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U.S. Dental School Applicants and Enrollees: 2003 and 2004

	Abstract

Top Abstract Number of dental school... Applicant and Enrollee... Applicant and Enrollee... Grade point averages and... Applicants and Enrollees by... Discussion

 
Following a 25 percent decline in dental school applicants between 1997 and 2001, from 9,829 to 7,412, the number of applicants over the last three years has increased to 9,433. Based on the rate of applicants to the class entering in the fall of 2005, it is estimated there will be a further 10 to 15 percent increase in the number of applicants, thereby exceeding the 1997 number of applicants. The number of first-time, first-year enrollees rose from 4,039 to 4,457 (10.4 percent) between 1996 and 2004, during which time three new dental schools were established (Nova Southeastern University; University of Nevada, Las Vegas; and Arizona School of Dentistry & Oral Health). Almost 54 percent of the 418 additional first-year positions can be attributed to the three new schools. Slightly over 47 percent of the dental school applicants were enrolled in 2004; 55.4 percent of the applicants in 2003 were enrolled. The number of applicants per first-time, first-year position was 2.12 in 2004 and 1.81 in 2003. It was 2.31 in 1997, the last peak of dental school applicants. (The most recent low was 1.34 in 1989.) The average GPA of the first-time, first-year enrollees continued to increase slightly, standing at 3.35 for science GPA and 3.44 for total GPA. Over the last several years there has been essentially no change in the average academic average and total science DAT scores of the first-time, first-year enrollees, standing at 18.7 and 18.5 respectively. However, the average perceptual ability score has declined slightly, from 18.1 to 17.3. Women were 43.9 percent of the applicants and 42.4 percent of the first-time, first-year enrollees in 2004. Five years ago, women were 38.6 percent of the applicants and 36.5 percent of the first-time, first-year enrollees. Underrepresented minorities comprised 12.4 percent of the applicants and 11.6 percent of the first-time, first-year enrollees in 2004. These percentages are little changed from those reported since 2001.

Most of the information in the annual applicant analysis is derived from the files of the application service administered by ADEA. This application service—AADSAS (Associated American Dental Schools Application Service)—is a centralized service that processes applications to participating dental schools in a standard format. Fifty-two of the nation’s fifty-six dental schools participate in AADSAS.

To finalize the applicant and enrollment data of the AADSAS participating schools, each AADSAS school updates its roster of AADSAS applicants to its entering class by adding to its roster the name of students who applied directly to the school, outside of the AADSAS process. The school also adds for their direct applicants the same applicant information as that of the AADSAS applicants. Then each school indicates which applicants on the roster were offered enrollment and which were enrolled in the entering class. The four schools not participating in AADSAS provide a roster of their applicants and enrollees, which includes the same information as that of AADSAS applicants. The rosters are submitted to ADEA for analysis.

The following terms are used throughout this report:

• Applicant: an individual who applied to one or more U.S. dental schools.
  
• AADSAS Applicant: an individual who applied to one or more U.S. dental schools through the ADEA application service and whose application was forwarded to the school(s) requested.
  
• Direct Applicant: an individual who applied directly to one or more U.S. dental schools, not using the ADEA application service. (A direct applicant also could have applied to schools through the ADEA application service. The applicant database is scanned to clear it of duplicate applicants.)
  
• Application: A completed application received by a U.S. dental school. One applicant generates as many applications as the number of dental schools to which he or she applied.
  
• Enrollee: An applicant who was matriculated at a U.S. dental school for the first time. Students repeating their first year of school were not counted.
  

Throughout the report, the number of applicants is the sum of AADSAS and direct applicants, "cleaned" of duplications; i.e., information for individuals who applied to dental schools through AADSAS and as direct applicants is combined so these individuals appear only once in the applicant database.

	Number of Dental School Applicants and First-Time Enrollees

Top Abstract Number of dental school... Applicant and Enrollee... Applicant and Enrollee... Grade point averages and... Applicants and Enrollees by... Discussion

 
The number of dental school applicants rose almost 100 percent between 1989 and 1997, followed by a 25 percent decline between 1997 and 2001. Over the last three years the number of applicants has increased 27.3 percent, from 7,412 to 9,433 (Figure 1 and Table 1). Based on the continuing increase in the number of individuals taking the Dental Admission Test (DAT) and the number of AADSAS applicants to the class entering in the fall of 2005, it is estimated that there will be a further 10 to 15 percent increase in the number of applicants, thereby exceeding the 1997 high of dental school applicants.

