Dr. Michael Glick’s July editorial, "Dental Education: An Evolving Challenge," brought focus to predoctoral education, with but a brief mention of postdoctoral education (JADA 2006;137[7]:940–4). Professional education must be considered as a continuum, from undergraduate to predoctoral to postdoctoral to lifelong learning (continuing education). It can be counterproductive to look at any of these entities in isolation when trying to improve the outcomes of dental education as a whole.
Dr. Glick raised an excellent point in that "enhancing collaboration between clinical and basic science faculty and incorporating more clinical experiences into the curriculum for the first two years of dental school would greatly improve the dental school experience."
Earlier, the Institute of Medicine’s landmark 1995 publication, Dental Education at the Crossroads,1 made a similar point: "Using excellent practice in the community as a model, dental school clinics should seek to be more patient-centered and efficient and to provide students with a greater volume and breadth of clinical experience."
Dr. Glick also notes that "reaching a level of proficiency to critique, assess and use new knowledge may be attained at the postdoctoral level, but it is rarely taught or required during predoctoral training." His conclusion from these observations, however, is quite different from the Institute of Medicine’s, which is that "all dental school graduates should have the opportunity for a year of postgraduate education with an emphasis on advanced education in general dentistry." Our colleagues in medicine understand this and long ago mandated postdoctoral training as a prerequisite for licensure.
Dr. Glick’s suggestion is that "postdoctoral programs are the source of future educators. It would behoove them, therefore, to provide training on how to become an educator and to emphasize the importance and value of a career in dental education." While one of the aims of postdoctoral programs is to train dental educators, it certainly is not the only purpose.
Postdoctoral programs provide extensive clinical training; in fact, almost every clinically practicing specialist is a graduate of a postdoctoral training program. We need to increase the numbers of both excellent clinicians and of clinician educators. As in the preparation of excellent clinicians, clinical educators need specifically targeted experiences. Addressing either can require addressing significant obstacles. To suggest "if, however, turning dentists into educators is too difficult a task, perhaps we should start programs that turn educators into dentists" may oversimplify the issue. It is not a matter of a metamorphosis from an educator to a clinician or vice versa; it is more of an economic matter for one who has talents as both a clinician and as a teacher. When considering making a salary of $100,000 as a faculty member working five days per week, while the other option is private practice with an income of three to four times that amount in four days, many choose the latter, especially if they are already strapped by economic burdens.
On the postdoctoral level, many faculty do clinical dentistry, education and, frequently, research. This has been a successful model for postdoctoral training and, perhaps most importantly, provides role models for the new dentist. The postdoctoral approach could conceivably be used on the pre-doctoral level as well. This would serve multiple purposes, not the least of which would be to change the perception of dental educators from ivory tower idealists to reality-grounded role models and mentors. As Dr. Glick indicated, we need to look at new paradigms and encourage innovation, not just in dental materials and concepts, but in the educational arena as well.
TOP
REFERENCES
