Dental trainees need practical experience

Press, 26 June 1989, Page 14

Dental trainees need practical experience

By

DESMOND SMITH,

B.D.S., D.D.H.P.

In the last issue of the “New Zealand Dental Journal,” a pertinent question was posed by one of the correspondents in the letters to the editor section. It asked: “Why, alone among the professions in New Zealand, is the graduating dentist able to proceed straight into independent practice?”

The young doctor must spend the first year after graduation inside the precincts of a hospital where there are any number of more experienced colleagues to provide support, mature judgment and whatever correction is required. The fledgling lawyer, after admission to the Bar, is obliged to linger in legal limbo for a couple of years before consideration for a partnership is allowed. The other health and social professions also ensure that the newcomers to their ranks serve an appropriate period of apprenticeship. For some reason, dentists have slipped through this precautionary net which acts as a commendable safeguard for the general public. Within a week or two of graduation, the newly capped dental surgeon can legally acquire a solo practice and begin to operate it without any recourse whatsoever to further training. In all fairness, it should be stated that such a situation rarely arises, for two reasons. The first is that a young man or woman at that stage does not have the considerable capital it takes to buy a dental practice. The second reason is that, to their credit, recent dental graduates appreciate only too clearly that their

Word of Mouth

training has been largely academic and protected by the safe environment of a university. Therefore, they seek to broaden the practical side of their experience, either by joining a hospital dental department or by accepting an assistantship with an established practice. Nevertheless, there are no legal restrictions to protect the public from some young worthy of the future who decides he knows enough already, without help from anyone. The University Dental School in Otago does a first class job in training men and womdn for the profession with its one intermediate and four specialist years of study before acquiring the Bachelor of Dental Surgery degree. But there always will be limits to what an academic institution can provide in the formation of its undergraduates. The ultimate training in caring for the dental health of patients, young and old, is obtained only in private practice, because it is not only technical skills which are required for a good dental surgeon. The ability to establish an effective working rapport with each patient, the aptitude for listening that forms so important a part of a good dentist’s manner and the experience to offer alternatives in treatment to the patient, build on what the university has taught.

Even practitioners with a number of years behind them are starting to appreciate the fellowship, advice and support they can receive by entering into associate practice with one or two colleagues, sharing not only expenses and staff, but also technical, medical and management difficulties. And, in the long run, these associate practices work to the benefit of the whole patient group because, when your particular dentist is sick, on leave or called away urgently and you have a broken cusp or violent toothache, there is always one of the other associates available to attend to you. Before we leave the subject of dentists and their training, there is one more problem which has been occupying the minds of dental legislators for some years. This is the worry about the middleaged or older dentist who has been in a one-man practice for a generation or more and just goes on the same from year to year, while dentistry around him is changing out of sight. He never attends national or international conferences and would not think of enrolling for a training seminar or post-graduate course. Some of the American states have made it compulsory for all dentists to do periodic post-graduate work in order to remain licensed. While the vast majority of New Zealand dentists, to my knowledge, stay well abreast of modern developments, perhaps it would not be a bad idea if we had something of a compulsory nature in this country too, so as to force any small minority to keep up with the majority who willingly serve their time in order to serve the public better.