Australian Dental Journal, June, 1984

Volume 29, No. 3

189

Career choice, plans and expectations of male and female students in dental science

Ray Over

Department of Psychology, LaTrobe University

John Spencer

Department of Conservative Dentistry, University of Melbourne

and

Wal McDougall

ABSTRACT-A survey undertaken in May-June 1981 identified the social and educational background of 212 students in dental science at the University of Melbourne, the factors that influenced their choice of dental science, and their career plans and expectations. The focus was on sex differences, since women now constitute 24 per cent of students in dental science. The major differences were in terms of subjects completed at the Higher School Certificate examinations, reasons for entering dental science, expectations about career interruptions, preferred specializations within dentistry, and the participation of women in dentistry.

(Received for publication May 1983.)

Introduction All five dental schools in Australia (Adelaide,

Melbourne, Queensland, Sydney, Western Australia) are situated in the older universities. Although no additional dental schools were founded during the period in which there was marked expansion in the Australian universities, enrolments in dental science more than doubled (from 648 in 1955 to 1461 in 1975).’ Student numbers continued to increase to 1551 in 1978 but had declined to 1432 in 1981 and could stabilize at around 1400.’~’ Up to 1970, women numbered approximately one in ten of all dental science students.’ By 1981, in contrast, 28 per cent of students entering dental science were women.’ Since the

’ Australian Bureau of Statistics. Universities statistics 1955; 1975; 1976; 1977; 1978; 1979; 1980; 1981. Canberra: Australian Bureau of Statistics, 1956, 1976. 1977. 1978, 1979, 1981, 1983.

* Barnard PD, ed. Facts and figures; Australian dentistry. 1981. Sydney: Australian Dental Association Inc, 1982.

representation of women increased at a time when enrolments first marginally increased then decreased, many of the women enrolled in dental science hold places that in previous years had been filled by men.

Census data show that women formed only 4 per cent of dentists in practice in Australia in 1933, 3 per cent in 1947, 5 per cent in 1961, and 5 per cent in 1%6.’ Seven per cent of dentists registered in all Australian states in 1972 were women and in 1980 women made up just over 10 per cent of dentists on the Australian dental register~.’.~ Since approximately 28 per cent of the students who now enter dental school each year are women, the sex ratio within dentistry will shift cumulatively over the next 30 years, or perhaps over an even longer period. At present

’ Department of labour and National Service. Professional and Technical Manpower Study Number 1. Dentists. Melbourne: Department of Labour and National Service, 1970.

‘ Barnard PD. ed. Facts and figures, 1973. Sydney: Australian Dental Association Inc, 1973.

190 Australian Dental Journal, June, 1984

per cent of fathers and 19 per cent of mothers were professional, technical, or related workers. Within this group 7 per cent of fathers and 3 per cent of mothers were medical practitioners and 7 per cent of fathers and 1 per cent of mothers were dentists. A further 25 per cent of fathers and 5 per cent of mothers were administrative, executive, or managerial workers. In contrast 15 per cent of fathers and 18 per cent of mothers were process workers, tradesmen, labourers, retail, clerical or domestic workers. Of the remainder, 13 per cent of the fathers and 11 per cent of mothers were either retired, pensioners or deceased, and 46 per cent of mothers were not in employment.

it is not known whether men and women who enter differ with respect to social and education background, reasons for entering, career plans, or expectations in dentistry.

Women accounted for only 5 per cent of enrolments at the time when Barnard, Wearn, Dowsett, and Siu in the early 1960s surveyed dental students at all five Australian universities.’ There has been no subsequent analysis of dental students on the same scale. Although Barnard from 1976 to 1980 surveyed first-year students a t the University of Sydney, his focus was on the dental habits of students and their contact with dentists.‘ No information was obtained on career plans or expectations. The data were not systematically analyzed by sex, although women constituted 25 per cent of the sample.

In the present study all students, first to fifth year, who were enrolled in dental science at the University of Melbourne in 1981 were surveyed. Students provided information on social and educational background, reasons for entering dental science, preferred alternatives to dental science, career plans and expectations including preferred work settings and expected income. Perceived sex discrimination in education and professional practice were also studied. The focus of the analysis was on sex differences in these areas.

