Being a new dentist today is a much different experience compared to 70 years ago when the NHS was first established – and some would say the same for 20 years ago. In this 70th anniversary year for the NHS I spoke to Shivana Anand, a young dentist and co-founder of a training company for new dentists, about what it’s like to qualify and become a dentist today, and what the future looks like…
Nigel Jones (NJ): Shivana, you only graduated four years ago, what was your experience of dental school?
Shivana Anand (SA): I think it is a very isolated environment in terms of the dental community. You’re in a bit of a bubble because you have a team of tutors and consultants, etc. who check everything you do. However, when you come out of university and move into dental practice you’re a lot more independent, and it’s a bit daunting. It makes you feel anxious and excited but bridging that gap was a big leap for me and is a big leap for many dental students for various reasons.
There’s a gap between dental school and practising dentistry – both clinically and from a business point of view. Whilst you’re studying, you learn the fundamentals of everything at a good level but you don’t necessarily learn the more specialist stuff to the same level, you only find your niche later. In terms of the business logistics of working in a practice, it’s completely new territory. At school someone else takes care of everything but in practice you have to look after it all yourself – finances, monthly income, outgoings, your reception team, your nurse, team morale. That’s what young dentists struggle to get to grips with the most as there’s no opportunity to learn about it before you have to do it for real.
“Whilst you’re studying, you learn the fundamentals of everything at a good level but you don’t necessarily learn the more specialist stuff to the same level, you only find your niche later. In terms of the business logistics of working in a practice, it’s completely new territory.”
NJ: When it came to entering practice, how did reality compare to your expectations?
SA: It’s a massive learning curve and I was able to take it on the chin, I was up for the challenge and I’m quite motivated to make the best of myself. But I have been told by a lot of younger dentists that they don’t feel the same at all, they feel quite scared, quite vulnerable and quite worried. There’s a lot at stake when you first go into a practice, especially as a foundation dentist when you’ve just graduated and you don’t have the choice of which practice you go into.
That year in practice really helps you to hone your skills as a dentist and builds your character so if you end up in a place where the fit isn’t correct, it can actually have a negative impact on you from both a clinical point of view but also from a personal perspective, and a lot of young dentists can end up feeling disheartened.
NJ: Do you think that feeling of vulnerability stems from a risk of litigation and complaints, or something broader?
SA: The risk of litigation is really hammered into young dentists when you’re fresh out of dental school. The culture is ‘you are a young dentist therefore you’re not as good a communicator and you’re not as good clinically so therefore you will be sued’. I don’t dispute the facts and figures, I think complaints and litigation are very prevalent, and therefore a source of concern. But I also think there’s a huge change within dentistry – there’s a lot more courses, social media use is high, young dentists are rising up, wanting to exceed expectation and do well. But with these changes comes added pressure. The pressure comes from a range of factors, such as, having complaints, being sued, not being good enough, finding your passion or niche, working in your new team, fear of what society think or say about you and how your patients will view you as a young dentist. So, in essence, yes, vulnerability is present but not necessarily only for risk of litigation and complaints, there’s a whole host of other factors involved.
“The risk of litigation is really hammered into young dentists when you’re fresh out of dental school. The culture is ‘you are a young dentist therefore you’re not as good a communicator and you’re not as good clinically so therefore you will be sued’.”
NJ: What have you found to be the biggest challenges since leaving dental school?
SA: Knowing what to do next was the biggest hurdle. Since I was 16 I knew I wanted to be a dentist, and I knew all the things to do to achieve that, in terms of the courses and qualifications to take. There is a path marked out – all the way up until you leave dental school. Then you’re all on your own, the plan has ended and it’s up to you to decide what path to take in order to be the best dentist you can.
NJ: When you talk to your peers or the dentists you’re mentoring, is there a consensus as to the most popular career path?
SA: I see a lot of people who want to be fully private early on in their career, and also a lot of people who would love to be a practice owner but have concerns about the financial burden, whether they have enough experience and are unsure about what steps to take next. I also know a lot of associates who want to specialise and do further training but are concerned about the costs, and time it would take. I’m a massive advocate of speciality training, I’m doing it myself, so it can be disheartening to hear someone say they don’t know how to make it work for them, and it’s a shame that younger dentists don’t feel that information is out there for them.
The NHS is still an attractive option to people, but I think the younger generation is less likely to choose just one area of work. More and more younger dentists, from the moment they graduate, are planning to work partly in the NHS, partly in private, to spend some time specialising, etc. it’s a much more mixed, individualistic approach.
“I think the younger generation is less likely to choose just one area of work. More and more younger dentists, from the moment they graduate, are planning to work partly in the NHS, partly in private, to spend some time specialising, etc. it’s a much more mixed, individualistic approach.”
NJ: What do you think the future of dentistry looks like for this younger generation?
SA: It’s very hard to predict. I still think there’s a place for NHS dentistry but whatever happens in terms of contract reform and the outcome of the prototypes, the only thing we can do as a new generation is to look at the direction the NHS goes in and see if we can positively use it – and if we can’t, we can’t.
NJ: Great, thanks for sharing your experience and insight with us Shivana
Shivana graduated from King’s College London in 2014 and underwent dental core training at The Eastman Dental Hospital, UCL Hospital and The Great Ormond Street Hospital in oral and maxillofacial surgery. She has also co-founded the Dental Training Consultancy and co-wrote a book ‘The Dental Foundation Interview Guide’. Shivana is also an honorary lecturer at the Dental Institute of Guys, King’s & St Thomas’ in London and member of the Wesleyan Junior Advisory Board.