?

[Beant]
Yeah. So that’s another thing. I’ve had a lot of people give all sorts of advice, like good. Not so good, but all well intentioned. And I’ve had periodontists say it to me. And I do agree to an extent. They say you should get your feet grounded in general dentistry, figure out what you like, don’t like, because it’s a massive commitment to limit your entire practice. And I just kept this all in mind. And what I thought was as a, well, I listened to this podcast myself. I have as a student.

And I remember in all your advice, you would say things like, and still do, get a camera, record your things, be the best you can, all that kind of stuff. So when I went into FD, I bought a camera when I could afford it. So I think it was in April time. So I’d saved up. So I’ve been working quite a few months and I bought it with the mindset of, I’m not going, because I know some people, and it depends on your situation, they’ll buy sort of not a halfway setup, but a nice setup that will do the job, but yeah, it’s not the bee’s knees, if that makes sense.

For me, I was like, nope, I just want to, it’s my personality, I just want to do it once, get it really nicely, and that’ll just last. So I got my setup exactly as you said, I would have my, I’d get in in the morning, I’d put my camera on the side, ready to go, and then my nurse, she’s great, she would always be ready.

When I wanted to take photos, she’d be there with the mirrors and I just practiced, I documented all my cases and I found that and that’s a tip I think for all FDs having just pretty much come out of FD. The photos I took, even though they’re not the best, I’m not really going to post them anywhere there for myself.

[Jaz]
I think you posted a few in the chat group, I remember.

[Beant]
I sent some privately, yes, so sort of like with the group chats, but when I say publicly, I think, I mean, I wouldn’t post someone like Instagram or something like that at the moment. More for, like, self growth, really, is the focus of them. Just asking for, like, opinions and stuff.

[Jaz]
Reflection. Getting reflection, seeing what you did well, analyzing afterwards.

[Beant]
Yeah, exactly that. And, I just found myself getting absolutely engrossed in my dentistry, really analyzing things. And I was enjoying it. And I realized how much, even with loops, you don’t see compared to the photos sometimes.

And it was really good to help me really improve. And I really took pride in that. And I also use that during my FD to make sure I felt like I’m at a good enough standard of general dentistry for where I feel I need to be. Obviously that’s hard to dictate when you have a certain FD, but I just wanted to be very solid at everything.

If something turns up, I can treat it. I don’t need too much help or, well, to be honest, any help at all, unless it’s something you wouldn’t expect a GDP to do kind of thing. And I actually became quite like the endo man in my FD year because I was in a FD practice where they had special interest endo.

And I said to myself, right, this year I still want to do perio, but I’m going to keep my eyes open because I’m still really fresh. I may fall in love with oral medicine, as in you don’t, I don’t know, kind of thing. And so my mantra in FD was right. Anything I don’t enjoy, I’m going to do more of. I don’t enjoy it because I’m probably not good at it.

And for me that was endo. I could do endo, but I wasn’t that great at them. I’d be there for quite a long time, kind of, I’d say a lot of faffing out. I feel that’s the best way to put it. I didn’t kind of move when one thing fell to the next, to the next. And anyways, my trainer, he’s like special interest endo and I remember I’d have, I’d take the PA and I’d like, make my diagnosis or whatever. And I’d show it to my trainer and be like, do you think this is endo-able? And it would literally be like a block with no canals. And I’d be like, please, please, no, please. And he’s like, yeah, you can endo that man. Of course it can.

And I’ll be like, oh no, why? But actually in all fairness, it got me really confident at molar endos by the end of the year. I wouldn’t say flying through them, but I was a lot more confident with the could do them sort of start to end with no complications. Don’t get me wrong. I’m sure if I did more endos, I’d run into complications.

It’s a massive field, but I think for sort of that GDP level of confidence, I would be very happy to extirpate, find the canals. And know what’s too difficult to refer on, kind of thing. I think I was very fortunate. And so, I really kept everything open in FD. I did a lot of pros as well, really looked like doing crown preps, and a bit old school, but three quarter crown preps as well.

[Jaz]
Good, very good.

[Beant]
So, I really tried to make the most of all this dentistry.

[Jaz]
It’s not like you were hedging your bets. You didn’t put all your eggs in one basket and then just did extra for the perio patients and then didn’t just try to avoid end endos and the crowns and stuff. You really made sure you had a well-rounded first year out of dental school experience and to get the exposure, which is really important.

