Abstract
BackgroundExisting research about the influence of educational debt on students’ decision to enter general practice immediately after graduation is conflicting. Other potential factors that could affect this decision include the influence of a spouse or other family member, the importance of a mentoring dentist, and how students perceive the burden of their debt. The goal of this study was to examine the importance of debt on career decision-making while also considering the role of other influences.MethodsResponses to a self-completed questionnaire of all final (fourth) year students at the University of Iowa College of Dentistry from 2007 through 2010 were analyzed to identify the importance of educational debt and the influence of spouses, other family members, and mentoring dentists in the decision to enter private general practice immediately after graduation. Statistical analysis included bivariate tests (t-tests and Chi-square tests) and multivariable logistic regression.Results58.9% of respondents (N = 156) planned to immediately enter private practice after dental school. Bivariate analyses revealed women to be more likely to enter private practice than their male counterparts (69.0% vs. 51.8%, p = .006). Students planning to enter practice immediately did not differ significantly from those with other career plans on the basis of marital status or having a family member in dentistry. Anticipated educational debt of at least $100,000 was positively associated with plans to enter private practice immediately after graduation. Self-reported importance of educational debt was not associated with career plans. However, the influence of a spouse, other family members, and family dentists were also positively associated with the decision to enter private practice. These factors all maintained significance in the final multivariable model (p < 0.05); however, educational debt of at least $100,000 was the strongest predictor of plans to enter private practice (OR = 2.34; p = 0.023).ConclusionsSince the 1970s, increasing numbers of dentists in the U.S. have pursued specialty training after dental school. However, rising educational debts may counter this trend as increasing numbers of dentists choose to immediately pursue general dentistry at graduation. This project has demonstrated the significant influence of educational debt, beyond other external influences.
Highlights
Existing research about the influence of educational debt on students’ decision to enter general practice immediately after graduation is conflicting
While American Dental Education Association (ADEA) notes inconclusive evidence regarding the effect of educational debt on post-graduation career plans, our results show that increased debt was associated with increased likelihood to plan to enter general practice immediately after graduation
Our study found that fourth year dental students with educational debt of at least $100,000 were more likely to plan to enter practice immediately after dental school than those with lower debt, even after adjusting for the influence of a spouse and others individuals who were identified as significantly influential on students’ career plans
Summary
Existing research about the influence of educational debt on students’ decision to enter general practice immediately after graduation is conflicting. Other potential factors that could affect this decision include the influence of a spouse or other family member, the importance of a mentoring dentist, and how students perceive the burden of their debt. With increasing national emphasis on preventive services provided in primary care settings, ensuring a strong general dentist workforce is of paramount importance for U.S dental schools. As the Affordable Care Act (ACA) is implemented over the few years, over 150,000 uninsured Iowans are expected to gain insurance coverage, including dental benefits, through the Iowa Health and Wellness Plan [4]. A sudden influx of newly insured adults with a backlog of untreated dental needs will turn to general dentists in private practice and public health settings for care
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