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Title
Career Paths and Aspirations among Postgraduate Dental Trainees on Completion of Clinical Residency Program at Tokyo Dental College
Author(s) Takahashi, T; Furusawa, M; Katakura, A; Sugito, H;
Hirata, S; Ishii, T; Kameyama, A
Journal Bulletin of Tokyo Dental College, 55(2): 103‑109 URL http://hdl.handle.net/10130/5623
Right
Description
Career Paths and Aspirations among Postgraduate Dental Trainees on Completion of Clinical Residency Program at Tokyo Dental College
Toshiyuki Takahashi1), Masahiro Furusawa2), Akira Katakura3),
Hiroki Sugito4), SoIchiro Hirata5), Takuo Ishii5) and Atsushi Kameyama4)
1)Division of General Dentistry, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan
2)Department of Endodontics and Clinical Cariology, Tokyo Dental College, 2-9-18 Misaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
3)Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, 5-11-13 Sugano, Ichikawa, Chiba 272-8513, Japan
4)Department of Clinical Oral Health Science, Tokyo Dental College, 2-9-18 Misaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
5)Department of Social Dentistry, Tokyo Dental College, 2-9-18 Misaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
Received 31 October, 2013/Accepted for publication 16 December, 2013
Abstract
Career paths and aspirations were investigated among postgraduate dental trainees on completion of clinical training at Tokyo Dental College between 2006, when clinical residency became mandatory, and 2011. Overall, those finding employment with inde- pendent general dental practitioners accounted for the majority (34%), followed by those entering postgraduate courses at the Chiba Hospital (20%), those embarking on a postgraduate clinical specialty course at the Chiba Hospital (16%), and those going on to other universities (7%). At the Chiba Hospital, the number selecting postgraduate courses, residency training (including further residency training or a postgraduate clini- cal specialty course), or employment with a general dental practitioner was almost the same; however, the number selecting postgraduate courses at the Suidobashi Hospital was low, showing a strong tendency toward becoming a general or clinical practitioner.
At the Ichikawa General Hospital, most of the trainees decided to remain at the same school or hospital as postgraduate students or residents, showing an aspiration toward further specialization. The results of the Fisher’s exact test showed a significant difference in career paths between the Chiba, Suidobashi, and Ichikawa General Hospitals. Trends among postgraduate dental trainees from this and other schools completing the clinical residency program here and subsequently entering postgraduate courses, further resi- dency training, or a postgraduate clinical specialty course at this school were investigated.
No major difference was observed in the percentage of trainees remaining at the same school or entering postgraduate courses between those from this and those from other schools; however, more trainees from other schools selected further residency training, while fewer selected a postgraduate clinical specialty course.
Key words: Postgraduate dental trainees —
Completion of clinical residency program — Trend — Path — Aspiration Clinical Report
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Introduction
The Dental Practitioners Act1) states that
“Clinical residency programs must provide dentists with the opportunity to cultivate their own personality as professional dentists, acquire basic skills, obtain a deep understand- ing of the role of dental medicine, and pro- vide appropriate treatment for the types of injury and disease that they are most likely to often encounter in daily practice, irrespective of their area of specialization”. Therefore, Tokyo Dental College has prepared different residency programs for its Chiba, Suidobashi, and Ichikawa General Hospitals to provide clinical training based on this act. The authors have already reported on clinical care pro- vided by dental residents6,8,9), the approach to improving initial residency programs5), coop- erative clinical training facilities4,7), specialized training3), a matching system within a clinical training facilities group10), and recent trends in dental residents2).
The goal of this study was to investigate recent trends among dental postgraduate dental trainees at Tokyo Dental College since clinical residency training was mandated in 2006, by focusing on their career paths and aspirations on completion of the clinical resi- dency program.
Subjects and Methods
Tokyo Dental College offers a clinical resi- dency program at each of its 3 hospitals (Chiba, Suidobashi, and the Ichikawa Gen- eral Hospitals), and 698 postgraduate dental trainees have completed this program since its inception in 2006.
Each of these facilities has prepared its own unique training program and accepts many postgraduate dental trainees every year. The college currently operates a total of 7 pro- grams: programs A, B, C, and D at the Chiba Hospital; programs A and B at the Suidobashi Hospital; and program A at the Ichikawa General Hospital.
Program A at the Chiba Hospital is a single-
type program. Thirty-two places were offered on this program in fiscal years (FY) 2006 to 2010, and 30 in FY 2011. Programs B, C, and D at this facility are management-type programs.
The number of places offered on program B was 30 in FY 2006 to 2010, and 24 in FY 2011;
that for program C was 66 each year; and that for program D, which was newly offered in FY 2011, was 8. The total number of places offered each year was 128.