View larger version (20K): [in this window] [in a new window]   Figure 1. U.S. dental school applicant and enrollment trends, 1989–2004

The number of applicants per first-time, first-year position was 2.12 in 2004 (Table 1), with 47.2 percent of applicants enrolled. This was 2.31 in 1997, the most recent high in the number of dental school applicants; with 43.2 percent of the applicants being enrolled. The most recent low was in 1989, with 1.34 applicants per position and 74.4 percent of the applicants enrolled. For a historical perspective, in 1974 and 75 (when concern was increasing about an emerging oversupply of dentists), there were 2.7 applicants per position, with about 37 percent of applicants enrolled; and in the late 1950s (when the concern was about an emerging shortage of dentists), there were 1.3 applicants per position, with 76 to 77 percent of the applicants being enrolled.

There are no data specific to identifying if, by how much, or at what point the percent rate of enrollment might affect decisions being made to pursue dentistry as a career and, thereby, the number of applicants to dental schools. There are many confounding factors that enter into that decision. However, a contributing factor may be a declining perception as to the possibility of being enrolled. The peaks of applicants and nadirs of percents enrolled have been followed by declines in applicants. A similar pattern has occurred with medical school applicants and enrollees, where a high of applicants in 1996 and 1997 gave an enrollment rate of less than 35 percent, which was then followed by a decline of applicants through 2002. This point should be considered as schools expand efforts to attract and recruit dental school applicants. Applicants must sense a probability of being enrolled. Even then, a number of applicants (of some unknown significance) above the number that can be enrolled could cause a decline in even qualified applicants due to a decline in a perceived possibility of being enrolled.

	Applicant and Enrollee Composition by Gender

Top Abstract Number of dental school... Applicant and Enrollee... Applicant and Enrollee... Grade point averages and... Applicants and Enrollees by... Discussion

 
There has been little change over the past four years in the percent gender composition of applicants and enrollees, fluctuating between 55.5 and 57.5 percent for men and about 42 and 44.5 percent for women (Table 2). This current plateauing of women applicants and enrollees follows a period of increases that occurred between 1996 and 2001, prior to which time women applicants and enrollees had been fluctuating around 36 percent. Schools continued to draw similar percentages of enrollees from each gender pool of applicants.

As the number of women dentists has increased, they have well established themselves in dental academia and moved into positions of leadership. Currently, almost 29 percent of full-time dental school faculty are women. Ten of today’s fifty-six dental school deans or interim deans are women. Thirty-one percent of the delegates to the ADEA Council of Faculties are women, and 37 percent of the officers in the ADEA Council of Sections are women.

	Applicant and Enrollee Composition by Race/ Ethnicity

Top Abstract Number of dental school... Applicant and Enrollee... Applicant and Enrollee... Grade point averages and... Applicants and Enrollees by... Discussion

 
Table 3 displays the number and percent of applicants and enrollees for 2003 and 2004 by race/ ethnicity. The percentages reported here for nonwhite enrollees are very similar to those reported by the American Dental Association in a 2003 and 2004 report of dental school enrollments by race/ethnicity, whereas the percent of white enrollees in the ADA report is almost 10 percentage points higher than the percent of reported white enrollees displayed in Table 3. It can be assumed, then, that the "Not Reported" numbers are primarily made up of white applicants (and thereby enrollees) who did not wish to report race. Under this assumption, Figures 2 and 3 display the minority applicant and first-time, first-year enrollee trend lines of 1990 to 2004. After five years of decline (1997 to 2002), there has been about a 22 percent upturn in Asian/Pacific Islander applicants, standing now at 1892. After being relatively flat over those same five years, the number of black/African American applicants has increased almost 30 percent since 2002 to 551; and Hispanic/Latino applicants increased over 22 percent last year to 554.

View larger version (21K): [in this window] [in a new window]   Figure 2. Minority applicants to U.S. dental schools, 1990–2004

View larger version (22K): [in this window] [in a new window]   Figure 3. First-time, first-year minority enrollees in U.S. dental schools, 1990–2004

Regarding first-time, first-year dental school enrollments (Figure 3), black/African American and Hispanic/Latino enrollments declined almost 25 percent during the early to mid-1990s. This decline coincides with the 1992 Hopwood vs. Texas lawsuit, which challenged the diversity policy of the University of Texas Law School, and the 1996 California proposition 209, which proclaimed that the state shall not discriminate against or grant preferential treatment to any individual or group on the basis of race, sex, color, ethnicity, or national origin in the operation of public employment, public education, or public contracting. So while underrepresented minority applicants were increasing, admission committees, under the influence of Hopwood and proposition 209, apparently were being cautious, and underrepresented minority enrollments declined.

