What After BDS: a Dilemma

"Dentistry," as they say, is an amalgamated field comprising skills of a doctor, engineer, and artist.

This five-year intensive course prepares a student with the technical and soft skills required to face the world as a professional dentist.

However, the journey from a dental student to a practicing dentist is filled with lots of ups and downs, uncertainty, perplexity, and miscalculations.

After completing a bachelor’s degree in dental surgery (BDS), the most obvious path that dentists opt for is a master’s degree in one of the specializations in dentistry (MDS).

There are over nine branches of specialization consisting of oral and maxillofacial surgery, conservative dentistry and endodontics, periodontology, public health dentistry, oral pathology, etc. to classify broadly, there are clinical and non-clinical branches in dentistry.

In India, the clinical branch for specialization is the most prevalent one considering the fact that dentists choose to undergo extensive clinical training over a period of three years to establish their own clinical practice in the future.

A study conducted in 2018 revealed that 76.40% of dental students were willing to opt for a master’s degree in dentistry [1].

Records show that in 1970, only 8000 dental students graduated from Indian dental institutions, the figure was 30,570 in the year 2010.

The author also mentioned that the total number of post-graduate seats available is only around 3000 compared to each year pass outs of 25,000 dental graduates [2].

This has led to an increase in the competition in the market with the saturation of dentists in every corner of the city.

Thus, after the internship, students get confused about their future course of action.

Numerous career options are available after dentistry in India as well as abroad.

However, due to a lack of seriousness, knowledge, and authentic sources of information, students end up making career decisions in a hurry without thorough planning and execution.

As a dental intern, I have been through this phase but got lucky to have learned my lesson early enough.

Through this blog, I would like to share different career options that I had come across while developing my career plan after graduation.

Choice of Specialties in Dentistry:

Dentistry has nine branches of specialization namely, oral, and maxillofacial surgery, paediatric and preventive dentistry, periodontology, oral pathology, public health dentistry, prosthodontics, orthodontics and dentofacial orthopaedics, conservative dentistry and endodontics, and oral medicine, diagnosis, and radiology.

Oral surgery (35.77%) was the most preferred choice followed by orthodontics (15.45%) and endodontics (15.45%).

Preference to oral surgery may be due to the possibility that it provides an opportunity to perform maxillofacial surgery, fulfils a desire to teach dental students and surgical residents, and is associated with a good monetary return.

This could also be due to the prestige and reputation of the specialization [1].

Aesthetic demands, relief from unbearable tooth pain, and good returns could be possible reasons for orthodontics and endodontics becoming a preferred choice of specialty for dental graduates.

For people interested in impacting the health sector on a large scale, a master's in public health dentistry would be an ideal choice.

Oral pathology is more inclined towards the non-clinical aspect and focuses more on research pertaining to dentistry at a molecular level.

Surprisingly, only 33.5% of undergraduate dental students find this subject interesting [3].

Hence, before selecting any specialty, one must study all the pros and cons, interest level, workload, finances, returns on investment, and other factors in detail.

MDS From India After BDS:

If a BDS graduate wants to pursue MDS, then certain steps have to be followed such as monitoring the exam application deadlines, list of required documents, etc.

In order to get admission to one of the MDS courses in a dental college in India, the National Entrance Eligibility Test (NEET-MDS) exam is the necessary eligibility criteria for all students.

NEET-MDS is an eligibility-cum-ranking examination prescribed as the single entrance examination for admission to various post-graduate MDS Courses under the Dentists Act, 1948 (amended from time to time).

No other entrance examination, either at the state or institution level, shall be valid for entry to MDS Courses.

Usually, students start preparing for the NEET-MDS exam during their one-year compulsory internship after completing four years of academics at any recognized dental institution in India.

Some students prefer joining coaching institutes while some opt for self-preparation.

Students must regularly check for updates on the entrance exam patterns, scheme of marks distribution, cut-off of the exam since the past few years, qualifying percentile, dates of submission of online application, eligibility criteria, examination fees, date of the exam, and declaration of result.

To make student's tasks easier, an information bulletin is available on the official website of the National Board of Examinations (NBE): https://nbe.edu.in/.

It consists of all the details regarding the NEET-MDS exam of that particular year. It also provides a list of colleges/institutes administering MDS courses.

Post the declaration of results, various rounds of counselling begin for the admission to MDS course.

Although the entire process seems lengthy, tiresome, and requires lots of patience, dedication, and strategic planning, it is beneficial in the longer run. After all, it is truly said,

“Difficult roads lead to beautiful destinations.” -Anonymous

What if not MDS?

Let's take a look at the broader picture now. Dentistry has immense scope after graduation if one wants to work as a clinical or a non-clinical professional.

If MDS is not a feasible option for you, then there are other doors of opportunity waiting to be explored. Some of them have been listed below:

Clinical Career Options After BDS Other Than MDS:

1. Establish your own dental practice directly after the internship.
2. Join a private clinic as a dental associate.
3. Join a trust or hospital with a dental setup.
4. Join corporate companies where they have clinical setups.
5. Join the Army Dental Corps.
6. Government jobs (e.g., Railways)

Non-Clinical Career Options After BDS:

1. Master of Hospital Administration (MHA)
2. Master’s in Public Health (MPH)
3. Master’s in Business Administration (MBA)
4. MBA in health care management.
5. Forensic odontology.
6. Clinical research
7. Pharmacovigilance
8. Medical transcription/virtual scribing
9. Medical coding

Dentistry in the USA After BDS/MDS From India:

Not only from India, but a lot of dentists from all over the world aspire to practice dentistry in the United States of America (USA).