Program A at the Suidobashi Hospital is a single-type program. Five places were offered on this program in FY 2006 and 2007, 10 in FY 2008 and 2009, and 7 in FY 2010 and 2011.
Program B at this facility is a management- type program, and the number of places offered on this program was 10 in FY 2006 to 2009, and 8 in FY 2010 and 2011. In FY 2006 and 2007, 5 places were also offered on pro- gram C, a management-type program. The total number of places offered each year was 20 in FY 2006 to 2009, and 15 in FY 2010 and 2011.
Program A at the Ichikawa General Hos- pital is a single-type program. Twelve places were offered on this program in FY 2006 and 2007, 10 in FY 2008, and 8 from FY 2009 to 2011. The total number of places offered each year was 12 in FY 2006 and 2007, 10 in FY 2008, and 8 from FY 2009 to 2011.
Data on residency programs held at each of the three facilities between FY 2006 and 2011 were collected and analyzed, focusing on the career pathways and aspirations of the residents on completion of the program.
Fisher’s exact test was used for the statistical analysis.
Results and Discussion
1. Career paths on completion of clinical residency program
Career paths on completion of the clinical residency program were investigated. The career paths of the 698 postgraduate dental trainees were as follows: further residency training at the Chiba Hospital (20), graduate courses at the Chiba campus (137), a post-
Takahashi T et al.
graduate clinical specialty course at the Chiba campus (109), further residency training at the Suidobashi Hospital (6), graduate courses at the Suidobashi campus (6), a postgraduate clinical specialty course at the Suidobashi campus (43), further residency training at the Ichikawa General Hospital (23), graduate courses at the Ichikawa General Hospital (17), a postgraduate clinical specialty course at the Ichikawa General Hospital (2), higher education at another university (49), employ- ment with an independent general dental practitioner (234) or at another facility such as a Tokyo metropolitan hospital (1), unan- swered (34), and undecided (17). Employ- ment with an independent general dental practitioner accounted for most of the future career paths (34%), followed by graduate courses at the Chiba campus (20%), a post- graduate clinical specialty course at the Chiba campus (16%), and higher education at another university (7%) (Table 1).
The total number of trainees from other universities enrolled in the clinical residency program between FY 2006 and 2011 was 85, with 40 postgraduate dental trainees (47.06%) remaining at our university. Their career paths on completion of the residency pro- gram were further residency training in 9 (23%), graduate courses in 18 (44%), a post- graduate clinical specialty course in 13 (33%), and full-time teacher in 0 (0%) students (Table 2).
The total number of trainees completing the clinical residency program between FY 2006 and 2011 at the Chiba Hospital was 554. Employment with an independent gen- eral dental practitioner accounted for the most of career paths (34%), followed by graduate courses at the Chiba campus (22%), a postgraduate clinical specialty course at the Chiba campus (19%), and higher educa- tion at another university (7%), showing a tendency to select general dentistry, graduate courses, or a postgraduate clinical specialty course at the Chiba campus (Table 1).
The total number of trainees completing the clinical residency program between FY 2006 and 2011 at the Suidobashi Hospital
was 96. Employment with an independent general dental practitioner accounted for most of the career paths (42%), followed by a postgraduate clinical specialty course at the Suidobashi campus (30%), graduate courses at the Chiba campus (7%), or higher edu- cation at another university (7%), showing a tendency to select general dentistry or a postgraduate clinical specialty course at the Suidobashi campus (Table 1).
