Understanding the Post-Graduate Motivations of Our Dental Students
Zach Stein, BSc, DMD; Dieter Schönwetter, BTh, BA, MA, PhD; Robert Schroth, DMD, MSc, PhD; William Wiltshire, BChD(Hon), MDent, MChD, DSc, FRCD(C)
Posted on February 24, 2011
Cite this as: J Can Dent Assoc 2011;77:b5
Dental educators need to make greater efforts to identify the post-graduate aspirations of incoming dental students. While the future plans of students become more of a priority during their third and fourth years of study, it would be beneficial to nurture these goals earlier in a student’s career. Some students enter dental school with definite plans to pursue a specific specialty after their dentistry degree. For instance, if a student has an ultimate goal of becoming an oral surgeon, it seems inappropriate to wait until the student’s final year to offer actual clinical experience. We believe that students with aspirations of attending graduate school should receive clinical exposure earlier in their course of study.
We conducted a study to determine the number of incoming dental students who were interested in pursuing a specialty before entering dental school. Surveys were completed by 88 dental students entering the DMD program at the University of Manitoba. Eighteen students (20.5%) indicated that they intended to pursue graduate dental education. The only specialties identified by these 18 students were oral surgery (5 students) and orthodontics (13 students).
The choice of these 2 specialties is noteworthy. Orthodontics and oral surgery are often associated with a high monetary return in comparison to other dental specialties.1 These specialties may also be regarded as offering a “glamorous” lifestyle, as well as privileged status within the community and among colleagues. The allure of such extrinsic motivators (i.e., economic return and prestige) can be attractive to students, who may perceive general dentistry as a necessary hurdle standing in their path.
It is important to distinguish between extrinsic considerations and intrinsic motivators, where students truly enjoy the academic pursuit of dentistry.2,3 Early exposure to a particular dental specialty as a patient may have guided some students toward their desired post-graduate programs. One possible explanation is that the common age for orthodontic braces (under 18)4 and for third molar extraction (18–25)5 coincides with the time students are preparing to enter college or university and getting their undergraduate studies underway. Although a single clinical experience could be a motivator, it would unlikely fully dictate a career selection. A lengthy shadowing experience may be necessary to accurately clarify these students’ motivations for choosing a specialty.
Our research showed that the majority of students who expressed a desire to specialize before entering dental school changed their graduate career plans during their first year of study. In fact, almost three-quarters (72.7%) decided not to pursue a specialty altogether. The reason cited by most students for deciding against specializing was that 2 to 3 more years of schooling would be “too physically demanding.” Other students believed their grades were too low to gain admittance into a graduate program.
We found it troubling to discover that many students failed to continue pursuing a specialty because of their grades. If the profession is going to encourage more dental students to specialize, students need to be aware that grades are just one factor in the post-graduate selection criteria. Clinical, research and volunteer experiences, along with strong community involvement, are all extremely valuable attributes that would be taken into account. To become a successful applicant to a specialty program, one must be willing to make him or herself a stronger, well-rounded candidate. For instance, post-graduate candidates should continue taking courses to increase their knowledge after completing dental school.
Dental organizations should take actions regarding these issues, both during dental school and also prior to admission. Dental educators should be able to give first- and second-year students the opportunity to gain clinical insight into all aspects of the profession. There could be a rotation during these preclinical years, where students would be exposed to a clinical environment. Second, the interview process for undergraduate dental school should be re-assessed. The majority of Canadian dental schools employ an interview format with both personal and situational type questions. Although this has some benefits, there are no questions that specifically address why a candidate has chosen dentistry as a profession. For example, the interviewing committees have little insight into why students are motivated to pursue dentistry, if candidates have any background or shadowing experience in dentistry, or if they have any interest in going on to a post-graduate program. If students do show an interest in a particular specialty, it would be beneficial to understand their motivation for choosing this discipline. It is important for students to show a sincere passion for dentistry, regardless of whether a specialty course of study is in their future. This could help distinguish between students who are solely motivated by extrinsic considerations and those who would enjoy general practice if their career path did not eventually lead to a specialty.