Sample characteristics In May-June 1981, all students enrolled in dental science

at the University of Melbourne were asked to complete a questionnaire of 30 items. The 212 respondents (89 per cent of enrolments) included 40 first-year, 43 second-year, 45 third-year, 44 fourth-year and 40 fifth-year students. Men (76 per cent) out numbered women (24 per cent).

Most of the students had entered dental science directly from school. Only 4 per cent had ever spent 12 months or more in continuous full-time employment. The mean age of first-year students was 18.2 years, and of fifth- year students 22.3 years. Only 3 per cent of men and 4 per cent of women were married. Almost two-thirds of students (65 per cent of men and 62 per cent of women) had completed secondary education at a non-government school. Eighty per cent had spent most of their life in a capital city, 8 per cent in a provincial city, 9 per cent in country towns, and 3 per cent in the country.

The occupational status of parents as reported by students was coded within the classification used in the 1976 population census.’ Male and female students came from similar social backgrounds. Across the sample, 46

Barnard PD, Wearn DI, Dowsett MH, Siu SK. The Australian dental student. Aust Uni 1969;7:37-63.

‘ Barnard PD. First year dental students, University of Sydney: characteristics 1976-1980. International Association for Dental Research, Australian and New Zealand Division, 20th Annual Meeting, 26-28 August 1980, Adelaide: mimeograph.

’ Australian Bureau of Statistics. Occupation classification extract. Canberra: Australian Bureau of Statistics, 1977. 1976 Population Census Information paper No. 9 (iii). Catalogue No. 21 14.0.

Educational background Admission of students to first year in the Faculty of

Dental Science, University of Melbourne is limited by quota. Students gain admission on the basis of course preference and performance in the Higher School Certificate (HSC) examination. The prerequisites are English expression, chemistry, and either physics, biology, or a mathematics subject. Since there are no separate quotas for men and women, the sex ratio of students admitted to dental science will reflect the course preferences of men and women, the scores they obtained in the HSC examination, and the subjects that they completed.

TABLE 1 Perceniuges of studenis eniering dental science who compleied

various non-prerequisite subjects ai HSC examination

Subject Men Women

(n = 50) (n = 162) ( n = 212)

Physics Pure maths Applied maths General maths Biology Languages Other

88.7 94.4 70.0* 54.1 57.4 46.0 52.7 56.8 38.0* 44.3 42.6 50.0 38.7 35.8 48.0 26.4 16.0 60.0* 26.8 26.5 28.0

*xi (d.f. = l ) , pc0.01

Women enrolled in dental science were less likely than men to have concentrated on scientific subjects during their HSC year. All students must have passed chemistry and English expression at the HSC examinations. Table 1 shows the percentages of men and women who com- pleted other subjects a t HSC level. Chi-square tests applied to the data showed that significantly more men than women completed physics @<O.OI) , and applied mathematics @<0.01), while more women than men completed a language subject @<O.OI) . More women completed biology and general mathematics, while some women took pure mathematics alone rather than in com- bination with applied mathematics.

Australian Dental Journal, June, 1984 191

TAW t 2 Alternatives to dental science that were ranked high when seeking

university admission (percentage of respondents) ~~ ~

Course

Medicine Biological science Veterinary science Engineering Physical science Law Architecture Social sciences Commerce Arts Agriculture

* X I (d.f. = I), p<0.05. tx' (d.f.= I) , p<0 .01 .

72.2 22.2 18.4 15.1 14.6 9.9 8.5 6.6

4.2 3.8 3.3

75.9 19.1 21.0 18.5 16.7 1 1 . 1 10.5 5.6 4.3 1.9 2.5

60.0' 32.0 10.0 4 .0 t 8.0 6.0 2.0

10.0 4.0

10.0 6 .0

TABL t 3 Factors identified as influential in choice of dentistry as a career

(percentage of respondents)

Men Women ( n = 50) (n = 162)

Interest in work of a dentist 53.7 76.0t Desire to work for and with people 58.0 84.0t Desire to be self-employed 64.8 52.0 Status of the profession 46.3 30.0* Anticipated level of income 58.6 28.0t Failure to meet quota in medicine 24.7 20.0 Compatibility with anticipated family

commitments 10.5 34.0t

* x 2 (d.f. = I ) , p<0.05. tx' (d.f. = I ) , p<0 .01 .

