Most orthodontic residencies place emphasis on the clinical and scientific aspects of orthodontics. The purpose of this study is to assess the effectiveness of practice management training during residency from the alumni's perspective, comparing four programs in California to USC where a year-long, 88-hour structured Practice Management Program has been implemented since 1994.

A 3-page survey was mailed to 251 orthodontists who graduated from LLU, UCLA, UCSF, UOP, and USC between 1995 and 2005. It consisted of questions regarding their practice demographics and finances, perceived initial and current competency levels in practice management, and educational experiences. Data from the returned surveys (n=110; response rate of 44%) was compiled and analyzed.

All the respondents combined averaged low to medium on initial competency level in practice management upon graduation, would like to have received moderately to significantly more additional practice management training during residency, and indicated medium to high current competency level. The USC alumni rated their initial competency level in practice management higher (16 out of 18 categories, 6 statistically significant) and desired less additional training during residency (17 out of 18 categories, 2 statistically significant) when compared to the alumni from the other four schools. However, there was no significant difference on the perceived current competency levels. Personal experience over time, continuing education courses, and professional meetings were the most valuable resources in improving most respondents’ practice management skills.

There is a widespread deficiency in practice management training during orthodontic residencies, especially in the areas of financial preparation and staff management. The USC Practice Management Program was perceived to be effective in better preparing the residents for practice upon graduation and may be used as a template by other residency programs to implement such changes.