February 1, 2003
by Stephen Zamon, DDS
If someone asked you who the most important person in the dental school is, what would be your response? Is it the Dean, a department head, the head of research, the head of clinics, full or part-time faculty?
To me, the dental student is the school’s raison d’tre. Without the student, there would be no dean or heads or support staff — in short, no school. Everything in a dental school must flow from the concept of educating that one student. How do we make his or her stay with us a meaningful experience? How do we challenge them, nurture them, and excite them about our wonderful profession? How do we turn them into a successful dentist, graduate student, researcher or teacher? From orientation to convocation, every effort of the academic, clinical, and support staff must be geared to create an environment that makes the school ‘student-user friendly.’
Unfortunately, not everyone involved in the education of that student believes in or understands this concept. Some educators employ the teaching technique of condescension and intimidation. Instead of challenging students to raise their sights, they bring students down with callous sarcasm. They set poor examples by undermining colleagues’ opinions and not admitting that there is more than one path to proper treatment. The result is that many students leave our Faculty vowing never to set foot in it again. This is reflected in their reluctance to donate to building campaigns or participate in continuing education courses.
Are things better today than in the past? Most definitely. Many of my fellow instructors are more empathetic and genuinely interested in the well-being of their students. But I still witness and am privy to incidents where some of my colleagues just don’t get it. Just last year one student came to me after a full-time staff instructor essentially called her an idiot in front of her patient. To her credit, she did not let the matter lie, but registered a complaint and was given an apology. I can only hope that the instructor learned from the incident.
The teaching of clinical dentistry in the fourth year or Comprehensive Care Programme (CCP) at the Faculty of Dentistry, University of Toronto, is the culmination of a student’s entire education up to that point. Previously, the first two years were spent learning the science of dentistry, and the last two applying the science in a clinical setting. Typically, a fourth year demonstrator might have said: “Forget everything you learned in the first two years.” No longer. The new curriculum endeavours to teach clinical dentistry at a first year level using evidence-based research. Students will know why something works or not. They are taught to be critical of everything, to question traditional thinking, to ask their demonstrators: why?
The CCP is designed to simulate a private practice as closely as possible. A team of instructors from the departments of peridontics, restorative, prosthodontics, and endodontics are headed by a coordinator. The coordinator meets with each student to formulate a treatment plan for every patient, assisted by all the disciplines. It is important that the coordinator be a well-experienced general practitioner so that a practical plan can be implemented, given the student’s level of expertise.
In a recent editorial in Oral Health, Dr. Randy Lang discussed the difficulty in attracting quality full-time faculty to Canadian dental schools because of budget constraints. The problem is not unique to Canada: many American full-time positions are not filled and, in fact, some schools south of the border have closed. The government must realize that oral health is part of medicine and should be funded as medical schools are. Dental schools supply a necessary function: in addition to the student’s education, they provide good care for indigent people. It is extremely costly to build and maintain a dental school because of equipment, supplies, and staff. The cost is borne by government, income from the clinic, and tuition. In order to keep the clinic fees low, the school consistently runs at a loss. Unless the government increases its funding, dental school tuition, now well above $20,000 per year, will continue to increase to American levels, leaving our graduates with debt of hundreds of thousands of dollars upon graduation.
Stress is as much a part of dental school as private practice. There have been instances where students are overwhelmed by pressure and have no place to turn. There must be a defined network of psychological support to help those students who are having difficulty coping.
I think, however, there are winds of change. A new administration claims it wants to make the school student-friendly. Indeed, in a recent article in “Alumni Today” Simon Young, the Dental Student’s Society President, noted: “Students at the faculty are now enjoying a better experience than ever before; students’ suggestions have not been falling on deaf ears; they now have an active role in defining their own educational experience.” Another positive step that the administration has taken is the reinstatement of the interview as part of the admission process, allowing other criteria as well as academics to be included in a candidate’s assessment.
It is paramount that every decision in a dental school, from the curriculum committee to clinical affairs to student support, must develop from the premise that the four years that student spends there is an enriched experience.
Remember the most important person.