Opening the flood gates: Foreign dentists can challenge the boards in 2011

[McMarauder]

Gaining a license to work in Canada does not necessarily mean that people will work in Canada.  There are many Australians, not just Canadians studying in Australia, writing the board exam as a backup option or as an opportunity to temporarily work abroad.  Plus there are Canadians studying abroad who write it, but may not return to Canada (quite a few in my class).  Furthermore I've met several dentists who were not trained in Australia, but were able to obtain licenses in the US/Canada, but ultimately ended up in Australia for various reasons. Those numbers do not tell the whole story.  No one is tracking where people actually end up. 

[Everclear]

Gaining a license to work in Canada does not necessarily mean that people will work in Canada.  There are many Australians, not just Canadians studying in Australia, writing the board exam as a backup option or as an opportunity to temporarily work abroad.  Plus there are Canadians studying abroad who write it, but may not return to Canada (quite a few in my class).  Furthermore I've met several dentists who were not trained in Australia, but were able to obtain licenses in the US/Canada, but ultimately ended up in Australia for various reasons. Those numbers do not tell the whole story.  No one is tracking where people actually end up.

 

You are incorrect I am afraid. The numbers on the link I have provided are those who gained certification through a pathway specifically for dentists who graduated from a non-accredited program. It's not logical to assume that after spending a significant amount of money applying for these exams and passing them that a good number would not practice in Canada.

 

The numbers you are talking about are completely different because graduates from Australia are considered graduates of an accredited program so they would NOT take the same pathway as other international dentists. Australian graduates would take the same pathway through the written exam and OSCE which is the same as domestic Canadian graduates. This is a MUCH cheaper exam and also pass rate is +90%.

 

The threat of oversaturation is not comming from graduates of American or Australian schools IMHO because line of credit limitations mean only those whose parents chip in a lot can now attend these institutions.

[Ostracized]

Incidentally, if you check this link, you'll see that the total number of licenses granted (people finishing the final NDEB exam and OSCE) has increased 50% in the last 5 years.

 

http://ndeb.ca/accredited/past-examination-results

 

Don't let 2015 fool you - the numbers aren't fully in yet on the equivalency process. Very upsetting.

[Everclear]

Incidentally, if you check this link, you'll see that the total number of licenses granted (people finishing the final NDEB exam and OSCE) has increased 50% in the last 5 years.

http://ndeb.ca/accredited/past-examination-results

Don't let 2015 fool you - the numbers aren't fully in yet on the equivalency process. Very upsetting.

Correct me if I'm wrong but the NDEB and OSCE candidate numbers also include the international dentists from non-accredited schools that went through the NDEB equivalency process. Because on their site, it does indicate that the final step of the equivalency process includes the OSCE exam: http://www.ndeb.ca/nonaccredited

 

Funny how the numbers really skyrocketed after 2011 (the year when foreign dentists were allowed to challenge for the boards).

[Dannny]

How many of you are interested in actually taking a united stand? Whining on an online forum isn't helping sadly. :/

 

If any one of you are, send me a PM! 

[guacamole]

The technical level of the FTDs in my class varied ALOT. You can learn from some but there were those that were scary to watch. From anecdotal experience (school and in practice), the bigger problem is the way a lot of them interact with patients and staff. I do believe that a qualifying program would at least bring the everyday skill level to a standard and allow them to understand Canadian culture before practicing.

 

Guys, it's not easy out there. It's not hard to get a job but it's really hard to land a good one so you can practice the way you want. Someone mentioned underemployment by th recent grads and it is absolutely true. It's not what it used to be, so don't get confused when you see or hear about "this wonderful practice 1h away from Ottawa" that is doing well. Pick your offices wisely, and don't be afraid to walk away if you feel like you are forced into doing something.

 

Some people don't even mind working for a lower collection %, or work on Sundays, or not taking co-pay. All that drives the associate market down. With all that being said, I think a lot of the FTDs end up working in ethnic practices/in their own community. My principal told me he got a lot of resumes from FTDs for an associateship, but they were not good candidates pre and on the interview. Even if they get the job, they may clash with the staff etc.

 

There's no point to this post but just the fact that I wish someone can be honest enough to tell us the complete truth when we were starting school.