[Beant]
Yeah, it’s exactly that because I thought alongside all of this, I was like, no matter what I do, none of this is ever going to harm what I’m doing. It’s all growth, it’s all learning, it’s all improvement. It’s all good stuff. And my actual goal was if I got good enough, I’d make it into portfolio which obviously I sent to you to be like, Hey Jaz, how does this look? And I wanted to show this to-

[Jaz]
What did I say at the time? I remember like opening something up, but I don’t remember the feedback I gave you. What did I say to you?

[Beant]
So I remember I asked this about a year, no, not a year ago now is it December I checked and I just said, Hi Jaz, sort of, this is my portfolio. It’s from FD. I just want to show a good standard of work that would be expected sort of at my level. What do you make of it? And you replied pretty quickly.

I’m really appreciative, actually. And you’re like, hey man, like it looks really good. Like it covers all the things I think someone at your stage should do. And like, it was very positive. So with that sort of in hand.

[Jaz]
Now, before I get inundated with 2000 portfolio checking service. My fee is 19, 995. No, what I do basically. So just so no one gets upset, right? I either reply in two minutes or two months. Okay. But if you want to get a reply on average within two hours to two days, then it’s going to be on if you DM me on the Protrusive app, on Protrusive Guidance, that’s like, if I don’t get back to you in two hours, I’ll get back to you in two days.

If you message me on Instagram, it’s got to be two minutes or two months. Okay. So best place to get me is on Protrusive Guidance. And what I would suggest is if anyone would like to share their portfolio, please come on the Protrusive Community. Just put it there, get over your fear. It’s a nice and geeky dentist who will definitely help you. So put it there and you’ll get lots of opinions and advice. And you never know, you might actually just find your next associate position just by sharing your portfolio on there.

[Beant]
Yeah, I completely agree because the chat at the time when I was, and I think it was the telegram before, it’s a really nice environment. And that’s why I felt confident to message you, because I think it’s quite a big thing to show people your work. It’s like you’re not exposing yourself, but you’re like, oh, this is how I actually do dentistry. And someone’s like, technically, because you’ve recorded it that way, microscope looking at it, aren’t they?

But I felt comfortable enough to do that. And you were very positive with it. And I was like, okay. This is good. So that made me feel a lot better. Okay. I’ve got a nice ish portfolio. Good for where I should be. And then, I know you’ve got some other questions. So we’ll probably dart around, but the aim of the portfolio was I got interviews because I’m aware I’m so young.

The question often always asked is you’re a baby. You can’t do dentistry, mate, no offense. But as in, it takes time. And I completely agree. It takes time to learn. But one thing I learned from a nurse when I was doing a DCT job was people all progress at different rates. It should be competency based, not necessarily time-based things.

People learn at different rates. And this was a Max Fax nurse who’s obviously seen regs for decades, where I’m sure like some junior regs are better than the senior regs just because they soak it up more. And I thought actually, yeah, like that’s true. People do progress at different rates. So with this portfolio, when I went to my interviews, which I’m sure we’ll get into, I showed them the portfolio and I said, hey, this is my general dentistry.

I think it’s important to kind of show you. I can do a fill in, I can do a crown, I can do an endo, like, I’m not going to be complete tunnel vision and only know how to do RSD and perio surgery, you know?

[Jaz]
That’s such a great way to do it, because when that inevitable question comes up, aren’t you too, I’m going to try and test you in this video, aren’t you too young? And then they’re like, how do you like these apples, right? Look at this standard of work I’m producing. I may be young, but I’ve been doing very concentrated, very high impact training, if you like, with a photograph, right? You’re really going all at it, building your portfolio, which not enough people do.

And I always encourage it, but to have the confidence to do it and to share it with someone is huge. Now, one thing I want to talk about is this element of time before starting specialization. Before the next segment I want to move to is we get to roast all the different specialties, which kind of like, let’s chat some crap about all the different specialties.

So it’d be a nice little fun segment basically, in terms of everyone listening to this and watching this thing. Hmm. Endo versus ortho and stuff. Let’s give our honest views and opinions. But before we get to that fun bit. I think there is no like thing whereby you’re too young or too old.

I think it’s individual for every dentist and you can make it work. And I think the benefit of doing it young is you haven’t picked up bad habits. Common one here. The other benefit is that you haven’t, like, I’m assuming beyond like, correct me if I’m assuming you haven’t got like, you’re not married with three kids and that kind of stuff. You haven’t got a mortgage, that kind of stuff. Right?

[Beant]
None of those responsibilities.

[Jaz]
Exactly. And so like, when I look back, I am like for my first five years, every single course that was available to me in like a 800 mile radius, I went on it. And like, when I look back now, I was like, oh man, now with the two kids, it’s very, very purposeful before it was like depth.

