Dentistry In Nepal – From Undergraduate Prospect

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    Dentistry In Nepal; Under Graduate Students, a document of unedited brains. Do they have any input into the selection of course topics and subject matter included in their curricula? Don’t know about this more in the worldwide frame but for Nepal- we don’t have any such privileges.

    We have a Bachelor Of Dental Surgery curriculum framed by the universities which stipulates competencies and associated biomedical and clinical knowledge that must be addressed during dental school. Although these competency requirements restrict the variance of educational experiences, students are eager to share their views on the curriculum within the realm of their educational experience.

    Unfortunately, dental schools tend to focus the microscope on passing rates on standardize tests rather than students’ perceptions of their education. Students’ views of particular courses and instructors are frequently shared from one graduating class to another.

    Students are often surprised to learn that comments placed on faculty evaluations or surveys do not affect the course from one year to the next. Simply put, the information provided in evaluations is often times not used to modify curricular content.

    Unfortunately, faculty unwillingness to listen to student comments, or make modification based on feedback, eventually leads to students’ frustration with the academic program, which could turn into a feeling of frustration toward the profession of dentistry.

    A SWOT analysis(Strengths, Weaknesses, Opportunities, and Threats) can be a best way to express the base of dentistry – here I have put my opinions in the context of dental education in Nepal at undergraduate level.

    dentistry-in-nepal
    Dentistry In Nepal

    STRENGTHS

    1) It is great that we have been able to work in the clinic already. It helps us to learn material in preclinical courses better when we can take an hour or two to try to use the information practically.  We feel actually learning something when we give each other injections, restorations, scaling, etc.

    2)The number of clinical hours is a tremendous strength of the dental schools.

    3)We have a comprehensive curriculum with diverse faculty and staff.

    4) The quality of the professors has been a strength because good teachers make their subject matter easy to learn and their enthusiasm makes the educational experience better.

    5)Few doctors/professors and postgraduate students have made impact despite all the ‘doctor’ titles, names, and other impression. They show initiative to reach out to students in the clinics and in classroom.

    WEAKNESSES

    1) A major problem is dental students have to worry about many things outside of their control such as patient scheduling, lab work, completing requirements, which leaves little time for learning. More than half of the students’ time in the third and fourth years is spent doing non learning activities. Students worry about getting things done or ‘signed-off’ by faculty and don’t take time to learn what they are doing.

    2)Too many students and too few chairs. Departments do not communicate with each other, leaving the student stuck in the middle. More jumping through hoops and illing out paperwork than actually doing procedures and learning.

    3)So much time is wasted in this clinic on things like changing encounter forms, getting new burs, organizing patients, scheduling, and searching for patients. There has to be a way to run things more efficiently.

    4)Our curriculum falls short in addressing applicable learning that requires more open-ended thought, conceptual learning, and applied instruction. We see the steps, but not the staircase. For the majority of time we just memorize material, which is never applied and is soon forgotten. Hard to get an overall concept of why we learn or do a certain thing.

    5)The basic sciences here are focused on teaching us to pass exams. There is little encouragement of creative, innovative thought. Tough courses were just taught to memorize. Microbiology and Pathology need to be more integrated with the courses in clinical dentistry. At times, instructors themselves have no idea (no kidding!) why a particular topic is being taught!”

    6)The manner in which some courses are presented seems unorganized or even scattered with no real goal or purpose. It seems they just want to get as much information out as possible. Each department has its own way of grading, setting competencies, designating thresholds, etc.

    7)There is too much overlap of very basic details and procedures. This takes up valuable time that could be spent clarifying ambiguous details in class.

    8)Lack of calibration among faculty related to providing corrective feedback and assigning grades is a widespread source of concern among dental students.

    OPPORTUNITIES

    1)Need more opportunities for clinic time; halfway through the second year, we are familiar with only three instruments: mirror, probe, and explorer.

    2)Provide more outreach programs to the local schools. We could be doing [screening and prevention services] at more schools and really helping out the community where there is a high caries.

    3)School should place an emphasis on newer and more modern techniques and applications such as implants, veneers, 3/4 crowns, etc.  We are taught a good basis of material, but when we graduate, we could end up being old-fashioned in regards to techniques. 3-D dental anatomy software on computer can really enhance knowledge of how teeth should be and occlude. More Internet sites with videos and procedure demonstrations be provided.

    THREATS

    1)Cost of Dental Education -Too expensive. Recently graduated students will not be able to volunteer and teach because they have massive loans to repay.MONEY! We pay so much for our education, but it still seems that they do not have enough money for us. If any articulators, plastic teeth, or instruments are needed, we have to pay out of our pockets.

    2)Faculty shortage is the greatest threat to quality. The faculty consistently indicate that they are not paid enough to make the job worthwhile. The smart people know there’s not as much money in teaching as in private practice, so it can be very difficult attracting quality full-time faculty.

    3)Increase in faculty-Lack of faculty coverage in clinic decreases number of chairs available for students. Leads to not being able to get requirements done.

    4)Requirement-based cherry picking dentistry is a major threat. Students are taught to treat the ‘big ticket’ items or what the student needs, and the patient gets shufled around and their needs go unaddressed. This is a major threat to the quality of dental education because you are forced to beat the clock and pass patients down and around. It is unfair to the patient and causes the student undue emotional stress. We view patients not in terms of what they need and want but in terms of what we need to graduate.

    5)Another threat has been that too much emphasis is placed on the number of procedures completed It encourages an environment where students, hard-pressed to get procedures done, can act unethically and put their own needs (i.e., the requirements) in front of the real needs of the patient. And the worst part of the system is that the faculty encourage this behavior. They over-treatment plan cases so that students can get their requirements completed.

    6)The requirement-driven curriculum adds stress on students. Students are blamed if they don’t meet their requirements, and students feel a lack of understanding and help from faculty. Being responsible for booking your own patients and looking for specific patients who have specific requirements are also added stressors. The focus should be on comprehensive care with pools of patients with different needs in order for students to meet requirements.

    Dentistry In Nepal
    Arzoo Gupta
    Dental Student BPKIHS

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