[guacamole]

And to all the recent grads, tell me how you feel. I cannot see a single organization that stands up for us, even though we are the group that's the hardest hit. Established dentists/ODA complain about saturation and say they will not retire any time soon because business is so tough, but I really find it hard to empathize with someone who has multiple offices and buildings that generate rental income. One of them told me that it should be mandatory for new grads to practice for a year in rural areas to get a full license in order to solve the saturation problem. What??

 

The schools are cash strapped and they bring in the FTDs through various programs to generate tuition income. U of T is increasing spots all around because of some twisted logic of "well there's a lot of FTDs anyway so let's increase enrolment for everyone and make some tuition money."

 

The college and the government think that it is not their role to regulate the market, but rather they are there to grant licenses to those who qualify. I think new grads are so underrepresented in organized dentistry. I'm not talking about posing for pictures in various dental society events.

[firesinx]

How many of you are interested in actually taking a united stand? Whining on an online forum isn't helping sadly. :/

 

If any one of you are, send me a PM! 

 

I'm down for this

[McMarauder]

with enough voices, Canada can do what Australia did..

http://www.canberratimes.com.au/act-news/dentists-removed-from-skilled-occupation-list-after-four-years-of-lobbying-20150710-gi9j6v.html

 

TL:DR - FTDs were able to challenge a couple of exams (similar to Canada's equivalency program), obtain certain visas, which enabled them to work in Australia as it was on the skilled occupations list.  The Australian Dental Association was successful in getting dentistry removed from that list.  However, these qualifying exams are still running, meaning that despite clearing these exams, FTDs are not able to work unless sponsored by an employer.  With the amount of saturation in Australian cities, very few employers are willing to do so.  Particularly since most Australian trained employers want to protect their own.

 

Dentistry is on Canada's Express Entry: Eligible Federal Skilled Worker Occupations list.

[Ostracized]

According to the ODA, dentistry was removed from the express entry list a couple of years ago.

[McMarauder]

According to Citizenship and Immigration Canada "Dentist" is still one of the listed occupations under category A.  I initially thought it was taken off as well, but it's still there, and FTDs on immigration forums are still applying for express entry.

http://www.cic.gc.ca/english/immigrate/skilled/noc.asp

[virtual reality]

According to Citizenship and Immigration Canada "Dentist" is still one of the listed occupations under category A.  I initially thought it was taken off as well, but it's still there, and FTDs on immigration forums are still applying for express entry.

 

http://www.cic.gc.ca/english/immigrate/skilled/noc.asp

 

My understanding was that the federal government created the equivalency process to enable FTDs who are permanent residents or Canadian Citizens to practice dentistry if they have the skills needed. However, because dentistry is on the express entry list and the fact that you don't have to be a permanent resident or Canadian Citizen to write those exams, nationals of other countries can write them and use that to immigrate to Canada. Wonderful!!

 

This is insane.

[virtual reality]

I would suggest writing a letter to your MP.

 

This could be a template.

 

I'm writing this email to express my deep concerns about the growing oversupply of dentists in Canada. 

 

I looked up the numbers and was appalled to see the exponential increase in foreign trained dentists licensed by exams. The number has gone up from 44 in 2011 to over 260 in 2014!  

 

I was under the impression that the government created the equivalency process to enable foreign trained dentists (FTDs) who are already Canadian citizens or permanent residents to practice the profession of dentistry if they have the skill sets needed. However, I found out that:

1. Dentistry on the express entry list for immigration and

2 You do NOT have to be a Canadian Citizen or permanent resident to challenge those exams.

This means that anyone can challenge those exams and gain entry to Canada as an immigrant!

 

Given the long years of education and tens of thousands of dollars a Canadian dentist invests in their career, it is definitely unfair to lower the barrier to entry to such low level. If I had known I would have considered another career that doesn't require such effort, dedication and financial cost.

 

Regards,

[virtual reality]

The technical level of the FTDs in my class varied ALOT. You can learn from some but there were those that were scary to watch. From anecdotal experience (school and in practice), the bigger problem is the way a lot of them interact with patients and staff. I do believe that a qualifying program would at least bring the everyday skill level to a standard and allow them to understand Canadian culture before practicing.

