The Herman Ostrow School of Dentistry of USC is celebrating a milestone.

Nearly 50 years ago, seven Cuban refugees were among the first class of students who graduated from the school’s international dentistry program.

Originally called the USC Special Student Program and later the International Student Program, the Advanced Standing Program for International Dentists (ASPID) was created in 1967 in response to the Cuban refugee crisis of the late ’50s and early ’60s when members of the professional class fled the country after Fidel Castro came into power. The United States government put out a call to schools to take in doctors and dentists to train them to practice here.

USC’s ASPID was the first program of its kind in the nation.

USC international dentistry: Diversity among students

These days, dentists from all over the world attend USC to acquire the skills taught in the United States.

“It’s well known that the U.S. has a very advanced dental education system, and oral health providers are very well trained in all specialty areas,” said Yang Chai, associate dean of research and an ASPID graduate, who came to the U.S. from China. “It is quite useful to be trained through the American system by attending a program like ASPID at USC.”

ASPID is a two-year program that begins with an intensive summer introduction to American dentistry. Afterward, students — who must have already completed National Dental Board Examination Part I to be accepted into the program — join their third-year colleagues in the regular DDS program. Following eight months of fundamental, technical and academic procedures training, their focus turns toward clinical training, where they begin working with patients in USC’s oral health clinics and community service programs.

“We get trained with the DDS students,” said ASPID student Amrita Chakraborty, who is from India. “I think that is a huge advantage for us because we get to learn a lot about the culture.”

Chai said ASPID’s diversity is an added bonus.

“It’s a group of individuals who bring their unique backgrounds into the program,” he said. “We not only learned from the professors at USC, but we also learned from our classmates. That was a really fun part of the program.”

Melika Haghighi said her favorite procedure so far is learning about digital dentures, but one ASPID class in particular made a special impact.

“Cultural sensitivity was an amazing course,” she said. “There were lectures that made me cry, and they emphasized the importance of understanding different cultures. USC provides an environment that makes everyone comfortable.”

From Dubai to L.A.: USC international dentistry

Haghighi was born and raised in Iran, but she studied dentistry in Dubai, United Arab Emirates. After graduation, she practiced for a year but felt her environment was too limiting. So she started researching different countries to see how to take her skills to the next level. She moved to the United States and started volunteering at USC’s mobile clinic and the John Wesley Community Health dental clinic on Skid Row, which validated her decision to apply to ASPID.

“My experience working on Skid Row was amazing,” she said. “I witnessed the impact USC has on oral health and the community. I chose USC because, to me, it’s more satisfying to have that influential effect on the community rather than in private practice. I saw that USC would prepare me for that.”

USC international dentistry addresses cultural challenges

The challenges international dentists face in the United States are not only cultural. Since every country practices dentistry differently, dentists who want to earn a DDS need to learn all aspects of standard care.

“They need to learn the material,” said Eddie Sheh, an ASPID graduate and its current director. “They need to know the rules and the language. Everything. Just like if you are a doctor, and you want to practice in the U.S., you need to know how we do things.”

Sheh, who was a dentist in Taiwan, said his schooling was very different than the hands-on training USC provides to it students.

“USC is very strong in practicing how to do it in a simulation lab and then treating many, many patients until you graduate,” he said. “Not many other schools in other parts of the world are like that.”

In many countries, dental school starts right after high school and is a six-year program. In Taiwan, when Sheh was studying, fifth-year students were allowed to go to the hospital and observe faculty perform procedures.

“If you were lucky, you got to step in and do a few procedures. If not, you just watched,” Sheh said. “You might be doing a lot of pediatric dentistry because they’re busy, and they need your help. Or you’d just be watching someone do a crown preparation, and you didn’t get to touch it. In my case, I never actually completed a crown preparation or a denture. I just watched.”

What USC does is simply everything, according to Sheh. Students get clinical training in which they are actually treating multiple patients with differing procedures until they are perfected.

“You get to practice what you are trained in,” he said. “You know exactly what to do.”

Aiming for perfection

Chakraborty noted two chief differences between her schooling in India and with ASPID.

“No. 1, you are trained to become a perfectionist,” she said. “USC teaches you to not do work that is just passable. They teach you to strive to do really good work. Another would be professionalism — how to approach patients, how to explain treatments and basically how to treat a patient.”

Treatment planning is the major emphasis of the program, Chai said, and students spend a lot of time learning how to provide a comprehensive treatment plan for patients along with doing procedures.

ASPID accepts 34 students each year out of the more than 1,000 who apply. The ASPID Class of 2020 is 67 percent female; 63 percent of the class are international students requiring a student visa, 29 percent are U.S. citizens and 8 percent are permanent U.S. residents. One hundred percent of the class has earned a foreign bachelor of dental surgery, doctor of dental surgery or doctor of dental medicine degree.

Stay or go home?

Another obstacle international dentists face when they come here is the feeling of starting from square one. After completing years of schooling and practicing dentistry in their countries, often the only jobs they can secure in the United States at first is as dental assistants.

“You graduate from your own country, and you are called a doctor,” Haghighi said. “Then you come here and you have to repeat everything.”

As an ASPID alumnus, Sheh understands what the students go through.

“I understand what they have to endure. That’s the good thing — they know I graduated from the program, and I can tell them what to expect when they complete it.”

The majority of ASPID alumni stay stateside, Sheh said: “That is why they come here. Unless they have other reasons to go back, like for their parents, I would say 99 percent stay here. That was what the program was designed for.”

Whether students stay here or return to their countries, the training they receive with ASPID is unrivaled.

“USC has such a long history and very strong reputation in the community as one of the leading institutions for educating future dentists,” Chai said. “And, naturally, everyone who wants to learn how to practice the best dentistry possible will come to USC.”

— Michelle McCarthy