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LONDON, UK: Various organisations have undertaken to evaluate the quality of life of UK dental students during recent years, and particularly as students have expressed that they have been struggling during the pandemic. The most recent study conducted by the British Dental Association Benevolent Fund (BDA BF) of about 7% of the entire dental student population in the UK turned up a shocking figure: 40% of those surveyed had considered withdrawing entirely from their dental degree.
The prospect of pulling out of dental programs altogether stems from students not having sufficient support both financially and in their own state of wellbeing, according to the study. Aside from 74% reporting being impacted by financial problems, additional pressures on the students came from mental health struggles (61%), family circumstances (59%), final year funding changes (particularly for students in Scotland who were forced to finance an additional year of dental school due to the pandemic) at 46%, and because of business closures due to the pandemic (44%).
With nearly 500 responses from across each of the 16 dental schools in the UK, the BDA BF felt their survey pool matched the distribution of dental students in the UK fairly accurately, with 77% of respondents identifying as female and 23% as male.
Students surveyed reported encountering a “tough luck” attitude from staff of their respective programmes and additionally shared that feelings of shame were a common factor in their struggles.
“When I reported injury and stress to a tutor, I was told to drop out. I do not know a final year dental student who is not on the edge of burnout,” said one survey respondent.
A June 2021 literature review commissioned out by the General Dental Counsel (GDC), titled “Mental Health and Wellbeing in Dentistry: A Rapid Evidence Assessment”, reported that students studying in bachelor’s and dental hygiene programmes struggled with moderate levels of anxiety and depression across the board, with more severe struggles with burnout particularly evident in fifth-year students. Nearly a full half suffered from poor mental health. The GDC also cited studies that noted that dental students in England had average or even lower than average wellbeing scores when compared to the general population.
In addition, a 2020 study titled “Stress, psychological distress, burnout and perfectionism in UK dental students”, asked 412 students from across all of the UK dental programmes to identify some of the most frequent stressors they experienced during their Bachelor of Dental Surgery training. Aside from the more common stressors surrounding exams and concerns about failing, 43.8% of students felt overwhelmed by their workload.
“When I reported injury and stress to a tutor, I was told to drop out. I do not know a final year dental student who is not on the edge of burnout” — survey respondent
Similarly, 40.5% felt there was not sufficient time to complete clinical requirements, with 40.1% reporting frustration with inconsistent feedback from tutors. The difference between the realities and expectations of dental school was a stressor for 33.3% of respondents as was patient lateness or absence for 30.5%. Financial responsibilities stressed 32.2% of students, having insufficient time for proper relaxation was a complaint for 30.5%, and an overall lack of confidence to be able to be successful as a dental student was an issue for 30.1% of respondents.
Aside from the 74% of students who reported financial struggles as a primary issue affecting their studies in the BDA BF survey, 56% noted that they required paid employment in addition to their studies to cover their costs of living. And only 24% shared that they had accessed financial support, whether from their university or family.
Shockingly, a full 51% said that they had not accessed any financial support even though they faced pressing financial issues. “My maintenance loan was not enough to cover rent and living costs and due to my family situation, I was not in a position to ask them”, shared one student. About 42% of those surveyed said they were not aware that financial support was even available to them, and 36% were uncertain of how to access it. About 7% of study participants was concerned about how they would be perceived for seeking financial help.
More than the other groups, older and international students struggled more than younger ones who had easier access to parental financial support. These groups struggled more because dentistry might have been a second degree, they were more likely to have dependents, have caring responsibilities, or have family abroad with complicated circumstances.
“As stated previously, there is no support in place (financial or practical) tailored to older students. I have had to investigate everything myself but was unsuccessful in securing any financial help,” reported one student.
Students who responded to the most recent survey did offer some insight into what their schools and other concerned organisations can do to help make things better. A common theme was for programmes to offer more protected breaks and time-off for rest in order to prevent or mitigate burnout. Some students shared that it would be helpful to have financial and emotional wellbeing management as part of their course instruction.
“Having lecturers who understand that it can be difficult to manage the course and living away from home makes a difference,” shared one anonymous respondent. Other suggestions included the need for programmes, both academic and those from outside, like the BDA BF, to provide education regarding the types of financial and wellbeing support available, as well as the criteria for eligibility and guidance and how to apply in a timely manner. Additional signposting and funding to help guide students toward resources like therapy and counselling were also noted as being important for insuring success.
The 2021 GDC study evaluated various courses of action for helping dental students with their overall wellbeing as previously conducted in studies of dental students around the world. The GDC report noted studied practices of offering group voluntary sessions helped students improve their awareness of psychological wellbeing and learn stress management practices, and further reduced the stigma of accessing counselling services.
“As stated previously, there is no support in place (financial or practical) tailored to older students. I have had to investigate everything myself but was unsuccessful in securing any financial help” — survey respondent
Some of the studies evaluated by the GDC study noted the efficacy of having dental students engage in brief therapy sessions that taught them how to cope effectively with problems related specifically to the dental environment, and the results indicated reduced stress and improve psychological health and functioning. The GDC also noted a study of dental students in Iowa in the US who were offered simpler lunchbreak outreach educational group sessions that were geared toward stress management, improved knowledge of stress management, and personal and professional growth and development. However, the students in this case were less inclined to engage in these public sessions and expressed a desire for the programme to be held more privately.
In summary, dental students in the UK expressed a desire for a more understanding and accommodating culture that promotes a better study–life balance, with more realistic academic expectations, and guidance on how to fund their studies without undue stress. Additional support from dental schools and staff toward mental health challenges would also be helpful. With 11% of the 40% who reported they had considered leaving their dental programme saying they had strongly considered it, and imposter syndrome a common struggle amongst those who responded to the survey, organisations and schools have a clearer path to making the way forward for future dentists more manageable.
“The main barrier [to completion] was stress/burnout. There were a few occasions where the workload became overwhelming,” shared another respondent. With a visible shortage of dentists across the UK, according to the BDA BF survey, the overall attitude that dental students are on their own just is not going to cut it any longer.
To read the full report, visit the BDA BF website here.
The BDA Benevolent Fund has a range of financial and wellbeing support services available for dental students in the UK.