Bill Klaproth (Host): This is an AAOMS On the Go podcast. I'm Bill Klaproth, and we're joined today by three oral and maxillofacial surgeons at varying stages of their careers. We have Dr. Hana Lim, a fourth-year resident at Howard University Hospital in Washington, D. C. We also have Dr. Flora Sarmiento, a recent graduate of the Howard program, who is in her first year of practice in Florida, and Dr. Raj Thakar, an OMS based in Katy, Texas. Dr. Thakar is in his fifth year of practice. I want to thank all of you for joining me today.

Hana Lim, DMD: Thank you so much for having us.

Flora Sarmiento, DMD: Thank you for the invite. 

Raj Thaker, DMD, FACS: Yeah, definitely a pleasure to be on here.

Host: Yeah, absolutely. Great to talk with you all. So, I understand all of you have been involved in AAOMS advocacy efforts and attended the AAOMS Day on the Hill. So, can each of you share your first experience with advocacy and what motivated you to get involved? Dr. Lim, let's start with you.

Hana Lim, DMD: Sure. So, my first experience with advocacy was during my second year of dental school. I think that was back in like 2017, but I was the ASDA vice president of our chapter and I had the opportunity to attend Lobby Day, which was in Washington, D. C. And that particular year was special because it was the first time that both the, both ASDA, so the Student Dental Association, as well as the ADA had a combined joint dentist and student lobby day.

That was incredible. There was over a thousand, I think, students, dental students and dentists that all gathered together, we were all there lobbying together with that common purpose of advocating for our patients as well as our profession. So ever since then, I've gone to every lobby day after that, and then since starting residency, I've also participated on, in an AAOMS Day on the Hill every year so far.

Host: Yeah, it sounds like it's made an impact on you. That's wonderful. And Dr. Sarmiento, how about you? 

Flora Sarmiento, DMD: Similar to Dr. Lim, I was able to attend Day on the Hill. This was my first year of dental school and it was through ASDA as well. One of the leaders that went with fellow dental students was an oral surgeon actually and he was very inspiring and, earlier on, I was able to see how important organized dentistry is and how important it is for us to advocate for our profession. 

Host: Absolutely. 

Flora Sarmiento, DMD: Good examples of that.

Host: Yeah, yeah, absolutely. And Dr. Thakar, how about you?

Raj Thaker, DMD, FACS: Yeah, you know, my first experience actually in any type of advocacy efforts was actually with AAOMS. I was a program liaison for my residency program. And I just kind of got connected with OMSPAC. And I've always wanted to kind of, get involved in like lobbying efforts. I knew that they did that when I was in dental school, but never really realized how that would have an impact on the specialty side. And ever since then, I've been kind of going every so often before my military service and after my military service. And it’s been awesome.

Host: Yeah, so I'm wondering if each of you can share a particularly memorable experience from your Day on the Hill. Dr. Lim, let's start with you.

Hana Lim, DMD: Sure, so my first Day n the Hill, which was in 2022, that was when the Resident Education Deferred Interest Act – REDI Act – that was first introduced to the Senate maybe like a month prior. And so that was one of the bills that were to be discussed during our current congressional meetings. And for those who may not know what the REDI Act is, it's essentially deferring your student loansand during that time you have no interest accruing. And that's while you complete your residency. And this applies to both medical and dental residencies. And so, having half a million dollars in post graduate student loan debt, this was something I was very passionate about. So during our congressional meetings, I talked about my student loan debt and also how much interest that I had accrued since graduating.

Luckily because of COVID, our interest was deferred for a little bit so that helped but when I told them my debt, the amount of interest that has accrued, everyone was shocked including some of the older oral surgeons as well. So being able to share my personal story and feeling so strongly about it, that was very memorable for me and hopefully for those that participated as well.

Host: Yeah, what an experience. Wow. Being able to testify like that, it's interesting how you say some of the older OMSs were like, how much are you in debt? It wasn't like that when went to school. 

Host: Right!

Host: Oh my goodness. Wow, that's a great story. Well, thank you for sharing that. And Dr. Sarmiento, how about you? Is there a particularly memorable experience from your Day On the Hill?

Flora Sarmiento, DMD: Absolutely. I've also remained you know, resolute to make time to participate in advocacy efforts especially as a resident. It could get very busy and hectic with the busy schedule they throw at us, but one of my memorable experiences was that my program director was one of the leading, he has a seat at the table with OMSPAC and he's very involved in AAOMS.

