The Facebook generation of dentists

The largest ever cohort of dentists in the UK’s history have just reached the end of their vocational/foundation training (FD1) year and an even larger crop of new graduates are just setting out on their professional careers, having just qualified.

Together they represent a watershed in the shape of the profession and its expectations, and quite possibly its relationship with the NHS, because this 2,300-strong group would (mostly) have taken the decision to apply for and start their undergraduate dental training just as the ill-fated 2006 contract was coming into force in England and Wales. Little did they know how much the world itself, let alone the world of dentistry, would have changed by the time they completed their studies.

At the time of their freshers’ events, the air was full of hope. Cool Britannia was cooler than ever, Gordon as fiscally prudent as ever, Tony looked like he was going on for ever, and a newly-installed third term New Labour government looked as solid as a rock – as it turned out, Northern Rock unfortunately – but certainly in the same rude health as Royal Bank of Scotland, HBOS and the Greek economy.

The latter had been buoyed by the receipts from the Athens Olympics, after all. A global economic crisis, followed by a long and painful credit crunch coupled with austerity measures and higher taxes, was an unthinkable prospect.

Closer to home, almost all of the major changes in the dental landscape have so far impacted upon England, but no part of the UK has been entirely spared the onslaught. This was not least because the GDC was seemingly determined to spread the pain as widely and evenly as possible so that registrants from every corner of the land stood the same chance of receiving an invitation to Wimpole Street to appear before one of the Fitness to Practise committees.

But if dentists (and especially, practice owners) in England are struggling to work out what they did to deserve the largesse that has been bestowed upon them in the past few years – UDAs, the PCT clawback lottery, HTM 01-05, CQC to name but four – spare a thought for the classes of 2010 and 2011.

Those who have qualified this summer include the first graduates from Preston (UCLAN) and Peninsula who join the dental profession a good few years older than your typical dental graduate because these are graduate-entry four-year programmes.

Next year, the ranks of graduate-entry UK qualifiers will be swelled by the first graduating students from the UK’s youngest dental school (Aberdeen).

Having been impoverished students not just once, but twice in what for most of them has been a short space of time, they all have a lot of catching up to do – but in another sense they have a head start in what is becoming an increasingly competitive dental employment market because of the extra maturity they have under their belt.

There is some significance, I think, in the fact that it is those who graduated back in the 1970s and 1980s who are most fearful for the future prospects of today’s young graduates. Perhaps because this older cohort can recognise how much easier it was for young graduates in the ‘good old days’.

But while the Facebook generation is understandably nervous about the uncertainties of the first economic downturn in their lifetime, and what it means for them and their employment prospects, they are also confident in their ability to carve their own professional careers, and on their own terms.

These careers will almost certainly assume a different shape from those of previous generations, but that has been true of every generation of dentists since Sweeney Todd.

Blind date
But that unprecedented number of dental students who are about to enter the final year of their undergraduate course have something completely different awaiting them when they graduate.

Next year the most curious of all developments will unfold in that the matching up of vocational trainers and trainees (I am using the ‘old’ terminology to facilitate a semblance of understanding for many of our readers through an otherwise incomprehensible topic) will be done centrally – that is, nationally rather than through individual regional deaneries. In practical terms the trainees will be placed in practices that they have never seen, as employees of people that they have never met.

How many employers do you know are told by a third party who they must employ, yet once the knot is tied, these total strangers have the same employment rights and protections as someone that the employer has had the opportunity to interview on one or more occasions?

This lunacy has been prompted, as you may have guessed, by fears of legal challenge on the grounds of discrimination in the selection and appointment process.  It says something about the present reactionary climate in the UK that any decision to prefer candidate A over candidate B is more likely to be interpreted as being discriminatory, than (for example) the fact that a practice owner who has invested heavily in developing their practice goodwill, might just feel happier entrusting their patients and the reputation of their business to candidate A.

Unless of course a new EC directive has ruled that one must always give preference to weaker candidates over stronger ones. It may even be that in an all-female dental practice it is felt that, in the interests of patient choice, the introduction of a male dentist may be beneficial and preferable, and gender reassignment seems a slightly disproportionate in this situation.

Nobody should act outwith the law, however daft it seems at times, but there are times when one should have the courage to do the right thing, for the right reasons, and then have the confidence in your ability to deal with any challenges as and when they arise. It is saddening to see the example that we are setting to tomorrow’s dentists because it perpetuates the same defensive mentality as they set out on their own professional careers.

And few would bet against legal challenges coming anyway, either from trainees who find that their VT/FD year has been disrupted by having been placed against their wishes in a totally unsuitable practice, with a trainer they actively dislike, or indeed from trainers who see their trainee departing in mid-year with all the associated disruption to the practice, staff and patients.

This new policy is not being introduced for the benefit of patients, practices or practice staff.  Nor for the benefit of trainers or trainees (however it is dressed up). The case made for its introduction is that it is guaranteed to be equally fair to all applicants, and to all trainers – and hence, safe from legal challenge. It could also be said to be equally unfair to all applicant trainees and trainers and particularly unfair to the best trainee candidates because their competitive edge counts for nothing.

At least they can console themselves with the knowledge that this trip to Planet Zork lasts only a year (or in some cases, two), after which normal competitive recruitment arrangements apply. The old placement system was not without its own problems, but it is difficult not to conclude that this is one more victory for belts and braces and one more defeat for balance and common sense.

So, let us wish the very best of luck to all today’s final-year students, recent graduates and young dentists – I have a feeling that they will do just fine, despite the succession of obstacles that is being placed in their path by previous generations of dentists who should know better.

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