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Two worlds, one profession

Preceptorships 2012

Dr. Larry Herwig ’84, and Roland Miguel, D4, at Herwig’s Dallas practice

 Media Resources/Steven Doll

From Dallas private practices filled with toy trains to West Texas community clinics where chickens strut by at lunchtime, preceptorships offer firsthand look at practice options

Over a buffet of steaming green beans, salad and meatloaf, dental students and preceptors catch up as they dish their entrees. The ballroom buzzes with conversation on this particular Friday in January, where D4s have gathered at the Adolphus Hotel in Dallas to meet with their preceptors. It’s been several months since students worked with the practicing dentists — many of them Texas A&M Health Science Center Baylor College of Dentistry alumni.

In the summer before their fourth year, the students got the opportunity to shadow practicing dentists, perform supervised work with patients and gain exposure to the profession beyond the college’s four walls.

The Preceptor Program — fully funded by the Department of Public Health Sciences and the Office of the Dean since the 1980s — lets up-and-coming graduates see what the outside world of dentistry is all about. The opportunity to observe different practices helps students think about career paths, and the variety of preceptorships offers another invaluable benefit: exposure to the differences between private practice and public health dentistry.

El Paso


“We were allowed to do fillings, extractions and emergency office visit exams.”

—D4 Alissa Nguyen


At the Preceptor Luncheon in January, it’s easy to tell which students have shared the experience of working at Centro de Salud Familiar La Fe, a network of nonprofit medical and dental clinics in El Paso, Texas. The students are clustered together in groups of three or four, and when all 12 of them pose together for photos, it looks like a reunion.

As Dr. Rene Rosas, dental director at the La Fe clinics — and an El Paso institution in his own right — enters the room, there’s a stir of activity. Students get up to greet him and his wife amid flashes of digital cameras and iPhones.

Even Dr. Quyen Nguyen, a staff dentist from the La Fe clinics, is there. As preceptorship coordinator, she makes sure students spend time at four of the community-based clinics, so they get a feel for the differences between urban and rural settings.

“For example, at the San Elizario Clinic, if you sat outside at lunchtime, you could have chickens walk past,” Nguyen says.

Inside the clinic’s walls, the pace of patient care is brisk; a highlight for students.

Preceptorships 2012

FROM LEFT TO RIGHT: D4 Laura Dinh; Dr. Quyen Nguyen, staff dentist and preceptorship
coordinator at the La Fe Clinics in El Paso, Texas; and D4
Alissa Nguyen.

 Photo courtesy Alissa Nguyen

“The feedback we get from students is that they do a lot of procedures,” Nguyen says. “At some of the other preceptorships the students are limited. We let them work independently and don’t hover over them. We say, ‘Let me see the patient when you start and when you finish.’”

Of course, the dentists are on hand to talk students through issues or answer their questions. Students appreciate the plentiful hands-on experiences.

“We were allowed to do fillings, extractions and emergency office visit exams,” says D4 Alissa Nguyen, who treated approximately six patients a day. By comparison, the staff dentists see an average of 20 patients, making for a steady workday.

Dallas


“We let the students see what works and what doesn’t work for them.”

—Dr. Jon Williamson


The scene in preceptor Dr. Jon Williamson’s Cedar Hill, Texas, office could be described as many things. Mainstream isn’t one of them. Especially when you consider the 200 feet of toy train track running through the space, mixed with air hockey tables for the kids and the low hum of music in the background.

“They come here and have a blast,” Williamson says of his young patients. “Parents say, ‘My child wants to go to the dentist.’ That’s OK, they come here to have fun.”

The surroundings may have something to do with it.

“It doesn’t look like a specific dental practice,” says Williamson, a 1988 alumnus. “Some people say it looks like a home. I don’t have itty bitty rooms,” he adds. “So I can look from one chair to another; I can see all three from where I’m sitting.”

He shows students these aspects of his practice to stress that they can develop their careers as they see fit. It’s one benefit of a private practice preceptorship.

“By bringing them into the general practices in the Texas area, they can see different examples of practices,” says Williamson. “We let the students see what works and what doesn’t work for them.”

At 1984 alumnus Dr. Larry Herwig’s Dallas practice, dental students also get their hands on the latest technology, like the iTero digital impression system and MagnaVu scope.

“It’s technology you don’t get to see in school, but that you’ll be competing with when you get out,” says Herwig. “That’s what I love getting to show the students, what they have to look forward to when they get out."

Alissa Nguyen, who also did a private practice preceptorship with Dallas-based Dr. Diep Truong, says the experience taught her more about the ins and outs of running a dental office.

“With Dr. Truong, I was able to talk to her about the challenges as a female dentist and what it takes to set up a successful practice,” she says.

Contrasts in care


“When we go into private practice, we typically see one type of patient.
You don’t usually see patients at the poverty level.
Here, you see a lot of dental pathology or trauma that you normally wouldn’t.”

—Dr. Quyen Nguyen


Even though preceptorships aren’t required, Alissa Nguyen notes the benefits of having exposure to both private practice and public clinic settings. She should know, considering she’s participated in several community-based preceptorships, including a week at the Hope Clinic in Cleburne, Texas, and at Medical Care Mission in Abilene.

“At the private practice preceptorship, I was only allowed to observe,” she says. “In short, I learned the business side of dentistry when I shadowed Dr. Truong. “Whereas at the El Paso and Cleburne preceptorships, I was able to do hands-on dentistry. I was able to improve on my hand skills and speed, get familiar with different types of equipment, and learn how to work in a limited dental setting, performing therapeutic dentistry.”

Halfway into his preceptorship at Herwig’s office, D4 Roland Miguel notes the stark differences between the procedures performed at public clinics versus private practices.

“We did a lot of extractions and amalgam fillings,” Miguel says of his May visit with Dr. Gordon Whitehead at the St. George Family Dental Plan Clinic in Utah. “We were doing some patchwork procedures. You can’t always use the materials you want but what you’re given. It’s about doing what you can with limited resources,” he says, noting the strong emphasis placed on providing great oral health care to patients with what was available.

“Here, we wouldn’t do an amalgam crown,” he says of Herwig’s practice. “We’re doing a lot of advanced procedures. It’s been insightful.”

Even though Williamson’s preceptor experience is within a private practice setting, he invites all of his students to volunteer with him at weekend events for Texas Mission of Mercy, an initiative of the Texas Dental Association Smiles Foundation, which provides charitable dental services across the state.

The volunteer work has lent Williamson perspective on the world outside his dental practice.

“It’s more focused instead of comprehensive,” he says of public oral health care. “In your own practice, you may see patients today, and you may see them three days from now, so you can divide up the work there and do longer care. But with public care, you have 30 to 45 minutes, and that’s it.”

Back in El Paso, Dr. Quyen Nguyen offers her take on the importance of exposing students to public care settings.

“When we go into private practice, we typically see one type of patient,” she says. “You don’t usually see patients at the poverty level. Here, you see a lot of dental pathology or trauma that you normally wouldn’t.

“That’s important to know how to handle. It’s important to be exposed to different environments in the dental field.”



Preceptorships 2012

Herwig and Miguel review an image taken with an iTero digital impression system at Herwig’s office. Miguel, who also
completed a preceptorship with Dr. Gordon Whitehead at the St. George Family Dental Plan Clinic in Utah, says he is leaning
toward private practice, but offers his take on one benefit of a public care setting.

“There are some pros to public health. You don’t have to worry about salary and overhead as much,” Miguel says.
“You have to think about that aspect more with private practice."

Media Resources/Steven Doll