So, at the time, our program director not only encouraged us to share our personal stories, but made time for us to go to the Day on the Hill. And it's very difficult, but we had to plan it out and we had to really coordinate with the other residents to stay behind. But again, just emphasizing how important it is to for everyone to get involved and having that support from the program director himself really encouraged us all to participate.

So half of my residency program was able to go and, we left half of them behind, but again, because, for a better outcome, just so that we can participate. 

Host: Yeah. It's good that you were able to experience that. And Dr. Thaker, how about you?

Raj Thaker, DMD, FACS: Yeah, actually. So it was kind of a weird story. I was in residency and you know, I've always believed a lot in just getting involved and being engaged in whatever type of community that we're in. And one of my attend… actually two of my attendings, Dr. Patricia Miller and Dr. David Greenman; we were actually talking about some of the things that they were involved in and be it medical mission trips and community service and civic engagement.

And actually they're the ones that really inspired me to kind of get involved with ROAAOMS and then of course eventually OMSPAC. And I think that actually the best memory was the fact that my first ever Day on the Hill, I actually physically got to meet my representative, Representative Gerald Nadler, and actually got to sit down with him personally.

There wasn't any other attendings there. There wasn't anyone there. I actually had, created all of my own appointments with everyone and to be able to actually meet my representative was pretty awesome, right? Because doing that actually gave him like a one-to-one touch with his constituents. And then it was yeah, and so that's actually probably one of the best memories I've ever had overall.

Host: Yeah, that's pretty cool. You got to sit with your own congressperson there uh, meet with him. Wow, that is What an experience I'm sure that was.

Raj Thaker, DMD, FACS: Yeah, and it was even more amazing because usually, you know we'll find out that so many of these congressional legislators have like a large administrative staff and that's usually many times who we're connecting with, which is a healthcare aid on those administrative staff. So being able to physically talk to him and then actually talk to him about things that are important, why they're important and just also just like the future of the country, like other things not even related to oral surgery was pretty amazing. 

Host: Hmm. Yeah, that, would be really cool to be in the halls of Congress and actually seeing our government at work. That is definitely pretty cool. Okay. One more time around the room, if I could. So I know that you have each participated in these advocacy initiatives like Day on the Hill. So I'd like to know how has it impacted your career or your professional growth? Dr. Lim, let's start with you. 

Hana Lim, DMD: Sure. So it's easy to not care about matters that may not have a direct impact on you. And being in these advocacy initiatives, it showed me that even if it may not directly impact me now, there may be some sort of correlation later. There, there will be an impact later. And so that just made me place more emphasis on what AAOMS or whatever, if any sort of organization, but specifically for AAOMS, what they are advocating for. It's important for the entire profession.

So not just the REDI Act, not just for residents, like this will influence decisions later down the road and how graduating residents may decide on their career paths. And there's a lot of other implications. And so that was a way for me to just be more open about all the different advocacy initiatives.

And then I also see just a lot more value in fostering these professional relationships. I, the first year that I went to Day on the Hill, I was representing Washington State, so I got to meet some of the oral surgeons there. And then in subsequent Day on the Hills, I was representing Maryland, and then D. C., and things like that. So just meeting all these other people who are other oral surgeons who are passionate about advancing our profession and fighting for our profession.

Host: Yeah so good networking as well. As you say, I love how you say it's easy not to care. You know, we're so busy in all of our lives and we have so many things pulling our attention in so many directions. I love how you say that, but then you say it's important that we pay attention now for potential impact in the future.

So I love what you had to say there. So thank you for that. And Dr. Sarmiento, how about you? How has this helped your professional growth, your career? How has it impacted you? 

Flora Sarmiento, DMD: I have to agree on that. It's quite easy to get caught up in the everyday. It's very busy for any oral surgery resident or any practicing oral surgeon and, you know, earlier on or late in life. I think it's just a busy day. But it's very important to still have a voice in our profession and defending our specialty.

It's the best profession and I think we all have a job to defend it. And staying organized, and like I mentioned earlier, having organized dentistry is very important in order to move forward and make strides to afford more, more forward than stay within the same problematic issues that we continue to having.

If we don't change them now, they'll for sure have an impact later. So it's very important for me to play a role in that. And I think if you want to start with a change, you have to start it with yourself. And I need to be a part of that change.

