| Abstract|| |
Background: Need to be constantly updated for professional and economic stability in today's competitive world has made a specialization in dentistry very essential. The aspirations and reasons for choosing a particular specialty for postgraduation contribute a lot for the future of that particular specialty. This study aims to identify the preference of specialty and the factors affecting the choice of specialty areas among dental graduates in a dental institution in Bhubaneswar, India.
Materials and Methods: A cross-sectional questionnaire study was conducted in November 2014 on 43 interns in a dental college in Bhubaneswar. A 10-item close-ended questionnaire extracted information on a 5-point Likert scale (5 = extremely important to 1 = not at all important) pertaining to possible future career directions, choice of postgraduate specialization, and factors influencing them. Data collected was analyzed using the SPSS statistical package, version 17. Both descriptive and inferential statistics were sought. The level of statistical significance was set at P < 0.05.
Results: The top ranked specialties for postgraduation were orthodontics 27.9% (n =12), endodontics 25.6% (n = 11), and oral surgery 18.6% (n = 8). Parental (86%, n = 37) and family (62.8%, n = 27) encouragement and support was recorded as the most important factor in the pursuance of postgraduation followed by encouragement from close friends (60.5%, n = 26) and mentor (51.2%, n = 22) by the interns.
Conclusion: The knowledge of factors influencing the choice of postgraduation may help provide important information to aid in planning educational programs, set priorities, and plan for the provision of adequate health care.
Keywords: Dental interns, motivations, perceptions, specialty
|How to cite this article:|
Sharma N, Jain K. Dental interns' study motivation and perception in formulating their specialty preferences in Bhubaneswar, Odisha: A cross-sectional study. J Educ Ethics Dent 2016;6:1-7
|How to cite this URL:|
Sharma N, Jain K. Dental interns' study motivation and perception in formulating their specialty preferences in Bhubaneswar, Odisha: A cross-sectional study. J Educ Ethics Dent [serial online] 2016 [cited 2023 Apr 1];6:1-7. Available from: https://www.jeed.in/text.asp?2016/6/1/1/216515
| Introduction|| |
The choice of a career is a critical decision that has an obvious impact on the future life pattern. The influence of job touches many facets of life, shaping one's values, attitudes, and habits. Dentistry has traditionally been among the sought after professions.
Previous studies on motives for choosing dentistry reveal a range of reasons that are similar and shared across various geographical regions: helping people, altruism,,,,, regular work hours,,, financial factors, good income, financially lucrative profession similar to medicine, financial security, prospects of being able to work abroad, job security,, prestige, social status, but in a few are unique to the specific regions such as interest, offers a specialized profession/recognized job,, other person's recommendation, failure to be admitted to other study programs, independence,, expectations of their family, perceived ease of employment, and being self-employed.
Continuing professional development has become the goal in almost every profession, and dental profession is no exception. Need to be constantly updated for professional and economic stability in today's competitive world has made a specialization in dentistry very essential.
Specialization in dentistry is provided at various institutions for a number of individuals. The students are confounded and perplexed by the choices available, and the ultimate decision of choosing a specialty depends on the interplay of various factors.
In India, the dental education is majorly divided into undergraduate and postgraduate dental education. The undergraduate dental course provides basic training to the students over a span of 5 years. Currently, 292 dental colleges recognized by the Dental Council of India (DCI) exist with total intake capacity of around 24,000 students per year. Among these, only forty colleges with total intake capacity of 1500 students are government colleges; rest are in the private sector.
On completion of the undergraduate course, the interested students can apply for a postgraduate dental course (MDS) in any of the nine specializations. Dental graduates can also opt for various diploma courses, certificate courses or fellowship programs in the dental fields from various colleges and organizations across the country.,,,
Students who have completed their BDS and 1 year rotatory internship or students who will be completing their rotatory internship before taking admission can apply for postgraduation. There are four options for a student to get admission for postgraduation: University/private school-administered entrance examination, state-administered entrance examinations, common all India entrance examinations (for which all eligible students qualify), and management quota with varying fee structure under each scheme.
Majority of the students have to apply for student education loan (with no subsidized rates) to pay for their course fees. Stipends during postgraduation are provided only in the government colleges and very few private colleges to meet the expenses.
The number of seats available for MDS (as on 2013) is only around 3865 compared to each year pass outs of 24,000 BDS students. This is a big bottleneck in career prospects of a dentist.
Further, the distribution of seats for postgraduation in all specialties is not equal. More numbers of seats are available for some specialties while for others seats are limited.
Also, with increasing competition for few postgraduation seats, there have been unsubstantiated newspaper reports, of corruption in the ranks of entrance examination. Such issues further complicate matters for the young student aspiring to become a specialist.
