The 10,000 Hour Rule

I recently finished reading a book by Malcolm Gladwell, titled Outliers. It was a great book that I would highly recommend to you all, and in fact, all of Gladwell’s other best-selling books too. The relatively short book (304 pages; A5) describes some stories of success. There was a chapter within the book that particularly struck me in which Gladwell describes an idea called “The 10,000 Hour Rule”. Basically, what he describes, with the help of a few widely known real-life examples (including the early story of Bill Gates and his phenomenal success), is that in order for anyone to truly become an expert in their chosen activity/profession/field, they will have completed roughly ten thousand hours of focused work on their activity of choice (for Bill Gates, this was programming).

The reason why I have very briefly touched upon that idea of The 10,000 Hour Rule is that I believe it very much translates into success within dentistry too. Now, when I describe success here, I am not sticking to any particular definition since success means different things to different people and has varying implications, dependent on the context used.

According to Gladwell, ten thousand hours roughly equates to 10 years of dedicated work, which means that to achieve 10,000 hours worth of real effort dedicated to your craft (in this instance, dentistry). This is important to bear in mind because it highlights that becoming an expert is not something that happens overnight. We need to have amassed a lot of experience clinically, treating thousands of patients before we can confidently call ourselves highly skilled/expert practitioners. And, the truth is that for most, it will probably actually take a little bit longer than ten years to reach these levels.

What can we do to expedite this process? How can we achieve greatness sooner*? Practice! Practice, practice, practice.

*There should be no particular rush. Enjoy life, don’t overwork and don’t neglect other aspects of your life chasing after an arbitrary 10,000 hours worth of work.

I think it is very reasonable to consider this a realistic notion within dentistry. But, I would perhaps argue that the 10,000 hours only starts after graduating from dental school – i.e. when the real work starts. And, I may even go a step further and say that it starts after the vocational training year is completed. What do you think? These are all just ideas, written out. If anything, I would like to stimulate your mind and provoke a discussion with you, the reader of this blog post.

To a large extent, as undergraduate dental students, we all have our immediate paths set out for us. As students we have a fixed curriculum to complete, a fixed number of patients to see in a week, limited access to the clinical skills or prosthetics labs for practice opportunities. Instead of worrying so much about what we will be doing 10 years after graduating, we should be focused on learning what we are taught, mastering the basics, understanding fundamental dentistry and having lots of fun! But, after graduating, the vastness of opportunities we can choose for ourselves becomes apparent. Only after leaving dental school do we really have the freedom to choose our own professional pathways, choose what courses/jobs/study clubs/equipment/reading to invest our time and money into – and that is when we will begin to define our pathways to ‘success’ by grinding towards achieving 10,000 hours.

Ten years post-qualification gives those of us who are really dedicated enough time to build up a huge amount of experience. However, as I mentioned before, let’s allow 15 years. Fifteen years gives us plenty of time to amass the knowledge, experiences, mentors and confidence to be exceptional dental professionals. And, if you think about it another way, considering most dental students will graduate as dentists aged ~23-26 (considering the age most dental students begin) then that means we will reach success and be highly-skilled by the time we reach our late 30s. That’s a nice outlook for our futures, don’t you think! 🙂

Becoming very experienced, highly skilled and consistently confident in our clinical work/approach is no fairytale, blemish-free journey. Mistakes will be made along the way, many mistakes. We will all make countless mistakes, most will be minor and inconsequential, some will be more significant. This is how it goes for everyone, no one is exempt from this obstacle course pathway. We learn from our mistakes. As a dental student currently, I am always learning from things I do in the clinic; these aren’t necessarily mistakes but they are typically inefficient, non-systematic approaches that are not ideal. As students, we are surrounded by experienced clinicians/nurses/technicians and our peers too, who can all guide us through these ‘mistakes’. I’d argue that the more mistakes we make, the better will become. We must embrace the mistakes we make and appreciate their lessons. Only by experiencing an error/mistake/inefficiency can we truly understand why there is a different, better way to do it next time. No one will be able to amass 10,000 hours of clinical dentistry without making countless mistakes. How we respond to these scenarios will be a testament to the clinicians we will go on to become.

