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

[CanadianDDS]

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.

Unfortunately RCDSO is not here to protect the interest of dentists they're there to protect the public. As long as the public doesn't complain (why would they, it's to their benefit to shop around to get a good price) then nothing will change.

[jeffbur]

Unfortunately RCDSO is not here to protect the interest of dentists they're there to protect the public. As long as the public doesn't complain (why would they, it's to their benefit to shop around to get a good price) then nothing will change.

The number of complaints and discipline increase every year, the standard of care is undermined; the insurance fraud is common event, overtreatment is everywhere, etc, The public never complained there are no enough dentists, why RCDSO license more dentists more than the market can handle.  Why the RCDSO dose not license more specialists， because there should be a stable ratio between GPs and specialists?

Is the RCDSO really doing all these to protect the public as they claim ?What is the motivation?

[McMarauder]

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.

Despite the fact that I benefited from such a reciprocal agreement, I agree with your sentiments.  However, I'd like to point out that most of the students heading to AUS and US are not mediocre.  "Mediocre" at my undergraduate university was ~65%, C-C+, or 2.0/4.0.  That won't get you into any US or AUS dental school.  Most of us were above average in undergrad, some of us even interviewed at dental Canadian schools but decided to go elsewhere when rejected (flat out or after being waitlisted to save time on having to reapply).  And even in dental school, we continue to be well above the class average.

[XZeRO]

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.

Let's look at this from a US, Romanian, or Australian perspective then. If a student from these respective countries were to attend a Canadian DDS for whatever reason (ie. scholarship+international experience?), when they return back to their respective countries, would they be considered inferior from those students that trained in their home country?? 

Who's to say a Canadian education is superior to an American, Romanian, or Australian one? 

 

Those returning to Canada from whatever education, whether they trained in the US or Australia, have to write the same exam as those that trained in Canada. If you think this bar is "lower" than the test for other foreign trained dentists, then we should really be looking at our own standards than to blame someone else for their "mediocrity".

 

From your thought path and in the best interests of Canadian patients, perhaps everyone, including those trained in Canada should write the equivalency exam written by foreign trained dentists? 

 

Which brings me to the next point... Since their standard is so much higher, perhaps it's not internationally trained dentists taking away your business. Perhaps it's the Canadian trained dentists losing their own business. 

 

Food for thought. 

[jeffbur]

Let's look at this from a US, Romanian, or Australian perspective then. If a student from these respective countries were to attend a Canadian DDS for whatever reason (ie. scholarship+international experience?), when they return back to their respective countries, would they be considered inferior from those students that trained in their home country?? 

Who's to say a Canadian education is superior to an American, Romanian, or Australian one? 

 

Those returning to Canada from whatever education, whether they trained in the US or Australia, have to write the same exam as those that trained in Canada. If you think this bar is "lower" than the test for other foreign trained dentists, then we should really be looking at our own standards than to blame someone else for their "mediocrity".

 

From your thought path and in the best interests of Canadian patients, perhaps everyone, including those trained in Canada should write the equivalency exam written by foreign trained dentists? 

 

Which brings me to the next point... Since their standard is so much higher, perhaps it's not internationally trained dentists taking away your business. Perhaps it's the Canadian trained dentists losing their own business. 

 

Food for thought. 

Typical thought from someone who understands clinical skill but clearly does not understand what it means to be a DOCTOR, a health care provider.  A couple of equivalency exams on paper or fake teeth on manikin are enough to qualify a dentist. essentially, they are no different from my hygenist, who once say the same thing,” give me handpiece ,I can drill too.” Because focusing on business and drilling on fake teeth, FTD think we are frustrated only because of losing business.  No wonder, The professionalism and autonomy of dentistry is going down , RCDSO’s dereliction of duty.

[cookiemonster99]

Typical thought from someone who understands clinical skill but clearly does not understand what it means to be a DOCTOR, a health care provider.  A couple of equivalency exams on paper or fake teeth on manikin are enough to qualify a dentist. essentially, they are no different from my hygenist, who once say the same thing,” give me handpiece ,I can drill too.” Because focusing on business and drilling on fake teeth, FTD think we are frustrated only because of losing business.  No wonder, The professionalism and autonomy of dentistry is going down , RCDSO’s dereliction of duty.

 

I believe other countries such as the US or Ireland or Australia have just as rigorous of a dental program as just any other canadian dental schools. 

My classmate's parents are dentists and they told me they would never hire a UBC grad ever again because of their lack of clinical skills.

They only start drilling in 3rd year(if i'm wrong please correct me but that's just what i heard)

Are the Canadian schools the best? Probably not but you can't say other countries grads are inferior just because you think so, they are governed by the same governing bodies and go through essentially the same standard as any other Canadian school which is why the CDA accredits them. 

