So, you’ve made the decision that you want to pursue OMFS. You may be the dental student that has no idea what the specialty entails or the student that scored a 99 on the CBSE and authored ten papers. Either way, an externship is a valuable experience and a must on your application. Basically, an externship is advanced, hands-on shadowing. Your time will be spent following residents and attendings around during their day-to-day activities. Depending on where you extern, you may assist in the OR, perform extractions in the dental clinic, suture someone’s face up in the emergency department at 3 a.m, or all of the above. Overall, it exposes you to a broader scope of the practice other than extractions and implants, gives you a taste of what resident life is like, and it lays the foundation for skills and knowledge to transition into a residency. Included in this guide are many things to consider ranging from applying to externships to preparation materials to leaving on a good note, and everything between.
How to Choose and Apply to Externships
Before you apply to an externship, you should have a good reason for externing there. What I mean by this is that you should not just randomly choose a program. If you don’t have a good reason for spending time at that specific program, then you are wasting your time and the program’s time. So, determine what you want from your externship. Are you interested in trauma? Do you want a program that is going to challenge you? Is the program in a specific location? Be able to answer this, because more than likely you will be asked. Also, it is highly recommended that you spend some time at your home program first. This allows you to receive some training and get some experience before heading out into the wild. Even if you really want to match at your home program, and don’t want to look bad, they will understand that it is your first time. You can always come back after spending time at other programs and show improvement then. Home programs are also an excellent way to see if OMFS is right for you. There is no need to spend money and time to extern at another program if you are not 100% sure you want to apply to OMFS. If you are having a hard time choosing somewhere to extern, you can always ask the residents or your faculty. More than likely, they will be able to give you some direction.
Other important things to consider when choosing where to extern, are how long to extern, how many externships to do, and whether or not to extern at programs you are strongly considering. Most externships require between 2-4 weeks for their externs. A lot of places will make exceptions, but be careful. If you only do one week at one program and make time to do two weeks at another, they could take that as you not being interested in them. Again, have a reason for everything you do. Personally, I think two weeks is a good sweet spot between getting to know everyone, and not being annoying. Four weeks is quite a long time and could either show that you are dedicated, or be around long enough for the residents and attendings to be tired of you. It is a tricky game to play, so make sure you are being wise in your decisions. This is subjective, and there are many people out there who will recommend doing the maximum time a program will allow. To each their own. Additionally, it is recommended that you do enough externships to see a variety of programs and procedures. Because time is usually at a premium once clinic starts, three to four externships seem to be what most people can manage. A lot of this depends on your school policies and how many breaks you have as there are some applicants out there that have been able to go to 7+ externships. Another thing to consider is whether or not to extern at a place you are highly interested in matching. Externing is a double-edged sword. I agree with most, that you should definitely extern at a program you would like to attend. It allows you to meet the residents and faculty and for them to become familiar with you. It also shows that you have taken the time to see their program. On the other hand, if you are inexperienced, or don’t have the best social skills, 2-3 weeks at a program could be disastrous. It would be better to put on your best face for a couple of days during interviews than bomb during an externship.
Once you have decided on where to apply, make sure that you get the paperwork in quickly and in an organized manner. Many programs only take two externs at a time, so if you are considering a program that is highly sought after it would be in your best interest to apply early. When I say early, I mean 6 months ahead of time at a minimum. Often not realized is the fact that there can be quite a bit of paperwork associated with applying to an externship. Depending on the program, this could consist of background checks, an up-to-date CV, and several letters of recommendation (one usually being the chairman or program director). As an example, here is a screenshot of the requirements necessary to apply for an externship at LSU New Orleans.
Make sure to check the program’s website and check with the person who handles the applications. Many times the website can be out of date and it’s a good opportunity to start a relationship with someone in the program. If you have faculty that takes their time writing LORs, then take that into consideration in your application process. Additionally, make sure your CV is well constructed. A great resource is UCSF’s Office of Career and Professional Development website. There you can find sample CVs, personal statements, etc all written specifically for OMFS applications. Overall, realize your application will probably be the first contact you have with the program and a chance to make a first impression, no matter how small that may be.
