What I Wish I Knew My First Year Out of Dental School by Dr. Tony Schicktanz

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Categories: Financial Planning and Investments; Practice Management, HR and Accounting; Practice Transitions;
What I Wish I Knew My First Year Out of Dental School 

by Dr. Tony Schicktanz

When Dentaltown asked me what I wish I’d known my first year out of dental school, a dozen things came to mind—better patient communication, clinical efficiency, or even ideal implant placement. When I really reflected on it, the most impactful lesson I’d tell my younger self is: Find your ideal job—and be relentless in your search for it.

I believe that burnout and its opposite, fulfillment, in your first years, has more to do with where you work than with anything else. Through social media, I speak with new grads daily. The contrast between the two most common avenues is stark: One doctor is producing $10,000 a day, has a growing skill set, and is planning trips to Spain. Another is working six days a week, barely making ends meet, and doubting their decision to be a dentist.

At its core, that gap is almost always explained by the associateship; the system, people, and culture surrounding the associate doctor.


The power (and risk) of that first job
Most millennial and Gen Z doctors start as associates in private practice, DSOs (corporate), or nonprofit clinics. The practice type, and more importantly, its systems, can put wind in your sails or anchors on your ankles.

I’ve seen classmates with similar hand skills and drive, but their monthly production differs by $50,000 or more in their first months of work. It’s not that one of them magically became more talented over the summer. It’s the systems and people. A team that gets new patients through the door, schedules their treatment, and makes the office feel like a home. A collections team that actually collects. Engaged assistants and hygienists backing up or reinforcing your recommendations, and a mentor who will stop what they’re doing to help you finish a case.

I’ve worked in both worlds, one office where $10k production days felt routine and another where scratching out $2k took the life out of us. Same dentist (me), same month, opposite outcomes. The difference was culture—staff, systems, and ownership—something associates usually don’t control. I’m a walking example of why choosing your environment matters. So learn from me, and the many before you, and find an associateship well aligned with who you are as a provider. Here is how I would find my ideal associateship if I were to start over again.


Your North Star associateship
Spend as much effort on your first job search as you did studying for boards.

Get specific about the associateship you want. Ask yourself these questions and write down your answers. Seriously… this is the making of your “North Star” associateship document, which we will use again later.

What kind of mentorship do you want? Clinical, business, or both. How do you want it delivered? Shadow days, weekly check-ins, CE support, calibrated case reviews, or direct clinical hand-holding (in my opinion, the most beneficial).

What procedures do you want to do? Write down what you want to do, (more importantly) what you don’t want to do, and what you want to improve. Target offices whose schedules align with your goals.

Who do you want to see? What types of patients make you feel fulfilled? Do you thrive with an underserved population, or do you prefer the most demanding cosmetic patients? Choosing the right demographic drives whether you feel like you’re flourishing or floundering.

What kind of ownership and culture do you care for? Do you want to have autonomy, along with the headache of managing staff, inventory, etc, or do you want to focus mostly on clinical work?

Once you define that ideal, chase it like your life depends on it. The wrong one becomes a pebble in your shoe, a minor nuisance at first, but over time can become grating at every step.


A field guide to vetting offers
These are the high-leverage checks so you don’t learn the hard way:

Know how you get paid and what those words really mean.
Most contracts pay on adjusted production or collections. Don’t accept “it all works out” as an answer. Ask for receipts (literally). Modern EHRs make pulling production or collection reports as simple as a click. If someone tells you, “It’s hard to figure out,” they’re either incompetent or lying to you.

If compensation is collections-based, request documentation showing collection rates and timing. Ideally, an office collects about 96% or more overall. That threshold typically makes collections and adjusted-production agreements “comparable” in most demographics.

Ask them to pull the top three CDT codes by revenue, the UCR (cash price), and the typical collected amount for each—fee-for-service vs. their top three insurers (include Delta/Medicaid/HMO if applicable). This exposes whether “30% of X” is actually 30% or a marketing scheme.

Dr. Schick’s tip: If they want to pay you based on collections, ask early in the interview process (office manager or recruiter) for the paperwork; it’s less awkward than pressing the owner or another dentist in the chairside meet-and-greet.

Define mentorship in writing.
“Mentorship” is not a vibe. Think about whether you desire clinical mentorship, business mentorship, or both. Ask about the degree of mentorship you’ll get. If you want help with specific treatments, ask if they are willing to stop what they are doing and help in your operatory… if they aren’t, you should know.

Dr. Schick’s tip: Consider learning through the Show-Try-Teach model. First, the mentor shows you the procedure while you assist, and then you try it yourself with the mentor as your assistant. Next, you complete a case all on your own, then you teach the mentor how you did it.

Pressure-test the schedule and patient flow.
A beautiful op doesn’t matter if you’re fighting to fill the schedule all day. Before signing, review the schedule for the next four weeks: new-patient counts, hygiene exams per day, and treatment plan distribution. Are treatments diagnosed by one doctor being placed on someone else’s schedule? Ask how many assistants per doctor, how many hygiene ops you will be in charge of, and the average number of doctor treatment hours per week. (Hidden bottlenecks live here.)

Dr. Schick’s tip: Watch a morning huddle. Great offices run them like a pre-flight checklist; struggling clinics skip them and “wing it.”