Host: Mm hmm. Well, I love what you had to say there, Dr. Sarmiento. It's our profession and it's our job to defend it. That really makes a lot of sense and uh, it's great that we have young people like you in the profession with that type of attitude. So, Dr. Thaker, they've set the bar high for you, Dr. Lim and Dr. Sarmiento. You're our veteran of the crew here. So, how has your advocacy initiatives helped your professional and career growth? 

Raj Thaker, DMD, FACS: Yeah. Actually, a big part of where the professional growth and the career growth also came was networking with other surgeons across the country. And what we do is, I think when you realize that you're really in a selected group of people who are in a profound position to be not only leaders in their own individual communities, but really be the force of that change.

And I think that that's the really, really cool part of like what we had. Going to multiple events, multiple Day on the Hill events, it was actually fantastic. I got to meet people from Hawaii to Alabama, you know, all the way to, back in New York and to Michigan, right. And in Arkansas, and then of course, back in Texas.

And it was even more important because it helps me connect and realize that we can all stay connected as a community and in that interconnected ability is super important for us, right. Both to advance our profession, but also to just have another job, connect with somebody, have another mentor. I mean, I found one of my best mentors, Bill Jordan, him and I really got to connect just because of Day on the Hill, and that's been amazing since.

And so it's more than just the advocacy effort, I think it's also about us being a part of a larger community. One of my mentors from the Navy, Dr. Bitonti, he's been really involved with OMSPAC from day one. And so, also just connecting with people from different stages of your life is, it's fantastic.

Host: Yeah, Dr. Bitonti is terrific. I had a chance to interview him a while back. What a terrific story. But Dr. Thaker, I loved what you had to say about networking and this connection helps build community. And like you said, it's huge. 

Raj Thaker, DMD, FACS: Absolutely!

Host: And like you said, you're a part of a selected group in a profound profession, and, you can be a foundation of change. I love what you had to say there. So that's really cool. So.

Raj Thaker, DMD, FACS: And so many of these, like, you know, if you look at it, like so many of us are in positions to be leaders within our own communities. And it really inspires us to not only realize that civic engagement, but also what we do within our own communities is just as important as what we do within our just profession. And it's really important. That's why within our profession, regardless of what side of the aisle you necessarily are, how we can all come together for something more important than just us. Right?

Host: Yeah, really cool how that can translate to your personal life and your own community where you live every day. So, another great thought. So, thank you for sharing that. I really appreciate it. Dr. Lim, a question for you. How supportive are your residency program and peers regarding your involvement in advocacy, and what specific issues are you advocating for that directly impact residents?

Hana Lim, DMD: Yes. So I, and I think I can also speak for Dr. Sarmiento as well, but we are both very fortunate because our program director, Dr. Dana Jackson, who's also the OMSPAC chair, so he's very supportive of us residents being involved in advocacy. It also helps that our Howard is in Washington, D.C. So you can see the capital actually from our hospital. So it's closely located, which is convenient, but we get full support from our program and especially from Dr. Jackson to participate in these events. We're also encouraged to take on, you know, various leadership roles, whether in our GME or through ROAAOMS, things like that.

So having that support, I think makes it a lot easier for us to get involved and, you know, being able to attend Day on the Hill, things like that. So I feel very fortunate and I'm very grateful for that. And the specific issues, as I mentioned earlier, so the REDI Act, I mean, that is directly going to affect our all of us residents just being able to graduate residency with less burden, less debt is huge.

And it's, that often drives how recent grads choose their jobs. They may go for jobs that are higher paying or they go into DSOs or, you know, there's a lot of different things there, but overall, this is going to help the entire country, like the entire healthcare profession.

Host: How cool it was you were there when that bill was going through being discussed. So how cool that, that you had direct knowledge and got a chance to see it happening in real time. So that's really cool. And Dr. Sarmiento, a question for you. So, how has your perspective on advocacy evolved since completing your residency?

Flora Sarmiento, DMD: Yes, so, during residency, like Dr. Lim mentioned we had a very strong support system and we had a leader that led by example by taking on roles in AAOMS and making sure to inspire us through his leadership and I, like I mentioned, it's very important for us to start defending our specialty from earlier on, like in residency, now that I've transitioned into after graduation, post-graduation, it helps me stay organized.

