Individuals at the high end of the academic distribution are not being attracted to careers in biomedical research.
The percentage of dental graduates interested in teaching, research, or administration is small and declining. Few students entering dental school are aware of a career path that includes oral health research, and even fewer consider this option as they complete their training.
The reasons for this low interest include the prospects of a high income in dental practice; accumulated high student debt; and a culture in many dental schools, especially among the clinical faculty, that values the technical aspects of dentistry and often marginalizes research.
The 2005 report lamented the fact that competition is great for the highest academic performers graduating from dental school and that the occupational activities most effective at siphoning off the best graduates academically are the various clinical specialties in dentistry. These training programs require anywhere from 2 to 7 years of additional study after dental school. Accordingly, the appeal of studying several more years for a Ph.D. degree to enter a field guaranteed to offer a lower level of compensation does not enter the consciousness of most graduates of dental programs. Although the current situation relative to the research personnel needs in the oral health sciences is about the same as described in the 2005 report, and though a new and disturbing trend has emerged that seems to de-emphasize research in dental schools, the goals of the new NIDCR strategic plan are well suited to addressing the key problems.
Assuming the current university-based model of both educating and employing research scientists in dentistry remains the operative paradigm, a key question is: What will it take to make both teaching and the research integral to a university-based teaching model appealing to the kinds of individuals required by the biomedical research enterprise in the oral health sciences? Implicit in the previous discussion have been the significant impediments to careers in education and research that materialize as a consequence of dental graduate debt and the need to balance salary and working environment.
What dental educators are really doing when they ask dental students to consider a research career is inducing them to make a dramatic break with their settled career aspiration of becoming a dentist. The available population of potential candidates is not only relatively small—fewer than 5,000 nationally—but also prejudicially filtered: All dental students have gone to college where they encountered research scientists. “They know what academic life is all about and understand what it means to be a professor,” Nash and Brown explain. “In deciding to go to dental school, they have consciously rejected the notion of an academic career. The fixity of this idea in a student’s mind—that they are going to be a dentist not a professor—generates a relatively high gradient against which dental educators have to prevail if such students are to be attracted to an academic career in spite of an explicit and antecedent decision against it.”
Clearly, the best science needs to continue to be brought to bear on problems in oral, dental, and craniofacial health. At the same time, however, a critical mass of investigators who possess a special and long-term commitment to research in the oral health sciences must be maintained. With these goals in mind, the committee believes that the following recommendations are consistent with the 2009 NIDCR strategic plan and that they offer a path forward for achieving that plan’s goals, namely, to increase the biomedical research workforce in the oral health sciences in order to bring the best science to bear on problems in oral, dental, and craniofacial health.
Recommendation 6–1: Working through appropriate organizations such as the American Association for Dental Research, the American Dental Education Association, and research-intensive dental schools, the National Institute of Dental and Craniofacial Research must increase efforts to achieve closer integration between schools of dentistry and the broader research, practice, and education communities with the goal of generating new and vibrant research pathways and partnerships for students and faculty.
Recommendation 6–2: Because individual research fellowships have proven more effective in terms of generating long-term research career commitments than institutionally based programs, greater opportunities for independent NIH research fellowship support is encouraged, including K awards, programs to support postdoctoral research for dentists, Ph.D. programs for non-dentists in subject areas relevant to oral health, and programs for internationally trained non-U.S.-citizen dentists seeking Ph.D. and postdoctoral fellowships. Partnerships with other components of the academic health system need to be developed and maintained based on recognition of the value added by the oral health sciences through systems-oriented approaches as already embodied in programs such as the Clinical and Translational Science Award programs and practice-based research networks. All such NIH-sponsored initiatives should explicitly identify a collaborative role for oral health research.
Recommendation 6–3: Ideally, programs need to be developed that offer tuition waivers or supplements, or loan forgiveness, or both, for the dental school component