And now it’s more about quality and stuff, but it made me well rounded. It made me who I am today. And so in a similar vein, before you get a mortgage, before you joined the rat race, it’s just like an extension of your uni training and you’re doing something that you love. And so it’s easy to just continue going.

Whereas if you’re a bit older, it might be difficult to get back to exams. And the thing you mentioned about hospital training is when you experience the pace of practice, man, I tell you, that was a big reason I didn’t go back to hospital to specialize because having that pace go back slow again is very difficult to do, but you haven’t tasted too much of that. So you can’t say that. So anything you want to add on being in the stage of career you’re at before you specialize.

[Beant]
Yeah, so one thing which was really helpful was I was speaking to one of the, she’s more junior reg at Birmingham, and this person, she’s done all four, she’s done loads of stuff, basically. She’s done DCT posts, then she became a registrar, then she went off to do some masters, then she’s done a PhD, and now she’s becoming a restorative consultant. And I was talking to her about sort of, as you said, I feel like when I’m going to practice, I’m going to love it. Like, it’s such a nice way to be.

You have your nurse, you control your times, you do this, you do that. Whereas dental hospitals, when you look back, they’re actually very slow as an undergraduate because you have to wait for your clinicians, you have to wait for this, wait for that.

[Jaz]
Painfully.

[Beant]
Yes. And she said to me, one piece of advice she had for me is if you don’t get too attached to it, you’ll be okay. And what she meant by that was, and she was speaking about salary. I won’t give numbers, but you’ll have an idea of what sort of a hospital sort of bread is on compared to an associate compared to, I don’t know, a super all out, all on poor dentists. People have an idea and it’s not too much about money.

She said the thing which can get quite difficult is you do your foundation, you might do a DCT year, then you go into practice and you’re on a nice healthy salary. Some people more, some less, but it’s a really good salary, right? I said the thing that can be very difficult is when you go back into these training posts, your money goes down again.

And it can be quite difficult to readjust to that and the line which got me was she said to me, I’ve never done that. She said, I’ve always sort of taken it very slowly. So as I’ve gone from sort of DFT to DCT to like lecture to register, it’s incrementally increased. She’s like, I’m not at the same level as all my colleagues in practice are, but to me.

I’ve always seen an increase in my salary. She said, so for me, that’s great. That’s good. But she said it’d be difficult, obviously, if I went from practice earning all that money to then going back down, because then I might have worries of how do I pay my bills? How do I, my car, that kind of thing.

Whereas it’s all, I guess, living in your means whilst your salary is slowly jumping. So I kept that in mind whilst I was sort of doing my early years. Like, okay, I’m enjoying this, but I don’t want to get too comfortable. Yeah, and I took this a bit wider of, I don’t want to get too relaxed in practice because I know once I stop and I’m happy in practice, I won’t want to do a lot more intense, intense study.

So I kind of kept that mindset up of in during my foundation year and my dental core training year. I want to go back into training. Don’t get too, too relaxed. Just keep it in the back of your mind. You’re going to have to keep watching lectures and stuff again. And that’s helped me a lot, actually, I think. Well, I hope I’m not going to be shelf shocked when I start my training.

[Jaz]
I think that’s a great point you made, refinances, and how difficult it is to readjust to actually now, instead of going from a salary to no salary, and now you’re actually paying the establishment to actually train you. But when people are 10, 15, 20 years, for those who choose to have children, they’re already thinking about private school and bigger houses and cars and financing the practice. And so it was very difficult to then, because when you go back into training at that stage, you have obviously the expenditure of the fees, and we’ll get to that in a moment for the course, but then you have opportunity costs as well.

Now that you’re actually giving your time towards uni, you’re not actually making an income. So you’re actually not only dipping into your savings potentially, but then you’re also losing out the income that you would have gained.

[Beant]
Yes, very stressful times.

[Jaz]
And investment. So in a way now that you don’t know any better, if you know what I mean. You don’t even know any different in a way co you can still continue that trajectory. So on that topic of finances, before we get to roast the specialists, how much does it cost to do so? Remember guys, we’re in the UK, in the US and then that, another question I wanna ask you is, did you consider the US, we’ll get to that, but let’s talk about the UK, your program. How much is it costing you per year? And just give us a flavor of that.

[Beant]
Sure. So this is the bit where I, and I’m sure everyone else will cry. So I’m very lucky. I’m really pleased to say I’m going to the Eastman. Can’t quite believe it. And it’s a three time, three year full time master’s in clinical dentistry. Drum roll, please. Not really going to cry. The fees are 37 and a half thousand pounds a year and they’re subject to-

[Jaz]
It’s for a home student?

[Beant]
This is for a home student. I’m a home student.

