Dentistry is no longer just the pulling out
of teeth, but an emerging branch of medicine with the emphasis on conservation
of tooth, replacement of teeth with life-like appearance, relieving a person’s
pain and improving his smile. In ancient history of Indian medicine and ayurveda,
dentistry was having its existence as a part and parcel of medicine for good
health. Despite the pace at which dentistry is moving forward the biggest fact
still remains that the new brigade of budding dentists is in a dilemma.
Dentists are amongst the 5% highest paid
professionals in the western world, whereas in India they are struggling to
earn a decent livelihood, baring a few. Although, there is a high burden of
oral diseases in the country but there are few job opportunities in India,
amounting to stress amongst the dental students.
Dental education has been regarded as a
complex, demanding and often stressful instructive exposure, involving an
acquisition of required academic, clinical and interpersonal skills during the
course of learning, with a dental college known to be a highly demanding and
stressful learning environment.
Common sources of the stress to the students
include meeting the requirements of the curriculum, achieving good grades, fear
of failing, approachability to the staff and patients being late or not showing
up for their appointments. Other causes include change in sleeping and eating
habits, an increased work load and new responsibilities and stress about
finding a good job after graduating.
The duration of Bachelor of Dental Surgery
programme is of five years, governed by the Dental Council of India. The fee
for studying dentistry is the highest for any undergraduate programme next only
to medicine and as compared to medicine, although there is a high burden of
dental disease in the country, there are currently hardly any job opportunities
for dentists in India. A main reason for this is that there is no oral health
policy in India at the national level, and in many states there are no dental
services provided under the public health sector. Consequently, job
opportunities for fresh undergraduates are solely concentrated in the private
sector, leading to an increased competition, thus limiting the earnings.
High levels of stress may result in mental
and/or physical ill health, substance misuse, absenteeism and diminished
efficiency at work or learning, quite evident among dental students, which is
higher even when compared with other students of health professions.
With increasing awareness amongst the urban
population and the stiff competition that dental graduates face, there has been
an increase in the number of aspirants for postgraduate courses. A heavy
competition exists to achieve admission for postgraduate studies, leading to an
increase in the number of unemployed dental graduates. The number of seats
available for M.D.S. is only around 3,000 compared to 25,000 B.D.S. students
graduating every year. Dentistry is regarded as a flourishing industry in the
western world, and the budding Indian dentists are in stress.
Majority of the dental graduates, given a
chance, would like to migrate to other countries. The reason for migration is
the monetary benefits that the dentists get in most of the developed countries.
The facilities in the developed countries are more advanced, easily accessible,
and promising as compared to those available in India. Those aspiring to rise
in research and academics also prefer to go abroad.
Increased awareness of Indian patients has
also raised their expectations from the dental practitioners. Awareness about
the dental education among Indian population has also decreased the charm of
B.D.S. degree alone and more number of patients tries to consult a specialist
for their problems. But the disappointing ratio of number of post graduation seats
to the number of fresh graduates passing out is a bottleneck in the career
prospects of a dentist. A large number of candidates also want to go for
government jobs, but are disappointed due to very limited vacancies.
The National Urban and Rural Health mission
programmes provide effective health care to the rural as well as poor urban
population, especially the disadvantaged groups including women and children,
by improving access, enabling community ownership and demand for services,
strengthening public health systems for efficient service delivery, enhancing
equity and accountability and promoting decentralization. These programs are
not only beneficial for the people but also provide employment to healthcare
professionals. Unfortunately, there are no such programmes for oral and dental
healthcare. In a country where 60% have never visited a dentist and 75% of
people clean their teeth only once or less than once a day, such programs are a
must.
A number of changes need to be considered in
the curriculum of dentistry. Students wishing to study dentistry should be
exposed to the nature of the profession and the study environment prior to
applying to this program. There should also be a provision of an entrance
interview to evaluate the candidate’s interest and suitability for the course.
Dental colleges should collaborate with educational experts in designing and
developing a curriculum structure which is more student-orientated, aimed at
enhancing the students’ psychological well-being whilst maintaining a focus on
academic and clinical performance and producing graduates with a positive
professional attitude. A stress reduction program could be implemented. Such
programs for dental students as including specific courses, stress-reduction sessions,
introduction to behavioural sciences and faculty incorporated advising systems
foster coping behaviours that are useful on a daily basis, as well as
preventative measures to reduce chronic stress effects.
It is now time that the policy makers of
Indian health system like the government of India, various state governments
and the dental council of India look into the matter to increase the number of
M.D.S. seats in government as well as private colleges under government quota;
create jobs in the government, private and semi-government sectors; conduct
orientation courses regarding future prospects in various dental colleges of
India, create counseling cells in each and every dental college to combat
stress amongst dental students, and launch programmes similar to National Urban
and Rural Health missions for dental and oral healthcare.
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