The evolving demographics of graduate dental education

A review is provided of the changing gender, racial and ethic distribution of enrollees in advanced dental education programs.     

Post-academic dental specialties 18. The graduate programme in periodontology

In 1987, the Dutch Society of Periodontology (NVvP) made it possible for dentists to be recognized as specialists in periodontology. This recognition lasts for 5 years after which, on the basis of an evaluation of the Consilium Parodontologicum of the NVvP, continuation of the recognition for another period of 5 years is possible. The Academic Centre for Dentistry at the University of Amsterdam and the University Medical Centre St Radboud at Nijmegen University provide a 3 year full time specialisation programme in periodontology. These programmes are approved by the European Federation of Periodontology. After successful completion of one of these programmes, recognition as periodontist by the Dutch Society of Periodontology can be requested. Possible recognition is based on an extensive evaluation during a one day site visit in the practice by the Consilium Parodontologicum.     

The graduate entry generation: a qualitative study exploring the factors influencing the career expectations and aspirations of a graduating cohort of graduate entry dental students in one London institution

Background

Dentistry in the UK has a number of new graduate-entry programmes. The aim of the study was to explore the motivation, career expectations and experiences of final year students who chose to pursue a dental career through the graduate entry programme route in one institution; and to explore if, and how, their intended career expectations and aspirations were informed by this choice.

Method

In-depth interviews of 14 graduate entry students in their final year of study. Data were transcribed verbatim and analysed using framework analysis.

Results

There were three categories of factors influencing students' choice to study dentistry through graduate entry: 'push', 'pull' and 'mediating'. Mediating factors related to students' personal concerns and circumstances, whereas push and pull factors related to features of their previous and future careers and wider social factors. Routes to Graduate Entry study comprised: 'early career changers', 'established career changers' and those pursuing 'routes to specialisation'. These routes also influenced the students' practice of dentistry, as students integrated skills in their dental studies, and encountered new challenges. Factors which students believed would influence their future careers included: vocational training; opportunities for specialisation or developing special interests and policy-related issues, together with wider professional and social concerns. The graduate entry programme was considered 'hard work' but a quick route to a professional career which had much to offer. Students' felt more could have been made of their pre-dental studies and/or experience during the programme. Factors perceived as influencing students' future contribution to dentistry included personal and social influences. Overall there was strong support for the values of the NHS and 'giving back' to the system in their future career.

Conclusion

Graduate entry students appear to be motivated to enter dentistry by a range of factors which suit their preferences and circumstances. They generally embrace the programme enthusiastically and seek to serve within healthcare, largely in the public sector. These students, who carry wider responsibilities, bring knowledge, skills and experience to dentistry which could be harnessed further during the programme. The findings suggest that graduate entry students, facilitated by varied career options, will contribute to an engaged workforce.     

In-state graduate retention for U.S. dental schools

Currently, dental school graduates are viewed as a resource by their institutions and those who underwrite their educational costs. The purpose of this study was to determine the percentage of dental school graduates who practiced dentistry in the same state as their dental school. Using the American Dental Association database of approximately 35,000 graduates between 1985 and 1995, the data were analyzed to determine the percentage of graduates who were retained and currently reside in the state of their dental school versus those located outside of that state ("exported"). It was also possible to calculate the number of dentists who moved into each state but were educated elsewhere ("imported"). The ratio of imported to exported graduates was calculated and indicated a positive flow into the state when greater than one and an outflow when less than one. Overall, mean graduate retention was 67.3 percent, 65.4 percent, and 44.3 percent for public, public state-related, and private schools, respectively, while the median graduate retention of 71.1 percent and 71.6 percent for public and public state-related schools made them indistinguishable. The mean import-export ratio for public school graduates was 2.9, indicating that on average nearly three dentists were imported to a state for every public dental school graduate exported. States' total import-export ratio for all types of graduates was 2.2, indicating that on average a little over two dentists were imported to every one exported by a state with a dental school of any kind. The medians for all these ratios were much more modest (0.95 and 0.80 for public dental schools and states with dental schools), indicating that they sent more students out of the state than they imported. Six public dental schools exported greater than 50 percent of their dental graduates, while five public schools retained more than 85 percent of their graduates. Only one private state-related school retained less than 50 percent of its students. In view of these results, it is apparent there is great variability in graduate retention, and the total yield of new dentists for each state is determined by both the retention rate for graduates and its import-export ratio. Most public and public state-related schools do a good job of retaining graduates. When they do send graduates out of state, the median shows they do not gain quite enough to offset those exported. In most instances, this becomes highly problematic only when a low retention rate is paired with a low import-export ratio. Each state must consider its unique situation carefully and consider its yield, the types of problems that face the state in terms of dental workforce, and possible solutions.     

The current character of practice and the expectations of dental students

For Minnesota these investigators obtained the percentages that dentists devoted to different aspects of practice, as well as the anticipations of dental students.     

Mutual expectations in the process of joining a dental health group.

