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To specialize or not?

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  • To specialize or not?

    Hey there, sorry, you guys have probably heard this question a million times. I’m a 28 year old general dentist who’s been working for 3 years now. Thankfully, I graduated with no debt and am married with no kids. Unfortunately, I’m tied down into working in a saturated state/city with high costs of living. I do not own anything at the moment. I currently make about 135k/year.

    I’ve been thinking a lot about specializing lately because I do not enjoy general dental work as much and prefer specialized work. I can live comfortably being a general dentist but I’m afraid that i’ll always have the “what if I would’ve specialized” thought in my head.

    I’m concerned about specializing potentially putting me 200k in debt and also having me lose 3 years of income. Also afraid of not having owned anything (no home) and the thought of starting a family with my wife getting pushed back a few years. Also worried that this will significantly set me back for retirement.

    The good things? More income (I could earn 30-50k/year more starting) and the ability to do procedures I enjoy more. I also think its nice to be considered an expert in a field.

    I know that the increase in income could possibly be obtained by becoming a practice owner as a general dentist also, but still afraid of having that regret of not having jumped into speciality and that i’d still be doing procedures I don’t enjoy as much. There are many general dentist practice owners who probably make more than specialists, but i’d guess that they’re very business-savvy.

    Decisions decisions.. how did you decide to specialize (or not)? How do you personally weigh the benefits/negatives? Sometimes i’m afraid that this may be an emotional decision (due to unhappiness in my current work setting) but am trying my best to analyze this from every angle.

    Thank you

  • #2
    unfortunately I don't know much about dentists and residency/fellowships, but good on you for not having debt. I hear some dentists are 1M in debt after graduating and buying/starting a practice.

    why are you tied down into working in a HCOL area? if you do pursue extra training would it be in the same area? would you be in 200k in debt and lose the potential 405k in income? would you have to take out extra loans to cover living expenses? what are your long term financial goals and how long do you want to work for?

    financially if you're aiming to retire early, extra training will set you back for sure. if you're planning on working for 20 years or more it'll pay off.

    emotionally you say you're unhappy in your current work setting. would you be happy doing general dentistry in a different work setting or area? it seems like you would enjoy being a specialist more with the different procedures, but are you assuming that or do you know you would like that more? sometimes the grass is greener but not always. if you would be happier doing the specialized work, the financial setback would be worth it with a long career ahead. better than dreading work every day.


    • #3
      Specializing can be great, or it may not. Oral Path? I wouldn't do it. Oral surgery. Easy path to young millionaire. I know endodontists in private practice making $300k, and I know endodontists in private practice making $1,300k. You'll get out what you put in. There is a ton of money in dentistry for the talented and hard working clinician. It won't come looking for you though. You have to go get it.

      Get out of the saturated location. Even if only an hour or two away to some small town or city. Family can travel to see you. You can travel to see family. You don't owe them anything. In my location, we just offered our new associate $300k guarantee, but will be surprised if he doesn't take home over $500k his first year as an associate, straight from residency.


      • #4
        The area I was thinking about was Periodontics. I say I think i’d enjoy the specialized work more because surgical procedures are my favorite and the one’s im fastest at doing.

        I’d enjoy being able to retire early but if specializing significantly puts you back for FIRE, I guess i’d bite the bullet and not specialize.

        The loss of income (lets say 360k) would happen if I specialize... but how would my citcumstance change if say, instead of being 200k in debt for specialty, I end up finding a cheaper school and say i’m only 60k in debt.

        thanks for the replies
        Last edited by Aapl; 04-27-2020, 09:20 AM.


        • #5
          Dude. You are 28 years old. Quit thinking about retirement and start thinking about building a life you want to live. If you don't like general dentistry, there is anything but a guarantee you'll like being a specialist. You also won't make $135k forever, but you need to purchase your own practice to make the numbers really work.

          Cain-Watters has the best numbers on practice owner income I've seen.


          • #6
            If you really enjoy perio and IF perio is a specialty in demand in the area you want to live and work then I think specializing makes sense. My general dentist friends tend to enjoy what they do. They tailor their practice to suit their wants and desires and they are good at running a practice and business. I think dentistry is a wonderful profession if you are an owner. I think it's an ok profession if you are an employee.


            • #7
              Dental specialist here. Make sure you specialize in an area you enjoy and not what makes the most money, obviously. As a recovering Cain Watters client, tell them I said to go to ************************. And don't buy any oil tanker parcels from them.


              • #8
                Originally posted by toofy View Post
                Dental specialist here. Make sure you specialize in an area you enjoy and not what makes the most money, obviously. As a recovering Cain Watters client, tell them I said to go to ************************. And don't buy any oil tanker parcels from them.
                Couldn't agree more. The Cain Watters numbers are inflated and fake. It's a big scheme to make you feel like you're mismanaging your practice so you hire them. Short of living in a rural town, nobody is making those numbers. Live and learn.


                • #9
                  The answer to your question is really to make the choice that leads to the most happiness. I know this is mushy but if you get up everyday and grind out work you'll never be happy. Either way you'll be fine from a money standpoint. Live well within your means and you'll be fairly stress free on the money side.

                  I've had a goal since college to be financially independent within 10-15 years of getting a real job. I'm 8 years into medical practice and think I'll hit my mark. The best part is that I don't think I'll stop working when I get there. I enjoy what I do. If you can add 5-10 years onto your career because going to work feels better then you'll be way ahead in the long run.

                  Don't put off having kids. They won't know they are poor and you'll be dead tired either way.

                  Try to be an owner in a business/group. The corporate guys are not here for anyone but stockholders. You learned enough to be a dentist. You can learn to be a business or part of a business. Just make sure to find a good mentor. I'm sure there are a few on this site.


                  • #10
                    Thanks for the replies everyone. I greatly appreciate it. The general consensus seems to be "go do what will make you happy" which is refreshing, especially in an investment forum, haha. Thinking about the lost income hits me hard, but ultimately, three years is very little in the grand scheme of things, I suppose.


                    • #11
                      You have no debt on your side which I would try to keep if I were you, especially with the near future of dentistry being a great unknown. Do not go to a program that costs you 200k because it is not worth any more than the program that costs you 60k. I paid around 90k for my 3 years of residency and it probably borders on the line of being worth it or not when you consider the lost income as well. Before you decide to specialize, make sure it is something that truly interests you more than general dentistry or you may find yourself in the same mindset in a few years.

                      Specializing for me really did enable me to do things that I loved doing and the pace at which I am able to practice is much more relaxing than general dentistry in my opinion. I really only need 2-3 surgical procedures per day to hit pretty good production. I did some GP moonlighting and I can tell you what I do as a periodontist is much more calm than running 2 columns of restorative dentistry and 2-3 hygiene exams an hour.