Some Canadian dental schools are implementing mentorship programs, where students have the opportunity to observe and interact with clinicians. We feel it is important that all dental schools provide such mentorship projects, preferably beginning in the first year of dental school. This would give students insight into different areas of the profession early on in their studies. We would also recommend that individual general practitioners and specialists become actively involved in these mentorship programs. Clinicians would then be able to give back to the profession by guiding the next generation toward the future. It would also be beneficial for undergraduate predental students to be required to spend time shadowing a clinician. Students showing an interest in pursuing post-graduate dental studies should be nurtured and developed early on and throughout the entire dental program.
THE AUTHORS
|
Dr. Stein is a practising dentist in Winnipeg and teaches part time at the faculty of dentistry, University of Manitoba, Winnipeg, Manitoba. |
|
Dr. Schönwetter is an associate professor and director of educational resources and faculty development, faculty of dentistry, University of Manitoba, Winnipeg, Manitoba. |
|
Dr. Schroth is an assistant professor in the faculty of dentistry, University of Manitoba, Winnipeg, Manitoba, and a research scientist at the Manitoba Institute of Child Health. |
|
Dr. Wiltshire is a professor and head of orthodontics and head of the department of preventive dental science, University of Manitoba, Winnipeg, Manitoba. |
Correspondence to: Dr. Zach Stein, 100-2265 Pembina Hwy., Winnipeg, Manitoba, R3T 5J3 Email: zstein0@gmail.com
The views expressed are those of the authors and do not necessarily reflect the opinions or official policies of the Canadian Dental Association.
References
- Cordes DW, Doherty N, Lopez R. Assessing the economic return of specializing in orthodontics or oral and maxillofacial surgery. JADA. 2001;132(12):1679-84.
- Biggs JB, Das JP. Extreme response set, internality-externality and performance. Br J Soc Clin Psychol.1973;12(2):199-210.
- Sherlock BJ, Cohen A. The strategy of occupational choice: recruitment to dentistry. Social Forces. 1966;44:303-314.
- Kiyak HA, Haluk I, Miotti FA. Orthodontists’ perspectives regarding treatment timing: a cross-national study. World J Orthod. 2004;5(1):40-47.
- Huang GJ, Rue TC. Third molar extraction as a risk factor for temporomandibular disorder. J Am Dent Assoc. 2006;137(11):1547-54.
Congrats on your recent article in the JCDA which I enjoyed reading, however I believe there are some further issues that need discussing. It would have been interesting to also assess if finances were a factor in dental students choosing not to continue pursuing a specialty. Further, it was only a 7% difference in students changing their minds from before dental school to after first year dentistry (could any stats be done here?). I don’t believe that asking dental students after only 1st year dental school is a good representation of their true interest in pursuing a specialty. Few dental students after first year have an understanding of each of the areas of dentistry. Indeed, fourth year students still don’t! To truly understand a speciality and want to pursue further training, don’t you have to be practicing general dentistry for some time? Some post-graduate speciality programs select students immediately following dental school. Do these students truly know what they’re getting into with the limited exposure they’ve had to that speciality in dental school? I find it troubling that students have specialty aspirations prior to dental school. They don’t understand dentistry, how can they understand a specialty? I disagree with you, dental school should nurture students in all areas of dentistry to become excellent dentists, they shouldn’t be responsible for identifying students interested in a particular specialty early on and guide them to that specialty with early clinical exposure as you assert. The problem I believe we have is not motivations for dental students to select a particular specialty. What’s important is to identify motivations (or lack of) for students to pursue research, teaching, practicing in rural and under-serviced areas and treating patients with low incomes and disabilities. We have a problem in finding dentists to graduate and pursue practice in these needed areas. We certainly don’t have a lack of dental students applying for specialty programs (just ask the program chair of any specialty department of any dental school in Canada) and I wish your study focussed more on these areas.
Sincerely,
James Noble
I agree very much with James. From my perspective after a career in public health dentistry (in Australia)the skills that all health professionals should have (or need to develop) in abundance are empathy and compassion in order to deliver patient-centred care and advocacy for a more just and caring society. Surprisingly perhaps, achievement of such an approach minimises the sense of victimhood for both professional and patient. The professional’s sense of being ineffectual (failure to realise perfection in their work and in their patients’ mouths and related behaviours) and of their work and care being undervalued is minimised and so is the patient’s sense of guilt and powerlessness. It’s a win-win for both professional and patient. Emotional sensitivity and maturity must become the primary goal of all health education. Otherwise we will eventually realise that we are failing our society and possibly surrender to a sense that humanity has gone about as far as it can go and that inadequacy reigns?