Productivity can be seriously affected when new persons join an existing group and little or no attention is given to the process by which that person becomes a member of the group practice. Parallels can be drawn between organizational management and the functioning of the dental team. Observations were made of three clinicians who attempted to join an existing dental delivery group. There are some predictable phases through which the joiner passes to acceptance or lack of acceptance in an existing group. Recommendations for groups to consider before either hiring or training members of a dental health group are given.     

Competencies in implant therapy for the dental graduate. Appropriate educational methods

Modern dental education should have in on one hand the necessary education and training to make modern dentists capable of implementing population and individual preventive strategies, and on the other make them competent to satisfy current public demands to most patients. Amongst the restorative procedures most demanded by patients implant therapy has reached a clear pre-dominance. Although specialists have traditionally rendered this therapeutic procedure, in simple cases there is seldom need for extensive surgical procedures and therefore there is a clear need to introduce these studies in modern dental curricula. To facilitate the harmonisation and convergence of dental education in Europe, the Association for Dental Education in Europe and DentEd have defined a set of competencies for the graduating dentist in the EU. Using the same framework, we herein define the agreed competencies in implant dentistry, within the different domains, for both the undergraduate and the postgraduate student. Within a context of a competence-based curriculum implant dentistry should be taught as part of the major and supportive competencies described with a strong emphasis on inter-disciplinarity and integration.     

Financial issues which may affect the graduate dental education system

This paper identifies issues, develops alternatives, and analyzes and evaluates the impact of trends and predicted changes in health care and health care financing; compares graduate dental education with nonprofessional and professional (especially medical) graduate education; and concludes there are greater similarities than differences in the financing of education in the academic disciplines and the professions. Two generalizations are drawn from this comparison: (1) practical experience under supervision precedes practice, and (2) the student pays for education solely for his or her benefit. Students are remunerated for productive work in lieu of compensated staff. This discussion identifies a distinction between medical and dental education that influences graduate dental education. In medicine, the prevailing practice in the clinical years is for students to observe care of patients provided by qualified physicians, in dentistry, prevailing practice is for students to provide care under the supervision of qualified dentists. A comparison of clinical training in medicine and dentistry discloses the following.     

A short guide to studying medicine for the dental graduate

Advice is offered to dentally-qualified trainees with an interest in oral and maxillofacial surgery who may be considering applying for a place in medical school from two trainees who have recently completed their medical studies.     

Teaching of bioethics in dental graduate programs in Brazil

In the field of human research, researchers are faced with unexpected moral dilemmas, as a result of the development of technologies applied to health. Due to the great importance of this issue, our objective was to evaluate bioethics instruction in the education of researchers in Brazilian graduate programs in dentistry. Eighty-seven graduate programs in dentistry, recognized by CAPES (Coordination for the Improvement of Higher Education Personnel) were evaluated in this study. Data were extracted independently by two researchers from the CAPES website, and from the websites of the graduate programs, directly or via links to the programs available at the CAPES website. Forty-eight out of 87 programs had an ethics/bioethics course as part of their curricula. Of the graduation programs graded 5, 6 or 7 by CAPES, 38% included bioethics courses, while 62% of the programs graded 3 or 4 by CAPES had bioethics courses as part of their curricula. These findings are an alert to those involved in dental research education, as they showed that, although resolution 196/96 by the National Council of Health regulating human research in Brazil was published ten years ago, bioethics instruction in Brazilian graduate programs in dentistry is still at an incipient stage. This situation indicates a need for ethics pedagogy in the education of young researchers.     

The emerging dental workforce: short-term expectations of, and influences on dental students graduating from a London dental school in 2005

AIM: The aim of this research was to identify short-term career aspirations and goals of final-year dental students at a London dental school and the perceived factors that influenced these aspirations. METHODS: Two methods were used to collect data on final-year students' short-term career plans and influences. Qualitative data were collected through focus groups and analysed using 'framework methodology'. These findings informed a questionnaire survey of all students at the end of their final undergraduate year. Data were entered into and analysed using a statistical software package. RESULTS: Thirty-five students participated in focus groups, with recruitment continuing until data were saturated. Ninety per cent (n=126) of the total population (140) responded to the questionnaire survey; the majority were Asian (70%), female (58%), and aged 23 years (59%). Short-term professional expectations focused around 'achieving professional status within a social context', 'gaining professional experience', 'developing independence' and 'achieving financial stability'. 'Achieving financial stability' was ranked as the most important influence in decision-making about their career in the short term (77%), followed by 'balance of work and other aspects of life' (75%) and 'good lifestyle' (75%). Four out of ten intended to work towards membership of a Royal College and/or becoming a specialist. Proximity to family (81%) and friends (79%) was an important or very important influence on location in the short term. Asian students were significantly more likely to rate 'proximity to family' (p=0.042), working in an 'urban area' (p=0.001) and 'opportunities for private care' (p=0.043) of greater importance than their White counterparts. CONCLUSIONS: Short-term aspirations involve 'achieving professional status within a social context', and personal, social, professional and financial goals. Location of future practice was significantly associated with ethnicity.