Get into good habits early. I know first hand just how tempting it can sometimes be to opt for an easy approach, to skip a few steps, to cut some corners in the clinical procedures we carry out. Avoid getting into bad habits, don’t allow yourself to do things if you know from the start it is not what you were taught, not what you should be doing or what is best practice. If someone was to have bad habits involved in their day-to-day clinical work, it becomes basically impossible to become a highly skilled expert, even after 20,000 hours!

If we think about hospital dentists, here in the UK working for the NHS: it is fair to say that most people would consider a clinician who has reached the level of a consultant to be an expert. I would agree with this idea personally. Now, if you think about the pathway to becoming a consultant in any field of dentistry (e.g. consultant in restorative dentistry), they will have completed lots of post-graduate training, sat a number of exams, had work/research published, and, been involved with teaching other dentists/dental students. It takes a lot of hard work to reach this level, including many years of clinical experience – so, we are probably looking at ~10,000 hours (or much more). This is just an example of The 10,000 Hour Rule for some contextual application.

Alternatively, you can also apply this rule to general dentists or those who have specialised. But, it probably is more directly relevant for a specialist or a clinician with a special interest (i.e. someone who has done further training and limited their practice to a specific sub-field, such as dental implants).

Regardless of the specifics of a dentist’s chosen pathway, we all carry out Continued Professional Development (CPD) with set requirements by the General Dental Council. This continuing education ensures we all are constantly developing, widening our knowledge base and consolidating our skills. Our career is one with lifelong learning, so, eventually, we should all amass 10,000 hours and become highly skilled expert clinicians.

There is no ceiling, no upper limit. We will always be able to get better, work faster, gain more experience, producing results to a higher standard. This makes dentistry exciting for us all. Greatness is not an exclusive club reserved for lucky ones, it’s a very realistic level we can all achieve. And, if you love what you do then you’ll never work a day in your life. Figure out what you love, pursue it and the ten thousand hours will be a breeze.

One thing you can do to help you along the way is to find mentors. These are people who themselves have surpassed this arbitrary 10,000-hour mark and are good at what they do. These are people who can support you, guide you, teach you and allow you to follow the path to achieving success whilst avoiding some of the pitfalls that may have limited them previously. Once you’ve identified your passion, the path you want to commit to then mentors will probably present themselves in your life.

Another thing you could do is gain experience in different settings. This is especially pertinent for junior dentists – expand your horizons early in your career, especially if you are not quite sure exactly what path you want to pursue long-term. It is probably a great idea to work in a few hospital posts, such as doing a year or two as a DCT (Dental Core Trainee). There are numerous posts in NHS trusts up and down the country who take on new junior dentists every year. I know of a lot of young dentists who recommend doing a SHO job in OMFS (Oral and Maxillofacial Surgery) for example. Alternative options might include doing a post-graduate taught/research programme at a dental institute of your choice, such as a Masters degree (of which there are many different options: part-time/full-time, a speciality of your choice etc). These are even worth doing if you are long-term considering working in primary care as a GDP.

Finally, this is just an important reminder to you (dental students) reading this that by focussing on the day-by-day, month-by-month, year-by-year work, by aiming to learn as much as possible in every scenario, by practicing at any opportunity, by aiming for good clinical results and by simply trying to be the best you can for each patient treated, then, in the blink of an eye you will become great at what you do.

Remember, step-by-step; don’t run before you can walk.

This for me is very inspiring. I am so fortunate to be so interested in dentistry and grateful for the opportunities I have to be able to pursue this passion. I am still a dental student but this positive and forward-thinking mindset is so important.

Thanks for reading. Let me know your thoughts on this all!