Annual ADEA Survey of Dental School Seniors: 2005 Graduating Class

Parental Education and Income

The average education and income of dental students’ parents is greater than in the U.S. population in general. In 2005, nearly 82 percent of students’ fathers had education beyond high school, with almost 46 percent having at least some graduate education (Table 2⇓). Over 74 percent of dental students’ mothers had obtained education beyond high school, with nearly 27 percent having a graduate degree or some graduate school education. In the U.S. population at large, just under 52 percent have obtained education beyond a high school level, and about 9 percent hold graduate degrees.¹

Nearly three-quarters of 2005 graduates were from families with a combined parental income of over $50,000 (Table 3⇓). The proportion of graduates from families with an income above $100,000 also continued to increase, rising two percentage points to nearly 44 percent in 2005. This is an increase from about 32 percent in 1997. Parental income was over $150,000 for almost 28 percent and over $200,000 for 19 percent of senior dental students in 2005.

Students’ Financial Independence and Marital Status

The percentage of seniors reporting financial independence from their parents remained stable, at about 65 percent in 2005 (Table 4⇓). The percentage of seniors reporting financial independence has been between 62 and 66 percent since 1995. During the 1980s and early 1990s, the percentage fluctuated between around 52 and 59 percent.

Since 2000, the percentage of seniors who were married has fluctuated between 41 and 44 percent (Table 5⇓). Following a drop in 2004, the percentage of seniors with a spouse in 2005 rose to nearly 44 percent. During the 1990s, the percentage increased to current levels from around 35 percent. The greatest percentage of married seniors was in 1978, when over 57 percent reported being married. Of married seniors, 44 percent had at least one child. Fourteen percent had two children; 8 percent had three or more children.

Choice of Dentistry as a Career

Upon entry into college, two-thirds of seniors had not yet decided to pursue a career in dentistry (Table 6⇓). Nearly 43 percent did not decide to pursue dentistry until their third year of college or later. One-third of students made the decision prior to college, 22 percent decided during high school, and almost 12 percent made the decision prior to high school.

Seniors were asked to consider the relative importance of a variety of factors in their decision to pursue a career in dentistry. The influence of each factor was rated using a 5-point Likert scale ranging from “Low” to “High.” The “High” and “Somewhat High” responses were combined to rank the importance of the factors by percentage of responses and is shown in Table 7⇓. Based on this ranking, the most influential factors were “Control of Time for Work” (87.2 percent), “Service to Others” (84 percent), and “Opportunity for Self-Employment” (83 percent). Historically, these factors have been the top three, with “Self-Employment” and “Service to Others” at times changing their order.

The next most influential factors in the decision to enter dentistry were “Income Potential” (81.1 percent), “Enjoy Working With Hands” (74.8 percent), “Variety of Career Options in Dentistry” (55.7 percent), and “Status and Prestige” (54.5 percent). These percentages are quite similar to previous years. As in the past, the reasons reported as least important include “Opportunity to Serve Vulnerable and Low-Income Populations” (44.1 percent) and “Service to Own Race or Ethnic Group” (25.9 percent).

When responses to the importance of “Service to Own Race or Ethnic Group” and “Service to Vulnerable and Low-Income Populations” in the decision to pursue dentistry were assessed by race/ ethnicity, substantial differences became evident (Table 8⇓). With respect to service to one’s own race/ ethnic group, 69 percent of black/AfricanAmericans and 54.2 percent of Hispanic/ Latinos responded “Somewhat High” or “High.” AmongAsian/Pacific Islanders and Native Americans, “Somewhat High” or “High” was reported 37.8 percent and 34.2 percent of the time, respectively. Among white respondents, only 15.5 percent responded “Somewhat High” or “High” importance to the reason of “Service to Own Race or Ethnic Group.” The reported importance of care to the underserved also showed differences by race/ ethnicity. The highest percentage of respondents reporting “Somewhat High” or “High” importance were black/African American respondents (63.8 percent) followed by Hispanic/Latinos (61.7 percent) and Asian/Pacific Islanders (55.9 percent). A little under 52 percent of Native Americans and 36.1 percent of whites reported “Somewhat High” or “High” the importance of service to vulnerable and low-income populations in their decision to pursue dentistry as a career.

