Abstract
- Top of page
- Abstract
- Introduction
- Methods
- Results
- Discussion
- Conclusion
- References
Introduction: Dentistry in Jordan is an attractive profession due to the high social standard it provides. This study aimed to investigate whether dentists would choose dentistry again and whether their professional expectations would change after years of practice. Of special interest were possible differences according to gender, age, degree and place of work.
Methods: A self-completion questionnaire was filled by a stratified random sample of 355 dentists in Jordan using closed questions. The questionnaire included professional, social and economic factors that influenced people’s choice of dentistry and whether they would choose it again and the reasons for that.
Results: The results showed that 52% of dentists who returned the questionnaire had dentistry as their first choice; the most important determining factor was the dentist’s grades in the general secondary education. Fifty-two per cent stated that they would not choose it for the second time, the main reason being the health problems acquired through the profession and the low income. Helping others and the social standard dentistry provides were the main reasons given for dentists to choose dentistry again.
Conclusion: We report that more than half of the dentists included in this study would not ‘choose dentistry again’ as their profession regardless of age, gender and degree. This is mainly due to health problems acquired and the low income. We found that job satisfaction is highly affected by the workplace, and that more females are dissatisfied by the profession. This suggests that cultural background strongly affects the career decision.
Introduction
- Top of page
- Abstract
- Introduction
- Methods
- Results
- Discussion
- Conclusion
- References
The inherent nature of the dental profession does not come without challenges. These may start during early years of study, when the students encounter a variety of difficulties such as; the long hours of clinical practice, the wide number of disciplines, the close interaction with patients, and may continue on a different level after graduation once the dental career begins. Many studies have investigated the reasons behind choosing dentistry as a career amongst students at different years of study (1–8). Although a majority of these studies explored the motivations of dental students, there is not much information on how dentists perceive their profession after years of practice.
During the early years of study, students seem to perceive their profession in an ideal way that may not be realistic all the time. Different student motivations for pursuing dentistry have been reported such as favourable employment conditions (2), altruistic motives (3), social status (4, 5), financial benefits (2, 7), features of the job (8) and a secure career (9, 10). As job satisfaction has long been associated with productivity, quality of work and more importantly quality of life, we asked the fundamental question: are practitioners generally satisfied with their practice and what are the main contributing reasons?
Of special interest is the profession of dentistry in Jordan and how attractive it is to people because of the social standard it provides; therefore, an increase in the number of students accepted each year is noticed. This may be a concern because as the dentist becomes truly engaged in this profession, those factors that led him/her to choose this profession might change and new perspectives may arise. In this study, we assumed that dental undergraduates and freshly graduated dentists have different professional expectations and views from more experienced dentists who have been in the ‘market’ for a while.
The aim of our study was to investigate whether or not the practising dentists were satisfied with their profession and whether they would consider choosing this career again. We tried to assess possible changes in attitude and outlook after years of dental practice. Furthermore, we attempted to investigate whether certain work conditions like the work environment, income and workload, degree, and gender, might be related to this second time choice or, in other words, contribute to the job satisfaction. Lastly, through this study, we also tried to highlight the impact of different factors such as social, financial or professional, on dentists’ choice of this profession.
Discussion
- Top of page
- Abstract
- Introduction
- Methods
- Results
- Discussion
- Conclusion
- References
This study provides a general insight into the satisfaction of dental practitioners in Jordan. It also enables a better understanding of reasons and motivations either for choosing a dental career or leaving it. However, it is worth noting that perspectives and motivations vary widely and might be influenced by differences in society and living standards (13).
In our study, the response rate was 58% and this is believed to be acceptable and comparable to response rates in other studies involving the general population (14). The respondents were mainly from the Ministry of Health and Royal Medical Services (public sector), whilst a lower response rate was achieved amongst university employees and the lowest among those who worked in the private sector. The response rate was probably affected by the length of the questionnaire, by not being of interest to some, or by concern about confidentiality, although the dentists included in the study were reassured that it was confidential and anonymous (15).
