How to apply to orthodontics in the USA as an international dentist?

As of 2021, ADEA published interesting statistics about the number of international dentists who are accepted into orthodontic programs in the US. Out of the 62 schools offering an orthodontic education, 47 admit international dental graduates without a U.S. license - even higher than AEGD.

While the number of programs accepting students is higher, the actual number of students being admitted is lower than AEGD at 129 residents, which roughly averages 3 residents per school. The one caveat you must not is that ADA assumes that not having a dental license is equivalent to not having a dental education in the U.S., but there are exceptions to that assumption. For example, applicants to SLUs orthodontic residency must have a DDS or DMD degree but don’t require licensure.

As an international dentist, your opportunities to apply to residency programs in the US, specifically in orthodontics, increase with your educational credentials.

Based on educational credentials

If you were foreign-trained during undergraduation and want to apply to an ortho program, consider earning a DDS or DMD degree first. 4 out of 5 schools that offer an orthodontic post-graduate education will consider you only if you have a DDS or DMD degree in the US.

International or foreign-trained dentists can earn a DDS or DMD degree by completing an Advanced Standing Program (an abbreviated version of the 4-year dental program American students must go through). By attending only the last two to three years of the DDS program in the US, you can earn licensure to practice and also become eligible to apply to all orthodontic residency programs.

Based on immigration status

Like most opportunities in America, orthodontic programs are too biased towards accepting students with a more permanent immigration status in the U.S. Infact; some schools explicitly call out in their criteria the need for applicants to have a permanent residency status or citizenship.

Since program cohorts are often small and in the single digits, many programs prefer avoiding the paperwork and diligence required to secure an F1 visa for potential residents. Since private practice dentists are also biased against hiring international dentists, schools can’t leverage their alumni network to secure opportunities for residents on a visa.

About half the residencies in orthodontics are hospital-based, which means you are attached to an actual hospital versus learning in a university. Hospitals need to sponsor a work visa (like an H1B) and can not take residents under a student visa (F1).

If the hospital is a non-profit institution, and most hospitals are, they can apply for a cap-exempt H1B, a work permit that isn’t limited by availability. Again, for just two new residents a year, hospitals don’t prefer going through the hassle of securing a visa, so you have a better opportunity if you have a green card (PR) or American citizenship.

Credentials

Before we take a deep-dive into all the important credentials you require to get into an orthodontic residency, here is a quick checklist that you can save to your smartphone.

Higher priority

• GPA
• Research Experience
• Eloquent Essays
• Strategic recommendations
• Academic standing
• GRE (Analytical writing)
• TOEFL (valid upto two years from matriculation date)
• Updated ECE report

Higher priority

• Community Service
• Shadowing experience
• Network

Let’s now discuss each of these credentials in a little more detail so that you keep in mind the key nuances that make them complicated.

GPA or Academic Standing

• Your dental school grade point average must be in its highest standing. Only the top 3% of dental school graduates in the U.S. apply and get accepted to orthodontics programs. Like Oral and Maxillofacial Surgery programs, orthodontics is a profession that attracts the best talent and rewards them with flourishing careers.
• Ensure your GPA is over 3.5 and as close to 4. If you have other scholarships, grants, or academic recognitions for your GPA, that will act in your favor while applying to the ortho programs. A high GPA isn’t a differentiator, but a low GPA is a bummer.

Research Experience

• As international dentists, we understand that you may not always have research experience as it isn’t a core part of foreign dental curriculums. However, research experience is super important to get into programs and especially those that offer a Master’s degree in addition to a certificate in Orthodontics.
• In terms of what research you pursue, try to do something aligned with orthodontics, is based in the U.S., and requires the rigor of publications appearing in International Journals. If you are still in your home country and don’t have opportunities to do this level of research, then at least reach out to professors or orthodontic residents in your college and assist them in their research.

Eloquent Essays

• Goes without saying that orthodontics is a profession of relationships. And most relationships begin with strong communication and sustain when promises are kept. Your essays are your first and biggest opportunity to showcase your ability to build a relationship with a stranger. It better be your best piece out there, a 2-page biography that would get you that interview call!
• You'll need to write two types of essays as part of your application. The first one is your personal statement which we recommend being 1 to 2 pages long or upto 7000 characters. The second one is your supplemental essays, which very few schools require.

Here are some quick tips on,

How to write your personal statement if you are an international dentist applying to a U.S. Dental School residency?

