Farhan Raza Khan BDS, MS, MCPS, FCPS
With the Pakistani population growing ever more and a disproportionate distribution of dental care providers concentrating at major cities; there is an acute need for dentists in many rural and semi urban areas of the country. There is an increasing opportunity for dentists with advanced clinical training to pursue dental careers in the country. However, it has been observed that the majority of the dentists who possess the advanced graduate education (CPSP based residency training or University based MDS post-graduation) prefer to remain associated with the academic institutions as faculty members. The probable explanation for this trend originates from an increasing demand for inducting clinical teachers at the academic institutions to satisfy the regulatory requirements setup by the statutory council.
Aspiration toward further specialization is considered as a progressive trend among fresh graduates. Ability to invest time, energy and money for building their capacity as specialist dentist is an honorable attribute but one has to understand a delicate difference between medicine and dentistry. For example, spending 5 years in urology training makes a simple MBBS graduate a specialist urologist. It’s easy for public to decipher the difference between a general medical practitioner and a urologist while the same is not true for a specialist dentist. A dentist after post-graduation still remains a dentist. Thus, the objective of any dental specialty training can be summarized as following:
1) To transform a dentist into a refined clinician who offers predictable/superior outcomes with the attention to details in the patient care.
2) To provide clinical teaching manpower for the academic institution.
3) To produce researchers and basic science teacher (in non-clinical areas).
Another interesting difference between residency trained medical graduate and dental graduate is their average take home earnings. Specialty training in any field of medicine does not only confer its recipient a distinction among generalist but also brings a significant improvement in job opportunities and monthly earnings. However, the same principle doesn’t hold true for dental specialists. There is only a little difference is observed in the take home earning of dentist after specialization compared to the GDP counterpart. The probable explanation is that the earning in a dental practice in countries such as Pakistan where literacy is low; is determined mainly by geographical location and socio-economic status of the practice neighborhood. The role of dentist’s years of advanced education and training has minimal role in patient’s attendance at his/her office. Moreover, the practice of referrals is best described as weak if not nonexistent. This trend is shown in a figure 1.
In this context, if a fresh graduate aims to establish him/herself into a refined general dental practitioner, it’s not mandatory to attend residency training. One can get affiliated to a experienced clinician(s) for 4-5 years and attend continuing professional courses, workshops and can still practice good dentistry within the framework of ethics and yet can obtain good monetary reward in the practice. However, if one wants to get the respect and honour of an academic title then the only way to progress is to get further education and training at an accredited institution.
Assistant Professor, Dentistry, Aga Khan University
< farhan.raza@aku.edu >