It helps me divide my time effectively, and I still want to be involved. I was very involved in ROAAOMS. I was involved in Day on the Hill. It's a very fond memory of mine during residency, having shared all those experiences with my co-residents and my director. But now, so in the real life, it just helps me stay organized with my timing and making time for that is important to me. 

Host: Yeah, certainly can be educational in many different ways and obviously you're an example of that. So thank you for that. And Dr. Thaker, you're a veteran here being in practice for five years now. So looking back, how do you think your early involvement in advocacy has helped your career and practice? And what do you have to say to those early-career OMSs who may not see the value in advocacy or are hesitant to participate in AAOMS's advocacy efforts?

Raj Thaker, DMD, FACS: Oh, yeah. Well, first thing there's this expression that we have in Texas. It's if you're not at the table, you know, you're going to be on the menu, right? And Brian Stone can talk about this. I mean, our delegation is probably one of the strongest delegations out there for a reason. And it is very important, right?

Because, at the end of the day, it doesn't matter what stage of your career you're in, doesn't matter whether you're in academia, or private practice, or if you're in some sort of a hybrid mix, doesn't even matter if you're primarily even like in a DSO mix. I mean, legislative efforts will inherently impact you.

And what we've realized, and I think what I've realized just by going to Day on the Hill, is that the people who are making decisions for us are not necessarily the people who are the most informed about what's best for us. And it's kind of our job to be able to go explain. We know what we feel is what's best for us and what's generally right.

And that's the beauty of what OMSPAC does. It's the beauty of what happens when you go to an OMSPAC event, because then you realize that not only can you come there in full force, but we, and I've talked to my colleagues both in a variety of other non-medical and non-dental disciplines, and I don't think there's very many organizations out there that are as organized, and I think as just generally dedicated, I think like we are. But the reality is that at some point you do need to have young blood that can connect with not only, like, these legislative aides, but young blood that can also just be able to communicate all kinds of issues that are important. And it could be everything from obviously small business reform, it could be everything from obviously Medicare and Medicaid reform, it could be everything from the ELISA Act.

It could be everything from talking about drug shortages or funding and you know, even prescription drug abuse. Like, the whole fentanyl crisis. Who better yet to talk about the opioid crisis than maxillofacial surgeons, right?

And we are, as the dental specialists, we kind of are in that position of leadership and for me, it's only made me realize that it helps me not only connect with other surgeons within our community, but it's really important for us then to come out as a unified force within our community and kind of carry that torch, which is what we need to do or else the profession will die.

Host: Yeah, carry that torch. I love how you said, if you don't have a seat at the table, you're on the menu. So you better get involved, right? So you have a voice in what happens. 

Raj Thaker, DMD, FACS: Yeah. Oh, yeah, you know, the advantage of getting involved also is just because you get to meet other people from all across the country. I can't tell you the number of surgeons I've met just from other areas in the country and also residents, too. I mean, remember, like, we all were residents also at one time, at one point in time, right?

So being able to connect with people upcoming into their career, also, discussing things that are important to them, what affects us, specifically, probably us three here on this panel is student loan reform, you know, and I went to the military right after residency and I didn't have a dime of my student debt paid for by the US military.

So, I did it out of choice, but it's a different story, right? Because, one of the advocacy efforts that we did have was to obviously create more equitable pay, or hopefully a slightly more equitable pay, right, for our military colleagues who are serving, even the ones that are potentially serving overseas, right. And that is really important, right, and that affects all of us, right, because you that affects both our manning, right, from that perspective, but also the ability for us to potentially have more surgeons go through that pipeline.

The same thing goes with us discussing student loan reform, but there's a whole variety of topics that you really get to learn and I think that's just invaluable, both from more than just one perspective, let's put it this way.

Host: Yeah, really good thoughts on that. So, Dr. Thaker, then let me ask you, what resources or advice would you offer to those who want to start advocating, but they just don't know where to begin? What would you say to that person?

Raj Thaker, DMD, FACS: Okay, super simple. The first thing to do is to see and just to try to get in touch with maybe your state oral surgery society, right? Because there's always going to be some sort of regional or state local society that you can get involved with that are going to have other oral surgeons. Just learn to connect with other people, right? 

And the second thing is contact people at AAOMS, contact people at OMSPAC, see how you can get involved.

I mean, I think it's fantastic. Anyone that hasn't attended Day on the Hill for a few years, you know, more often than not, they have the funds to be able to help new attendees attend this type of a conference and this type of a convention and meeting in general.