How to Choose and Apply to Externships
In an effort to not make this guide unbearably long, I’m going to be very to the point in this section. Most externs know that there are certain things you should know or have on an externship. Actually knowing these things and having these materials is what separates an excellent extern from a poor one. Obviously, this section could go on and on with things you should know, but that’s a game with no end. If you do want to play that game, just memorize OMFS Secrets, but good luck with that.
Things you should know:
- Head and neck anatomy (include leg and arm anatomy for flaps if it’s a cancer heavy program)
- Basics of core OMFS procedures
- How to write a prescription
- Suturing basics
- How to write a basic H&P
Things you may not know, but could make you look good:
- Know how to read “fishbone” labs
- Common drugs IV/PO
- Complete cranial nerve exam
- Arch bars
Most of the above information can be found here.
Read the 101 Suturing: Extern Edition to get up to speed on suturing
Materials and equipment:
- Maxwell’s Quick Medical Reference
- Small, spiral reference book with lab values, etc. Cheap and no reason to not buy one right now. Seriously, it’s $5 on Amazon prime people (which is 50% off for students; take advantage of it).
- Pen light
- Any small, bright pen light will do. I have this one and it seems to work well without breaking the bank.
- If you want a light with sharp borders, this one works too.
- Watch
- Choose something that is easily cleaned and that you don’t mind getting scratched. Timex has an expedition line that is cheap and reliable. Also, don’t be the extern walking around with a Rolex.
- Good pens
- Self-explainable. Just get these.
- ID badge holder
- I like this one because I can put my I.D. in it and a credit card for coffee, etc purchases.
- OMFS Secrets
- The essential guide to OMFS. Either know, or have a basic understanding of as much material in here as possible.
- Small notebook
- Literally, anything that is easy to carry and you can write on. There is a small section for notes in Maxwell’s, but that will easily fill up. I recommend Fieldnotes because it’s relatively high quality, small, and you can get them in different formats. Amazon also has an endless selection of small notepads and notebooks.
- Proper attire and scrubs (ask the program beforehand what color/type)
- Miscellaneous supplies available in hospital
- Tongue depressors (used for exams)
- Paper measuring tape (can use back of Maxwell’s instead)
- Medical swabs (long q-tips; variety of different uses)
If anyone has any good suggestions or something important I left out, please let me know or comment below.
Externship Etiquette
This section can be summed up with two statements. The first is, “be professional.” Hopefully, as a dental student, you already know what this means. Be respectful to residents, faculty, fellow externs, and, most importantly, patients. Talking poorly about someone will rarely get you ahead so just don’t do it. Make sure to pay extra attention when faculty are speaking, and do your best to stay off of your phone. If you don’t know something, admit to not knowing it. Make sure you know it next time. So many things like these are common sense, yet time and time again people find ways to screw these easy things up. This leads to the second statement of, “keep your eyes open and your mouth shut.” There is an appropriate time to talk or be a part of a conversation and usually that time is only when you are addressed. Be honest with yourself. You are probably a third or fourth-year dental student. In other words, you know nothing. Imagine if a pre-dent student was talking about the pros and cons of a zirconia crown while you were doing a DO prep on #15. Now imagine how much worse it sounds to be asking an attending almost anything while they are resecting a mandible. As an extern, your job is to shut up and learn. Absorb every little scrap of information you can so that you might make yourself a little useful. Remember, the attendings and residents do this every day without you. If you can be present and not make their job any harder than it already is, then you are doing a good job. At the end of your externship, make sure to leave on a good note. Thank the faculty and residents in person for hosting you and send thank you letters to at least the chairman and the program director. Ideally, they’ll remember who you are, and welcome you back on interview day as someone they would like to see as a resident.