Why I went back for a GPR

I was recently inducted as a Fellow in the American College of Dentists. At the annual ceremony, held in Houston, standing next to people who have 15, 20 or 30 years of work experience after dental school, I felt a little out of place. After all, at the time, I was only 4 years into practice.

A colleague standing in front of me asked, ‘hey, so what do you do? Where is your practice?’ I nervously said, ‘I’m doing a residency program in Oakland, CA. A GPR actually.’ ‘Wow, okay!! If I may ask, why did you go back for a GPR (General Practice Residency)? Didn’t you graduate in 2018?’ This was not the first time I had been asked this question. I also knew it is certainly not the last time. 

Life in private practice

I practiced for 3 years in Seattle and 1 year in San Francisco before going back to school for a GPR. In those first three years, I struggled to find a boss who would also be my clinical mentor. I thought I’d come close to finding one, however the relationship soured when I left the practice abruptly due to a medical emergency.

When my family moved to the Bay Area, I found, what I still believe to be the perfect associateship. I was busier than I could imagine. We were the only GP practice in town, with an excellent reputation because of the owner dentist. The staff was supportive, kind and took good care of me. Everyone was respectful, even our patients! I thought to myself, an associateship cannot get better than this.

However, I was also getting bored. I was doing general dentistry day in and out. Cutting crowns and bridges, restoring implants, and going over new patient exams. To mix things up, I started teaching one day a week at a local dental school. Although I enjoyed my time teaching eager and innocent dental students, I started to worry. ‘Is this it?’

Even if you’re drawing a great income, and giving back to the community, you can’t hide the sinking feeling in your heart. I realized, if I was not feeling professionally fulfilled, there’s just no faking it.

Following your passion

Photo by Clark Tibbs on Unsplash

The LEND (Leadership and Education in Neurodevelopmental Disabilities) program I had completed in 2021, while still in Seattle, kept coming back to me at this time. To be honest, it was also haunting me! I had a LEND sticker on my fridge reminding me of my commitment to work with patients with special health care needs. At the time, I wasn’t seeing any of those patients in private practice. Statistically, most patients with special health care needs end up in the Medi-Cal system and are cared for at FQHC’s (Federally Qualified Health Centers) or dental schools. I also realized that while I was emotionally ready to care for this patient population, I was not clinically ready. Does dental school prepare us well in this regard? Having just a few weeks of rotation at a special care clinic while in school is not enough.

This was what led me to a GPR after four years of practice. And one quarter in, I know it was the right thing to do. During my residency, I’ve been able to meet mentors and advocates for public health dentistry who inspire and motivate me to become a better dental professional. There is a huge degree of burnout when seeing patients in the Medi-Cal system. The sheer volume of patients, the energy many patients bring into the office, of frustration and disillusionment with our public health system, can get to the providers too. Which is why it surprises me to meet educators and experienced clinicians who come to work daily with a big smile on their face and remain compassionate with every patient. I am being taught by people who are truly making a difference in their communities and are proud to be doing so.

Why a GPR

The biggest thing I’m learning during this year is working with patients who are medically compromised. I am slowly becoming confident in my abilities when it comes to caring for them in a private office setting. The most important reminder I have had during this time is being a tireless advocate for your patient and community.  

If you haven’t considered doing a GPR after your dental school, let this article be a gentle reminder that its worth a thought. Especially to those of you who are internationally trained, and exhausted with the additional education to prove yourself worthy of a dental license in America. When in the right residency program, you will not regret it. Remember that after all, it’s just a year long, it will be over before you know it, and you will be left with an excellent understanding of your capabilities. And just maybe discover a passion for something else other than bread and butter dentistry.

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