 

Guys, it's not easy out there. It's not hard to get a job but it's really hard to land a good one so you can practice the way you want. Someone mentioned underemployment by th recent grads and it is absolutely true. It's not what it used to be, so don't get confused when you see or hear about "this wonderful practice 1h away from Ottawa" that is doing well. Pick your offices wisely, and don't be afraid to walk away if you feel like you are forced into doing something.

 

Some people don't even mind working for a lower collection %, or work on Sundays, or not taking co-pay. All that drives the associate market down. With all that being said, I think a lot of the FTDs end up working in ethnic practices/in their own community. My principal told me he got a lot of resumes from FTDs for an associateship, but they were not good candidates pre and on the interview. Even if they get the job, they may clash with the staff etc.

 

There's no point to this post but just the fact that I wish someone can be honest enough to tell us the complete truth when we were starting school.

I think you're underestimating the impact FTDs will have on the professions. Some of them were specialists in their home countries and can do many procedures the Canadian grad can NOT do.  I also know a couple who opened their own offices only one year after getting their license. Lowering the barrier to entry will increase the competition and give patients much more bargaining power over you.

[jeffbur]

Canadian grad

 

I think you're underestimating the impact FTDs will have on the professions. Some of them were specialists in their home countries and can do many procedures the Canadian grad can NOT do.  I also know a couple who opened their own offices only one year after getting their license. Lowering the barrier to entry will increase the competition and give patients much more bargaining power over you.

Standard care is one of the important ways to protect the public. Because canadian grads was taught concept of canadian standard care in school, we know what we can do, and what we SHOULD NOT do, so we will refer out. Thus the patient will not take the unnecessary risk even Canadian grads are able to do the procedures . Now FTD adopt their own “standard care” from the country they come from and do procedure Canadian grad taught not to do, it not only put the patient under more risk, but also makes Canadian grads more aggressive because we need to survive in this saturated market. It is clearly seen in the dentistry less and less procedures are referred out, patients are treated below the standard care. The college and the government think that it is not their role to regulate the market, but it is their role to protect the public. Good job  risking the health of patient by lowering the standard care.

[cookiemonster99]

Canadian grad

 

Standard care is one of the important ways to protect the public. Because canadian grads was taught concept of canadian standard care in school, we know what we can do, and what we SHOULD NOT do, so we will refer out. Thus the patient will not take the unnecessary risk even Canadian grads are able to do the procedures . Now FTD adopt their own “standard care” from the country they come from and do procedure Canadian grad taught not to do, it not only put the patient under more risk, but also makes Canadian grads more aggressive because we need to survive in this saturated market. It is clearly seen in the dentistry less and less procedures are referred out, patients are treated below the standard care. The college and the government think that it is not their role to regulate the market, but it is their role to protect the public. Good job  risking the health of patient by lowering the standard care.

 

I don't really completely agree with you especially when you say they adopt their own "standard care" 

The FTD dentists are well aware of what they can and can not do in terms of their scope of practice. 

Who's to say the Canadian standard of care is the best? Why not the American way? 

 

There's definitely variation of skill in terms of FTDs out there but it's up to them if they want to take on a risky procedure rather than refer out because they are ultimately responsible for the safety of the patient. If they screw up and get sued it's their fault........

[jeffbur]

I don't really completely agree with you especially when you say they adopt their own "standard care" 

The FTD dentists are well aware of what they can and can not do in terms of their scope of practice. 

Who's to say the Canadian standard of care is the best? Why not the American way? 

 

There's definitely variation of skill in terms of FTDs out there but it's up to them if they want to take on a risky procedure rather than refer out because they are ultimately responsible for the safety of the patient. If they screw up and get sued it's their fault........

 

I don't really completely agree with you especially when you say they adopt their own "standard care" 

The FTD dentists are well aware of what they can and can not do in terms of their scope of practice. 

Who's to say the Canadian standard of care is the best? Why not the American way? 

 

There's definitely variation of skill in terms of FTDs out there but it's up to them if they want to take on a risky procedure rather than refer out because they are ultimately responsible for the safety of the patient. If they screw up and get sued it's their fault........