Seniors were asked to consider the influence of ten factors on their decision to pursue a career in dentistry (Table 9⇓). Again, a 5-point Likert scale (Low to High) was used. The percent of respondents reporting “Somewhat High” or “High” importance were combined to rank the overall influence of the factors. Based on this scale, the most influential factors were a “Family Member or Friend Who Is a Dentist” (49.5 percent) and “My Family Dentist” (46.6 percent). The high rating of these two factors shows the influence current dental professionals can have in encouraging students to consider careers in dentistry. The next most influential factors were “Awareness of Dental Workforce and Market Trends” (39 percent) and “Family Member or Friend Who Is Not a Dentist” (33.1 percent). These factors have been similarly reported in the past.

As has historically been the case, there was a sharp decline in the percentage of students reporting that the other listed factors had a “Somewhat High” or “High” influence on their decision to pursue dentistry. They include “Participation in a Pre- or Post-Baccalaureate Dental Career Development or School Admissions Program” (16.5 percent), “Visit to a Dental School” (14.6 percent), “Career Day” (7.9 percent), “Recruitment by a School” (8 percent), “High School or College Counselor” (6.9 percent), and finally a “Brochures on Careers in Dentistry” (5.5 percent). The reported influence of each of these factors represents a combination of the influence of the factor when a student has exposure to it and the percentage of students exposed to the particular factor. Many students do not participate in a pre- or post-baccalaureate dental career development or school admissions program or a specific recruitment program; however, these programs may have a powerful impact on the students who do. The influence of the two components contributing to the ratings of these factors cannot be separated.

The influence of the ten listed factors was also evaluated by race/ethnicity of the student. The proportion of students rating the influence of factors as “Somewhat High” or “High” varied by race/ethnicity for many factors. The most substantial differences were in “Participation in a Pre- or Post-Baccalaureate Dental Career Development or School Admissions Program” (12.6 percent of white students; 23.1 percent of minority students), “A Family Member or Friend Who Is a Dentist” (53.4 percent of white students; 43.2 percent of minority students), and “My Family Dentist” (50.1 percent of white students; 40.2 percent of minority students). Minority students reported greater influence of high school or college counselors, brochures, career day visits, visits to a dental school, and specific recruitment by a dental school. Responses on the influence of a family member or friend who is not a dentist and awareness of dental market trends were similar for all respondents regardless of race/ethnicity.

Educational Debt

The average entering educational debt reported by senior dental students in 2005 was $19,876 (Table 10⇓). The average total educational debt upon graduation was $129,639 in 2005. At public dental schools, the average graduating educational debt was $104,483; at private and private state-related schools, it was $161,500. The one-year increase in graduating debt, between 2004 and 2005, was 5 percent at public schools and 4 percent at private and private state-related schools. Average graduating debt since 1990 by type of school is displayed in Figure 1⇓.

Financial Support for Meeting Dental Education Expenses

Nearly 30 percent of 2005 seniors reported that they had experienced “Much” or “Very Much” concern about their ability to finance their dental education; 16.6 percent reported “Very Much” concern (Table 16⇓). About one-fourth (27.5 percent) of seniors reported that they had been “Somewhat” concerned about financing their dental education, and 17.4 percent had had “Very Little” concern. The remaining 25.5 percent of seniors reported that they had not been concerned about financing their dental education.

The percentage of students reporting “Much” or “Very Much” concern was highest among Hispanic/ Latino students (34.3 percent), followed by Asian/ Pacific Islander (33.9 percent) and black/African American (31 percent) students. “Much” or “Very Much” concern was reported by 26.9 percent of white seniors and 28.5 percent of Native Americans. The lowest percentage of students reporting “No” concern were Asian/Pacific Islander (20.4 percent), black/African American (24.7 percent), and Hispanic/Latino (25 percent) students. “No” concern was reported by 27.4 percent of white students and 34.3 percent of Native Americans.

The reported percentage of seniors’ dental education financed through self/spouse income/savings, loans/ grants/scholarships, and gifts/financial support from parents/relatives is shown in Table 17⇓. Nearly half of the seniors indicated that they used no income or savings from either themselves or their spouse to finance their dental education. Another 28.3 percent of students financed 10 percent or less of their dental education through income and/or savings. Only 14 percent of seniors financed more than 20 percent of their dental education through income and/or savings, with 4.1 percent financing over 50 percent through savings and/or income.

