Yara Oweis Department of Conservative Dentistry Faculty of Dentistry University of Jordan Tel: +962 6 5355000 / +962 79 6861789 Fax: +962 6 5300248 e-mail: firstname.lastname@example.org, email@example.com
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.
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.
A self-completion anonymous questionnaire was randomly distributed to a total number of 600 dentists practising in the Kingdom of Jordan using a stratified random sampling method. The dentists’ population in Jordan was divided into different sectors (based on the place of work) including the Ministry of Health, Royal Medical Services, the dental schools at the University of Jordan and the University of Science and Technology, and the private sector (private dental clinics, centres and hospitals). The sample also included dentists with a wide range of clinical experience (from only 1 year up to 40 years of practice).
The questionnaire was given by hand to each of the dentists included in the study and the plan was to ask the dentists to fill them in instantly. We were obliged to leave a considerable amount of the questionnaires for dentists working in private practices, and some for those working in universities to fill them in later as they could not fill them on the spot. Dentists working in the public sector were keener to participate and fill it quickly as asked. Recall visits and reminders by telephone calls were undertaken (sometimes up to four times) by one of the authors (YO) to collect the completed questionnaires. Other methods mentioned in the literature were presumed to be less effective as they were unusual for the community (11). A number of dentists (approximately 50) especially from the private sector refused to participate in the study in the first place giving reasons of not having time to fill it or that it is not of interest to them.
After going through previous studies, the questionnaire format was extracted and was expanded and modified to satisfy the new objectives of the study. Mainly closed questions were used.
The questionnaire included basic personal information about the dental practitioner; gender, age, marital status, number of children, income, place of work and qualifications. The first part of the questionnaire aimed at analysing the factors that influenced people to choose dentistry for their career and whether dentistry was their first choice. Causes that were thought to be relevant were provided in the questionnaire for dentists to choose from, and were grouped into three main categories: social, professional and economic factors. These factors are listed in Table 1.
Table 1. Factors affecting the person’s choice to study dentistry as listed in the questionnaire
Having a relative who is a dentist
The ease of finding a job
Obtaining high grades in the general secondary education examination that qualified me for dentistry
Dentistry provides the opportunity of self employment
Influence form family and/or friends
Regular working hours in comparison with other medical professions
Pressure and insistence from the family
Dentistry provides the opportunity to work with one’s own hands
The profession offers the opportunity to interact with different people and to help them
Flexible working schedule
Dentistry offers a good social standard
Dentistry is a scientific, evidence-based profession
Having a good experience visiting a dentist influenced my choice
‘On-call’ duty is restricted to certain specialties
Dentists do not deal with life or death cases routinely
I used to work in a profession related to dentistry
Dentistry provides a high income
The number of years of study is less than other medical professions
Work is secure for me as a family member is a dentist
The practical application of knowledge
The second part of the questionnaire aimed at investigating whether dentists changed their view about the profession, and whether they would choose it again if time ‘went back’. Two lists of factors were also provided for dentists to choose from, one for dentists who answered ‘no’ (or do not know) and another for those who answered ‘yes’. The factors in both lists are shown in Table 2.
Table 2. Factors affecting the dentists’ decision on re-choosing dentistry as a career as listed in the questionnaire
Factors that influence dentists not to re-choose Dentistry
Factors that influence dentists to re-choose Dentistry
Dentistry is not financially profitable
Dentistry provides the opportunity to work with people and help them
Working hours turned out to be longer than expected
This profession is of a high social standard
Dentistry is a physically demanding job which caused me different medical problems
The ease of finding a job
I found it difficult to deal with blood and saliva
The opportunity of self employment and not having a boss
I found it difficult to work with patients at this level of proximity.
Working schedule is flexible
Disappointment with people’s ignorance of their oral health
Dentistry provides the opportunity to work with one’s hands
Difficulty in accepting people’s fear and hatred to dentists
Night calls are limited to certain specialties
Disappointment with the social standard dentistry offers in Jordan
Dentistry offers the opportunity to apply what you learn
Dentistry turned out to be nothing but a boring routine
Dentistry provides excellent income
Dentistry does not provide any challenges
Dentists do not deal with life-threatening cases on a daily basis
Dislike of the medical sciences
Difficulty in finding a job
Starting one’s own practice is very expensive
The lack of good dental technicians
The lack of opportunities for postgraduate studies in Jordan
The high cost of postgraduate studies abroad
No income security for those who have their own private practice
The inadequate income for those who are employed
The working environment is not satisfactory
I am experiencing problems with the boss/manager
I am experiencing problems with my colleagues
Statistical analysis of the resulting data was performed using SPSS version 16.0.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics, frequencies, one way ANOVA, t-Test, tabulated Chi Square tests and Multi and Uni-variant analysis were conducted to compare dentists’ views according to gender, age groups, degree and place of work.
