Shortening the duration of dental school not the right solution, Acta contends
The government wants to shorten dentistry education from six to five years. What do dentists and students at Acta dental school think of that idea? “It’s an out-of-the-blue idea that just can’t be done.”
The cabinet wants to shorten dental school from six to five years. Minister of Public Health Ernst Kuipers announced this last Tuesday in a letter to the House of Representatives. This is how the cabinet wants to make dentristry training cheaper to make room for 50 extra study places.
This is because there is a shortage of dentists, one that will only increase since in 10 years, 42 percent of the currently employed dentists will retire. Therefore, dental school must be expanded from 243 places to 375. The cabinet wants to make money available for this by reducing the number of training places in medicine and shortening the duration of dental school.
“We understand the major problem of the dentist shortage, but from our expertise as Acta, we think there are better solutions than shortening dental school, such as increasing enrollment and training more foreign dentists,” said Etienne Verheijck, director of education at Acta dental faculty. “This plan appears to marginalize oral health care even further.” Indeed, oral health care receives a much smaller budget (€3 billion) compared to health care (€99 billion), dentists believe, despite the fact that oral health care is largely paid for privately and training is relatively inexpensive. In fact, training a clinically competent doctor costs three and a half times as much as training a clinically competent dentist.
Dentists and the professional association for dentists KNMT already announced in an RTL News article that they consider it an “unfeasible and bad plan.” Students are also concerned.
Lotte Koning ter Heege (23), a dental student at Acta, says: “What concerns me is that we need more dentists for the increasingly complex oral care we have to provide. This is due in part to the increasing number of elderly patients who keep their own teeth. That leads to more complex care because the patients take more medication and their teeth have a history. So shortening the training means less time for complex care during training, and that is precisely the care we need to start providing.”
Indeed, the further students get in the training, the more complex patients become, which is why the sixth year is also important. Eliminating the sixth year results in dentists who are less competent and costs go up because specialists are then needed, Verheijck warns. “We see that with dentists who have had a five-year education, as used to be the case.”
Yo-yo policy
This is not the first time that the government has adjusted the length of dental school. Verheijck comments: “The government keeps going back and forth. We started in the 1960s with a six-year course of study. In 1986 it went back to five years, and in 2008 it went back to six. So the government is looking for the right length of study.”
A seven-year course would be even better, says Albert Feilzer, former dean of Acta and professor of general dentistry (UvA & VU). Dentists nowadays must deal with modern digital techniques in addition to the old analog ones, and also handle larger numbers of staff and elderly who have many more medical problems.
According to Feilzer, five years of training is not possible: “A dental hygienist who can make small fillings receives a higher vocational education in four years. That would mean that a dentist should learn all surgery, drilling, all types of treatments ranging from root canal treatments, periodontology, dentures, crowns, bridges, you name it, in one additional year. That is an idea plucked out of thin air that is simply not possible.”
According to the cabinet, a shortening of dental training from six to five years is possible within the applicable training requirements laid down at the EU level. Feilzer says: “They ignore the fact that in many countries, dentists must first do an internship following a five-year training program. And all programs differ. In the U.S., the system is set up differently, but a comparable program takes about eight years.”
“The proposal insinuates that we were included in the consultation,” Verheijck responds, “but that is not the case. It would be very unwise of the cabinet to act without considering input from dental professionals. We would like to collaborate and play an active role in this. I propose setting up a national working group with the three programs in Amsterdam, Groningen, and Nijmegen.”
According to Verheijck, the only sustainable solution to the dentist shortage is to increase the enrollment of dentistry students. “There has already been consultation with other study programs and there is sufficient capacity. The Acta building is also large enough, although rooms would have to be adapted.”
This would inevitably cost more money: “There is no solution that will cost less,” says Feilzer. In addition, the current programs are already suffering from serious deficits because they do too much for the money they receive. Says Verheijck: “We have been working for years to put on the ministerial agenda that more money is needed. Corners have already been cut everywhere.”