And then you really get involved and it just takes one time to realize that, Hey, this is something I should do probably every single year. And I've noticed that the more people that attend, the better it is. So contact your local oral surgery society, your state local or state oral surgery society.

See if you can get involved with, some of the legislative efforts. And here in Texas, we have, obviously we have TOMSPAC, and we have a lot of other things that go on with it too, right? I mean, but yeah, with that being said, that's probably the best and easiest way. And then of course, everyone at AAOMS is really nice, man.

Like, you can, you can talk to anyone there. I mean, anyone's chomping at the bits to try to see who we can get involved. And, you know, we're really inclusive. So

Host: Absolutely. Really good thoughts. So thank you so much for sharing that. Well, this has been a ton of fun talking with all three of you. Before we wrap up, I'd just like to go around the room and get final thoughts. Dr. Lim, if we could start with you. Final thoughts on why it's important to get involved and why should people get involved and how has that helped your practice? Final thoughts.

Hana Lim, DMD: Right, so, you know, it's definitely important to, to get involved and know what issues are surrounding our profession. Kind of going off of how we can get involved definitely, like, on a state or local OMS society very much important. I just wanted to throw out there that for residents who are interested in going, ROAAOMS does offer scholarships. Soyeah, it's, a great opportunity to network as well and meet people who are, passionate about oral surgery and caring for our patients. So I say start early and yes, definitely get plugged in earlier throughout your career as well. 

Host: That's, great advice. Start early is a great thought. And Dr. Sarmiento, how about you? Final thoughts.

Flora Sarmiento, DMD: Yeah, final thoughts. Start early uh, stay organized, you know, organization and coming together. Back to Dr. Thaker's community comment, you know, I agree with that. If you build community, you are also stronger and you can move forward much easier when you're organized, stronger and much more efficient that way. Not to mention, you build a sense of community in your own state or within the oral surgery networking.

Host: Yep, absolutely. Good thoughts. And Dr. Thaker, how about you? You're our anchor here. Wrap it up for us. Your final thoughts.

Raj Thaker, DMD, FACS: I don't know about the anchor with the Navy analogies, but I'll definitely, I'll definitely say this, that this is probably one of the most important activities and just probably one of the most influential organizations you can be involved with. And I actually feel that every resident, at least one time during residency, ought to have to go and just be a part of just the advocacy efforts, just to see what it's like.

But it's really easy to be involved. You can always find ways to get involved and don't be afraid. I think the biggest thing I would tell people is like, Hey, if it's just something to do, if it's something you can do, just don't be afraid. There's plenty of ways that you can be involved and just see what happens.

And there's so many ways that I think it's just financially and just personally rewarding. It's rewarding in the sense that you get to meet other people. You never know when you're gonna make a contact and essentially end up with a job in a different city in a different state that you never thought you would have lived in. 

Or it could even end up being, hey, I just made a friend, and next thing you know, you guys are all meeting up at conferences and meeting up at this and meeting up at that. These things are really, really important, right? And at the end of the day, it's all about us coming together as a community.

And you'll realize that the oral surgery community is very well connected and you want to be a part of that. And you want to be a part of that positive legacy, not necessarily the stuff that happens in the other communities, right? Where there's not a lot of banding and connection. And it's very doable.

And if anyone ever wants to reach out, I think probably to me, or I'm guessing anyone on this panel, please feel free because it's something that I think all three of us are very passionate about, but it's also something that… right?

Flora Sarmiento, DMD: Yes, absolutely. Anybody can contact me regarding involvement. You know, I've mentored some people into it and any way I can help. I'm an open book.

Host: Love it.

Raj Thaker, DMD, FACS: Yeah, absolutely. Same, please. 

Hana Lim, DMD: Same.

Host: Great. Well, I want to thank all three of you, Dr. Hana Lim, Dr. Flora Sarmiento, and Dr. Raj Thaker. Thank you each for your time today. We appreciate it.

Flora Sarmiento, DMD: You're very welcome.

Raj Thaker, DMD, FACS: Thank you.

Hana Lim, DMD: You're welcome. Thank you.

Host: Absolutely. A lot of fun talking with you. And to get involved in AAOMS's advocacy efforts, or for more information, visit AAOMS.org/Advocacy. And if you enjoyed this podcast, please share it on your social media and make sure you subscribe so you don't miss an episode. Thanks for listening.