The career dilemma for graduating residents: Academe or private practice

We are moving toward an age where new academic skills, such as learning the methods of teaching and the process of course designing have become new goals and standards of education. Yet as educational programs continue to be improved, old problems still linger in academics and have a direct bearing on who will direct our future and become our successors.

A new era of orthodontic education is dawning, and just how it will go is a conundrum — anyone’s guess. There are new creative programs in orthodontic education that address the reduction of “qualified” orthodontic faculty members. Historically, at least since the 1990s, issues regarding recruitment and retention of qualified orthodontic faculty members have been, and still are important and challenging topics at many orthodontic conferences as noted by Roberts in 1997.

When an environment for both academe and research can become a reasonable career choice for graduating residents, the future of orthodontics will be positive (Bednar, 2007; Turpin, 2007; Peck, 2003). In past years, many residents had solid interests in teaching and research as a career choice (Larson, 1998). However, those days are gone.

Orthodontic education has been in a state of flux — academics and research have not become competitive with full-time clinical practice as career options (Peck, 2003). Specifically, the problems associated with recruitment and retention of full-time orthodontic faculty members have been, and are still on a spiraling decline (Turpin, 2007). The preservation of pedagogy in orthodontic education, the potential social justice implications, and impact on the public are directly related to: (a) education of well-trained orthodontists, (b) healthcare delivery, (c) outreach programs, (d) welfare agencies, and (e) public service communication.

When applicants are interviewed for a residency position, many speak about their aspirations of joining a faculty and becoming active in research after graduation. For an applicant holding a Ph.D., he or she often mentions full-time teaching in addition to becoming a researcher. However, by the end of his or her educational program, goals soon became more about clinical practice and making money rather than an academic career; no longer is teaching or research a priority. Bednar (2007) stated, “In 2004-2005 there were 250 funded yet unfilled full-time faculty positions at dental schools across the country, 19 of which were vacancies in orthodontic programs” (p. 1).

According to Turpin (2007), two of the most urgent problems facing orthodontics were attracting more qualified individuals for careers in orthodontic education and replenishing the attrition of full-time postgraduate faculty positions. Our leadership has addressed these educational issues but has not been able to reverse the declining number of well-trained, full-time faculty members. If faculty vacancies continue to rise, it would have a negative impact upon the (a) education of orthodontic residents, (b) future of the profession, and (c) healthcare and educational resources for the public and society (Trotman et al., 2002).

On a different but related issue, most postgraduate orthodontic program faculty members have never had any formal training in the methodology of teaching or course design; they teach what they learned from their own clinical experiences. With this in mind, it is encouraging to see a few new and novel educational programs for junior and mid-career orthodontic faculty members to learn about such academic skills.

One of the first workshops on faculty career enrichment in orthodontics (FACE) occurred in October 2012. The second FACE workshop was held this year on March 7 at the University of Michigan School of Dentistry. These workshops, led by recognized orthodontic teaching experts included an interactive format with topics, such as:

• Principles of course design starting with the end in mind
• Methods to encourage active learning in the classroom and clinic setting
• Methods for successfully incorporating technology into the classroom

Another related program for faculty members was the James L. Vaden Educational Leadership Conference, held on May 3. This conference emphasized excellence in orthodontic education, concentrating on graduate program standards. These programs will hopefully change the decline of ‘educated’ orthodontic faculty members and the increased attrition of full-time postgraduate faculty positions.

However, at the present time, alea iacta est — the die has been cast. Why would a graduating resident forego the incentives of private practice and a decent starting salary, to accept low paying academic position with little hope of advancement and a mounting financial struggle, especially when the major focus of his or her education has been to treat patients? As noted 10 years ago by Johnston (2002), sadly there is still no market for a career in academe as there was prior to the twenty-first century. If experience has taught us anything, it is that money talks! Most new graduates make decisions that are personal matters, i.e., supporting a family, paying back educational loans and living a decent lifestyle.

One measure of an individual is how well he or she can overcome adversity; the future of orthodontic education is also at the crossroad of adversity - the trying times associated with academic careers in education.

Until profitable career options in education become a reality, the supply of orthodontic educators and researchers will be limited. American-educated residents are blinded by future prospects of earning a living and may never regain their sight towards considering a career in academics.

Until academe becomes a profitable career option, orthodontic education may experience a diminished or daunting outlook. For the new orthodontic graduates, regardless of whether their path leads to academics or private practice, aspirations should be concentrated on practicing to the best of his or her ability.

Note: This article was published in Ortho Tribune U.S. Edition, Vol. 8, No. 7, Winter 2013 issue. References are available from the publisher.