Comparison of clinical productivity of senior dental students in a dental school teaching clinic versus community externship rotations.

The aim of this study was to report on the clinical and monetary productivity of fourth-year dental students at community-based clinical sites and school-based clinics at the Harvard School of Dental Medicine (HSDM). This study included forty-seven students from the graduating classes of 2006, 2007, and 2008. These fourth-year students were required to spend twelve weeks at one of several participating community health centers throughout Massachusetts and New Hampshire. Students also treated their patient pool in the teaching practice at HSDM in the fourth year. The most common sixty American Dental Association procedure codes were compared, and variables were created by grouping them by specialty or type of service. HSDM dental students completed 8,365 procedures at an externship site during their community experience. An average of 178 procedures was completed per student, and mean revenue of $17,486 was produced. In comparison, the same students completed 3,640 procedures during an equal amount of time spent (normalized for this study) at the school teaching practice clinic, where each student completed an average of seventy-seven procedures and generated $16,802 in revenue. The results of this study show that fourth-year dental students at the community health centers, working under the supervision of adjunct faculty, completed more than double the number of procedures they did in the HSDM teaching practice clinic. However, the revenue generated was very similar at the two sites. In addition, the types of procedures performed by students at externship sites were simpler than the complex and specialized procedures performed at the HSDM clinic, which include fixed and removable prosthetics, periodontal surgery, and implantology.