Fifty-two per cent of the respondents answered yes to the question ‘was dentistry your first choice’ in comparison to 46% in a similar study conducted at the University of Jordan on undergraduate students (1). This difference in percentage might be due to the different age profile of the study sample whereby we found that a higher percentage of dentists in the older age groups (30—39), (40—49), and (50—59) had dentistry as their first choice. Grouping dentists in these age ranges rather than dividing them into different groups with 10-year intervals starting from age 25 (14) was thought to be more accurate as these groups are believed to share similar conditions, views and expectations. Students in Jordan usually graduate at the age of 22 or 23. These newly graduated dentists lack experience, they are undecided about whether to apply for a job, continue their studies or to leave the country to find a position elsewhere. In addition to that, their income is low, they face difficulties finding a job and starting their own practice is costly. Later in their career (after the age of thirty), dentists start to feel secure in their job and have a stable income and they would already have finished (or about to finish) their postgraduate degree.
As for the reasons for choosing dentistry; the same study mentioned earlier (1) showed that the highest score was given to dentistry being a prestigious profession and helping people. This was different from our findings where the most important factors were the dentist’s grades in the general secondary education and the family’s and friends’ influence. Different motivations were given by males and females with the males being more motivated by financial factors and this was in accordance with our findings, whereas females were motivated by the chance of helping people and this differs from our findings where females were more influenced by their grades in the general secondary education and the family and friends’ influence. This difference again might be explained by the difference in the age profile between the two studies whereby older age groups were examined in our study. This might be an indication of the social change in the Jordanian society over the previous years, where nowadays females are more independent and have the option to choose their career and can become active members in the society with less family influence and more interest in volunteer work and public services than was the norm a few decades ago.
At this stage, it is worth mentioning that the large number of unemployed dentists as revealed by the registers of the Jordan Dental Association (12) might be partially explained by the increasing number of young adults studying dentistry in Jordan and abroad leading to a large number of newly graduated dentists, who are still unemployed, as the market in Jordan is not in need of such numbers. Whether a percentage of those actually chose to change their career due to lack of job satisfaction is a question worth looking into.
Interestingly, the unemployment rate amongst dentists in Jordan does not seem to render the profession less appealing for school leavers. Cultural and social factors influence young people in their career decisions, as it is believed in Jordan that a ‘doctor’, whether medical or dental, has a much higher social status than any other profession.
With regard to the factors influencing dentists in re-choosing dentistry for their career, the results were also in accordance with the raising up of both males and females in the Jordanian society regardless of their profession and degree of education where the males do not like having a boss in general and are asked about the income because they are the ones who support the family, whereas females do not like to spend long hours at work because they are the ones who look after the house and take care of the children and it is not their prime duty to support the family financially and if they work it is just for them to prove themselves and help the husband in case his income was not sufficient.
Career satisfaction is a topic that has been frequently investigated, and most of the results tend to show a high percentage of satisfied dentists (16–18). One literature review (19) revealed that relations with colleagues as well as diversity of work were the main contributing factors; on the other hand, too much work and not enough income were the main reasons for decreased job satisfaction. They also stated that job satisfaction is partially determined by socio-cultural factors and by the physician himself.
In our study, we tried to relate job satisfaction to the dentist’s willingness to choose the career again. Thirty-eight per cent of dentists stated that they would choose dentistry again compared to 52% who would not. The main reasons given for re-choosing the profession were the human interaction this job allows. This finding is not strange for the Jordanian society where people in general are very hospitable and like to help others no matter what the cost. This is considered an inherited Bedouin value that is still built into the Jordanian character.
Given the stressful nature of the dental career, there is a need to understand and improve the quality of life of dentists. Our study demonstrated that a high rate (52%) of dentists are not willing to choose this career again. The main reasons contributing to this were the fact that dentistry is a stressful, physically demanding job that does not always provide a high income especially amongst fresh graduates and this is in accordance with previous studies (18, 20–22).