Some studies state that the reason for the migration of dentists could be due to better job opportunities, better working and living conditions, and career growth and development [4].

If a foreign-trained dentist is planning to practice dentistry in the USA, then the following are the steps to go by [5]:

1. Complete BDS along with a one-year compulsory internship from any recognized dental institution.
2. Acquire DENTPIN (online)
3. Evaluation of credentials: Submit the required documents.
4. INBDE Exam (Integrated National Board Dental Examination)
5. TOEFL Exam: English proficiency exam
6. Apply to USA universities via the ADEA CAAPID site.
7. Submit the required documents to the university.
8. Interview and bench (clinical) test.
9. On clearance of the above steps, you get admitted to DDS/DMD program (Duration: 2 years) in a university that accepts international students for advanced programs in dentistry.

Following is the list of official websites that provide details of the application procedure, exams to be given, and the list of colleges that provide advanced dental education programs for foreign-trained dentists:

https://www.ada.org/

https://www.ece.org/

https://jcnde.ada.org/nbdhe

https://www.ets.org/toefl.html

https://www.adea.org/

Dentistry In Canada After BDS/MDS From India:

Apart from the USA, Canada is also the most preferred option for dentists to establish their clinical practice.

If an Indian dentist is planning to practice dentistry in Canada, then the following are the steps to go by [6]:

1. Complete BDS along with a one-year compulsory internship from any recognized dental institution.
2. Evaluation of credentials: Submit the required documents.
3. Assessment of Fundamental Knowledge (AFK) exam.
4. Go for the equivalency process or for the degree completion process.

Equivalency Process:

• After clearing the AFK exam, the Assessment of Clinical Judgement (ACJ) exam and Assessment of Clinical Skills (ACS) exam has to be cleared.
• After clearing these exams, enter the NDEB certification process. (NDEB: National Dental Examining Board of Canada)
• NDEB written exam.
• Objective Structured Clinical Examination (OSCE)
• After clearing these exams, you will receive NDEB certification.
• Apply for a provincial license.
• Practice in Canada

Degree Completion Process:

• After clearing the AFK exam, apply to universities for DDS/DMD program.
• Interview and bench test.
• Complete the two-year DDS/DMD program.
• After completing the DDS/DMD program, enter the NDEB certification process.
• NDEB written exam.
• OSCE exam
• After clearing these exams, you will receive NDEB certification.
• Apply for a provincial license.
• Practice in Canada

Following is the list of official websites that provide details of the application procedure, exams to be given, and the list of colleges that provide dental education programs for foreign-trained dentists:

https://ndeb-bned.ca/

https://www.ece.org/

https://www.ielts.org/

Conclusion:

Since the advent of the internet, information is accessible to us with one click.

Today, there are numerous organizations or official government bodies that regulate entrance exams, counselling, and admissions.

If you visit the aforementioned websites, you will find that every website systematically provides all the details along with queries.

One must be patient enough to go through the technicalities meticulously in order to understand the entire process and collect significant and relevant information.

Additionally, another important aspect is interacting with people who are studying or working in that particular field.

They are well-versed in the actual situation, the difficulties, and hurdles that one might face while applying for a study program or while staying in that region, etc.

This prepares us beforehand for any challenges that might come along the way.

After completing my final year of BDS, without procrastinating, I started exploring career options and accordingly spoke to as many people as possible.

It took me many months of planning, research, and communication to conclude.

However, developing a plan alone is insufficient. One must be consistent and disciplined enough to follow the plan, track their progress regularly, and keep themselves updated with the current information.

Hence, hard work and smart work go hand-in-hand in order to achieve success. As one of my mentors appropriately told me - “Put your head down and focus on the process. The outcome will fall into place.”

References:

1. Vatsul Sharma, Nidhi Gupta, Vikram Arora, Preety Gupta, Nishant Mehta. Factors affecting future specialty choice among dental students in Haryana. Journal of Scientific Dentistry, 2017;7(1):12-17
2. Jain H, Agarwal A. Current scenario and crisis facing dental college graduates in India. J Clin Diagn Res. 2012; 3824:1892. PubMed | Google Scholar
3. Saluja P, Khurana C, Dave A, Arora M, Kumar S. Perception and willingness toward oral pathology and histology as a subject and profession among Indian dental undergraduates. Dent Res J 2020;17:472-9.
4. Balasubramanian, Madhan & Brennan, David & Spencer, Andrew & Short, Stephanie. (2016). The international migration of dentists: directions for research and policy. Community Dentistry and Oral Epidemiology. 44. n/a-n/a. 10.1111/cdoe.12223.
5. Allareddy V, Elangovan S, Nalliah RP, Chickmagalur N, Allareddy V. Pathways for foreign-trained dentists to pursue careers in the United States. J Dent Educ. 2014;78(11):1489-1496.
6. Boorberg NB, Schönwetter DJ, Swain VL. Advanced placement, qualifying, and degree completion programs for internationally trained dentists in Canada and the United States: an overview. J Dent Educ. 2009;73(3):399-415.