[Jaz]
What? How much is it for an international student?

[Beant]
60, 000.

[Jaz]
Damn, inflation. Do you know how much it was back in I hope I’ve got my, like, facts right, right? I think back in the day when I was looking at these programs, it was about, it was either 18 or 23k at that point. Yes, so Let me know what you think.

[Beant]
So, to make myself cry, I remember looking in fourth year. And the same course cost was about 23 grand. So in the space of what, three, four years, it’s gone up by 12, 000 pounds, which is absolutely astronomical.

And then as well as that, I’m not from, I’m from the Midlands, so I don’t live in London. So I’m going to also have to bash out living in London as well. So it’s a lot of money. And I’ll be very honest. My family, cause I’m sure this is what people want to know. I’m very fortunate. My family can help me pay the tuition fees.

There’s no beating about the bush. I’m very lucky. I’m very privileged I wouldn’t be able to even try for this if I didn’t have the support of my family. And I think it’s important to be honest about that and not make people think oh my gosh, what am I doing myself? How’s this guy done this? I’d like to be very honest and the other thing I’ve done as well is during my All my employee time, FD, DCT, that salary’s all been saved.

I’ve lived at home, saved all of that. And that’s, I’m going to sort of pay for all my living costs in London as well. Because as I’m sure a lot of people know, London is not a cheap place to live. And I’m hoping to start work later on down the line in the course. So that’s sort of the headlines. It’s extremely expensive.

And that’s, I think, another reason why people tend to do it when they’re a bit older. They’ve worked in practice a few years. They’ve got the money behind them and it makes perfect sense, really, because it’s a real big barrier and it’s quite a shame, I think, actually, but that’s the headline.

[Jaz]
Did you consider, and I appreciate it, honestly, and it’s great to have this, sort of, everyone’s unique story, so that’s good to know, did you consider U. S.? Going to the U. S. to do a Perio Prosth program?

[Beant]
I did for about 30 seconds, so I did, look, all the periodontists I spoke to, who spoke to me, they said you get just because of the nature of the way the Americans practice, nothing wrong with that, nothing better or worse, just the different way they practice.

They tend to do a lot more surgery in America. If you want to be a periodontist, you are a surgeon. You want to do surgery, get the practice. I spoke to one of my professors at university. And he did the maths penny for penny. He’s quite a big name. So he’s got connections all around the world. And he worked out to be about a million pounds, great British pounds cash. It is going to cost you over the course of the duration of the fees. So, I mean-

[Jaz]
Those who are listening to Spotify, you did not see the way my mouth just opened there. So this, so the way this is calculated is basically the tuition fee plus the living fees there. So does that also take into account the lack of income that you get, or?

[Beant]
Yeah, I don’t think it was lack of income, I’ll be honest, because once he hit me with that figure, I was the same as you, my mouth just dropped open, and I knew that’s way too much. You can’t afford that, like that’s crazy money, and I didn’t really entertain it too much, but I asked him a bit, and he said, well, in university, or sorry, colleges in America, and don’t get wrong, you may get a lot of people say this is different, and it’s not the case, I just took my professor at face value, but he said.

At colleges, you may be looking at like 50 grand a year for a whole three years. And then you have to pay for your books, your textbooks, everything. It’s not sort of all included in the price. And I’ll be honest, when I just heard a million, I was just like, what? No. And I think another thing for me, which was quite important was if I was to go to America, and this is a lot of advice people gave to me, if you’re going to America, the costs are out what is set in America. In order to make that back, you’re going to want to practice in America to be able to repay off your debts, aren’t you?

Whereas for me, my friends, my family, my whole life’s here. I’d want to come back to the UK. And I thought for myself, there was no, I didn’t see any real benefit in going to America, getting over set, because in debt, along with my student debt from undergrad, just to be a sad, in debt little man for my whole life. So that was quickly written off.

[Jaz]
And I think it’s good you did your research and it’s important to share that. Now, whether those figures are higher, lower, it doesn’t matter. It’s important. Everyone does their own research. It is true that specialist training will be a lot more in the States than it is in the UK at this moment in time.

And the earning potential in the U S we know is greater and in the UK. And I think you hit that true, but you also are correct that the surgical experience you get in a perio program in the U S is significantly more in the UK. That’s something we’ll come in terms of it. How do I know that when I was doing my DCT in Sheffield, like they were talking about some of these, Indian international students coming over and also from the Middle East and they started this program in the UK and they were like, well, hang on a minute, like I’ve only done like two surgeries and it’s been like three years or whatever, right.

