Dental Curriculum - Is it time for change?

 

Karachi, Pakistan:

The Medical and Dental Council of Bangladesh has recently approved a new curriculum for the Bachelor of Dental Surgery (BDS) programme, by extending their four-year programme to a duration of five years. The decision was taken in Dhaka to improve the knowledge-base, skill-set and global accreditation of Dental graduates in Bangladesh.

In Pakistan too, over the past several years, the medical and dental sector stakeholders and academicians have been repeatedly engaged in a similar debate over the appropriateness of our current health sciences curriculum, which was inherited way-back from the Britain Raj in the Subcontinent. Numerous debates were aimed to make the Pakistani graduates competent enough to cure the patients, using the latest advancements in medical sciences & techniques, while becoming more competitive on a global scale.
Prof. Dr. Ayyaz Ali Khan (PhD) – the leading dentist and researcher of Pakistan, in a statement given to Dental News recently said that; There is a need for total revamping of the Dental curriculum, which has so far failed to meet the needs of our society. The current curriculum debate in Pakistan is mostly revolving around arguments on shuffling various topics from one subject to another. It totally ignores the importance of our social demographics. We do teach Implants to our under-graduates, but we forget that Implants is only 3% of the market needs.

Dr. Ayyaz further stated that; Our grads are virtually ignorant of Paediatrics, although more than 25% of our society comprises of young citizens. We ignore the subject of Geriatrics, although 22% our society comprises of elderly people. The fresh dental graduate knows little about treatment considerations for Medically-compromised patients, despite the extremely high incidence of Diabetes and Hepatitis. We need to completely realign our syllabus after identifying the demographics and the diverse needs of each segment of our society. In order to create comprehensively trained dental surgeons, our BDS programmes might as well be extended to a duration of 6 years.

Another pioneering Dental Surgeon, seasoned academician and the Editor of JPDA – Dr. Inayat ullah Padhiar commented on the curriculum, saying; There is a lack of research-orientation in our BDS programme curriculum, whereby our graduates donot gain sufficient skills or inspiration towards research or segmentation of their patients, which can lead them to qualify in the more demanded specializations. The society's demographics and disease-burden needs to be categorized according to the different regions in the country. Dr. Inayat feels that the regulatory guidelines provided by PMDC are similar to the globally accepted rules, however, as a nation we lack the will to implement the rules, strictly & prudently, in every aspect of our social and professional lives. Thus, more prudent behaviors are desirable in the field of dental education too.

“Our colleges are also accused of producing elitist doctors, who are best suited to practice in urban centers rather than in the less privileged rural communities. Our community based dental awareness programs are still in an infancy stage and are suffering from the neglect of higher decision making bodies and even of the dental professional organizations. We need to re-define the characteristics of our doctors to enable them to meet the specific needs of our health-deprived society, with a more humane approach. But we can only do this successfully, if we provide the rural dental clinician with decent amenities of life. There is also a need to focus on disease-prevention, rather than disease-treatment,” Dr. Inayat added.

Pakistan needs a paradigm shift towards research oriented and clinical based scientific methodologies with emphasized training on medical jurisprudence and human consumer rights as well. In Pakistan, there is no dearth of experienced professionals and academicians, who have the global exposure to upgrade our curriculum and enable faster access to global developments.

Pakistan Medical and Dental Council (PMDC) has the authority and responsibility to lead and guide all the medical and dental education institutions, with a regulated curriculum, to ensure uniformity of syllabus and train all the Graduates in important subjects, surgical skill and relevant sciences.

There have been numerous debates, where Dental and oro-facial educators were collectively deliberating to enhance the knowledge and skills of our students and graduates. The new scientific revolutionary era of molecular biology, genetic tissue engineering, bio-informatics and nano-technology appear to reshape the current trends and practices in dental care education, services and curriculum designing.

Internationally, there is a transformation towards new research-based, objectively structured and clinically oriented curriculum, which should not only be able to produce health care professionals with a broad knowledge and expertise of existing dental scientific concepts, but also with a global vision to develop new strategies in prevention and management of human diseases with a major emphasis on evidence based clinical practices.

However, the health education systems in Pakistan and many other developing countries, have not evolved sufficiently to match this revolutionary era of scientific development. Presently followed and practiced clinical dentistry concepts and techniques are perhaps rather old and mainly focus on the symptomatic relief of oral health related issues and rehabilitation or repair of damaged or lost natural body parts. The very important components like oral healthcare education and prevention of these disease conditions are greatly neglected in the presently working system of dental health education. The supportive utilization of our robust print and electronic media has not been optimized for this purpose. The assimilation and incorporation of recent advancements & technologies is also quite slow.

The establishment of a National Dental Council (exclusive of PMDC), has also been recommended to carry out evaluation, recognition and structuring of dental profession on an independent basis. Several gurus of dental education in Pakistan also recommend that the BDS programmes in Pakistan should be extended to a 5 years duration, to make it more comprehensive and gain global acceptance. All the stakeholders must work together with the universities and PMDC to reach the right conclusions, solid decisions and a comprehensive road-map for resolving this crucial issue of upgrading the curriculum. We need a stronger academic visionary leadership and collaboration.