SPECIALTY PREFERENCES AMONG UNDERGRADUATE DENTAL STUDENTS IN LAGOS STATE NIGERIA

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A.O. Awotile¹, L.L. Enone¹, C.O. Amadasun¹, F.O. Oburo², T.O. Adenuga-Taiwo¹, W. Alakija³

1. Department of Restorative Dentistry, Faculty of Dentistry, College of Medicine, Lagos State University, Ikeja, Lagos.
2. Department of Restorative Dentistry, Lagos State University Teaching Hospital, Ikeja, Lagos.
3. Department of Community Health, Faculty of Clinical Sciences, College of BMedicine, Lagos State University, Ikeja, Lagos.

Abstract

Background: In choosing Dentistry as a field of study and specialization, adequate information as well as the passion for the provision of oral health services should be taken into consideration.

Objectives: To determine the recent trend in career choices, aspirations and the reasons for choice of area of specialization among dental students in Lagos State, Nigeria.

Methodology: This was a cross sectional descriptive study that utilized a structured questionnaire to collect the demographic data, reasons for career choice, career aspirations, reasons for specialization, reasons for non-specialization and practice preferences from dental students aged 18 to 32 years. The data was collected and analysed using SPSS version 23. Associations between categorical variables were assessed using Chi square and Fisher exact tests. P-value <0.05 was assumed to be significant at 95% CI.

Results: A total of 139 students (males 38.8%, females 61.2%) with a mean (SD) age of 23.04±2.6 years were involved in this study. Interest in Dentistry was the major reason (74.8%) for choosing the profession by the students and 2.2% of them chose Dentistry due to peer pressure influence. Oral and Maxillofacial Surgery was the specialty of choice (34.1%) followed by Orthodontics (18.7%) and Conservative Dentistry (12.1%) respectively. Dental Radiology (1.1%) was the least popular specialty. Slightly more than half of the students, 46(50.5%) intend to practice outside Nigeria.

Conclusion: Most of the students chose Dentistry based on their interest in the profession and about half of them intend to practice outside the country. The most sought after dental specialties were Oral and Maxillofacial Surgery, Orthodontics and Conservative Dentistry respectively

Keywords: Dentistry, Career, Specialties, Dental students

Introduction

One of the most important decisions in an individual’s life is to choose a field of study. This decision would impact on the individual’s overall life and future^.1 Many professions and career paths are available in modern times. This makes the choice of the career to pursue in life very challenging to many individuals.² A lot of money and time would be spent in order to gain the required skills and competencies for selected careers, hence it’s important that adequate thoughtfulness and carefulness is considered in choosing a career path as well as having adequate information.¹

Dentistry is defined as the “evaluation, diagnosis, prevention and/or treatment (non- surgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/ or the adjacent and associated structures and their impact on the human body; provided by a dentist, within the scope of his/her education, training and experience, in accordance with the ethics of the profession and applicable law”.³

The history of Dentistry was initially documented by Dr. Vincenzo Guerini, of Naples, Italy, who wrote about Dentistry from the earliest times to the beginning of the nineteenth century.⁴

Dentistry is a noble profession that provides oral health care to all categories of people, therefore, it is important that those joining the profession and planning to specialize have adequate information and genuine passion for provision of oral health services.² The choice of Dentistry as a career among dental students has been a subject of study for many years and in different countries around the world.⁵ The motivational factors for dental students career choices according to a study were modifiable work schedules, time to spend with their families and avenues to offer service to disadvantaged members of the populace.⁵ Altruism, which is the belief that the wellbeing of others is more important or equal to the wellbeing of oneself, has been discovered to be a major dental students’ primary motivation as well as prestige, social image and financial reward.^7,8 Also, comparing the two genders, income was more important for male students than the female ones, who mostly relied on family advice in their study of choice.^1,9

Over the years, Dentistry has evolved into various specialties, subspecialties and has become an advanced science. The different specialties in Dentistry include Orthodontics and Dento-facial Orthopaedics, Dental Public Health, Oral and Maxillofacial Surgery, Endodontics, Periodontics, Oral and Maxillofacial Pathology, Oral and Maxillofacial Radiology, Conservative Dentistry, Paediatric Dentistry, Oral Medicine and Prosthodontics.³ In Nigeria, Endodontics is one of the subspecialties under Conservative Dentistry. Newly graduated students have to choose between joining the workforce immediately and continuing their education and training as specialists.¹⁰

Some factors influencing specialty choice include the expectation of material rewards, societal appreciation of a specialty and specialists, response of patients to treatment by specialists and the role of specialty teachers^.11 Other factors that influence the choice of career and specialties include: academic interest, service to humanity, childhood dreams and personal interest, parental influence, friendliness and attitude of teachers. ¹² Gender differences have been observed in the choice of area of specialization. Females have been found to prefer certain specialties compared to males, such as males preferring the surgical specialties.¹² Prestige was also a factor that contributed to choice of specialization, as males based their decisions on this while females did not. Whereas some of the highest influencing factors for women were easy compatibility with having a family and enough time for leisure activity.¹³

Other factors identified are potential financial income, self-employability, personal interest, job security, fear of litigation, possession of special skills, intellectual content of specialty, affluence of residents in the programme, length of residency, good income within specialty, private practice opportunities, pass rate in department and grants for overseas training.^14,15

It has also been noted that specialization desires formed during undergraduate medical education are retained even when these undergraduates become interns.¹¹ It is therefore important to ensure that adequate career information is provided to future undergraduate dental students, so as to guide them in their career and specialty choice path.¹⁶ Specialty preferences of dental students determine to a great extent the future composition of the dental workforce, as persistent shortage and an unequal distribution of workforce across the dental specialties in Nigeria has been observed over the years.¹³ Determining the specialty preferences of dental students is very crucial in the planning of oral health service, policy formulations and in career counseling