Or whatever. I’m just making that up. And then they’re like, my friend in Texas has done this many surgeries. And so there is that element there. And so you’ve got to consider it. So now is the point we get to roast especially. So, Beant, why did you not choose prosthodontics?

[Beant]
So prosthodontics I actually have a big love for Prosth and this isn’t me just like cushioning it before I say no one. My final year tutor was a really big on prosth. He absolutely loved it. He always he did a mfc back in, was it the 90s or early 2000s at Manchester? He learned all sorts of things. So sort of like your victoria rims your admix. That’s where I did the three quarter crown perhaps like I really enjoyed prosth but and this is where I apologize for all the prosthodontists out there.

I, because I’m doing the MClinDent route, I have to be very honest and look at finances. It’s all well and good applying for this degree and thinking I’m doing great. If I stay in debt forever, well, for me, that’s not really a fantastic life to live. And I thought about it as a general dental practitioner, and I spoke to my colleagues.

I was like, when would you refer to a prosthodontist? And it was hard to kind of answer that because from our perspective, you wouldn’t really, me and my friends, and obviously it’s a limited group, wouldn’t really refer necessarily for a crown. I love doing a crown, I’d want to do it myself, you know?

And then removable pros, again, I think it’s just because of where I was taught, I love doing it, I love getting a nice suctions here on my upper denture, or when I’ve pull those impressions out. I’m like, yeah, this is going to be a good one. There’s not a lot of things I thought I’d refer for. And the only things I could think of would like really complex restorative rehabilitation cases.

And in which instance I probably refer to a dental hospital anyways, because if I offered a patient all the options, which I would, it’d be. You can go to your NHS or you can go and pay 20 grand for a specialist and well, I know what I would do. I tried the NHS first. I think we’re very lucky to have that system in this country.

And so it became sort of a bit, well apparent to me. I think the referral base for doing prosdontics privately, maybe a bit more difficult to sell because ultimately I will be end up in practice and it’s fantastic having all this extra knowledge, but if I can’t rerate myself for the amount of investment I’m putting in, I think that’s going to be a bit sticky hole for myself.

So that’s why I didn’t choose pros it was, I think a difficult one and also I prefer perio more like the surgery, the gums, the guts, and the finesse of it. So yeah, that’s why I didn’t choose pros. It was I think like sort of a longer term outlook. It looked great sort of the offset. But for me, I just didn’t feel it could match up, you know at the end.

[Jaz]
I totally agree. But, massive respect to my prosthodontist friends, but sometimes it’s difficult to establish yourself as that referral base. And sometimes I think maybe you’re just getting all the shit. One of the jokes I make, and some of my best friends, Hodge and Ricky, they’re prosthodontists.

One of the jokes I make on courses is refer this patient who you don’t like to a prosthodontist you don’t like. So it’s like a little joke I make. So sometimes you might see in this hospital, sometimes you get all the junk. basically, right? You get the junk. And sometimes it’s not the procedure is difficult.

It’s the patient that’s difficult. And she always wants someone to refer to, but that’s not a reason not to do prosth, but the whole prosth element, right? Multiple crowns, full mouth rehabs, lots of general dentistry, full mouth rehabs, lots of general dentistry, all on fours, that kind of stuff. So nowadays, it’s like blurred lines between, okay, what do we actually need a pros for?

However, pros, I don’t think there’ll be, I think they’re very employable. However, lots of people who do an MClinDent and Prosth end up being general dentists with just like really good general dentists in practice and still doing checkups and stuff. I have seen that. So good point there. Why not endo?

[Beant]
Endo? I’ll hit you with the main one. I don’t think I could be hand filing toothpaste for the rest of my life. So I really enjoy endo actually. I think when I graduated at Birmingham, we got some good numbers actually. I have to give them credit. I did like a molar, incisor, I did a canine, I even did a re root canal of a retained root, that was a whole car crash, but I did it and it was a good experience.

But I came to like Endo a lot actually during my FD to do all this stuff, but I think it wasn’t what’s wrong with Endo. I think it’s what I preferred with perio. Perio, sort of, you’ve got the non surgical, you’ve got the surgical. If you want to go into a bit of oral medicine, you can as well. You’ve also, if you want to be a bit of a nerd, you’ve got the immunology, you’ve also got the microbiology.

It’s really broad and I didn’t quite see that sort of breadth within a specialty. I know it’s called a specialty obviously for a reason, but for endo, obviously, it’s RCTs, your main bread and butter all day, isn’t it? Whereas I feel like, for me, Perio offered a bit more. If I want to just do non surgical debridement all day, I can.

