Changes in Dental Students' Immediate Post-Graduation Plans

Objectives: This study looks at response consistency during a 12-month period, concerning survey questions relating to immediate post-graduation career plans of dental students. Methods: 180 of 222 (81.1%) University of Iowa second-, third-, and fourth-year dental students were surveyed in August 2006 and again in August 2007, regarding personal information and various factors in the career decision-making process. Responses were analyzed to determine consistency at two time points, using kappa statistics and symmetry test for nominal and ordinal responses and Wilcoxon signed-rank test and intraclass correlation for continuous responses. Results: Interest in general dentistry increased over time (p=0.0001), with an accompanying decrease in plans to specialize (p<0.0001, ICC=0.57). Of those who were interested in private practice, there was a difference in post-graduation plans (p=0.0322, kappa=0.38); interest in associateships rose (25.0% vs. 41.4%), while interest in partnerships fell (25.6% vs. 14.8%). However, amongst the entire group, there was an increase over time in willingness to explore different career options (p<0.0001, ICC=0.39). Additionally, there was an increase in the influence of clinical experience (p=0.0003, ICC=0.12), and a decrease in comfort level with general business activities (p<0.0001, ICC=0.42). Importantly, there was not a statistically significant change in the amount of educational debt anticipated by students (p=0.8140, kappa=0.74), nor in its influence on their expected post-graduation career plans (p=0.6190, ICC=0.49). Conclusions: Of those students planning to enter private practice, there was a shift in immediate career plans toward associateships. This may be a result of subjects' decreased comfort with general business activities involved in running a practice. Furthermore, dental students' anticipated educational debt is relatively fixed, and its impact on their expected post-graduation plans is similarly stable. Overall, data indicated a moderate agreement level between pre- and post-surveys. Additional longitudinal research is needed to determine causes of the changes in the decision-making process.