Historical overview of orthodontic education, from the beginning up to the 21st century (Part 4)
In 2002, 300 full-time faculty positions were unfilled, and an additional 200 to 600 new faculty members would be needed every year thereafter (Trotman, Bennett, Scheffler and Tulloch, 2002). The American Dental Education Association (ADEA) and the American Association of Orthodontists established task forces to study this shortage, which they declared was at a crisis level and that academe was no longer an attractive career option (Trotman et al., 2002; Peck, 2003).
The Task Force included leading orthodontic educators, members of the AAO Board of Trustees, and dental school deans. Weaver, Chmar, Haden and Valachovic (2005a) found there was an estimated 241 vacant full-time and 55 part-time faculty positions at the 56 U.S. dental schools in 2003-2004.
Trotman et al. (2002) noted that the full-time faculty attrition problem would have a negative impact on dental education and health care in general. Several earlier small-scale studies reported similar findings, that postgraduate orthodontic education was facing serious consequences regarding the ability to attract qualified, full-time tenure track faculty members (Larson, 1998; Roberts, 1997; Valachovic Weaver, Sinkford and Haden, 2001).
The demand for orthodontic care by the public and in the number of clinicians willing to provide this care has reshaped the workforce dramatically in a short period of time. In 2000, the AAO hired an outside research and planning group to conduct a study of its members who were 50 years or older (Turpin, 2003a). They reported that 25 percent of respondents expected to stop practicing completely by 2004, and 56 percent expected to stop practicing completely by 2014.
Many of those clinicians have decided to delay their retirement for several years. Until recently, most new graduates could choose from many practice opportunities. Turpin reported that one student, ready to graduate after 10 years of scholarly pursuit, stated, “I would be happy to take a hygiene job for a while, if something doesn’t break soon.” Those graduates reported far fewer opportunities, according to Turpin.
Hindsight so often provides an unequivocal opportunity for reflection on successful and unsuccessful decisions. Such theoretical and empirical content could be summed up as the essence of a force for change by the following quotation from Larson (1998), “There is no doubt that dedicated orthodontic educators have been critical to the development of the specialty. The question is whether the faculty will be there in the future to continue this history of strong education.”
All orthodontists and institutions must be proactive in preserving the specialty; academe must be perceived as an attractive alternative to private practice, and exposure to the academic world must begin in the dental school. The AAO and its foundation (AAOF) are in a position to make a difference. They must lobby for changing the way an academic orthodontist earns a living while providing an opportunity to advance the field academically.
As noted by Johnston (2002), sadly there is no market for a career in academe as there was prior to the 21st century.
As recent as 2016, according to Conley (2016), “Faculty recruitment and retention [still] remain significant challenges in orthodontics.” If experience has taught us anything, it is that success in clinical practice is largely unrelated to science, evidentiary or theory applications, especially when most techniques work and nothing else really matters. Alea iacta est, the die has been cast: Why would a graduate forego the incentives of private practice to accept a position in an unrewarding existence and struggle, especially if there is no scholarly challenge, when he or she has been trained their entire educational career to treat the public? Until the specialty decides that there is profit in a scientific, evidence-based approach to clinical practice, the supply of teachers and researchers probably will not increase to levels of the past.
American-born residents may not glean the value that is required and necessary for considering a career in academe. Hopefully, the future will provide enhanced career opportunities for our graduates, but until academe is respected by the specialty as a whole, orthodontic education will continue to present a diminished and unfortunately a daunting outlook for its future.
Note: References for all parts of this article are available upon request from the publisher.