But if, hey, if I want to be doing gum surgery all day, muco gingival stuff, or implants, it’s still within my remit. So there’s a lot more out there. But I do think I would have got a bit stir crazy in practice, just only doing, like, lower and upper sixes for the rest of my life.

[Jaz]
I remember being on a train once, train journey. I was a dental student. I met a dentist on there who, you notice I was a student because I was reading understanding partial dentures. One day I’ll get there and he saw me, he said, he struck a conversation with me. He says, oh, I’m a dentist, kind of thing. Oh, nice. And he asked me about what my goals are.

I was like, you know what? At that time I had the Dr. Godfrey at dental school and he reinspired me and I was like, you know what? A quite fancy endo. And then he said to me, ah, the problem with endo is you’re specializing in something that’s about. This tall is about this tiny, basically, right?

And it made me think, but that’s not the reason I didn’t go for endo in the end. I actually think endo’s a phenomenal specialty for the following reasons. Like if you want a job as a dentist, that you don’t bring a dentistry home with you, right? Endo is a good one, right? Because when you’re a prosthodontist, like, like Ricky and Hodge, they’re constantly planning, they’re looking at cbct, they’re doing letters to their patients kind of thing.

It’s nonstop. Okay. What I do, where, whether I’m doing some Invisalign or I’m doing some a tooth wear case. I always have my clinical at home with me as well. You know, ask my wife. In perio, I think you will do as well. You’re doing implant planning, you’re thinking, you’re planning and stuff. Whereas with endo, yes, I’m sure.

I don’t want to discredit the amount of planning that goes into it, but it’s very much, you got your scope on, you’re in the game and then you can just go to the pub and not have to worry about anything, there’s a huge element of that. And it’s not something noble about saving teeth, right?

There is something noble and beautiful about saving teeth. So if you want a high income speciality that is good work life balance, maybe it is something like a noble cause of saving teeth, getting people out of pain, et cetera. I think endo, I think endo is a fantastic speciality personally.

[Beant]
I think I’d agree as well. I think it comes out, as you said, personalities, if you’re that kind of person who wants to go home. And I respect that a lot.

[Jaz]
If you’d like protocols, if you’re like very protocolized and you’re very disciplined in that sense, and you’re happy to just do one element, like a really high level, great. But like I said, if you want a breadth, then perio offers that. Why not go into, which other specialties are there? I don’t want to go into like oral med and that kind of stuff. I think the main ones I want you to talk about were Prosto and Endo as competitors. Ortho, let’s just do Ortho. Let’s just roast Ortho. Okay. Why not Ortho?

[Beant]
So, well, I think ortho is a funny one, so that, well, not funny actually. I think a lot of people get exposed to that when they do their work experience or they have braces and they’re like, yeah, this is cool, and I was the exact same. I was like, dude, this is quite cool. This is before I’d even done dent, like got into dentistry.

I was like, actually, like, you can see the way they change their smile. You see the patients regularly. It seems quite nice to see from the patient perspective, quite relaxed and quite cool and chill. It’s like, yeah, yeah, this is cool. And then, I’ll be honest, I think it’s that personalities to specialties thing.

When I have my ortho training, and in fourth year, I was like, oh, this is not for me. I mean, I can appreciate it, especially like the orthognathic level stuff. It’s extremely impressive. It’s life changing, all of this. I’ve got a very big respect for it. But I was like, no, for me, I couldn’t think of anything worse than just planning and just trying to figure out movements, over jets, overbite.

I thought, no, I just want to get in there and like do stuff. And also just less on the oral surgeon, ripping out the people, the max fax surgeon, the orthognathic surgery. I was like, ah, I think I couldn’t see myself doing it, literally sort of like visualizing my head. Could I see myself doing ortho? And I was like, no, I just don’t think I’d be happy. It just doesn’t suit my personality, to be honest. I was like, yeah, nah, I couldn’t do ortho. For me, it was just boring.

[Jaz]
I used to think that orthodontists don’t have a pulse, but then I met some really charismatic, cool orthodontists and then that changed my perspective. But there’s a famous saying, if you don’t like dentistry, become an orthodontist. Like if you don’t like the matrix bands, the blood, that kind of stuff, you want something that’s very clean, then ortho, because ortho is more the planning, it’s in your head, the actual treatment plan, it’s the thinker’s game, right?

Exactly. So maybe it does attract certain personality types more, income wise and that kind of stuff. You can’t touch it. It’s golden. Like orthodontists do very well overall. It is something that you do take home with you in a way, and it can have a downside. If you’re seeing lots of children, it’s very high paced, but overall it’s a great speciality.

