We have no future direction, vision and strategy in dental education-Ahsan Sethi


 Seminar on Dental Education during AEME 2017 Conference

We have no future direction, vision and strategy
in dental education - Ahsan Sethi

We follow non-integrated curriculum which is teacher centered
and we are not willing to change - Ayyaz Ali Khan

KARACHI: A seminar on Dental Education was part of the scientific programme of the AEME Conference on Medical Education held from March 3-5, 2017. Organized on second day of the conference at the Jinnah Sindh Medical University, it was chaired by eminent dental surgeons Prof. Mervyn Hosein Dean College of Dentistry at Ziauddin Medical University along with Prof. Saqib Rashid, President of Pakistan Dental Association. The invited guest speakers included Dr. Ahsan Sethi from Khyber Medical University and Prof. Ayyaz Ali Khan from Federal Dental College, Islamabad.

Dean of the Dental School at JSMU Prof. Kefi Iqbal in his introductory remarks said that under the new set up they have just admitted the first batch to the dental school. The objective of the seminar is to provide an opportunity to the leadership of the dental profession to think about practice of dental education in Pakistan. Our key challenge is to identify core competencies of dental education to help PM&DC as well as Higher Education Commission.

Dr. Ahsan Sethi was the first speaker who talked about Challenges of Modern Dental Education in Pakistan. He traced the history of dental practice in Pakistan when it was just confined to dental extraction and dentist till now is usually not considered as a doctor. However, now dental education is changing all over the world to become patient centered education. He also referred to the Dental Education curriculum by the PM&DC prepared in 2003. Unfortunately, we have no future direction, vision and strategy. In the past what we were taught in the dental schools even our teachers did not know and dental students were considered as a liability by the dental teachers. Our focus used to be on procedures and comprehensive dental care was lacking.  There was a weak link between medicine and dentistry. We were marginalized because of lack of patient education; faculty did not provide us any good role models. We had shortage of dental educationists. There was absence of research culture and career counseling. However, time has come that we will have to change with the time, he remarked.

On left Prof. Mervyn Hosein along with Prof. Saqib chairing the seminar on Dental Education during the AEME
Conference on Medical Education held at JSMU on March 5, 2017. Picture also shows Prof. Prof. Kefi Iqbal and
Dr. Ayyaz Ali Khan speaking on the occasion. On extreme right Prof. Lubna Baig is seen participating in the discussion.

Dentistry should be renamed as oral health. We are trying to make some changes and move in that direction. There are fifteen dental colleges in the province of Khyber PK and we have uniformity of objective and outcome competencies. We have made it mandatory to attend Certificate course in Health Professional Education for the entire dental faculty. We have identified competencies of a general dentist and decompressed the curriculum. In the curriculum there was no relevance of certain things which have been removed and new things added. We are practicing integrated curriculum with patient centered learning and efforts are being made to upgrade dental surgeons to oral health physicians. We have introduced meaningful education collaboration between geriatrics, paediatrics. We expose dental students to patients from the very first day and give emphasis to evidence based practice. We have introduced School Health Services, community clinics and provide safe, standard comprehensive care environment. He laid emphasis that we need to establish comprehensive care clinics, introduce new technology, and focus on holistic performance dental care. PM&DC needs to register new dental specialties. He concluded his presentation by emphasizing the importance of holistic patient care, professional ethics, Interprofessional education and collaboration, critical thinking, patient management and informatics, research and scholarship. Dental curriculum needs to be increased to five years so that the dental graduates can ensure compliance with clinical care and continuous professional development. Dental students also needs to be exposed to specialties like ENT, Paediatrics and Geriatrics and we must aim at overcoming the obstacles to change, Dr. Ahsan Sethi remarked.

Prof. Ayyaz Ali Khan who was earlier affiliated with Sheikh Zayed Hospital Lahore and is now working at Federal Postgraduate Dental School at Islamabad talked about “Our Current Assessment and Attendance system: Are we producing competent professionals”. His presentation was based on his personal experience over the years. He pointed out that we have few short cuts. He himself during his trailing used those short cuts and despite being deficient in certain areas, he could qualify as dental graduates.

However, when he started practice of dentistry only then he realized that the subjects which he omitted or did not give any importance were not only relevant but also very important to practice dentistry. Under the present circumstances anyone who gets 50% marks is passed which means that he or she can omit the 50% of the questions. We are following old curriculum which had not been updated for many years. We follow non-integrated curriculum which is teacher centered and we are not willing to change. There are certain tutorial gaps and each subject has its own block in the curriculum. No one talks about competency. We organize dental conferences but do not talk about learning competencies. We used to have four dental colleges twenty five years ago but now their number has increased to forty one. We have compromised on training curriculum. Quality of BDS programme is questionable and we are not documenting what we are doing. A surrey among eight hundred dental graduates of twenty three dental colleges showed that only 59% thought they were competent to practice dentistry. We must work and recommend competency based curriculum. Our dental curriculum comes from the West with no indigenous input. We must look at global benchmarks but at the same time it is also important to add what the country needs and what is our requirement. However, we have created mediocracy in dentistry. We have not done anything till today but let us do something now and revamp the dental curriculum. When we talk about increasing the duration of BDS to five years, some people say it is being promoted by the private sector so that they can earn more money from student fees.

Participating in the discussion Prof. Shahjehan Katpar pointed out that we spend very little of our GDP on Health and still meager on dental health. We have no input from the professional in National Oral Health Programme. Since now we have dental educationists, let us demand that only qualified dental educationists should represent the dental profession in the PM&DC as well as at other professional forums. Prof. Saqib Rashid remarked that we just talk and do nothing later. We are not good at implementing. We have finalized certain core competencies and forwarded it to the PM&DC. Every dental college, he further stated was doing something good but we needed to ensure its implementation across the board. Dental surgeons have some personal problems which need to be resolved. We are competent and must ensure that dentists have good exposure to the patient. Prof. Mervyn Hosein opined that we need to check the competency of our dental colleagues as well as dental colleges. Dental students must have core knowledge of basic and medical sciences.  Prof. Mrs. Hosein remarked that when we were invited to a meeting everything had already been finalized without any input and we do not agree with quite a few things which were recommended in that meeting referred to by Prof. Shahjehan Katpar. Mr. Shaukat Ali Jawaid opined that there was no shortage of funds but the dental profession does not utilize the funding properly. Just look at the huge funds collected from the Pharma Trade and Industry for dental conferences.

Some of it can be used for research, scholarships for dental postgraduates rather than spending it on social events. Dental profession need to put its own house in order and keep pace with the new developments. Prof. Major Gen. M. Aslam highlighted the importance of upholding merit in selection and transparency at all levels besides emphasizing on professionalism and upholding professional ethics. Prof. Lubna Baig Pro VC JSMU urged the participants to come up with practical recommendations. Basic oral aspects in basic sciences need to be included in dental curriculum. It was also emphasized that now there are about forty five dental institutions and if they think and work with one voice, the concerned authorities will be forced to listen to them.