The returned completed questionnaires were 355 giving a response rate of 58%. The distribution of respondents according to gender, work place, age group and degree is summarised in Table 3.
Table 3. The distribution of respondents into males and females according to age, degree and place of work
Place of Work
Royal Medical Services
Ministry of Health
The total number of dentists working in Jordan (up to May 2010) in different sectors, as well as the unemployed, retired, deceased and dentists working outside the country (as provided by the Jordanian Dental Association), is listed in Table 4 (12).
Table 4. Distribution of dentists in Jordan according to gender and the place of work according to the records of the Jordanian Dental Association until 1/5/2010 (12)
Place of work
Ministry of Health
Royal Medical Services
Outside the country
Dentistry as a first choice
Fifty-two per cent of dentists who completed the questionnaire stated that dentistry was their first choice, whilst the remaining 48% stated that it was not (32% had medical sciences as their first choice, 13% engineering, 2% social sciences and 1% general science). When age was taken into consideration, one way ANOVA (post hoc Tukey test) showed a significant difference only between age groups (22—29) and (40—49) years, where more dentists (66%) in the older age group had dentistry as their first choice in comparison with (41%) in the younger group.
When all the answers were grouped together (independent of the gender), the most important determining factor was the dentist’s grades in the general secondary education that qualified him/her for studying dentistry. This was followed by family and friends’ influence, the hope for a higher income, the chance to practise a scientifically driven profession, self employment, social standard, years of study, manual work, applied scientific knowledge and the opportunity to interact with different people.
However, when gender was taken into consideration, the most important reasons for choosing dentistry given by males (Fig. 1) were higher income, self employment, family’s and friends’ influence, grades in the general secondary education and the social status. Interestingly, for females (Fig. 2), the reasons that led to choosing dentistry were the high grades in the general secondary examinations, the influence of family and friends, the fact that dentistry is a scientific profession, the relatively short period of study when compared with medicine and the desire to have a profession with manual work.
In answer to the question whether dentists were satisfied with the profession; 20% stated that they were very satisfied, 49% were partially satisfied 10% answered they did not know 13% were not really satisfied and 7% were not satisfied at all. Combining the very satisfied and the partially satisfied categories together showed that according to gender, 69% of females and 69% of males were satisfied, whilst according to the place of work, the highest scores were achieved among those who worked in the private clinics (77%), followed by those who worked at the universities (72.9%), then the Royal Medical Services (68.9%), and the lowest among those who worked at the Ministry of Health (61.4%). A higher percentage of satisfied dentists holding a postgraduate degree was found (76.9%) compared with those with a bachelor degrees (BDS) (64.5%). According to age, higher satisfaction levels were found in age group (30—39) followed by the age group (40—49).
Dentistry a second time
In answer to the question whether dentists would choose dentistry a second time, 38% answered that they would choose dentistry again for their career, 52% would not and 9% were undecided.
The data showed that regardless of the dentist’s gender, the most common and important reason for not re-choosing dentistry was that dentists found that dentistry a physically demanding job, which caused different medical problems. All the reasons are shown in descending order in Fig. 3. On the other hand, the reasons for re-choosing dentistry for a career (Fig. 4) showed that the most influential factor was that this profession provides the opportunity to work with people and help them. Other influential factors included the high social standards that the profession provided, the fact that dentistry offers the opportunity to apply what you learn and to work with one’s hands, the opportunity of self employment and not having a boss, this profession has an artistic side to it, dentistry provides an excellent income, the ease of finding a job, the working schedule is flexible, night calls are limited to certain specialties and dentists do not deal with life-threatening cases on a daily basis.
