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More and more the stories abound about new graduates and young professionals who are ‘leaving the profession’ (whatever that means now) in search of a better life elsewhere because what they signed up for is not what they had been given.

I’m exposed to this in many different ways and in fact in a couple of weeks time I go to the local secondary school to do mock interviews for prospective dental students who want to enter dentistry.

I’ve thought about this a lot, I’ve met with young practitioners who are frankly fed up and depressed by their life within a UDA system which is not what they imagined; they were only very new when they first signed up to dental school.

This was not a system that they saw when they did their work experience.

What I write in these pages though is not really about dentistry; dentistry is just a metaphor for society.

As I reflect on this, it wasn’t much easier when I qualified. What dentistry was like in 1994 was very different to what it had been like in 1989.

When I graduated I went straight to work as a House Officer at Glasgow Dental Hospital School and my salary was £13K.

This was 50% of the salary of my friends who entered VT, I was quite happy with that understanding the reason why I was making a financial sacrifice.

I doubled my salary the following year (but my friends in practice had double theirs again). I took a small incremental increase the following year as I completed 2 years as a senior House Officer in Nottingham and Derby. I then decided to give up a place at Medical School and go into VT and took a 25% reduction in income to do that (the VT salary had dropped by then).

So I entered my life as a general dental practitioner from 1997 and finally giving up NHS dental practice around 8 years later.

It struck me this week that what the young dentists I speak to are complaining about are exactly the same things that the young dentists that I worked with when I was doing VT were complaining about.

The environment was different but the complaints are the same.

They hate the system, they can’t do quality work, it’s like being on a treadmill, and it’s not what they signed up for.

I didn’t sign up for an NHS dental treadmill where I couldn’t do the work that I wanted and to be unhappy for the rest of my life; but I started to change my circumstances in 1997 as soon as I entered VT.

I asked for permission to stay on at the hospital for 1 morning a week to provide a day case oral surgery list and surprisingly was granted that.

I also asked my principle in practice if I could put aside 12:30-1pm on a Monday to do oral surgery in the practice (30 minutes a week). He allowed me to do that. I began to retain in implant dentistry and paid for my courses, I travelled and tried to see dentistry in other places. Not massively, but as much as I could.

I met as many dentists as I could and I became involved in dental politics; both in the local British Dental Association section and in the local Dental Committee and Oral Health Advisory group in Nottingham.

Ultimately I would go on to be one of the fore founding members of the British Association of Surgical Dentistry (became the British Association of Oral Surgery) that came into existence following a meeting in a house in Coventry!

All through this I did the best I could within the system in which I worked. I was not the best NHS general dental practitioner by a long way, but I tried to look after my patients to the best of my ability and in general they were very grateful.

Slowly as oral surgery increased and implants increased I was able to cut down my NHS general dentistry, ultimately giving away a large capitation list to somebody else (for free not selling!) and then ultimately giving up all forms of general dentistry.

It was around 2006 that I was able to concentrate on oral surgery and implant dentistry entirely and not until 2010 that I was able to concentrate only on oral surgery with no restorative dentistry.

If you count back there you’ll realize I qualified in 1994.

It took 16 years until I got to the point where I wanted, which was to be an oral surgeon full time.

From 2010 to 2017 I then tried to build a practice (two practices actually). Its only now in 2017 that I have anything like the shape of the thing that I envisaged many years ago.

It’s not that I do not feel sorry and even heart broken at times speaking to these young professionals who are some of the most gifted and brightest of students, who enter into dentistry only to feel that they’ve been ‘battered down’ into a system not of their making and certainly not of their liking.

The fact is though is that we have to work together on this.

Success is measured in decades; it’s hard to see that when you’re 23 and hard to believe the old guys who are trying to tell you that.

It’s about one day at a time and one patient at a time and trying to do your best.

Once you become fed up, or down trodden by one system then perhaps its time to make a plan to move towards another system that might suit you better.

The secrets here though…

If you want to earn the big bucks, realistically you do it in NHS dentistry (at least at the moment). That is a hard life, but it is well remunerated financially.

If you want to work in a wonderful place with a wonderful team then you don’t make the big bucks.

The choice is yours. In the end it comes down to this, at the start of your career you can choose to be good or you can choose to be rich but you can’t choose to be both at the same time.

Blog post number: 1487