The total number of trainees completing the clinical residency program between FY 2006 and 2011 at the Ichikawa General Hospital was 48. Selection of further residency training at the Ichikawa General Hospital accounted for most of the career paths (43%),
Table 1 Career paths on completion of clinical residency program (Chiba, Suidobashi, and Ichikawa General Hospitals)
CH SH IGH Total
FRTCH 17 (3) 3 (3) 0 (0) 20 (3)
GCCC 127(22) 7 (7) 3 (6) 137 (20)
PCSCCC 106(19) 2 (2) 1 (2) 109 (16)
FRTSH 0 (0) 6 (6) 0 (0) 6 (1)
GCSC 4 (1) 2 (2) 0 (0) 6 (1)
PCSCSC 14 (3) 29(30) 0 (0) 43 (6)
FRTIGH 3 (1) 0 (0) 20(43) 23 (3)
GCIGH 3 (1) 0 (0) 14(29) 17 (2)
PCSCIGH 0 (0) 0 (0) 2 (4) 2 (0)
HEAU 37 (7) 7 (7) 5(10) 49 (7)
EIGDP 192(34) 39(42) 3 (6) 234 (34) Other facilities 1 (0) 0 (0) 0 (0) 1 (0) Unanswered 34 (6) 0 (0) 0 (0) 34 (5) Undecided 16 (3) 1 (1) 0 (0) 17 (2)
Total 554 96 48 698
Unit: person, (%) CH: Chiba Hospital, SH: Suidobashi Hospital, IGH: Ichikawa General Hospital
FRTCH: Further Residency Training at Chiba Hospital, GCCC:
Graduate Courses at Chiba Campus, PCSCCC: Postgraduate Clinical Specialty Course at Chiba Campus, FRTSH: Further Residency Training at Suidobashi Hospital, GCSC: Graduate Courses at Suidobashi Campus, PCSCSC: Postgraduate Clinical Specialty Course at Suidobashi Campus, FRTIGH: Further Residency Training at Ichikawa General Hospital, GCIGH:
Graduate Courses at Ichikawa General Hospital, PCSCIGH:
Postgraduate Clinical Specialty Course at Ichikawa General Hospital, HEAU: Higher Education at Another University, EIGDP: Employment with an Independent General Dental Practitioner
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followed by graduate courses at the Ichikawa General Hospital (29%), higher education at another university (10%), graduate courses at the Chiba campus (6%), and general den- tistry (6%), showing a tendency to select fur- ther residency training or a graduate course at the Ichikawa General Hospital, unlike the trainees who completed their training at the Chiba or Suidobashi Hospitals (Table 1).
Many trainees who received training at the Ichikawa General Hospital selected gradu- ate courses or further residency training at the same hospital. These courses offer a medical training program in which the trainees can study oral surgery or receive training specifi- cally designed to meet the needs of a super- aging society from the second residency. The Ichikawa General Hospital also offers an advanced residency program targeting den- tists of above-average skill who wish to further specialize. This may explain why many of the trainees selected training at this same facility.
2. Future aspirations on completion of clinical residency program
To analyze the future aspirations of the postgraduate dental trainees on completion of the clinical residency program at each facility, they were divided into one of the fol- lowing 3 groups: 1) those who entered post- graduate courses (graduate courses); 2) those who remained at the university or hospital to receive further residency training or enter a postgraduate clinical specialty course (resi- dency training); and 3) those who found
employment with an independent general dental practitioner. Our hypothesis was that those who entered postgraduate courses were keen on specialization; those who sought employment with an independent general dental practitioner were keen on becoming a general dental practitioner; and those who remained at the university or hospital as a resident were interested in both of the above paths.
Among a total of 698 trainees, those select- ing residency training was the highest (253, 36%), followed by general practice (234, 34%), graduate courses (160, 23%), and undecided (51, 7%) (Table 3). Among a total of 554 trainees at the Chiba Hospital, those selecting general practice was the highest (192, 35%), followed by residency training (178, 32%), graduate courses (134, 24%), and undecided (50, 9%) (Table 3). Among a total of 96 trainees at the Suidobashi Hospital, those selecting residency training was the highest (47, 49%), followed by general prac- tice (39, 41%), graduate courses (9, 9%), and undecided (1, 1%) (Table 3). Among a total of 48 trainees at the Ichikawa General Hos- pital, those selecting residency training was the highest (28, 59%), followed by graduate courses (17, 35%), and general practice (3, 6%) (Table 3).
The future aspirations of the trainees on completion of the clinical residency program at each facility were compared. At the Chiba Hospital, the number selecting graduate courses, residency training, and general prac-
Table 2 Career paths of postgraduate dental trainees from other schools on completion of residency program
Year 2006 2007 2008 2009 2010 2011 Total
FRT 3 3 1 1 0 1 9 (23)
GC 1 2 6 3 4 2 18 (44)
PCSC 1 0 1 2 5 4 13 (33)
FT 0 0 0 0 0 0 0 (0)
Total 5 5 8 6 9 7 40
Unit: person, (%) FRT: Further Residency Training, GC: Graduate Courses, PCSC: Postgraduate Clinical Specialty Course, FT: Full-time Teacher
Takahashi T et al.
tice was almost the same (134/24%, 178/32%, and 192/35%, respectively); however, the number selecting graduate courses at the Suidobashi Hospital was lower (9, 9%) than those selecting residency training (47, 49%) or general practice (39, 41%), showing a strong tendency towards becoming a general clinical practitioner. One factor in explaining this pattern may be that postgraduate dental trainees are more likely to encounter a wider range of patients at the Suidobashi Hospital, as it is located in the heart of Tokyo and is visited by many who have not been able to receive adequate treatment at local clinics.
