DEBATE: A lack of funding and a lack of ministerial understanding of the high costs of the degree programmes is forcing AU and KU to use research grants on training new dentists, write the two deans Allan Flyvbjerg and Ulla Wewer.

2015.10.21

By Allan Flyvbjerg, Dean of the Faculty of Health, AU and Ulla Wewer, Dean of Health and Medical Sciences, KU

The medical and dentistry degree programmes have more in common than white lab coats and the extremely high minimum grade point averages.

Both degree programmes offer a demanding theoretical syllabus followed by the crucial and important clinical training, where the future graduates actually get their hands on – and get to try – what they will be working on in the future.

A lack of public dentistry hospitals

This is a very well-tested educational model that benefits the students and, not least, the patients who will be treated by the graduates in the future.

If you have been a patient at a public hospital, it is very likely that you have been attended to by a medical student. The situation is somewhat different in the case of clinical training for dentists. As there are no public dentistry hospitals, the university operates its own odontological hospitals.

The reason is that we wish to ensure that the dentistry students both learn and train their skills – so that they are able to diagnose and treat oral and dental diseases. These are, in the nature of things, fully expected competences for a dentist. Also for the newest graduates.

No dentists on call

This places special demands on the university's dentistry degree programme and its dentistry hospital. Not least because, while a newly qualified medical doctor who is in doubt about something, can resort to a physician on call, a newly qualified dentist is often alone with the patient at the clinic. 

This is taken into account during the training of dentists. The training facilities at the dentistry hospital are fully-equipped, and the teaching in the clinic takes place under the supervision of clinical instructors. However, the problem is that running a hospital is expensive.

As operators, the university is responsible for everything from treating the wastewater from clinical treatment, to phasing-out the use of silver amalgam, and the continuing education of the clinical instructors. Previously, the university was awarded a specially earmarked “clinical grant” towards the operation of the hospital, but this has not kept up with the times at all. The consequence is that the university uses an increasing portion of its research grant to operate the hospital.

A completely untenable situation, which sends the competitiveness of our odontological research into a negative spiral, especially as it is already very difficult for the odontological researchers to obtain external grants.

Hidden fight for survival

It is common knowledge that the operation of Denmark’s hospitals faces severe and sustained pressure, though there is strong political and public attention.

By comparison, the operation of the country's two dentistry hospitals is a lonely fight for survival without spectators. We have again urged the Minister of Higher Education and Science to consider a solution in the form of a “clinical taxameter system”, which takes into account the high cost of training dentists.

In England and Norway, the dentistry degree programme is financed in this way. We believe that it is both a reasonable and fair model.

The question is: do we wish to continue to train high quality dentists in Denmark? And whether we should accept that the internationally recognised quality of our odontological research is being eroded?

It is up to the politicians to give us an answer!