Article
Gaining work experience in a healthcare field such as Dentistry is essential for any potential Dental student. There is no other way to appreciate the demands of the profession, and shadowing a general dental practitioner for a period of time will give an invaluable insight into the career an applicant may be considering. Entering a vocational degree without a good foundation of the career the degree is training for can result in students dropping out of their degree or leaving the workforce, minimizing the financial return for all stakeholders concerned – the NHS, Office for Students and the students themselves. This editorial will outline difficulties encountered by students seeking work experience and address many of the concerns raised by dental professionals when being asked to provide work experience placements.
The landscape of UK Dental School recruitment today
There are 17 Dental Schools in the UK and, in general, Universities report applicant to place ratios of between 8 to 16 applicants per place (unpublished data reported by Admissions Staff at UK Dental Schools). A typical offer from a UK Dental School is 3 A levels at grades AAA with some Universities offering A*AA, or a BSc at a 2:1 level. Dentistry applicants also often complete further testing, such as the Universities Clinical Aptitude Test (UCAT) or BioMedical Admissions Test (BMAT), as specified by each individual University. Furthermore, applicants are often asked to provide evidence of volunteering placements within the wider society, and work experience in a dental setting.
Why is work experience needed?
Most UK Dental Schools either strongly recommend or require applicants to have undertaken work shadowing prior to applying for Dental School.
Students are training to become a dentist and, simply put, if they do not appreciate the career they are entering then they cannot make an informed decision. Unlike many higher education pathways, such as purely academic degrees, the career decision is made at the point of entry to the University course as opposed to during or after. Students may be encouraged into the profession by family or careers advisors, who themselves may have an outdated or inaccurate idea of the reality of a career as a newly qualified Dentist today.
Dentistry has had a reputation as a high earning career for many years. Today the wage for salaried dentists within the NHS is between £40,629 and £80,9001 but, as many of us know, there is a huge range of earnings within the self-employed sector. While it can certainly be said that Dentistry is a career with potentially very high earnings, it could be argued that the reputation Dentistry has as a ‘high earning job for life’ may be outdated. Furthermore, Dentistry can be a stressful career, with litigation fear, dissatisfied and difficult patients and risks of making mistakes being shown in a recent survey to be some of the main stressors.2 It is important that potential dentists know about the scope of the career, the positive aspects, the day-to-day working life and the potentially negative aspects in order to make an informed decision as to whether they think they are the right person for the job. The only way for students considering Dentistry to do this is by shadowing a Dentist, and discussing the career with somebody who is in the profession.
Access to work experience
The demographic of students entering Dentistry is still skewed towards those from areas with higher progression to education and higher socio-economic areas, and female dental students outnumber male by approximately 6:4.3 It is important to note that underrepresented groups, such as students from areas with low progression to higher education, may find access to work experience placements more difficult than those who may have family members or friends within the profession. Students from lower socio-economic groups have a lower chance of acceptance onto Dentistry courses when compared with higher socio-economic groups (40.3% cf 51.4%),4 and this inequality is the focus of many current Widening Participation schemes nationally.
What does all this mean to a Dental Practitioner?
Many dentists enjoy providing work experience, as it offers them an opportunity to really make a difference to a potential dentist of tomorrow. Many want to enhance their practice's reputation, or to contribute to enhancing future workforce planning.
Below are some quotations from current BDS students at the University of Birmingham. It is worth noting that these students commenced their course when work experience of ‘10 days’ in an NHS practice was strongly recommended, but not essential for successful recruitment. The position taken now is that a minimum of 3 days in a practice with either NHS or NHS and private dentistry is essential. All were in clinical years of training at the time of answering, and they were asked:
‘It was very difficult for me to get work experience as all the dental practices didn't have insurance to cover under 18s (that's what they told me) and the fact that it is in the local area it might breach confidentiality. I pleaded with my own dentist and finally got a week, however, he made it very clear to me that he only accepts students from a certain school so I should count myself lucky. I ended up doing one week with him.’