Many factors that we thought might contribute to the dentists’ choosing dentistry another time were analysed. Including the dentists’ age, gender, place of work and whether dentistry was their first choice. Cross tabulation was done to analyse this and the results are shown in Table 5.
Table 5. Results of chi square test and P-value of second time choice against degree, gender, place of work and first choice
Second time choice (%)
Do not know
Place of work
Royal Medical Services
Ministry of Health
According to the highest degree obtained, dentists were divided into two groups. One group included holders of BDS and the other included practitioners with higher degrees [masters, certificates, diplomas, PhD(s), Jordanian board, fellowships and so on]. T-test showed no statistically significant difference between the two groups in choosing to study dentistry a second time.
With regard to the working place, a statistically significant difference (P <0.05 one way ANOVA) was found between dental practitioners who worked at the Jordanian Universities and at The Royal Medical Services, and also between dental practitioners who worked at Jordanian Universities and at the Ministry of Health. No statistically significant differences were found amongst other groups. Sixty per cent of the dentists who worked at the universities, 27% at the Royal Medical Services, 32% at the Ministry of Health, and 41% at the private clinics were willing to choose dentistry again. Results are shown in Table 6.
Table 6. Comparison of choosing dentistry a second time (one way ANOVA) between different places of work
Place of work
P-value (significant at P < 0.005)
Royal Medical Services
Ministry of Health
Royal Medical Services
Ministry of Health
Ministry of Health
Private Clinic Private Hospital
Forty-eight per cent of dentists who had dentistry as their first choice answered ‘yes’ to choosing dentistry a second time. On the other hand, 29.3% of dentists whose first choice was not dentistry changed their minds about the profession and stated that they would re-choose dentistry, whilst 62.3% maintained their view. A statistically significant difference was found between these groups (P <0.05 one way ANOVA).
To study the gender difference, cross tabulation was also used to compare males’ and females’ choice of dentistry for their career a second time. Thirty-five per cent of the females answered ‘yes’, 53.3% answered ‘no’ and 11.9% were undecided. Whereas 40.8% of males answered ‘yes’ compared to 52.1% who answered ‘no’, while 7% were undecided. This was compared with their answers with regard to having dentistry as their first choice for their career originally. Results showed a decline in the percentage of females who would choose the profession a second time and an increase in the percentage of males. Table 7 shows Cross Tabulation of dentist’s gender vs. dentistry as a first choice and vs. choosing dentistry a second time.
Table 7. Cross tabulation of dentist’s gender vs. dentistry as a first choice and vs. choosing dentistry a second time
Was dentistry your first choice?
Would you choose dentistry a second time?
Do not know
Which are the most influential factors?
Multi and Uni-variant analysis were performed to find the most important factors that played a role in re-choosing dentistry. When comparing the reasons for not choosing dentistry again amongst males and females, a statistically significant difference was present in answer to the questions about the infection control as this issue was more important for females than for males. Whereas for those who would choose dentistry again, a statistically significant difference was present in the three variables: the opportunity of self employment (where 51% of the males chose it and only 13% of the females), the night calls are limited to certain specialties was more important for females (38% of females chose it compared to only 17% of males), and that dentistry provides excellent income was more important for males (31% of males chose it compared to 22% of females).
When comparing the reasons for not re-choosing dentistry according to the highest degree obtained, a statistically significant difference was present in answer to the question about postgraduate studies abroad, whereas for those who would choose dentistry again a significant difference was present in answer to the question about dealing with life threatening cases.
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.
The results of this questionnaire demonstrated that a large number of dentists would not choose dentistry again for their career if given the choice regardless of age, gender and degree. However, these are practising dentists who have not actually left the profession. This reflects a large number of frustrated malcontented practitioners. Apparently, what these dentists expected when they first joined the dental school was not fulfilled during their years of practice and this is demonstrated by the decline in the percentage of dentists who chose dentistry for their career the first time and would re-choose to do it again if time goes back. Therefore, it seems of utmost importance to establish orientation courses that would explain to students the true nature of this job; what to expect when they graduate, job opportunities, unemployment rates, the cost of starting a dental practice and the fees for postgraduate studies.
The work capacity of the society must be considered when deciding the number of students admitted to Jordanian dental schools.
Further studies should be carried out to look further into the reasons for dissatisfaction in this profession and to divulge the true nature of discontent amongst dental practitioners in Jordan.