Most students who enter dental science have completed HSC subjects that also serve as prerequisites for admission to agriculture, engineering, medicine, science, and veterinary science. Students were asked to identify the degree courses for which they had expressed a strong preference when seeking university admission. Table 2 shows the alternatives to dentistry that were attractive to students. Medicine was clearly the preferred alternative, and 35 per cent of men and 16 per cent of women had a higher preference for medicine than dentistry. However, only 14 per cent of men and 4 per cent of women in the sample reported that at the present time they would prefer to be a student in a degree course other than dental science.

Career choice Most students made their career choice near the end

of schooling. In all, 22 per cent of respondents had decided prior to Year 11 to pursue a career in dentistry, 12 per cent during Year 11 , and 39 per cent while in Year 12. Almost all students (26 per cent) making a later

decision entered dental science as a second preference to medicine. The persons reported as having had most influence on the decision to pursue a career in dentistry were dentists (reported by 31 per cent), another relative (11 per cent), a teacher (10 per cent) and paradental personnel (6 per cent). Although men and women did not differ in terms of when during secondary education they decided to pursue a career in dentistry, women were more influenced in career choice by dentists and by fathers.

Table 3 shows factors that students in the sample reported had influenced their decision to pursue a career in dentistry. Significantly more men than women were attracted to dentistry by income @<0.01) and status (p < 0.05) while women were influenced more than men by interest in the work of a dentist @ < O . O l ) , the desire to work for and with people @<0.01), and the likely compatability of dentistry with anticipated family commitments @<0.01).

Career plans Most students intended to enter full-time dental practice

on or soon after graduation. However, only 36 per cent of men and 14 per cent of women anticipated that there would be no major interruptions during their professional career. Among those anticipating interruption, 62 per cent of men and 53 per cent of women saw extended overseas travel as a likely cause. In addition, 67 per cent of men and 52 per cent of women saw further study as a likely cause of interruption. At the same time, only 12 per cent of the sample had a definite intention of proceeding to further education in dental science at a master or doctorate level, while 13 per cent reported that they probably would, and 55 per cent that they possibly would.

Child-rearing was anticipated as being a cause for in- terruption to their working life by 70 per cent of women and 6 per cent of men. Only 16 per cent of women expressed any uncertainty as to whether they would marry in the future, and 88 per cent of women expected to have families of two or more children.

Although more than 75 per cent of the students in the sample had spent most of their early life in a capital city, only 52 per cent intended to work in a capital city after graduation. The other preferrred locations were a pro- vincial city (26 per cent), a large country town (12 per cent) and a small country town (9 per cent). The pattern of preferences was similar for men and women. From comments made by several respondents, it would seem that the anticipated move from a capital city reflected the perception that students had of regional differences in supply-demand relationship for dental services.

Students were asked to identify the type of dental practice in which they would like to work during the year following graduation, the second to fifth years follow- ing graduation, and during the remainder of their pro- fessional career. Table 4 lists the responses obtained. Almost all students expected to work in salaried positions in the year following graduation, with twice as many in

192 Australian Dental Journal, June, 1984

TABLE 4 Preferred type of dental practice at different periods following graduation (percentage of respondents)

First year Years 2-5 Later

Men Women Men Women Men Women

Academic dentistry Dental research Voluntary registrarship School dental service Armed services Dental hospital/regional clinics Salaried assistant in private

Private practice (solo/group) Specialist practice

practice

01 01 01 08 05 20

57 07 01

00 00 00 08 08 31

53 00 00

05 01 00 07 04 07

34 38 04

10 05 00 02 02 10

43 29 00

03 04 00 03 01 04

03 55 28

00 03 00 00 00 10

18 54 15

TABLE 5 Percentages of men and women with preferences f o r differenr

specializations

Specialization Total Men Women (n=212) (n=162) ( n = 5 0 )

