Labour has announced a plan to provide free dental care by - in part - training more dentists, but students in the country’s only dental school are asking: who’s going to teach them?
Free dental care could return $1.60 to the economy for every dollar spent, according to last year’s incredibly named “Tooth be Told” report by the Association of Salaried Medical Specialists. Labour wants to make this a reality, and to staff this new workforce they plan to increase the enrolments of the Bachelor of Dental Surgery course by 50%. “The domestic cap increase would be welcomed,” said Professor Paul Cooper, Otago’s Dentistry Faculty Dean.
Otago’s Dental School has campuses in Auckland and Dunedin. Any new dentists will have to either graduate from one of those institutions or be brought in from overseas. And while debate swirls about the feasibility of this plan, with many dental professionals pointing out “cavities” in the model, students currently in the course are worried about a more fundamental problem: who’s gonna be their tutor?
We spoke to a range of dental school students and graduates at the start of the year about changing patient fees at the Otago campus, and the one problem they all brought up was an apparent lack of tutors. These tutors are in charge of supervising practical sessions in the Dental School, and students have complained that they’re already stretched thin.
The practical sessions take place in rows of operating environments called bays, and ideally a tutor will supervise one to two bays of students per session. Jeremy*, who left the Dunedin programme two years ago, said that it wasn’t rare to see a tutor trying to balance four or five bays at once.
These days, “by the books”, that seems to have changed and a tutor is responsible for every row. But when enough tutors can’t be found, rather than short-staff the sessions, the practicals can be cancelled entirely. Jeremy complained that often their practical sessions would be cancelled because a tutor couldn’t be found, and said that the quality of a dental education at the Otago campus was reflective of this shortage. When asked if he would prefer his dentist to have trained at the Dunedin or Auckland campus, he just laughed and said, “No question, Auckland.”
The shortage costs students experience, and adding an extra 50% to that class size would have to be met with a similar rise in tutors. Because right now, the consequences are apparent: Rose* said that she’d had friends blocked from practical sessions because they already had “too much experience”. These people had only performed two tooth extractions, but priority was given to students who hadn’t done any at all. Josh* said he knew people who did their first root canal just two weeks before leaving Otago - though apparently “that’s not too unreasonable”.
Some tutors are graduate students, but plenty are professionals from the clinical world. At the Auckland campus, apparently most are clinical. There are several reasons why Dunedin has fewer clinical staff, including the fact that Dunedin is just a smaller city with fewer people. But there’s also the fact that the pay for tutoring a session is lower than competitive professional rates, meaning there isn’t as much incentive to take on the workload.
Jeremy said that with tutors stretched thin, even the simplest procedure can take hours. Students are meant to see two patients in a single three-hour session, but it was “normal” to only book in one “because you know that’s all you’ll have time for.” And when that single patient cancels, which happens “more than you’d think,” students are left without a second patient and nothing to do during the session. “And then [the admin] criticise you for not seeing enough patients!”
We asked the Uni about how they plan to fill this workforce. Paul Cooper was swamped with media requests this week but was able to get back to us. He explained that the increase in enrolments wouldn’t happen overnight, and that a longer lead-in period would give them time to grow the tutor pool. “We would aim to start building the dental tutor workforce to be ready for an increase in class sizes,” he said.