Exploring dental educational diversity: a cross-national examination of national dental qualification frameworks | BMC Medical Education

The present study compared the national dental qualification frameworks of the UK, Turkey, and Pakistan, revealing significant variations in their structure, focus, and implementation. These differences reflect each country’s unique healthcare needs, educational priorities, and resource availability.

Previous studies compared the duration of education, model, general curriculum, student and curriculum assessment methods, and the type and hours of courses offered at many dentistry faculties from countries with different levels of development [1, 15]. In this study, the educational qualifications of countries with different development levels were compared.

It was observed that there were many differences between the three educational national dental qualification frameworks. For example, in DUÇEP and GDC, the situations that students will diagnose and treat and the situations that they will only diagnose and refer to the relevant branch are discussed in detail. According to DUÇEP, a student who graduated from the faculty of dentistry should be able to diagnose and treat reversible pulpitis; In dentoalveolar retrusion/protrusion, they should be able to diagnose and refer to the relevant specialist. Similarly, a student who graduated from GDC can extract erupted teeth and roots in permanent and primary dentition; They should diagnose unerupted teeth and remaining roots and refer them to the relevant specialist. However, there is no information on this subject in PMDC. In Pakistan, graduate qualification levels can be established per international standards to increase the quality of education and graduate students with equal knowledge levels throughout the country.

There is a regulation in PMDC that states that all exams conducted in dentistry faculties are recorded in a central system and this record must be made and submitted to the council before January 15 of each year. This increases evaluation transparency and improves the perception of quality assurance among graduates. However, in both the GDC and DUÇEP curriculums, the management of examination practices is delegated to the faculties. This situation may lead to differing content and assessment methods and subjective evaluation in each faculty within the same country.

The recommendation of problem-based learning (PBL) is common [16]. Problem-based education was developed instead of discipline-based education to develop cognitive skills. The discipline-based learning (DBL) tends to provide theoretical education in the early years, focusing on memorization rather than the development of psychomotor skills [17]. In PBL, students use real-life problems as a learning context, employing ‘triggers’ from the problem situation to define their learning goals. PBL engages students in group work to solve ill-defined and open-ended problems by following steps such as analyzing problems, setting goals, gathering resources, summarizing ideas, and reflecting on problem-solving experiences [18]. In this approach, disciplines are expected to be integrated both horizontally (multiple disciplines integrated in one unit) and vertically (basic or clinical sciences) [19, 20]. For PBL to be successful, a large number of faculty members, physical conditions for small group discussions, and sufficient institutional resources are needed. While PBL is performed in the UK and Turkey, DBL is performed in Pakistan [21]. This situation may lead to differences in the level of clinical preparation from faculty to faculty and inequalities in the quality of patient care. Integrating PBL elements into the existing system in Pakistan can enhance students’ competencies and problem-solving skills. In addition, the implementation of clinical practices, such as in UK and Turkey, also helps students develop their communication skills.

Private universities comprise In Pakistan, 43 of 61 faculties, in Turkey, 30 of 105 faculties, and in the UK, 2 of 16 faculties [11,12,13,14, 21]. While private universities often provide more advanced educational opportunities, the increased number of graduates can lead to employment challenges. In addition to having a small number of dentistry faculties in the UK, the number of students admitted to these faculties is strictly regulated and their quotas are determined according to need. In Turkey, the number of quotas is high to improve public health services (approximately 11.000 annually), but the employment rate of new graduates in the public sector is limited. This situation shows that demand for the health workforce and quotas are not integrated. Additionally, quota size in Turkey can cause imbalances in the distribution of lecturers. According to 2023 data, there are 46.076 dentistry students in Turkey. The number of lecturers is 2.599. Thus, the student-lecturer ratio in Turkey is approximately 17.7:1 [11]. This ratio is approximately 8:1 in UK universities [22]. This situation can make it difficult to apply the competencies envisaged by DUÇEP at the same level in all faculties. In Pakistan, the relatively low quota is due to infrastructure and faculty numbers.

When the educational content of dentistry faculties is examined, it is seen that there are common courses across dental faculties. For example, Ethics, Community & Preventive Dentistry, and Communication [7, 23–24].

Every educational system has its strengths and weaknesses. Dental faculty lecturers should adopt best practices that are consistent with institutional and societal expectations. Future national dental qualification frameworks should emphasize PBL, standardized assessment criteria, graduate competencies, and continuing professional development.

There are some limitations to this study. The study compared the national dental qualification frameworks of 3 countries with different development levels. To reach more general conclusions, studies comparing the curricula of more countries can be conducted. Another limitation is that qualitative comparisons were made. To obtain quantitative data in future studies, surveys on student feedback, academician opinions, and patient satisfaction can be conducted based on well-established curricula. Thus, not only the curricula but also the difficulties encountered in the implementation of the curricula and the differences between faculties are examined.