A number of studies have been carried out on characteristics, motivations,,, and aspirations of dental students throughout the world. Only few studies focusing on the factors that affect the choice of postgraduation have been conducted in India., Apart from the challenges mentioned previously, there are many challenges intrinsic to the profession, and some problems are specific to India., Hence, this study was conducted with the aim to identify the preference of specialty and the factors affecting the choice of specialty areas among dental graduates in a dental institution in Bhubaneswar, Odisha.
- To identify the preference of postgraduation specialty among dental graduates
- To assess factors those affect the choice of postgraduate program selection
- To determine the relation between demographic characteristics and choice of postgraduation.
| Materials and Methods|| |
A descriptive cross-sectional questionnaire survey was carried out to identify the choice of postgraduation and the factors affecting the choice of specialty areas among interns in a dental institution in Bhubaneswar, India. The study was conducted in one of the private dental colleges during the last week of November 2014 after obtaining permission from the concerned authorities. Ethical consent was obtained from the Institutional Review Board before the start of the study.
Total enumeration method was followed. Data were collected for two consecutive days. All the interns who were present during those days and willing to participate formed the participants of the study. Informed consent was obtained from every participant before the start of the study. Of the total 50 interns, 43 of them participated giving a response rate of 86%.
A self-structured closed-ended ten item questionnaire was developed. The questionnaire was developed based on various questions regarding similar topics from the available literature.,,,,
The questionnaire was assessed for its comprehensibility by ten volunteer interns of the previous batch. It was then modified to its final form on the basis of their feedback.
The questionnaire was divided into 3 parts:
- First part obtained information on interns' demographic characteristics such as age, sex, and parent's educational qualification and income.
- Second part enquired about the possible future plans of the intern, choice of postgraduation, and the support system for postgraduation.
- In the third part, the interns were supposed to rate the factors influencing their choices of postgraduation on a 5-point Likert scale, with five indicating very important to 1 indicating not at all important.
The participants were assured of confidentiality as no names were recorded. Data collected was analyzed using the Statistical Package for Social Sciences (SPSS) version 17 (IBM, Chicago Inc., IL USA). Descriptive statistics, mean rank score, and Chi-square tests were sought. The level of statistical significance was set at P < 0.05.
| Results|| |
Out of the 50 interns, 43 of them participated in the study (n = 43, response rate 86%). They were in the age group of 22–24 years with the mean age being 22.93 ± 1.009. About 39.5% (n = 17) were male and 60.5% (n = 26) were female. Majority (95.3%, n = 41) of the interns reported their nationality as Indian. The majority of the interns belonged to an educated family background with 52.4% (n = 23) and 56.1% (n = 24) interns reported their father and mother to have a bachelor degree respectively. 76.74% (n = 33) of the interns wished to pursue postgraduation immediately after completion of an internship while only 2.33% (n =1) did not wish to pursue postgraduation at any point of time [Table 1]. The difference in the postgraduate plans of the interns and parent education was not statistically significant (P > 0.05) [Table 2].
|Table 1: Distribution of participants based on their demographic characteristics (n=43)|
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|Table 2: Relationship between parent education and postgraduation plans of participants (n=43)|
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The choice of postgraduate specialty was ranked based on the mean [Table 3]. The top-ranked specialties for postgraduation by the interns were orthodontics (27.9%, n = 12), endodontics (25.6%, n = 11), and oral surgery (18.6%, n = 8). Specialties like oral pathology were preferred by 7% (n =3), oral medicine and radiology and public health dentistry by 4.7% (n = 2) of the interns. No significant gender differences were found.
With regards to encouragement, parental (86%, n = 37) and family (62.8%, n = 27) encouragement and support was recorded as the most important factor by the interns in their pursuance of postgraduation followed by encouragement from close friends (60.5%, n = 26) and mentor (51.2%, n = 22). This difference was statistically significant [Table 4].
|Table 4: Distribution of participants on the basis of source of encouragement for postgraduation and its plans (n=43)|
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One year after graduation, most of the interns wished to see themselves as either doing postgraduation or any certificate course. 34.9% (n = 15) of them also wished to join clinical research/hospital management courses or academics. While 5 years down the lane majority (58.1%, n = 25) of them dreamt of either working solo in their own clinical setup or working in a private clinic with partnership (37.2%, n = 16). About 41.9% of them also hoped to as enter academics [Table 5].
|Table 5: Future plans of intern (n=43) 1 year and 5 years after graduation from dental college|
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While calculating the proportion of items influencing the choice of postgraduate specialty among interns, the responses were converted from a 5-point Likert scale to a dichotomous scale (important and not important). Variables focusing on why a respondent chose a particular specialty were ranked based on mean [Table 6]. Own interest (93%, n = 40), income (83.7%, n = 36), and possess skills or talent specific to the specialty (83.7%, n = 36) were ranked highly. Furthermore, ranked highly were scope for private practice (79.1%, n = 34), intellectual content of the specialty (72.1%, n = 31), and scope for consultancy (69.8%, n = 30).
| Discussion|| |
As per the DCI guideline which forms the basis of dental education in India, every dental student is required to complete a 1 year compulsory rotatory internship in all departments before being eligible to receive the bachelor's degree in dentistry. The 1 year internship program trains them to become a safe dental practitioner serving patients to their best ability, developing clinical insight, independent decision making using sound professional judgment and appropriate intervention. It is also during this time that specialty preferences of interns tentatively made during the undergraduate years get consolidated. This cross-sectional study assessed the different factors affecting the choice of postgraduate specialty among interns in a dental institution in Bhubaneswar.