Make sure the patients, the procedures, and the practice autonomy line up with your lists from earlier.
If you want to focus on crowns and bridges, but every patient needs teeth extracted and dentures, this becomes a recipe for disaster. If you want to see underserved, geriatric patients, but you work in a family practice seeing parents and their kids, you’re going to dread every patient encounter. If the practice doesn’t let you choose what shade of composite it stocks, but you love looking at dental catalogs, you’re going to feel stuck and handcuffed. Although these examples are hyper-specific, the atmosphere makes the experience, and you’ll be counting down the minutes to clocking out each day rather than being present and enjoying the challenging but rewarding career that is dentistry.

Dr. Schick’s tip: Spend some time reflecting on yourself. Think about what patient population makes you feel the most rewarded. Consider the procedures that make you feel energized.


A simple search plan
Here’s my step-by-step guide to running a job search:

Step 1: Know your target
Have your “North Star” associateship document from earlier open: the mentorship you want (clinical, business, and cadence); procedures you want/don’t want/need help with; the patient population that energizes you; and the types of practices you’re open to and why. This becomes your search filter and your interview script.

Step 2: Prepare materials that actually get through the resume funnel
Associate dentists live in a world where many positions must be applied for through online job boards like Indeed or Glassdoor. These large websites leverage AI to play dental practice matchmaker of sorts and link possible resumes with job postings. Therefore, you should craft your resumes in such a way that evades automated screeners (AI) and therefore lands on human eyes. I find that simple, well-structured resumes that clearly state who you are, where you want to work, and which procedures you perform tend to work best with AI filters. Once the AI intrinsic to these websites matches you with possible job listings, it’s time to leverage your uniqueness.

Using AI is all the rage, and it has tons of amazing uses, but I have found that it is not great at creative writing or at getting your voice through. No matter how many prompts I use, I find that the best cover letters are written like a personal novel and then edited, with or without AI. Take time to think about who you are and what you stand for. Put your phone away and spend 30 minutes writing a cover letter draft nonstop. Then use AI or ask for feedback to craft a killer cover letter. Submit your personalized cover letter and resume to offices that have reached out to you personally through these large job boards, as these are actual humans at the hiring office who are now interested in you.

Step 3: Prospect like an owner
Network upstream: Reach out to specialists who get referrals from GPs in your target area and ask who runs a tight, growing practice. Local supply reps and brokers are also great sources for an honest opinion on a practice. Email owners and office managers directly with a short note that connects your goals to their patient population and systems.

Step 4: Interview the practice just as much as they interview you
Interviews aren’t passive; you should understand the practice as much as they understand you. Here are some key questions to ask: “How do you track collections versus production, and what was last quarter’s overall collections rate?” (Ask to see the report.) “What are your top three CDT codes by revenue, and what are the typical collected amounts for FFS versus major insurers, including Delta, Medicaid and HMOs?” “For a new associate, what does mentorship look like on the calendar?” “How are treatment plans scheduled—do my diagnosed procedures land on my schedule every time?” “What is the assistant-to-doctor ratio? How many hygiene ops? What’s the new-patient flow per month?” “What have your most successful past associates done in their first 90 days?”

Additionally, develop questions to determine whether the practice fits your needs. These will need to be specific to you.

Step 5: Compare offers apples-to-apples
Use the collected UCR and insurer data to model what a typical month might look like. To put rubber to the road, estimate what you are likely to produce and earn based on your clinical skill set and the procedure mix you observed on the schedule. Knowing what the office will typically charge/earn (UCR/insurer data), you can model what your months might look like from a day-to-day clinical to a financial outlook.

Estimated daily production = procedure mix × UCR/insurer data × your daily efficiency

I have created several free resources on my website, including a “Total Compensation Calculator,” to help you when comparing job offers. They are free, so please use them as you see fit. You can visit the site at theeducatedassociate.com/total-compensation-calculator.

Dr. Schick’s tip: If they quote “100% collections,” make sure that doesn’t mean “we wrote it off to square up the numbers.”

Step 6: Negotiate the operating environment, not just the number
In addition to the percentage paid, negotiate: the cadence and degree of mentorship; a CE budget linked to your goals; scheduling rules that keep your diagnosed work on your schedule; and access to performance data, including daily production, collections and claim attribution.


The bottom line for year one
Don’t settle. Hold out long enough for the environment where you’ll thrive. Ask the hard questions. Request the numbers. See the schedule. Clarify mentorship on the calendar. Evaluate patient populations with the same honesty you bring to your treatment plans.

No job will be perfect, but you can stack the deck so that even the hardest days are within a system that multiplies your effort rather than mutes it.

Your first associateship shapes your growth, your skills, confidence, and income. Find the launch pad, not a detour.

And if you’re already in a tough situation, remember you’re not alone. Sometimes, the most professional thing you can do is to leave that position and find a practice whose systems, people, and patients let you do the dentistry you trained for—and love it again.
Author Bio
Dr. Tony Schicktanz Dr. Tony Schicktanz graduated from the University of Colorado in 2021. Since that time, he has worked in private practice and DSOs. His primary focus outside the operatory is providing education to recently graduated dentists so they can find early career success. He has published one book, How to Land Your Dream Dental Associateship and owns The Educated Associate, LLC.
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