Lots of thinking, think about growth and that kind of stuff, and even treating adults and the demand for straight white teeth will always be there. So orthodontist will always be employable. Just one more, my friend, oral surgery, let’s roast oral surgery, because yes, you mentioned the F word, right?

You mentioned finesse, right? And I think that’s why I think of a periodontist holding a scalpel compared to a oral surgeon holding a scalpel. That was one thing that a periodontist once told me. Is that the reason why you didn’t go oral surgery?

[Beant]
To be honest, I think it’s cause I got exposed to the perio more before the oral surgery. And I saw the way they had all that delicacy and finesse. So yeah, I love the finesse compared to oral surgery. And I quite like doing cosmetic aesthetic y things, but I wouldn’t do aesthetic bonding. For me, it’s a bit too high pressure, high states. It’s not a match for me, but I thought, Oh, like doing like gingivectomies or recession coverage grafts, like that’s a bit of me that.

And then, I quite like the principles of surgery and for oral surgery, it may be a very naive view, but it feels like when you’re in practice, you’re primarily just going, not just, but you are going to be taking out teeth. And I did a really good DCT year, just gone in Maxfax. I did a New Cross, shout out New Cross, fantastic unit.

And one of the things they said to us was it’s a numbers game with oral surgery, not in a bad way. The more you do, the better you get it. And you can whip wisdom teeth out in 10, 20 minutes. 20 minutes is long. Bang, bang, bang, bang, bang. And I kind of thought, well, this is after I’d already decided I wanted to do perio, but it kind of reconfirmed.

I, again, I like the breadth that comes with perio and oral surgery is very much, it’s like a military mission, right? We’ve got to take out this tooth, whatever costs, you’re getting it out. Do it. And I was like, yeah, it’s cool. But I think it would get a bit too routine for me. And again, it’s like endo. I think if that’s the way you would kind of.

It’s a fantastic specialty. I’ve got a lot of respect because, don’t get me wrong, half the things they take out and I’ve seen taken out and I’m like, I don’t know how you’ve done that. Like in my max fax, there was a, oh gosh, it was like a horizontally impacted, or what was it, three molar. And it was in the palate and it was, the roots were in the line of the arch or something ridiculous.

They were crossing between like the palatal side of the five and the buccal side of the four or something crazy. And they’re having to like dig in through the palatal buccal side. And I was just, I was a system. I was like, like, gosh, this is insane. Like, this is really cool. Just couldn’t be taking teeth out all day. I think I still love taking out.

[Jaz]
I think that in terms of implants and the stakeholders of implants, prosthodontics will claim that, oh, we are the stakeholders of implants. Perio very much have a strong claim for no, it should become, you know, implants should be a perio speciality. I mean, no one will ever stake a claim in that oral surgeons.

Plenty of oral surgeons that are really into their implants. So you always have that scope as well. So you’ve really got to figure out, okay, day in, day out. I think a great top tip would be, if you’re considering specializing, go into practice, observe an oral surgeon, observe an oral surgeon.

That’s both working in more of an extraction remit, but also one that’s doing implant remit. Do the same for Perio. And then you will get your answer in terms of what’s the kind of daily workflow. In terms of another way to think about it, that these different specialties is gratification. So you have some specialties that lend themselves to instant gratification, like endodontics in a way, right?

Obviously you have to wait for it to heal, but you get that thrill of the field or the post op x ray, you get that applause there. So instant gratification, endo or surgery in a way, and then the delayed gratification like perio, ’cause you could wait for their healing orthodontics is very much delayed gratification.

And so I think your personality type also may lend itself in terms of how would you like to be gratified?

[Beant]
Yeah, I think so too. ‘Cause for perio, like in my FD year, I still want to do my very perio, very sort of systematically well for the level I could do. And I would come in and I’d ask my patients all a simple question.

I’d say this sounds. And I’d phrase it like this, this sounds really stupid, but has anyone shown you how to brush your teeth? And then to sort of ease it off, I’d say I was only shown properly in my third year at uni, and I’m training to be a dentist. And then they’d all be a bit disarm. And I think is all the tips from your podcast, actually, it was where you invite the patient to allow you to sort of explain things to them.

So you get that invite, ask permission first. Yes, exactly. And the amount of patients it changed. And I’ll be like, so you should do it like this. One, two minute thing and they’d come back and they’d be so glad they’d be like my bleeding stopped to feel so much better and this would be like at the checkups later down the lines for people not with like gingivitis, not necessarily like your grade four stage C whoppers. And I really like that because I think the patients can see the long term impacts. As you said, I think it leans to my personality style, which is all the reason Perio kept confirming to me.