In response to the Hopwood decision and proposition 209, fifty health professions organizations (including the American Dental Education Association) formed the Health Professionals for Diversity Coalition. The coalition’s objectives were to support the right of institutions to determine their own admissions policies, stating that "achieving diversity does not require quotas, nor does diversity warrant admission of unqualified applicants. But the diversity we seek does require a conscious effort to build healthy and diverse learning environments appropriate for our missions."

In this context of support, dental school admissions committees began to more boldly review and revise their selection and admissions criteria; and between 1998 and 2004, underrepresented minority enrollments recovered their losses. However, beyond recovering from the declines of the early to mid-1990s, there has been little change in the number of first-time, first-year enrollees by race/ethnicity. Hispanic/Latino first-time, first-year enrollees have increased by eight, from 245 to 253. Black/African American first-time, first-year enrollees have increased slightly more, by twenty-six, from 215 to 241. The number of Native Americans has increased from fifteen to twenty-four.

Using the first-year under-represented minority enrollments obtained from the American Dental Association’s annual reports on predoctoral dental education (Figure 4), a most similar picture presents: a decline in black/African American and Hispanic/Latino enrollees through the mid-1990s, followed by recovery through 2004 to a point similar in number to what they were in 1990. Whether using the ADEA first-time, first-year enrollee data or the ADA’s first-year enrollment data, it is evident that the number of underrepresented minority dental students today is little changed from what it was in 1990. The percent composition of the first-year class by underrepresented minority students is less today than it was in 1990, 12.3 vs. 13.8 percent. There are still fourteen dental schools with no black/African American first-year enrollees and six with only one first-year enrollee. There are three schools with no first-year Hispanic/Latino enrollees and twelve with only one.

View larger version (15K): [in this window] [in a new window]   Figure 4. First-year URM dental school enrollment, 1990–2004

	Grade Point Averages and Dental Admission Test Scores

Top Abstract Number of dental school... Applicant and Enrollee... Applicant and Enrollee... Grade point averages and... Applicants and Enrollees by... Discussion

 
Table 4 displays the average grade points and DAT scores of dental school applicants and enrollees from 1998 through 2004. Over this time period, grade point averages of applicants and enrollees have increased by just over one-tenth of a point: applicant science GPA, from 3.02 to 3.13; applicant total GPA, from 3.14 to 3.25; enrollee science GPA, from 3.24 to 3.35; and enrollee total GPA, from 3.33 to 3.44. Whether or not the slight increases reflect "grade creep," the averages do reflect the tendency to select from a relatively high academic-achieving applicant pool individuals with the higher GPAs. Over this time period, the average DAT scores have fluctuated by 0.5 to 1.0 point, between their high and low averages, with the DAT scores of the enrollees always slightly higher than those of the applicants, again reflecting the tendency to select individuals with higher DAT scores. The DAT scores in 2004 for applicants were as follows: academic average, 17.6; perceptual ability, 16.7; and total science, 17.4. The DAT scores in 2004 for enrollees were as follows: academic average, 18.7; perceptual ability, 17.3; and total science, 18.5.

	Applicants and Enrollees by Predental Major Areas of Study

Top Abstract Number of dental school... Applicant and Enrollee... Applicant and Enrollee... Grade point averages and... Applicants and Enrollees by... Discussion

 
The major area of study for dental school applicants and enrollees was biological science, 50.4 and 51.4 percent respectively (Table 7). Almost 15 percent of the applicants indicated their major area of study was predentistry (or other health profession). Slightly more than 13 percent of the enrollees were predental majors. Chemistry/physics was the major area of study for 14.0 percent of the applicants and 14.1 percent of the enrollees.

	Discussion

Top Abstract Number of dental school... Applicant and Enrollee... Applicant and Enrollee... Grade point averages and... Applicants and Enrollees by... Discussion

 
Between 1989 and 1997, dental school applicants increased by almost 100 percent, from 4,996 to 9,829. This increase was followed by a 25 percent decline in applicants between 1997 and 2001. Between 2001 and 2004, there was a 27 percent increase, with the number of applicants returning to 9,433. Based on the number of AADSAS applicants to the entering class of 2005, it is estimated that this number will increase by another 15 percent, thereby exceeding the 1997 high number of applicants by over 1000.