 

The saturation is mostly in big cities where people feel the crunch, if you're willing to go rural you won't be complaining

[XZeRO]

 

My classmate's parents are dentists and they told me they would never hire a UBC grad ever again because of their lack of clinical skills.

They only start drilling in 3rd year(if i'm wrong please correct me but that's just what i heard)

 

Either your classmate's parents are people that I know or that statement may be resonating through the dental circles...

Interesting nonetheless. 

[jeffbur]

I believe other countries such as the US or Ireland or Australia have just as rigorous of a dental program as just any other canadian dental schools. 

My classmate's parents are dentists and they told me they would never hire a UBC grad ever again because of their lack of clinical skills.

They only start drilling in 3rd year(if i'm wrong please correct me but that's just what i heard)

Are the Canadian schools the best? Probably not but you can't say other countries grads are inferior just because you think so, they are governed by the same governing bodies and go through essentially the same standard as any other Canadian school which is why the CDA accredits them. 

 

The saturation is mostly in big cities where people feel the crunch, if you're willing to go rural you won't be complaining

only considering clinical skill, that is what is dentistry now. Forget everything else, go make money, that is what college want dentists to be anyway.

[cookiemonster99]

only considering clinical skill, that is what is dentistry now. Forget everything else, go make money, that is what college want dentists to be anyway.

 

Not sure what exactly u mean........but yes dentistry is a lot of clinical skill. 

 

I don't think the college's main priority is dentists making money....the college's main priority is to ensure the dentists that are practicing are adequately trained to practice and to ensure the safety of patients

[CanadianDDS]

Despite the fact that I benefited from such a reciprocal agreement, I agree with your sentiments.  However, I'd like to point out that most of the students heading to AUS and US are not mediocre.  "Mediocre" at my undergraduate university was ~65%, C-C+, or 2.0/4.0.  That won't get you into any US or AUS dental school.  Most of us were above average in undergrad, some of us even interviewed at dental Canadian schools but decided to go elsewhere when rejected (flat out or after being waitlisted to save time on having to reapply).  And even in dental school, we continue to be well above the class average.

Mediocre in terms if getting the grades to get into dental

School ie GPAs if around 3.3-3.6, that wouldn't get you an interviews. Of course you are right, there are some students which were above average and for some reason couldn't get into Canada bc just say they are not good at the interview process. But the majority do not represent that pool of students.

[CanadianDDS]

Let's look at this from a US, Romanian, or Australian perspective then. If a student from these respective countries were to attend a Canadian DDS for whatever reason (ie. scholarship+international experience?), when they return back to their respective countries, would they be considered inferior from those students that trained in their home country??

Who's to say a Canadian education is superior to an American, Romanian, or Australian one?

 

Those returning to Canada from whatever education, whether they trained in the US or Australia, have to write the same exam as those that trained in Canada. If you think this bar is "lower" than the test for other foreign trained dentists, then we should really be looking at our own standards than to blame someone else for their "mediocrity".

 

From your thought path and in the best interests of Canadian patients, perhaps everyone, including those trained in Canada should write the equivalency exam written by foreign trained dentists?

 

Which brings me to the next point... Since their standard is so much higher, perhaps it's not internationally trained dentists taking away your business. Perhaps it's the Canadian trained dentists losing their own business.

 

Food for thought.

 

That's a very simplistic view, yes the Canadian board exam is not vigorous and the pass rate is high but that doesn't devalue the canadian dental education system you forget to include that there are also 4 years of dental education attached to it and prior to that competitiveness to get in. The point I think I failed to bring across is this: I'm not here to devalue any other country's dental education system, but it's unfair that there are some but not all using a back door way to get into dentistry. If dental school is so competitive in canada than priority should be given to canadian dental grads. The only real set back of not studying dentistry in canada is the cost and consequently debt load upon graduation. But by looks of it with increase in tuition and poor job market, steadily canadian new dental grads are facing the same fate. It's counterintuitive to me that canadian dental schools are quick to weed out mediocre students but then are so leniant in having them return upon completion of their dental degree abroad.

[jeffbur]

Not sure what exactly u mean........but yes dentistry is a lot of clinical skill. 

 

I don't think the college's main priority is dentists making money....the college's main priority is to ensure the dentists that are practicing are adequately trained to practice and to ensure the safety of patients

you understanding of college's duty is too narrow.

The college priority is protecting the public and the profession. Ensuring practicing dentists with adequate training is only small part of it( even that , they are not doing it well). Avoiding overtreatment, decreasing insurance fraud, the lowering the complaints etc are also important too.