[Jaz]
I think Perio, I mean, I don’t want people to come away thinking that, oh, after this episode, Prosth doesn’t sound so great. I don’t want to bash any speciality, but overall, Perio, I think is a good speciality in the breadth that gives you, because we have an aging population. We’ll forever have recession. We’ll forever have gummy smiles. We need crown lengthening, both aesthetic and functional and patients who don’t respond so well to initial periotherapy, periodontist is a great specialty.

So congratulations for making that decision. I’m very excited to see your development. You’ve answered all the questions I had, and I think as a Protruserati, it’s great to see you get in. So well done. It’s so nice. And please do keep us posted on the Protrusive app. Tell us monthly check ins or every six month check ins, how are things going? What are you learning? It’d be really exciting to see your growth. And as you’ve been in London, if I’m in central London, I’ll hit you up. Go to Dishoom together and we’ll catch up.

[Beant]
No, that’d be great. Thanks. And I just want to say thanks for letting having me on. And if you don’t mind me doing one thing, one of my friends, Lucy, she’s going to be really embarrassed. She’s like, can I have a shout out? And she’s like, I was laughing. It’s like, yeah, I’ll give you one. And she’s like, no, don’t do that. I’m going to be so embarrassed if you do that. So Lucy-

[Jaz]
Surname, otherwise all the Lucy’s will be like, oh.

[Beant]
It’s Lucy Whistle. Now she’s going to be really embarrassed and kill me.

[Jaz]
Dr Whistle, thanks so much.

[Beant]
Oh, she’ll love it, but hate it at the same time. But it got me thinking of just one last thing I want to say, and it’s just a tip for everyone. Obviously, it sounds fantastic. I’ve got in and I’m really grateful, but me getting in was a complete team effort, definitely not myself.

It’s all the people I’ve met along the way. It’s the periodontist, it’s the peeper units, the people through all the posts I’ve done. They’ve all given me tips here, tips there, helped me do this, helped me do that. And I think when people look at specialist training, it’s quite daunting. The way I would look at it is look at dentistry.

When we all came to undergrad, think of like I presume like your parents may have helped you, your siblings, your teachers. You might go on like a course. I don’t know. It’s all a team effort at undergrad level. It’s the same thing here surround yourself with good people. They’ll help you out. Everyone will give good advice. And yeah, it’s a team game like I completely say that with open arms I would not have gotten in without the help from everyone along the way.

[Jaz]
Amazing. No, it’s a lovely little tip. Do not do it alone always people to ask. And if anyone wants to reach out to you, be able to be like, Hey, you know, I’m thinking about Perio. Can I get some advice? How’s the best to reach out?

[Beant]
Yeah, of course. So, I think I can give you my email address or something. They can just email me.

[Jaz]
Come on the app and they can DM you. Okay. On the app, basically. And therefore we’re not giving your email out to thousands of people and you’d be inundated. Your full time job will be replying to emails about specialty training from all over the world. So, thank you so much for sharing that. That was really valuable. I think it’s great to, it was nice to just talk about different specialties and give a perspective.

These were just our opinions, but it may help someone to decide or not decide to specialize. So, thanks so much, Beant. We’re wishing you all the best. Maybe we’ll get you back, maybe to the middle or to the end of your training to see how things are going, get a flavor of that and wishing you all the best if you ever need anything. I now live in West London. Give me a shout. We’re always here to help you, both me personally, but also as a community, we all have your back.

[Beant]
No, thank you. And I mean, same for you guys and by everyone listening as well. It’s a great community, Protrusive, very diligent, like anything I can help, more than happy to even if it’s just a, Oh, Hey, what do you think of this? Yeah, cool. So saying back out at yourself and everyone who’s listening, happy to help.

Jaz’s Outro:
Amazing. Thank you so much, buddy. There we have it, guys. Thank you so much for listening all the way to the end. This one is not eligible for CE, but there’s hundreds of hours of CE waiting for you on Protrusive Guidance.

It’s the home of the nicest and geekiest dentists in the world, and I’ve got all my like Master Classes in there and all the CPD questions for 99% of the episodes, which are eligible for CPD. I want to thank Beant once again. He’s been a Protruserati since he was a student. It’s been great to see his progress.

I’m so excited for you Beant to enter your specialist training and we’ll keep in touch, see how it’s going. We’re all rooting for you. If you know anyone who’s thinking about specializing and they’re not sure, maybe send them this episode and thanks again for always tuning into Protrusive.

I want to thank my team as always. Erika, Gian, Julia, Krissel, Mari, Rakesh, Emma, and Nav. You guys are what help drive Protrusive and help us to create the content and serve you guys. Thank you so much. I’ll catch you same time, same place next week. Bye for now.