Canadian standard care may not be the best( there is no best way anyway), but it is set up by the royal college and implemented through the education and practice discipline, every dentist in Canada should follow.  Scope of practice is not a practical rule because of it vague borderline.  Also, the skill of individual dentist is not reliable rule to judge if the dentist screws up.  FTPs without knowing Canadian standard of care will do all the procedures they think they can do, not refer them. Then in this saturate market, Canadian grads will do the same thing without considering standard of care. Then it becomes who is lucky not to screw up. No matter who screw up, It will only cause more damage to the public, the college should be held responsible for it.

[McMarauder]

FTPs without knowing Canadian standard of care will do all the procedures they think they can do, not refer them. Then in this saturate market, Canadian grads will do the same thing without considering standard of care. Then it becomes who is lucky not to screw up. No matter who screw up, It will only cause more damage to the public, the college should be held responsible for it.

The way I see it is, would I rather risk losing my registration/ruining my reputation to make an extra few bucks now... or would I rather do the right thing, make less, but still have work to do for the years to come.  I don't think everyone is willing to risk their registration like that.

[jeffbur]

The way I see it is, would I rather risk losing my registration/ruining my reputation to make an extra few bucks now... or would I rather do the right thing, make less, but still have work to do for the years to come.  I don't think everyone is willing to risk their registration like that.

Good for you to think this way. But I am not talking about individual dentist,   It is a fact there is more and more pressure from oversaturation of dental market and less and less dentists refer patient out.

[McMarauder]

Good for you to think this way. But I am not talking about individual dentist,   It is a fact there is more and more pressure from oversaturation of dental market and less and less dentists refer patient out.

another way to see that is, more and more dentists will find themselves in trouble, and will later have restrictions placed on their ability to practice, thus making way for those who practice ethically.  it's a self selecting process - or am I thinking too idealistically?  There's no denying that the market is a tough one...

[jeffbur]

another way to see that is, more and more dentists will find themselves in trouble, and will later have restrictions placed on their ability to practice, thus making way for those who practice ethically.  it's a self selecting process - or am I thinking too idealistically?  There's no denying that the market is a tough one...

 

Cause harm to the patient, then discipline the dentists, if it is what college is doing, who can benefit from the situation?

[McMarauder]

Cause harm to the patient, then discipline the dentists, if it is what college is doing, who can benefit from the situation?

no one. it's crappy situation =(

[Dannny]

another way to see that is, more and more dentists will find themselves in trouble, and will later have restrictions placed on their ability to practice, thus making way for those who practice ethically.  it's a self selecting process - or am I thinking too idealistically?  There's no denying that the market is a tough one...

Definitely too idealistic!

[Que]

If people are interested in having a unified voice, how about contacting your dental school's representatives from Federation of Canadian Dentistry Student Associations (FCDSA)? There is strength in numbers

 

Here is their Facebook page: https://www.facebook.com/fcdsa/?fref=nf

[CanadianDDS]

So I have been reading through most of the posts on this thread. I'm a Canadian DDS that earned my DDS from a Canadian uni in Ontario and have been practicing for about 3 years. Everything I'm about to say is purely opinion and many may not agree

Yes I do agree there is an oversaturation of dentists in large Canadian cities and it is mainly bc of the foreign trained dentists however I think canadians heading to the US and Australia are partially to blame although they are not the number one cause I find it unfair to blame it fully on internationally trained dentists. From my understanding many foreign trained dentists get their degrees from universitues in their home countries that are hard to get into but I know many Canadians with very low GPAs who cannot get into Canada bc of their low GPAs and heading to the US and now Australia. I think

American and Australian grads should also be classified as international; who's to say their degree is any higher than someone who gets their degree from say Romania. I actually find that many internationally trained dentists practicing here were top of their class whereas I find many Canadians who earned their DDS degree from the US or Australia were mediocre students who essentially paid for their degree. The equivalency exam that the foreign trained dentists need to master is very difficult in comparison to the licensing exam taken by canadians, americans and australians. Essentially my point is we shouldn't be pointing our fingers solely towards internationally trained dentists and the partial blame should be on canadians from american and australian programs. I think there should be no reciprocity between canada and the US and Australia and grads from either of those two countries should also write and take the same practical exams as the internationally trained dentists.