Observership in Manhattan New York

It is becoming more and more popular amongst dental students throughout the country to seek short-term experience in a foreign Dental School as a means of broadening their experience and horizons. This is the account of one such experience.

Before embarking on their final year of Dental School, many UK students seek to pursue international experience during their summer holidays, usually community work in the form of an elective. Students are exposed to an entirely different world of both dentistry and society, with circumstances varying greatly all across the globe.

For myself, I was fortunate enough to organise a monthlong observership in Manhattan, New York, shadowing Dr Gerald Curatola at his illustrious clinic, based in one of the most affluent avenues of the city.

It was clear from the first day I arrived at the office of ‘Rejuvenation Dentistry’ that Dr Curatola, more colloquially referred to by his clientele as “Dr Gerry” or “Dr C”, has made great contributions to American aesthetic and restorative dentistry. The clinic is decorated with accolades and testimonials from academics and celebrities alike, the practitioner taking especially great pride in the latter, advertising himself to New York as “the dentist to the stars”.

Staying true to these promising commendations, the practice is outfitted with an incredible range of state-ofthe- art equipment and technology, including solid state digital radiography, an on-site laboratory with CAD/ CAM milling capabilities and an erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) dental laser, Curatola’s latest addition to his armamentarium. As a British dental undergraduate, these advanced facilities were quite a sight to behold, providing some insight into the huge appreciation Americans have for their cosmetic dental needs.

Throughout my observation period, I was exposed to a myriad of procedures and techniques not yet known to me, as well as some advanced operative knowledge that had only been touched upon in my years of university study thus far, namely restorative implant placement, assessment and maintenance. I was especially curious to observe laser therapy cases, having sought some independent reading of my own for the writing of a university paper last year.

Contrary to popular British opinion, Dr Curatola’s multi-purpose dental laser is not merely a peripheral device. Periodontal therapy, tooth preparation and even minor oral surgery were all effortlessly carried out during my placement, amongst an exhaustive list of other procedures. I was introduced to a novel concept termed “biomodulation”, a process stimulated by laser therapy to encourage healthier post-operative soft and hard tissue regeneration and repair. Following the concept closely, Dr Curatola presented me with some serial radiographs monitoring the process taken from his own patients, which showed some promising results.

My placement did not entirely just take place in the clinic. Holding an academic teaching post at New York University (NYU), Dr Curatola was kind enough to schedule some meetings for me to meet with the admissions staff for the Doctor of Dental Surgery (DDS) conversion programme, as well as various specialised international programmes. I appreciated this immensely and as I would eventually like to work in America, I was very curious as to the requirements for such an endeavour in the future. Although I was only in attendance for the final week of term (before the students were to break up for a mere two week holiday!), I was able to chat with many of the current students and tutors, gaining some perspective into the syllabus and teaching methods currently employed in American dental schools.

Similar to the UK, there appears to have been huge efforts made to mould the modern U.S. dentist to adopt a conservative mindset with each and every patient, which I found to be an encouraging revelation, given America’s privatised healthcare system. However, in contrast to British dental school ‘Evidence Based Learning’ (EBL) techniques, the approach to tuition at NYU also appeared comparatively didactic in design, establishing a well-structured and objective syllabus, but with less emphasis on independent learning and development.

In addition to the conversion course, the international programmes I was also invited to observe were very informative and thorough. They gave dental professionals qualified in their home country an opportunity to study new operative skills abroad, as well as earn a postgraduate qualification from a highly prestigious and internationally renowned institute.

I did however take note that financing enrolment would be a huge determining factor, as aspiring dentists would need to be prepared to part with an estimated $80,000 (£52,000) per year of study in tuition fees alone!

In summary, although the placement I had undertaken this year was strictly observational, and very different from the organised electives many of my peers experienced, I would say the insight and knowledge I have acquired, as well as the network of great and influential people I have met, has more than compensated for the absence of practical, hands on experience. I would greatly encourage future undergraduates to seek and plan an independent international observership if the opportunity presents itself.
Joseph Gray

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