In Jordan, most of the dentists work an average of 40 h/week. In private clinics, dentists only take weekends, national and religious holidays as days off. They work two shifts with an average of 8 h/day. Rarely do they take vacations with fear of their monthly income being reduced (which is not stable). Employees in the public sector, in addition to the aforementioned days, get thirty non-successive days of leave for dentists working for the Ministry of Health, and 36 days for those who work at the Royal Medical Services. Dentists working at the Jordanian Universities have 42 days of annual leave in addition to weekends, national and religious holidays. These long working hours (especially in the private sector) are accompanied by low income, which is not correlated with the effort given and the continuously rising living expenses.
As in any other profession, a viable recognisable difference exists between the private and public dental sectors. The private sector is usually associated with financial benefits and professional independence, while the public domain may be viewed as an environment in which the dentist may develop and acquire proper training, and the multidisciplinary environment usually allows exposure to different specialties and encourages continuous educational opportunities. On the other hand, the nature of work involves the treatment of a significant number of patients in a short period of time, lack of autonomy and a low income (23, 24). Our study revealed that the place of work had an impact on the willingness for re-choosing dentistry as a career. Dentists from both The Ministry of Health and The Royal Medical Services (representing the public sector) gave higher scores to the low income and the health problems that the profession has caused, as reasons for not re-choosing dentistry, and this was further emphasised with the lower percentage of dentists being satisfied when compared with other sectors.
Before conducting this study, we presumed that the level of education would play a role in job satisfaction. To our surprise, there was no statistically significant difference between specialists and general practitioners in re-choosing dentistry, although there was a statistically significant difference in satisfaction level whereby those who had a higher degree were generally more satisfied than general practitioners. This may be explained by the limited number of dental specialists in Jordan [623 specialists out of 2127 practising dentists (12)] and the fact that general practitioners are involved in all types of treatment and few patients are truly referred to specialists thus increasing their workload and rendering them less satisfied. General practitioners could also be frustrated for not being able to resume their postgraduate studies, which has an impact on their level of satisfaction (24). It is worth mentioning that until 2005, any dentist holding a postgraduate degree in Jordan was considered a specialist; however, new regulations set by the Jordanian Medical Council dictate that for a dentist to be considered a specialist, s/he should successfully get a specialty qualification that involves a minimum of 3 years specialised training in a recognisable university, followed by successfully passing the Jordanian Board Examination in that dental specialty.
The assumption of the working hours’ flexibility that dentistry offers renders this profession highly attractive for females. However, the feeling that medicine is more prestigious than dentistry in the Jordanian society renders medicine more preferable by males. Studies have shown that the number of female students enrolling in dental schools has increased in the last decade (2, 7, 25). This is similar to Jordan where the number of females accepted each year in the Faculty of Dentistry at the University of Jordan is more than the number of males. Reasons that were given by both females and males for choosing dentistry reflect the social and cultural backgrounds of both genders, where females can be more influenced by the family and males are more interested in the financial gain and the professional independence.
A review of the contribution of women dentists to the workforce found that two-thirds of the respondents said their career in dentistry had fulfilled their expectations and they would choose to study dentistry again. This was different from our findings as there was a decline in the number of females who were willing to re-choose dentistry as a career (26).
The overall impression from this questionnaire is that the cultural background strongly affects the career decision and that this influence is particularly perceived between males and females. Job satisfaction is affected by the workplace and it seems that many dentists get disappointed with the financial rewards of the profession. It also appears that more females are dissatisfied by the profession, probably because their ideals were not met, and they were bombarded by the cruel nature of the profession.
The market need should be analysed and the Jordan Dental Association has a major role in educating school leavers about the employability and financial situation, in addition to the different specialties’ needs, the workload and the stressful nature of the job.