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The government hopes to introduce an internship programme for local dental graduates as well as “a period of assessment” for overseas-trained dentists. Photo: HKU

Explainer | What’s behind row over quality of Hong Kong dental school training and do claims of students having ‘zero actual experience’ stack up?

  • Dental students have clashed with government over proposal to make graduates intern for a year in public sector before being granted full registration status
  • Accusations of ‘significantly inadequate’ clinical training have drawn sharp criticism from students, who point to high standards compared with some top global schools

Hong Kong dentistry students and the government have clashed in recent weeks over the training of aspiring dentists, with lawmakers considering changes that will require graduates to intern for a year in the public sector before they get full registration status.

The Post examines the debate and how the city’s dental training compares with other jurisdictions.

1. Why have dental services and training entered the spotlight?

Authorities put forward a bill to amend the Dentists Registration Ordinance at the Legislative Council last month.

The government, which said it made the proposal to improve dental services, hoped to introduce the internship programme for city dentistry graduates as well as “a period of assessment” for overseas-trained dentists.

The internship would require graduates to spend a year working for the Department of Health or Hospital Authority before they could obtain full registration.

Officials said the arrangement, similar to an arrangement already in place for doctors, could “enhance [graduates’] clinical experience in real-life work settings” and get them familiar with practising in the city, thereby improving patient safety.

The proposed bill also aimed to introduce new pathways to recruit dentists trained elsewhere amid a long-standing staff shortage.

Scrutiny of the bill by lawmakers also sparked debate over the city’s dental services, with those offered by the public sector being labelled as largely insufficient, especially for underprivileged people who could not afford to see private dentists.

2. Why does the government want to introduce an internship?

The government said the internship proposal was in response to claims by the Dental Council of Hong Kong, which in past accreditation exercises accused graduates from the University of Hong Kong (HKU), the city’s only institution that offers dental training, of having a “severe lack of clinical experience”.

The spotlight centred on the bachelor of dental surgery programme, which offers six years of training and admits 90 first-year students annually.

The government, highlighting findings by the regulator, said the implementation of clinical training in the curriculum was “significantly inadequate”, and experience in dental procedures varied greatly among graduates.

Authorities added that some students had “zero actual experience” in performing some dental procedures, according to records presented by the university’s faculty of dentistry.

The council first raised the problems in a 2014 review. Similar criticism was made in another report in 2019/ The regulator reported to the authorities in 2022 that the faculty’s follow-up efforts on recommendations made in the previous two reviews were unsatisfactory.

The government warned that the bachelor’s programme could be removed from the city’s accredited list if no improvements were made, which would force graduates to take another licensing exam before they could become fully registered dentists.

Undersecretary for Health Libby Lee Ha-yun said the internship option was “taking the middle road”, with no possibility of a delay to the arrangement, which would start in 2025 if the bill was passed.

Patients wait for dental services at the public Tsuen Wan Dental Clinic. Photo: Yik Yeung-man

3. How have students responded?

Dentistry students said accusations of inadequate clinical training were biased.

They said in an open letter on Thursday that they had been required to perform certain dental procedures and treat a specific number of patients before they could graduate and obtain a registration licence since last year.

Students due to graduate next year were also required to submit at least seven copies of case reports and pass an assessment before they could graduate.

Students said that records showed that all graduates last year managed to meet the requirements set by the Dental Council.

They also urged the dean of the faculty to explain to students the outcome of the council’s reviews and changes for the programme, and clarify to the public how it could follow up on the watchdog’s recommendations and maintain the quality of the programme.

The students also complained there was a lack of information on how the internship scheme would work, and asked for talks with the authorities, the council and the faculty to gain more clarity.

4. How does local training compare with some top institutions overseas?

The six-year undergraduate dentistry training in Hong Kong is among the longest in the world. Programmes in the United Kingdom and Australia in general last for five years and those in the United States take four years on average.

The city’s programme is also among the best in the world and took top spot in an international ranking from 2016 to 2018 and hovered between second and third from 2021 to 2024.

The students’ open letter said requirements imposed on Hong Kong dental graduates by the Dental Council appeared to be more stringent than some other top institutions around the world.

They said city students were required to complete certain dental procedures before they could graduate, such as extracting a minimum of 15 teeth, conducting root canal therapy on at least eight teeth, making dental crowns on no fewer than eight teeth and at least four removable partial dentures, as well as treating at least 50 patients.

On the other hand, the Karolinska Institutet in Sweden, among the top 10 dental schools this year in the same international ranking, required graduates to extract at least one tooth, conduct root canal therapy on at least one tooth, make dental crowns on a minimum of five teeth and no fewer than two dentures, and treat at least 20 patients.

Even the University of Zurich’s dental school, which is ranked eighth in the world, did not impose requirements as stringent as Hong Kong’s.

Students at the two European schools did not need to undergo internships before graduating.

5. How has the city’s only dental school responded to the criticism?

HKU’s faculty of dentistry has remained largely quiet amid the controversy.

The university only issued a statement on Wednesday and said the faculty was “continuously enhancing its curriculum”. It added it welcomed recommendations and suggestions from the council.

It said it was also working closely with the council and implementing recommendations.

HKU added it was also “actively working” with a variety of stakeholders, including the government and the council, to develop internship arrangements.

But the back-and-forth between students and the government led the Dental Council chairman, Dr Lee Kin-man, to call for a meeting with students to explain the situation.

Lee on Friday said the university was organising a meeting, the details of which have not yet been disclosed.

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