‘If I had been able to do work experience with a GDP, I think I would've gone on to do medicine.’
‘NHS GDP work experience would definitely have been more useful but I wasn't able to get it. Perhaps I will be in for a shock in DFT.’
‘I personally found it quite challenging to get work experience. None of my family was in medical or dental professions and my own dentist didn't want to take on work experience students.’
‘I enjoyed my work experience a lot more than I thought I would and the role of a dentist was much more extensive/specialized than I originally thought. It made me appreciate dentistry a lot more and I felt I made an informed decision.’
‘I was not able to get NHS GDP work experience. At the time, private GDP was accepted. I got the impression that only private dentists had time to put up with teenagers looking for work experience. I probably contacted around 10 GDPs, both NHS and private.’
These stories show how useful and valuable having a work experience placement is for a potential dental student. You may remember the first time you observed a dentist and what it taught you (positive or maybe not so positive!) and the difference you can make to a student's life is huge. Often, work experience placements are organized through friends or family, but for lots of students from more diverse backgrounds this may not be possible.
Perceived barriers to providing work experience
Below is a list of perceived barriers to providing work experience encountered by local practitioners across the West Midlands at a CPD event; a mix of private and NHS dentists, and those who did and did not offer work experience placements:
Myth 1: ‘Confidentiality is a problem’
Confidentiality is obviously an essential part of a Dentist's role, and this needs to be outlined to any student undertaking work experience during an induction at the start of a placement – a template for a suggested induction is included in the HEE document reference at the end of this article.5
Myth 2: ‘We can't have work experience students, it's an insurance issue’
‘Individuals on work experience are covered by your existing employers' liability insurance policy, provided they are a member of the Association of British Insurers’.5 Many indemnity organizations also view the supervision of work experience students as part of the role of a dentist, including the DDU, MDDUS, and Dental Protection.
Myth 3: ‘Health and safety means we can't provide work experience’
Any students work shadowing will not be involved in clinical duties, therefore there are no extra health and safety concerns outside those of the usual business of a dental practice.
Myth 4: ‘We can't have any work experience students as we or they haven't had a DBS check, or they aren't registered with the GDC’
If students are aged 16-17, no DBS check is necessary for the supervisor (although all GDPs should have had a DBS check). No DBS check is needed for those on work experience either, as they must be supervised at all times within the practice. The student on work experience will not be undertaking any form of clinical Dentistry, therefore do not need registration with the GDC.
Myth 5: ‘Our patients wouldn't feel comfortable having a student observe their treatment’.
There may be instances when this is true, however, in the vast majority of cases, patients are happy to have an observer present, and many feel that it shows that their dental practice is providing a good standard of care. It can be made clear by reception that a work experience student is there that day and then the patient has an opportunity to decline having the student present if they would prefer before they enter the surgery.
Nearly all of the list above is addressed by the document Filling you in - Dental Work Experience Toolkit,5 published by Health Education England and Dental Schools Council in 2016. This document is available online (see link in references) and contains all the information a practice needs in order to provide work experience placements.
I want to provide work experience. Who do I offer it to? How can I run the placements?
Dentistry students may find that 3 days provides them with a good all-round appreciation of the job. Simple things like maybe offering a one-for-one arrangement where, for every friend or family member you offer work experience to, you offer the placement up to another student from a different recruitment pathway as well. This could be a student who has approached the practice, or a student who is currently on a Widening Participation pathway at a local University. Again, the HEE document5 has all the information you will need on preparing for and organizing a programme for a placement.
It is sensible to assess the likelihood of a student having the academic requirements to enter Dentistry; while you do not need to screen work experience applicants academically, it would make sense to ask if they are aware of the academic grades they will need to enter the profession and ask if they are confident of achieving these.
In conclusion, work experience can be life changing for students considering a healthcare career. Please do give some thought to it if this is something you can help with – your efforts should be minimal and the return is potentially very rewarding!