In saturated market, dentists will  do everything to survive, overtreatment, insurance fraud,  low price competition are very common now.  As governing body, the college know the situation is deteriorating, but what they are doing is to make the vicious competition worse.  It is dereliction of duty

[CanadianDDS]

The number of complaints and discipline increase every year, the standard of care is undermined; the insurance fraud is common event, overtreatment is everywhere, etc, The public never complained there are no enough dentists, why RCDSO license more dentists more than the market can handle.  Why the RCDSO dose not license more specialists， because there should be a stable ratio between GPs and specialists?

Is the RCDSO really doing all these to protect the public as they claim ?What is the motivation?

You are correct about the insurance fraud and complaints but the average patient doesn't know that standard of care is decreasing they just assume all dentists are unethical, they don't attribute to the fact that Canada is allowing a higher population of people obtain dental licenses, unfortunately they just generalize that we are all bad. So in turn they shop around to find what in their mind they think is a dentist who charges less for the same amount of "unethical" work. Therefore they may complain but their complaints are in the wrong direction ie. complaining about one dentist as opposed to complaining about too many dentists coming from educational backgrounds or skills that are not in line with proper dental care and ethics. For example, Jane Doe goes to dentist A, gets bad work done but at a reduced cost than say dentist B. Jane Doe complains to RCDSO about dentist A, the RCDSO doesn't attribute it to the fact that if we tried to keep more Canadian grads practicing as opposed to foreign trained grads this wouldn't happen, no they say dentist A is bad. Jane Doe will continue shopping around for a dentist with the least amount of cost but superior work. What is essentially happening is ethical dentists with good clinical skills are forced to reduce their costs as a result of this, now patients are demanding exceptional superior work at an unfair lowered cost. 

[CanadianDDS]

To be honest, I think at the end of the day it's all about money; schools make money off of international students and more students attending their schools and the RCSO makes money by licensing foreign trained grads. It's unfortunate they don't target the root of the cause but instead try to rectify problems after the fact. Ie. punishing dentists after a complaint is made, why not do something to prevent complaints from even happening in the first place?

[cookiemonster99]

you understanding of college's duty is too narrow.

The college priority is protecting the public and the profession. Ensuring practicing dentists with adequate training is only small part of it( even that , they are not doing it well). Avoiding overtreatment, decreasing insurance fraud, the lowering the complaints etc are also important too.

In saturated market, dentists will  do everything to survive, overtreatment, insurance fraud,  low price competition are very common now.  As governing body, the college know the situation is deteriorating, but what they are doing is to make the vicious competition worse.  It is dereliction of duty

 

Aha i wanted to simplify things. I implied that ensuring safety of the patients included all those things you said but yes those are just a few of the things that the college does. 

 

I think the saturation is mostly in big cities, if you're willing to go out a bit further you should be fine in terms of finding work

[jeffbur]

Aha i wanted to simplify things. I implied that ensuring safety of the patients included all those things you said but yes those are just a few of the things that the college does. 

 

I think the saturation is mostly in big cities, if you're willing to go out a bit further you should be fine in terms of finding work

 finding work maybe is the only thing you want, but not me. I am not worried when the college create fair environment and let us focuse on dentistry. . Appearantly, the college is not intrested in this.

[cookiemonster99]

 finding work maybe is the only thing you want, but not me. I am not worried when the college create fair environment and let us focuse on dentistry. . Appearantly, the college is not intrested in this.

 

Not sure what exactly you mean but things will NEVER be fair in this world. I have classmates that have practices they can just walk into and take over the patient load whereas I don't come from a family of dentists so I have to start at the beginning......Is there fair? No....if you can't face the fact that there's always going to be unfairness maybe dentistry isn't for you.

 

Sorry to sound harsh but it's the truth......If you can't adapt then find something else do to

[virtual reality]

Oversupply.

 

I think a lot of us are getting off topic here. I think we shouldn't point fingers and make assumptions about the competence and work ethics of any dentist groups. There is good and bad in all dentists whether they are Canadian grads, FTDs, or grads of the US, Australia, NZ, or Ireland.

 

The main point here is that the sharp increase in the number of FTDs will disrupt the supply/demand equation in the dental marketplace. The growing saturation is not only evident in the three large cities, it's also becoming evident in all urban centres across the nation and it's creeping into surrounding rural communities.

 

We need to lobby the government to step in and:

1. Put a cap on the number of FTDs

2. Make it mandatory to be a Canadian citizen or permanent resident to be allowed to challenge the equivalency exams.

 

Otherwise, every dentist regardless of their educational background won't be able to make a decent living.

 

In my opinion, opening the flood gates is big business for many parties such as:

1. Universities offering courses to FTDs

2. Dental supply companies

3. Dental brokers

4. Dental contractors

5. Landlords

6. Provincial regulatory bodies

[jeffbur]

Not sure what exactly you mean but things will NEVER be fair in this world. I have classmates that have practices they can just walk into and take over the patient load whereas I don't come from a family of dentists so I have to start at the beginning......Is there fair? No....if you can't face the fact that there's always going to be unfairness maybe dentistry isn't for you.