Children’s dentistry Dental public health Oral surgery Endodontics Orthodontics Periodontics Preventive dentistry Prosthetics (including

fixed prosthetics)

35 6

34 11 34 9 9

12

27 4

38 I 1 36 10 I 1

12

64’ 128 188 12 28

8 6

12

*f (d.f. = I ) , p < 0 . 0 5 .

the private sector as in the public sector. In the second to fifth year after graduation most students expected to work in the private sector on a non-salaried basis (typically in solo or group private practice). More than 75 per cent of students predicted that they would spend the remainder of their careers in non-salaried private practice. Significantly (p <0.01) more women than men expected to remain as a salaried assistant. Although proportionately more men than women predicted that they would even- tually enter specialist practice, this difference was not statistically significant (p <0.05).

Table 5 shows the specializations in which men and women reported that they would prefer to work if they were to specialize. Proportionately more men than women expressed preference for oral surgery as a specialization @<0.05), while proportionately more women than men preferred children’s dentistry (p <0.01), and dental public health @<0.05). The pattern of preferences was similar for students in different years of dental science.

Students in the sample were asked whether they felt that any of the following professions was of a higher status than dentistry: accounting, architecture, engineer- ing, law, medicine, pharmacy, psychology, school teaching, science, social work, veterinary science. Medicine (endorsed by 74 per cent of men and 76 per cent

of women) and law (40 per cent of men and 48 per cent of women) were the only professions rated by more than 5 per cent of either men or women in the sample as being of higher status than dentistry.

Perceived sex differences The students in the sample reported whether they

agreed, disagreed, or held no opinion in relation to six statements concerning women in dental science education and in the practice of dentistry. Table 6 shows the per- centages of men and women responding in specific ways to each question. Substantially more men than women believed that a quota should be imposed to limit the number of women admitted to dental science, that men perform better than women in dental practice, that the professional status of dentistry will fall if there is a marked increase in the number of women dentists, and that women dentists find it harder than men to gain public acceptance of their professional role. More women than men believed that women achieved higher academic grades than men during dental science education. There was no difference between men and women in their opinion as to whether there is discrimination against women in dental science education.

Discussion Students who were enrolled in dental science at the

University of Melbourne in 1981 had many attributes in common with the Australian dental students whom Barnard, Wearn, Dowsett, and Siu surveyed in 1964.’ The major change between 1964 and 1981 was in the sex ratio of students who enrolled in dental science. The represen- tation of women increased from one in twenty students to one in four.

Women who enter what has traditionally been a male- dominated profession in the English-speaking countries may have to overcome substantial attitudinal barriers during their education and in the workplace. Male and female students hold different opinions about the par- ticipation of women in dentistry. Male students were more

Australian Dental Journal, June, 1984 193

TABLE 6 Opinions of male and female students about women in dentistry

(percentage of respondents)

Agree Disagree Uncertain/no opinion Statement

M F M F M F

The ratio of women to men entering training in dental science should be

In general, women achieve higher academic grades than men during dental training 18 34 48 16 34 50

In general, men perform better than

There is discrimination against women during dental training 22 24 63 60 15 16

The professional status of dentistry will fall if there is a marked in- crease in the number of women dentists 24 0 56 90 20 10

Women dentists find it harder than men dentists to gain public accep- tance of their professional role 68 42 13 34 19 24

fixed by quota 11 0 80 100 9 0

women in dental practice 29 0 37 88 34 12

likely to believe that women do not perform as well as men in dental practice, and that they have lower public acceptance of their professional role. Some male students would like to see fewer women admitted to dental science and they fear that the changing sex ratio of dentists will lower the status of the profession. It would have been of interest to have obtained answers to similar questions from dentists currently in practice and from academics in dental schools. Despite the seemingly negative views held about women in dentistry by some of the men they were no more likely than the men to feel that there is sex- ual discrimination within dental science education. Den- tistry was deemed to offer men and women equal oppor- tunities for career development.

