Career prospects among dental and medical residents: A cross-sectional study

INTRODUCTION

Career refers to the process and actions taken by a person throughout a lifetime, especially those related to the person’s occupation. A career is often composed of the jobs held, titles earned, and work accomplished over a long period rather than just referring to position.^[1] The number of students enrolled in medical education has increased by around 85% in the past 10 years from 188,187 in 1995–1996 to 348,485 in 2005–2006^[2] indicating that a large number of students prefer to select medical fields as their most suitable career option. The current estimated doctor to population ratio in India is 1:1700 when compared with world average of 1.5:1000^[3] indicating that despite improvement in health-care delivery systems, there is still a demand of doctors for the treatment of common diseases. It is not only the medical profession which has seen this transformation but also dental profession has witnessed similar changes. The total numbers of dental colleges in India according to the Dental Council of India (2013) are 300 and the numbers of dental graduates passing per year are 25,000.^[4] In the past 10 years, the dentist population ratio in India has increased considerably. The current dentist population ratio in India is 1:10,000.^[4] Due to the increase in the number of colleges and number of dental graduates passing every year, the dental profession has also witnessed tremendous changes. On personal interactions with the dental graduates, it was found that they were not satisfied with their jobs because opportunities for dental graduates were limited with very few jobs in government sector.^[5] The practice of dentistry is changing. Group practices in the United States are expanding. The character and structure of large group practices are shifting as well.^[6]

A recent study by the authors examined dentist satisfaction in different practice settings. In that study, information about career satisfaction was gathered from dentists practicing in three settings: Solo practices, small group practices, and large group practices.^[7] Dentistry is a profession with a wide range of possible pitfalls where dentists are subject to wide variety of occupational factors that greatly affect their well-being.^[8,9] Many studies have shown high prevalence of physical and psychological disorders in dental practice also.^[10,11] Therefore, it is hardly surprising that dentistry has even been classified as a hazardous profession.^[12] However, as any other profession, dentistry is a rewarding job as well. There have been very few studies reported in literature among dental and medical residents in Kerala. Hence, this study was conducted with the aim to compare the career prospects among medical and dental residents in private institution.

MATERIALS AND METHODS

We conducted a cross-sectional study in the month of June 2019 in private dental institutions (Al Azhar Medical College and Al Azhar Dental College) with the aim to compare the career prospects among medical and dental residents.

The study included a total of 52 dental residents and 60 medical residents based on convenience sampling technique. Hence, the total sample size comprised 112 medical and dental residents. The sample size estimation was done based on the findings of the pilot study done on 25 medical and dental graduates, and using the formula of Cochran^[13] for the determination of the number of people keeping alpha as 0.05 and accuracy as 0.08, the total sample size of 112 was finalized. Ethical clearance to conduct the study was taken from the Institution Ethics Committee. The study objectives were informed to the participants and those willing to participate were included in the study. The participants who were not willing to participate were excluded from the study. A consent form was signed by the participants before the study. The participants had the right to withdraw, at any point of time, from the study. No incentives were given to increase participation.

A self-administered questionnaire was distributed to the participants. The questionnaire comprised 10 questions that were designed to assess the satisfaction toward their career. The questionnaire also collected information on demographic characteristics. The questionnaire was distributed to the participants by a single investigator. The questionnaire included multiple choice questions and after receiving the full explanation of how to fill the questionnaire, the participants were asked to select one of the most appropriate choices from the provided options. The study was conducted by a single investigator and any doubts arising during the survey were clarified by the investigator himself who was always available during the study.

All statistical analysis was performed using the SPSS version 20 (IBM SPSS, SPSS Inc., USA) and P ≤ 0.05 was considered as statistically significant. Descriptive statistics and Chi-square test were performed.

RESULTS

Mean age of the participant is 24.52 [Table 1]. Out of 60 participants, 68% belonged to the female category and remaining were males [Table 2]. Significant difference was observed between dental and medical residents regarding reason for selection of field, satisfaction, reason for dissatisfaction [Table 3].