 

Sorry to sound harsh but it's the truth......If you can't adapt then find something else do to

Accept it or leave it.  what an arrogant attitude. Nothing I can say, but walk away from the argument.

[cookiemonster99]

Accept it or leave it.  what an arrogant attitude. Nothing I can say, but walk away from the argument.

 

I don't think i'm arrogant at all. I'm simply stating the truth. 

 

The real reason that so many people are complaining is because they're not going to be taking home that $1 million dollar pay cheque period.  

 

End of argument. 

[CanadianDDS]

I don't think i'm arrogant at all. I'm simply stating the truth. 

 

The real reason that so many people are complaining is because they're not going to be taking home that $1 million dollar pay cheque period.  

 

End of argument. 

Actually, that's far from the truth, generally speaking there are more associates than principle dentists and I know of know associate dentist whether in a big or small city grossing a million dollars. Yes money is a big factor but it's also the level of service we are providing and our reputation. The amount of competition is causing many dentists to act as business men and women and the thing some dentists are resorting to is quite embarrassing, like cleanings for $60 dollars, free whitening, be a new patient and we'll give you our first born lol. What are we a car dealership? There is a certain level of professionalism that needs to be maintained...do you see MDs offering free surgeries or procedures if you become their patient? no. Yes there is a business aspect to dentistry, but the things I am seeing some dentists do just to get a new patient to walk in through their office door is nothing less than embarrassing. 

[CanadianDDS]

Not sure what exactly you mean but things will NEVER be fair in this world. I have classmates that have practices they can just walk into and take over the patient load whereas I don't come from a family of dentists so I have to start at the beginning......Is there fair? No....if you can't face the fact that there's always going to be unfairness maybe dentistry isn't for you.

 

Sorry to sound harsh but it's the truth......If you can't adapt then find something else do to

There is unfairness in everything however, there are certain things that can be controlled so that unfairness doesn't need to exist. That's a very "oh well, shrug your shoulders" kind of attitude that you have. Why leave it up to chance something that can be changed? Also your example of some graduate going directly into their parent(s)' private practice after graduation vs someone like yourself (including me) who have to start from scratch I think is irrelevant to this discussion, yes this is something that can't be controlled but opening up the gates to foreign trained dentists including Americans and Australian grads can be controlled so why not do something about it. 

[CanadianDDS]

I really think this thread should not be left to be drowned out by other topics. I am very concerned about the future of dentistry and so should anyone else already in the field or planning to pursue it. The future of dentists in Canada is quite grim and the statistics that I have read from the ODA journal about the future of dentistry predicts hard times ahead. I didn't enter into this profession so that 90% of it becomes business, dentists should not be worried about that  or where they should be practicing; instead they should be focusing all their time on and energy in becoming good health care practitioners and clinicians providing exceptional services to all their patients and this over saturation is preventing that from happening. 

[cookiemonster99]

Actually, that's far from the truth, generally speaking there are more associates than principle dentists and I know of know associate dentist whether in a big or small city grossing a million dollars. Yes money is a big factor but it's also the level of service we are providing and our reputation. The amount of competition is causing many dentists to act as business men and women and the thing some dentists are resorting to is quite embarrassing, like cleanings for $60 dollars, free whitening, be a new patient and we'll give you our first born lol. What are we a car dealership? There is a certain level of professionalism that needs to be maintained...do you see MDs offering free surgeries or procedures if you become their patient? no. Yes there is a business aspect to dentistry, but the things I am seeing some dentists do just to get a new patient to walk in through their office door is nothing less than embarrassing. 

 

I get what you mean about the professionalism but you do see advertisement in the MD world. Look at LasikMD, that's one example. 

 

At the end of the day, the doctor's office is also a business and they run it as such. They don't need to advertise for patients because most of them already have enough patients and their salary is capped no matter how many patients they see after a certain amount. If it's a new practice of course they're going to be advertising for new patients. 

[seeking1]

This is a cross-post with another thread, but I felt this article might be pertinent to this thread's discussion: http://www.cbc.ca/news/politics/more-foreign-workers-tpp-1.3338189

 

Might the Trans-Pacific Partnership impact dentist and other health professional credentialing in Canada?

 

"Sweetman also said labour market provisions will affect some people positively, others negatively. For example, an influx of dentists and pharmacists could harm people working in those fields, but help consumers.

 

"There will be winners and losers — it depends on where you sit," he said. "If I was a pharmacist or a dentist I would be really worried about it.… If I was a consumer of dental services I would probably be quite happy, because prices are going to go down.""