Tag: canada

Oversupply of Dentists in Canada

On By dentistrycanada2 Comments

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It used to be that a dentist right after graduating would hang out their shingle and not before long there would be lots of patients coming through the door. Dentists did no or very little marketing. In fact, most dental offices were on high floors in professional buildings. Yet dentists were quite busy and most of them were booked 3-9 months in advance.

Today, the picture has changed considerably. Dentists nowadays strive to be in very high exposure retail locations that come at a premium. They spend a lot of time and money on marketing and advertising campaigns. However, most of them are only booked a couple of weeks in advance.

You might be wondering why you’re seeing a dental office sign at every street corner in all cities across Canada. The answer is simple: there are too many of them!

According to the Canadian Dental Association, the population to dentist ratio has been dropping in all the provinces. In Ontario, the ratio dropped from about 1800:1 in 1997 to about 1500: 1 in 2013. In Newfoundland, it fell from about 3700:1 to about 2700:1 over the same period. Those ratios are even lower in urban centres like the GTA, Montreal, and Vancouver.

populationDentistRatios

Courtesy of the Canadian Dental Association.

Back in the late 90s and early 2000s, it was thought that there will be shortage of dentists in Canada as baby boomer dentists start to retire. However, this has proven not to be the case as the number of dentists entering the market has been far more than the ones exiting especially in the last few years due to the launch of the equivalency process and reciprocal accreditation of Australian, New Zealand, and Irish dental schools.

According to the National Dental Examination Board of Canada (NDEB), 1101 dentists were certified in Canada in 2017. Only 483 dentists graduated from Canadian Dental Schools with a DDS or DMD. 235 dentists earned their dental degrees in the US, Australia, or New Zealand. A staggering 307 dentists were certified through the 3-exam equivalency process up from only 44 in 2011.

By comparison, the number of dentists in the US (population of 323 million) went up from 195,722 in 2015 to 198, 517 in 2017. That’s an increase of about 1400 dentists per year for a nation that’s about 10 times bigger in population than Canada.

Foreign-trained Dentists in Canada

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Up until 2010, a dentist would have to graduate from a Canadian or US dental school to be eligible for licensure in Canada.

Graduates of dental schools outside North America had to go through an advanced standing or qualifying program at an accredited North American dental school. This literally involved re-doing the last 2-3 years of dental school with regular dental students and graduating with a DMD or DDS degree.

Getting accepted at those qualifying or advanced standing programs was very competitive as there were only 70-80 spots across Canada. In order to get in, successful candidate would have to perform better than other candidates in all these competencies:
1. GPA earned in dental school in their home country
2. ACFD exam: a written exam on fundamental knowledge of dentistry
3. Interview by dental school teaching staff
4. Assessment of clinical skills: various clinical excersises on typodonts and manikins.

Successful foreign trained dentists who were accepted had to apply for loans and bank lines of credit in order to pay tuition and other expenses which were comparable to what a regular dental student would pay. A dentist in North America typically graduates with about 100-300 thousand dollars of debt.

In 2011, the government started:

  • Reciprocal accreditation of dental schools in Australia, New Zealand, and Ireland (2012).
  • Launched the Foreign trained dentists FTDs equivalency process.

The Equivalency process for FTDs consist of a set of three exams:
Part 1: Fundamental knowledge written exam
Part 2: Clinical judgement written exam
Part 3: A clinical assessment exam: excersises on typodonts and manikins

The exams cost less than ten thousand dollars, don’t involve a real patient, don’t test all clinical skills, and can be passed within one or two years. Applicants don’t have to be a Canadian citizen or permanent resident to write them. In fact, dentistry is on the express entry for immigration to Canada.

The number of successful FTDs has skyrocketed in the last few years. When the program first launched in 2011 only 44 candidates passed. In 2014, the number was over 260, which is equivalent to the graduates of 6 typical Canadian dental schools.

 

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