There are several factors that contribute to increases and decreases in dental school applicants. There is knowledge (or perception) of the occupational outlook for dentistry from the perspective of the supply and demand status of the dental workforce and reported rates of return on a dental education. There is also the momentary or long-term attractiveness of other occupations that compete for career decisions. The increases in applicants in the early 1990s can, in large part, be attributed to dentistry reemerging as a challenging and financially rewarding career choice, with a long-term positive occupational outlook. The decline in dental school applicants in the late 1990s correlates with the increased interest, during that period of time, in business, computer science, information technology, and the worlds of dot-com and e-trade. Medical schools experienced a similar decline in applicants in the late 1990s, as those same areas had very strong attraction and competed well with the health professions for career choice. However, after the fallout/shakeout of various areas of business, investments, and entrepreneurial dot-com and e-trade domains, dentistry in particular has regained what it lost in applicants and shows continuing growth through the number of individuals taking the Dental Admission Test and already applying to the entering class of 2006.

When there is a decline in dental school applicants and a fall in the applicant to enrollee ratio, concerns begin to arise as to the academic quality of the applicant pool, as measured by GPAs and DAT scores. Will the schools be able to fill their projected number of first-year positions with individuals that fall within acceptable ranges of GPAs and DAT scores? During the applicant decline of the late 1990s, this was not the case. All of the aggregate averages and scores increased, resulting in increases in the aggregate averages and scores of enrollees.

When there is an increase in the number of applicants and an increase in the applicant to enrollee ratio, admission committees are pleased to have a larger applicant pool from which to select and offer enrollments, particularly if the academic quality of the pool remains high. But this too poses a dilemma. When a school receives many applications for a limited number of first-year positions, what are the criteria that define and support a selection process that ensures capable students, competent graduates, and practitioners that best serve the public’s health? This becomes even more complex as schools address their role in improving the diversity of the oral health workforce through efforts to ensure a more diverse student body. The U.S. Supreme Court in its June 2003 ruling on cases regarding the admissions policies of the University of Michigan upheld the right of universities to consider race in admissions procedures in order to achieve a diverse student body and said that as long as a school does not use quotas to achieve diversity, it may include race when evaluating and selecting students. However, as the applicant pool increases and the number of first-year positions remains little changed, competition and selectivity increase. The result may be greater volatility in the admissions process, with further challenges as to race/ethnic fairness.

After more than a decade of increasing first-year enrollments, the first-year dental school enrollment of 2004 was six less than that of 2003; and based on a 2004 survey of dental school deans regarding interest and capacity to increase class sizes, little further expansion of first-year enrollment is expected. What is expected is a continuing increase in the applicant pool, a continuing effort to increase underrepresented minorities within the applicant pool, a continuing and expanding commitment to ensuring a diverse student body, and an increasing competitiveness and selectivity in dental school admissions. Cognitive abilities, as measured by GPAs and DAT scores, may correlate with success as a dental student; but GPAs and DAT values and ranges have yet to be correlated with success as competent, professional, caring practitioners. As a range of GPAs and DAT scores is acknowledged and accepted and less arbitrary reliance and use are made of the cognitive abilities of applicants in the admissions process and as more noncognitive experiential criteria are considered, it becomes even more critical to codify and publicize a school’s admission requirements and selection criteria so as to meet judicial and societal scrutiny for fairness.

But this is more than affirmative action. This is more than improving the diversity of student bodies as a means of closing the diversity gap in the oral health workforce, which will help reduce oral health disparities among underserved communities and populations. Resolving issues of equitable access to oral health care is a responsibility and obligation of the whole profession—education, regulatory, and practice communities alike. But the dental schools do control the admissions process and, thereby, have the responsibility to administer and document a fair process that selects a diverse body of capable students, giving rise to competent graduates and practitioners that best serve the public good and the public’s health.

	Footnotes

 
Dr. Weaver is Associate Director, Center for Educational Policy and Research; Mr. Ramanna is Senior Analyst, Office of Information Technology; Dr. Haden is Associate Executive Director and Director, Center for Educational Policy and Research; and Dr. Valachovic is Executive Director—all at the American Dental Education Association. Direct correspondence and requests for reprints to Dr. Richard Weaver, American Dental Education Association, 1400 K Street, NW, Suite 1100, Washington, DC 20005; 202-289-7201 phone; 202-289-7204 fax; WeaverR{at}ADEA.org.

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