1. Don’t explain “why dentistry”?:By the time you apply to a residency program, you’ve probably already accumulated between five and ten years of experience in the dental industry. You are already wearing a white coat and have treated a patient. Justifying why you chose dentistry in the first place is immaterial to an admissions committee unless if your ‘origin story’ relates to orthodontics like ‘wearing a headgear.
2. Don’t recite your CV: Your resume (or curriculum vitae) is a summary of your credentials, whereas your personal statement (or SOP) is a story about fit. Your resume says WHAT you’re made of, and your essays say WHY you believe a school should accept you. Don’t take bullets from your CV and rearrange them into sentences. Instead, keep the document aligned with facts but different in narration.
3. Don’t justify backward:Some people were born to orthodontists and might have aspired to join the profession even when they were kids. Many others might have only discovered orthodontics when they joined dental school - and that’s ok. In your personal statement, don’t get too worked up about when you knew you wanted to be an orthodontist and much as why you wanted to be one. Tie how every experience in your life helped you prepare to become an orthodontist.
4. Clear short and long-term goals:A key differentiator in your personal statement is how you draft your goals. The end defines the means. While, like most residents, you may prefer to join any employer who pays you well and meets your expectations, the clarity with which you express that is important. Remember, you are competing with other applicants who were consumers, friends, and children of American orthodontists.
5. Focus on 3 pillars:Define the key themes that connect you with the profession of orthodontics and narrate stories where you’ve showcased them. As examples, you can speak about working with large teams rather than small teams, appreciating systems built on digital software rather than artistry applied directly to teeth, entrepreneurship, and referral relationship-building skills, or even inventory and supply management.

Strategic recommendations

• You must be prepared to receive at least 5 recommendation letters when you apply to a US orthodontics program. We’ve specifically called out the word “strategic” since programs don’t explicitly mention who they expect your recommenders to be. You could receive a LOR from someone who is not related to dentistry and still have it positively impact your admissions.
• Your strategy to look for recommenders must be based on (i) how well the person knows you from observation and can articulate the skills or qualities that showcase your fit for a program and (ii) how relevant the person’s job description is related to the orthodontics industry. International dentists must further consider how familiar and relatable the recommender might appear to a US-based admissions committee. A foreign dean’s recommendation may not make an impact on par with a general dentist you mentored under during your preceptorship
• The recommendations that are submitted to ortho programs are done directly on the PASS website, confidentially, without the applicant’s knowledge. The recommender is exposed to a series of prompts like “How well do you know the applicant” or “What are the applicant’s strengths and weaknesses,” and the recommender is expected to answer them with brief essays.

GRE (Especially the Analytical Writing section)

• Most orthodontic programs expect you to produce a GRE score in addition to other academic credentials. This is an exception to just orthodontics and is followed by only very few specialty programs across the country. The GRE has three sections - an analytical writing section scored out of 6, a quantitative section for 170 points, and a qualitative section for 170 points.
• To stay competitive, you’ll need to score about 150 points in each of the quant and qual sections and score above 4 in the analytical writing essay. The essay is given the most important while comparing your GRE score against the rest of the applicant pool since it closely resembles the skillset needed to articulate a treatment plan in orthodontics.

TOEFL (Test of English as a Foreign Language)

• We could argue why this is a requirement, especially with some countries already using English as its mainstream medium of education, but it is. Even for dentists who come from India, the second largest English-speaking nation in the world, appearing for the TOEFL and securing a score of 100 seems necessary. Please score higher than that because of your competition.
• Two things to keep in mind are the expiry date and priority sections. Your TOEFL score must be valid until the time you matriculate (or start) your orthodontic program. Among the different sections, your speaking and listening scores are the most important since foreign-trained dentists generally struggle at them these sections reflect your exposure to America

Updated ECE report

• Your ECE report is America’s way of interpreting your home-country dental school GPA. Here is a detailed article on how to apply for your ECE report if you are doing it for the first time. If you’ve already applied for one, make sure your orthodontic program starts before it expires in five years.

Application Timeline

Once you’ve got the right credentials documented, the next step is to start applying. We’ve compiled a sequence of events below that you can follow to apply to the orthodontic program of your choice.

1. It's important to apply early. We recommend applying as soon as the cycle starts in May. You’ll be too late if you're applying after June.
2. Decide quickly as to whether you are applying to MATCH or non-MATCH. Most programs that use the MATCH process to shortlist applicants (like UIC) ask them to sign a waiver that they haven’t applied to any programs that haven’t participated in MATCH (like Iowa).
3. Start preparing your personal statement and CV (resume), and try to have your first draft ready by March. These documents don’t just help you tick boxes on your checklist but also help inform your application strategy.
4. Start requesting your recommendation letters in May. Make sure to schedule time with your recommender for a strategy call where you walk them through your personal statement and CV and discuss the key points you’d like highlighted.
5. Arrange financials to apply to 15 to 20 programs by May. Admissions rely on quantity as much as quality for international dentists. Applying to more programs definitely improves your chances of getting interviews, and you’ll have to plan finances for that. We recommend saving up $4,000 to apply to 15 schools and fly to 7 interviews.
6. Interviews begin late in September and are completed before November. That’s a super narrow window, so make your plan to travel well in advance, allowing for flexibility in tickets and prioritizing which interviews you want to attend when there are conflicts.

Hope you find this information useful. The reason we know so much about the process is because the founder of PASS Simplified Dr. Nourah, is herself an international dentist who secured admission to the orthodontic program at UIC (University of Illinois at Chicago). If you want more information on how she applied, please watch https://youtu.be/HeJ8i0KfmGQ.