Student Spotlight: Sydney Shapiro DDS/MPH’21, President of the American Student Dental Association

It’s a given that COVID-19 dramatically altered what it’s like to be a dental student today. But as we learn from Sydney Shapiro, a Class of 2021 DDS/MPH candidate at Columbia University College of Dental Medicine (CDM) and the president of the American Student Dental Association (ASDA), the pandemic also has created opportunities for progress. In this Q&A, Shapiro shares what it’s like to be a dental student at this unique time, which are her top priorities as ASDA’s president, and what the future holds.

You’re a fourth-year dental student and president of the ASDA, and we’re in the midst of a pandemic. You have a lot going on!

Life is good, all things considered. The last four months have been challenging in a way that nobody could ever have predicted. I've been in New York the whole time, and everything happening here in March and April was challenging in itself. Columbia put together an online curriculum very quickly, which was great, and my ASDA duties have kept me busy, which I’m thankful for. At the same time, I also appreciate having this extra time to spend with my family. But we are going back to school, and I’m really excited. I miss being in clinic and seeing my patients and classmates.

It seems like the road to dentistry is a labor of love for you.

It is. I was about seven or eight years old when I knew I wanted to be a dentist. I loved my orthodontist and pediatric dentist, and I wanted to be just like them. Later, I shadowed dentists to see if it was the right career for me and learn about the profession, and I knew it was perfect. I like the balance between science and art, building relationships with patients, and educating them on oral health.

How did you end up at Columbia University College of Dental Medicine?

What drew me initially were the people. The community at CDM is incredible. It’s inclusive and collaborative—which makes getting through dental school so much more enjoyable.

Your involvement in ASDA began right away and has grown over the years. What drew you to making it a bigger part of your dental school experience?

I realized that ASDA would complement my dental school experience through advocacy and the mentorship available, as well as leadership development. Through ASDA I learned a lot about dentistry that we don't necessarily learn in the clinic or classroom. I now have a deeper understanding of issues facing groups of students, and of how I and other dental students can make a difference advocating for them. Through ASDA I have had the opportunity to work with so many passionate people, at Columbia and across the country. I wanted to give back to an association that completely shaped my dental school experience. So I just kept getting more and more involved in any way that I could.

That advocacy is a big part of your role as president of ASDA, and one of the top priorities you’ve spoken about is the licensure issue. What do people need to know?

ASDA has been advocating for licensure reform for years. It’s a complicated problem that existed before the pandemic and has been exacerbated by COVID. Typically, to obtain an initial dental license, a student has to graduate from an accredited dental school and pass the national board examinations as well as a clinical patient-based examination. ASDA’s advocacy efforts have focused on the last part: We want to eliminate the use of human subjects in the clinical exam because of reliability, validity, and ethical issues.

On top of that, each state dental board decides the pathways it will accept for initial dental licensure, so there are restrictions on portability with the current initial pathway to licensure.

It seems like there’s a pressing problem at the moment with COVID-19 causing clinics to close or limit patients.

Yes. The class of 2020 needs to get licensed to start residency and their jobs, but if you can’t see patients, that’s not possible. In March, as licensing examinations were canceled in light of COVID-19, ASDA recognized the need to advocate for non-patient-based examinations and held conversations with key stakeholders.

In response to the pandemic, the American Dental Association released the Dental Licensure Objective Structured Clinical Examination a year early, and regional testing agencies expedited the release of their manikin-based clinical examinations. With these examinations available, ASDA advocated for state dental boards to accept alternative pathways to licensure.

The pandemic has catalyzed temporary and sometimes permanent licensure reform in 27 states.

You were advocating for licensure changes before COVID-19 on the basis of ethics. What are the ethical considerations for the patient-based examinations?

If a student fails a patient-based clinical examination, the patient is potentially left with a restoration that’s below a standard of care. There’s also the issue of sequencing. For example, a lesion might be saved for a clinical licensure examination rather than being treated at the appropriate time. In dentistry, our patients’ health and well-being are our top priority. When we start dental school, we repeat an oath. It says that a patient’s health is our first consideration. We abide by the ADA and ASDA Code of Ethics. I think it’s time for licensure to reflect those principles.

And the other major advocacy is around student loans. How much money do dental students owe by the time they complete their training?

For the dental school class of 2019, the average student debt was over $265,000. The cost of dental school education is a barrier to students entering the profession, and it limits postgraduate opportunities. Fewer people have the ability to go into public health or academia or to practice in dental shortage areas. It’s clear something needs to be done about student debt and the high interest rates graduate students have. Therefore, ASDA lobbies for bills at both the state and federal levels to reduce dental student debt barriers.

What does the future hold for you?

I’m going to be applying for pediatric dental residency programs.  

It sounds like you may end up inspiring some little kids, just as the dentists and orthodontists you visited inspired you. What do you think when you look back on your time at CDM?

I’m really thankful and have enjoyed the last four years tremendously. I feel super fortunate for all the support and opportunities I’ve had. And for the people I’ve met. You make the kinds of friends who will come over for holiday dinners, or show up at your clinic chair within three minutes of sending them a text that you need their help. The faculty, alumni, and administration have been supportive and accessible, too. I’m very grateful for my time at CDM.