DISCUSSION

The career development and career prospects expressed by dental professionals are an area which has attracted much recent research.^[14-16] In our country, with the increase in the number of dental colleges and increase in the number of dental graduates passing every year, there is a big question whether the dental professionals have satisfaction toward their profession. Very frequent career enquiries and growing anxiety by the residents and graduates motivated us to undertake this study. We compared their career satisfaction with the medical profession which enabled us to assess whether it is only the dental profession that has witnessed change in career satisfaction of graduates or if the medical profession too has also undergone such metamorphosis. The study was conducted by means of validated self-administered questionnaire and a striking difference in career satisfaction was observed among medical and dental graduates. The medical graduates were found to be well satisfied with their profession, whereas the dental professionals expressed low level of career satisfaction. Even amongst those dental residents who expressed satisfaction, a majority (51%) were only moderately satisfied with their career. In a study done by Crossley and Mubarik,^[17] it was found that dental students were significantly more likely to be motivated by “status and security,” “high income,” and the “nature of the occupation” when compared with their medical counterparts. However, in the present study, the dental professionals cited poor salary, lack of interest, and fewer jobs in market as their main reasons for growing dissatisfaction. The present Indian scenario of dentistry is miserable where many of the dental residents reportely went on strikes and even a few cases of suidice also surfaced in recent times. The growing physical/verbal attacks on doctors also should be noted in this context. The growing dissatisfaction prompted them to not recommend the dental professional course to their fellow students. The differences were found to be statistically significant. Nearly 77% of medical residents and 87% of dental residents preferred to go abroad for further studies. According to a recent study, there has been 256% growth in Indian students going abroad in the past decade or so^[18] and most cited better jobs, salary, and better lifestyle as their major reason for going abroad. Research with dental practitioners has determined that system of remuneration, the characteristics of the working environment, and the type of service, in which an individual works all exert an influence on the practitioner’s experience of their working life.^[19-21] The medical and dental syllabus has been dealing with the traditional methods of curative therapy. With the advent of newer technologies in medical and dental fields, majority of the medical and dental graduates agreed with the fact that their syllabus needs to be revised by their council to cope up with the changing trends of education systems. To the best of our knowledge, there have been very few studies conducted in India to compare career satisfaction among medical and dental graduates and the findings of this study is an eye-opener for the council to create job potentials in the market and create better placements for dental graduates to maintain the sovereignty of this profession. Effective steps should be taken by the government to create awareness among masses toward dental treatment to avail dental services. National Oral Health Policy has been formulated by the “Dental Council of India,” through the inputs of two national workshops organized way back in 1991 and 1994 at Delhi and Mysore, respectively,^[22] but till date, it has not been implemented. There is an urgent need to implement the National Oral Health Policy. Only after better placement and better salary will a dental graduate be satisfied with his/her profession and will express the same level of job satisfaction as a medical graduate.

CONCLUSION

In medical profession, it was found that majority (71%) of the total residents were satisfied with their career. Majority (73%) recommended joining medical profession as a safe and bright career alternative. Poor pay scale among 54% of the medical category and 59% suggested less job in the market was the reason. Majority (73%) in medical residents and a very minimal (23%) of the dental residents would recommend the own profession to the fellow colleagues; lack of jobs, poor pay scale, and poor placement are the main barriers leading to dissatisfaction among dental graduates. These identified barriers, if corrected, will lead to a boom in the dental profession. This research was limited to dental/medical residents of one particular city. Therefore, further studies involving a larger sample that included more dental/medical colleges across the state can be carried out to facilitate generalizability of the findings. Social desirability to the self- administered questionnaire and the cross-sectional design does not allow for the assessment of changes in psychological status overtime. It is recommended that the study has to be conducted at multiple sites to get a more generalizable result. The study has included residents rather than graduates, so the expectations of the doctors/dentist career experience might change over the years.