Although the sex ratio of dental students has changed, most faculty positions in dental schools in Australia are held by men. The 1980 edition of the Commonwealth Universifies Yearbook listed for the Australian dental schools only three women among 103 academic staff at lecturer level or above.8 No woman has ever held an appointment at the level of professor in an Australian dental school. Even though relatively few students reported that there was discrimination against women, women as students may be potentially handicapped by the absence of same-sex role models and mentors among academic staff who can shape the development of their careers. Positive discrimination in appointment of women dental academics has been suggested within Australian dental schools.

The men and women who enrol in dental science dif- fer to some extent in both the factors that affected their

Association of Commonwealth Universities. Commonwealth Universities Yearbook 1980. Vol. I . A-B. London: Associa- tion of Commonwealth Universities, 1979.

choice of a career and in their intended professional involvement. Intended professional involvement may have important consequences for workforce planning. Workforce planning identifies relationships between the anticipated capacity to supply dental services and the expected need or demand for services. Capacity to supply services not only reflects actual numbers of dentists, but also their workforce participation and productivity. Fett found that many women who trained as doctors in Australia subordinated professional activity to family life- cycle demands, whereas the reverse was the case for men.p While raising children many women either ceased practice or practised part-time. The extent of professional involve- ment of women currently registered as dentists in Australia is not known. Margaret Seward found that half of all women on the British dental register in 1975 were mothers of children under 15 years of age.'O Although 85 per cent of all women dentists engaged in some level of practice (and most of the remainder were only temporarily out of the work force) only 35 per cent were practising on a full-time basis. The extent and content of the workload of dentists has been shown to vary considerably between the sexes. Ashford and Cole have documented the sub- stantial differences in output of care provided by men and women dentists of the same age in Britain." Women dentists carried out about three-fifths of the number of courses of treatment as did their male colleagues.

' Fett lone. The future of women in Australian medicine. Med J Aust 1974;1:689-98.

l o Seward Margaret H. The provision of dental care by women dentists in England and Wales in 1975. London: British Postgraduate Medical Foundation, 1976.

" Ashford JB, Cole PN. Aspects of general dental practice in the National Health Service. J Dent 1981;9:1-15.

H

194

Although women dentists attracted considerably younger patients this was not a factor in explaining the variation in output. The importance of output differences between the sexes on the determination of supply of care has been recognized in the dnetal area and demonstrated in the medical area.”.” However with changing attitudes towards non-maternal child care, it may be that the multiple roles of wife, mother, and dentist will be resolved in a different manner in the future.

Australian Dental Journal, June, 1984

practice. Together these aspects may indicate a preference for a less entrepreneurial style of general dental practice and more empathetic relationships with people. This could aid the growth of alternative forms of dental care delivery such as pre-paid capitation group practices or corporate dentistry and an expanded public dental service. Both sexes anticipated interruption to their professional careers through travel or further study, but many women also anticipated interruption due to child rearing. The move- ment of both men and women into and out of the workforce may be the genesis of retraining programmes and periodic re-accreditation that may eventually apply to all dentists. Although factors affecting career choice could alter considerably, if the factors influencing female students’ choice of dentistry as a career remain as documented, and their careers follow the paths outlined, the practice of dentistry may undergo considerable change as the proportion of women dentists increases over the next 30 years.

Conclusion Several aspects related to career choice and path may

have important influences on the practice of dentistry in the future. Women were less likely than men to be attracted to dentistry by income and status, but more by the opportunity to work for and with people. Propor- tionately more women than men intended to remain as salaried assistants, while fewer planned to enter specialist

’ * Spencer AJ. Dental manpower: a transitional matrix analysis of supply. Aust Dent J 1982;27:248-53.

’’ Maynard A, Walker A. Doctor manpower 1975-2000: alter- native forecasts and their resource implications. A report for the Royal Commission on the National Health Service. London: Her Majesty’s Stationery Office, 1978. Research Paper Number 4 .

Address for reprints: A. J. Spencer,

Department of Conservative Dentistry, University of Melbourne,

Melbourne, Vic., 3000.