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There are new calls for more accurate dental workforce data and a more streamlined approach to assist in the accreditation process for migrant dentists. By John Burfitt
There are few surprises in the findings of the 2022 Federal Government’s National Skills Commission report, which highlights the shortage of dental practitioners in every Australian state and territory.
From dental specialists right through to dental assistants, each role within the profession scores a ‘shortage’ ranking in the report, while all earn a ‘moderate’ rating for projected future demand.
Just how extensive the shortage is no-one really knows because, as Australian Dental Association president Dr Stephen Liew explains, no comprehensive analysis of dental workforce supply and trends has been conducted since Health Workforce Australia was disbanded back in 2014.
“What we really need to know as we plan for the future is what is the playing field, and the big question is whether we have a maldistribution versus a workforce shortage,” he says. “Frankly, the data on that is non-existent. We often have to work with anecdotal evidence about trends. It’s pretty clear we do have a maldistribution situation with far more dentists needed in regional and rural areas, but we have to be careful about what we are advocating for when we don’t have real numbers to work with.”
Which makes dealing with the issue of migrant dentists working in Australia especially difficult. In April, the Federal Government released the ‘Independent review of overseas health practitioner regulatory settings’ report, concluding that in many instances, registration of overseas-trained practitioners was “slower, more complex and expensive” than in other countries.
The report recommended streamlining application processes, better recognition of experience and skills of migrant workers, and aligning English language standards with those of countries such as New Zealand and the UK. It also claimed that ‘international peers have made their own regulatory process simpler and cheaper, without lowering standards’.
Health Minister Mark Butler said the review would lead to better workforce planning and greater regulatory flexibility. “There are things we can do to reduce red tape,” he said at the time.
Dr Liew says the Government’s position is encouraging. “We (the ADA) welcome that [accreditation of overseas dentists is] being closely looked at—so long as it is carefully balanced with the safety of the Australian public because they have a high level of trust in the high standards of our dental practitioners.
“In select countries, like New Zealand, the UK and Ireland, we have mutual recognition so those dentists can have their qualifications recognised quite quickly.”
Applicants from other countries, however, need to meet the requirements under a skills assessment conducted by the Australian Dental Council. This involves undergoing both a written and practical examination. Candidates are allowed a number of attempts at the practical exam.
According to the ADC’s 2021 Annual Report, between 1 July 2020 and 30 June 2021, 580 practical examinations in general dentistry were delivered across 29 examination sessions. Of the candidates sitting the practical exams, only 209 candidates—36 per cent—passed the assessment. In the previous year, it was 19 per cent and in 2019, 13 per cent.
We often have to work with anecdotal evidence about trends. It’s pretty clear we do have a maldistribution situation with far more dentists needed in regional and rural areas, but we have to be careful about what we are advocating for when we don’t have real numbers to work with.
Dr Stephen Liew, president, Australian Dental Association
In early 2021, the ADC revised the practical examination component which covers communication skills, and also updated criteria in assessing those skills needed for clinical information gathering, diagnosis and management planning.
Egyptian-born Dr Alaa Sherif graduated from Suez Canal University with a Bachelor of Oral and Dental Medicine and Oral Surgery in 2014, and finished her internship program in 2016 before moving to Australia in 2017.
She began the ADC accreditation process in 2019 and passed the written exam. In 2022 she underwent the practical exam but failed on her first attempt. A few months later, she passed on her second attempt and received her Australian accreditation.
She is currently on maternity leave after the birth of her child and plans to start work with a Melbourne practice early in 2024.
Dr Sherif welcomes the news that the accreditation process is under review.
“It can be frustrating to cope with and I know some other migrant dentists who eventually gave up and have followed alternative pathways as the process can be very stressful,” Dr Sharif says.
While she passed on her second attempt at the practical exam, Dr Sherif believes receiving feedback after failing would assist dentists with the process.
“That would be so helpful and highlight the areas where a dentist needs to do some more work,” she says. She also strongly suggests that any dentist about to try for accreditation do some focused self-evaluation of their skills.
“If there are areas you know are your weak spots, then put some work into them in advance so you become stronger. You need to keep trying.”
The Australian accreditation of skilled migrant dentists is an issue that generates strong feelings. Many candidates want better streamlining of the process, more support in negotiating the process, feedback on exams, and more dedicated study resources to be available. Some also question the high cost—close to $10,000—of gathering all the necessary documentation and then sitting the exams.
Dr Liew says the ADA and ADC continue to work closely on a range of issues. The ADA provides feedback from its members about their own experience as overseas dentists becoming registered in Australia.
Dr Liew believes there has always been a genuine desire to improve the registration process without compromising current practising standards. “We could find a happy medium if all the data we needed was up to date,” he says.