The present study reported higher number of females as compared to males, a finding common to many other studies on dentistry.,,, The majority of the interns in our study wished to pursue postgraduation immediately after internship. This may be the result of the increasing number of specialization courses in India over the past few years and the high monetary gains by practicing in a specialty field. Most of the interns reported to be from professional families with well-educated parents which might have been influential in determining the future career plans of the interns. However, no significant association was found between father and mother's education on the intern's future plans of postgraduation, P > 0.05. Similar results were found in another study by Orenuga et al. on Nigerian dental graduates. Parental support and encouragement in pursuing plans for postgraduation were found to be statistically significant P < 0.05 in this study. A possible explanation could be that in India, most students are dependent on their families financially and emotionally hence their encouragement and support is vital to their decisions.
Specialties such as orthodontics, endodontics, and oral surgery were the most favored while oral medicine and radiology, oral pathology, and public health dentistry were not preferred by the interns. These results are similar to other studies reported in the literature., Even in the medical literature, the graduates prefer surgery more than other specialties perhaps because of the perceived prestigious status among medical specialties. No significant gender differences were recorded in the choice of postgraduate specialty.
Among factors affecting the choice of postgraduation specialty, in our study, students own personal/professional interest followed by good income, possess skills/talents specific to that specialty, scope for private practice, and intellectual content of the specialty were some of the most important factors. The least important factors were spouse opportunity, unsure of specific clinical skills, lack of overcrowding in the field, scope for research, and interest in community service. These results are in contrast to another study where good income and was ranked moderately important while the factor of predictable work hours was ranked relatively highly along with clinical training and intellectual content of specialty. An interesting point was that though investment in medical/dental education is quite expensive; in our study and in another study, educational debt was ranked as moderately important factor. Here, again no gender differences were observed with any of the factors.
The career preferences made by dental students and factors influencing these preferences are of importance to dental workforce planners especially in times of oversupply or undersupply of dentists. With regard to the future plans of the dental graduates in our study, most of the dental graduates visualized themselves to be in clinical practice (solo or in partnership) 5 years down the lane. Very few of them wanted to work in a government or a military set up. At present, less than 5% of dentists are employed in public health-care systems. Reasons could be because private practice of dentistry is more fruitful than being attached to the dental hospitals. Working at a dental hospital provides fixed income with slower annual growth as compared to a private practice. This trend away from the general practice in public hospitals is disturbing, as primary care can best be provided at the community level by general practitioners, especially in rural areas where the disease burden seems to be comparatively high through primary health centers and community hospitals.
Declining interest in academic dentistry is a major concern among many societies. Dental faculty members often complain of low salary, heavy workload, and full time working hours and thus have less desire in getting an academic position. Considering the fact that one of the major motivations in choosing dentistry is independent working hours, most dentists would prefer to reduce their working hours and devote more time to self and family. A considerably low percentage of interns in our study showed interest in pursuing an academic career which is a cause for concern that may lead to faculty shortage thus adversely affecting the quality of dental education in dental schools.
There are many factors playing role in the specialty selection and preference among the dental interns. These all substantial factors should be equally justified and addressed for all specialties of dental science so that this quantitative and qualitative inequality of dentists and specialists can be nullified.
Limitation of the study
Being confined to interns from a single dental college, the results may not be applicable to other parts of India. Conducting a focus group or pilot testing the questionnaire prior might have helped us to assess if all of the important factors are listed. A few open-ended questions could also have been included to provide more clarity.
| Conclusion|| |
This study was aimed at identifying the most important factors influencing the choice of postgraduation among interns. Further studies may be conducted to find out if they actually pursue the specialties they intended to and their level of satisfaction.
Furthermore, encouraging the DCI or other organizations to administer a similar annual questionnaire to all interns in India would provide a consistent way to track national and regional trends in postgraduate dental education. Delineation of factors that influence students' choice of postgraduate specialty may assist in predicting and proper planning of the dental workforce in India.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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Department of Public Health Dentistry, Institute of Dental Sciences, K-8 Kalinga Nagar, Bhubaneswar - 751 003, Odisha
Source of Support: None, Conflict of Interest: None
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]