This suggests that those selecting this particu- lar program are keen to pursue a clinical career rather than go into the field of research.
At the Ichikawa General Hospital, the post-
graduate dental trainees selected graduate courses (17, 35%), residency training (28, 59%), or general practice (3, 6%), showing a tendency toward specialization (Table 3 and Fig. 1). This may have been because these particular students were interested in com- pleting a >2–3-year residency at the Ichikawa General Hospital, which offers a medical program and training in team-based medi- cine from the second residency focusing on changes in dental medicine. The results of the Fisher’s exact test showed a significant difference in career paths between the Chiba, Suidobashi, and Ichikawa General Hospitals.
Trends among postgraduate dental train- ees from this or other schools who completed the clinical residency program at Tokyo Den- tal College and subsequently entered gradu-
Table 3 Career paths on completion of clinical residency program Chiba Hospital Suidobashi Hospital Ichikawa General
Hospital Total
Graduate courses 134 (24) 9 (9) 17 (35) 160(23)
Residency training 178 (32) 47(49) 28 (59) 253(36)
General practice 192 (35) 39(41) 3 (6) 234(34)
Undecided 50 (9) 1 (1) 0 (0) 51 (7)
Total 554 96 48 698
Unit: person, (%)
Fig. 1 Future aspirations on completion of clinical residency program
*: Fisher’s exact test showed significant difference in career paths at Chiba, Suidobashi, and Ichikawa General Hospitals.
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ate courses, further residency training, or a postgraduate clinical specialty course at this school were analyzed. Between FY 2006 and 2011, 698 postgraduate dental trainees, con- sisting of 613 from this school and 85 post- graduate dental trainees from other schools, completed such training programs. The num- ber of trainees remaining at the same school was 323 (52.69%) from this school and 40 (47.06%) from other schools, showing no major difference. The number of trainees from this school entering graduate courses, residency training, and postgraduate clinical specialty courses here was 142 (44%), 40 (12%), and 141 (44%), respectively, while that from other schools was 18 (44%), 9 (23%), and 13 (33%), respectively. Although the entry rate to graduate courses was similar between these two groups, that to residency training was higher in trainees from other schools, while that to postgraduate clinical specialty course was lower (Table 4). The fact that the Ichikawa General Hospital offers an advanced residency program geared towards dentists of above-average skill seeking further specialization may have contributed to these results.
Conclusions
Career paths and aspirations were investi- gated among postgraduate dental trainees on completion of clinical training at the Chiba, Suidobashi, and Ichikawa General Hospitals of Tokyo Dental College between 2006, when
clinical residency became man datory, and 2011. Overall, trainees seeking employment with an independent general dental prac- titioner accounted for the majority (34%), followed by those entering postgraduate courses at the Chiba Hospital (20%), and postgraduate clinical specialty courses at the Chiba Hospital (16%) or another university (7%). At the Chiba Hospital, the number selecting postgraduate courses, residency training (including further residency training and postgraduate clinical specialty courses), or employment with a general dental practi- tioner was almost the same; however, the number selecting postgraduate courses at the Suidobashi Hospital was low, showing a strong tendency towards becoming a general dental practitioners. At the Ichikawa General Hos- pital, most of the trainees decided to remain at the same school or hospital and receive residency training as postgraduate students, showing aspirations to gain specialized knowl- edge. No major difference was observed in the percentage of trainees remaining at the same school or the entry rate to postgraduate courses between postgraduate dental trainees from this and those from other schools;
however, more postgraduate dental trainees from other schools selected further residency training, while fewer selected a postgraduate clinical specialty course.
Acknowledgements
The author would like to thank Professors
Graduate courses Residency training Postgraduate clinical
specialty course Total Postgraduate Dental Trainees
from this school 142 (44) 40 (12) 141 (44) 323
Postgraduate Dental Trainees
from other schools 18 (44) 9 (23) 13 (33) 40
Total 160 49 154 363
Unit: person, (%) Table 4 Postgraduate Dental Trainees from this and other schools entering graduate courses, residency training,
or postgraduate clinical specialty course at this school Takahashi T et al.
Takuo Ishii, Masahiro Furusawa, Akira Katakura, and SoIchiro Hirata, and Associate Professors Hiroki Sugito and Atsushi Kame yama for their cooperation. The author also thanks Associate Professor Naoki Sugihara from the Department of Epidemiology and Public Health for their advice on the statistical analysis.
This study was conducted with the approval of the Ethics Committee of Tokyo Dental Col- lege (Approval No.385).
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Reprint requests to:
Dr. Toshiyuki Takahashi Division of General Dentistry, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan E-mail: [email protected]