The reported percentage of seniors’ dental education financed through gifts or financial support from parents and/or relatives was similar. Over 44 percent of seniors reported receiving no gifts or financial support from family and/or relatives in financing their dental education. Approximately 27 percent of seniors financed 1 to 10 percent of their education through these means. Gifts and/or financial support were used by 21.8 percent of seniors to finance over 20 percent of their dental education, with 11.6 percent financing over 50 percent through these means.

Over 76 percent of 2005 seniors reported financing more than 50 percent of their dental education through loans, grants, and/or scholarships. Nearly 49 percent financed over 90 percent using loans, grants, and/or scholarships. Eight percent of seniors financed between 21 and 50 percent of their dental education through these means. Six percent of 2005 seniors financed between 1 and 20 percent, and 9.4 percent financed none of their dental education through loans, grants, and scholarships.

Student Loans

In 2005, 93.1 percent of responding seniors reported financing part or all of their dental education through one or more types of loans. The subsidized and unsubsidized Stafford loan programs remain the most frequently used, reported by 82.6 percent and 78.5 percent of seniors respectively in 2005 (Table 18⇓). Loans obtained through the Perkins loan program and the Health Professions Student Loan program were each reported by nearly 32 percent of the seniors. This is an increase from the percent reported in 2004. After decreasing in 2004, use of ADEAL and other private lender loans increased to 26.6 percent in 2005, similar to the percent reported in 2002 and 2003.

Families/relatives provided loans to 16.3 percent of responding seniors in 2005. This is similar to 2003 and 2004, but lower than years prior to 2003. In 1980, over two-thirds of seniors reported using loans from family/relatives to finance part of their dental education. The percentage of seniors obtaining personal bank loans to finance their education continues to increase with 9.1 percent of seniors reporting such loans in 2005. This is up from 6.7 percent in 2003 and 8.0 percent in 2004.

The percent of seniors who reported obtaining loans from their school was 9.1 in 2005. The percentage has fluctuated between 8.8 and 10.4 percent since 2001. Use of state loan programs was reported by 2 percent of seniors, a decrease from the 2.7 to 2.9 percent of reported in recent years. Loans for Disadvantaged Students remained stable, with 4.1 percent reporting such loans. The percentage of seniors reporting credit card debt was 10.7 percent.

Grants, Scholarships, and Loan Forgiveness

In 2005, 49.9 percent of seniors reported having received one or more grants or scholarships, down from 52.5 percent in 2004. One-third of the students reported grant/scholarship support from their dental school (Table 19⇓). The percentage of seniors who received state grants/scholarship decreased from 12.0 percent in 2004 to 11.6 percent in 2005.

The percent reporting federal grants/scholarships decreased from 11.2 percent in 2004 to 10.6 percent in 2005. Need-based federal grants and scholarships (Scholarships for Disadvantaged Students) were reported by 4 percent of seniors in 2005. In 2005, 7 percent of seniors reported obtaining scholarships from one of the uniformed services, the Indian Health Service, or the National Health Service Corps. These percentages are very similar to those reported in 2004.

Almost 10 percent of seniors reported plans to participate in a repayment program that included partial or complete loan/scholarship/grant forgiveness in exchange for fulfillment of a service or placement obligation. This is a decline from the nearly 13 percent reported in 2004, but similar to the percent reported in 2003.

Rating of Time Devoted to Areas of Instruction

Seniors were asked to rate the amount of time devoted to areas of instruction as “inadequate,” “appropriate,” or “excessive.” The areas of instruction are divided into two primary categories, the first containing areas related to basic and dental sciences and clinical disciplines and the second pertaining to dental public health and community dentistry.

Within basic and dental sciences and clinical disciplines, the areas with the highest percentage of students reporting “inadequate” time included implant dentistry (40.4 percent), orthodontics (35.3 percent), and practice administration (35.5 percent) (Figure 4⇓). The percentage reporting inadequate time in implant dentistry, 40.4 percent, has declined from over 50 percent in 2001. These areas were followed by endodontics (18.5 percent), geriatric dentistry (17.2 percent), and pharmacology (16.9 percent). These areas are the same as those reported in the past, although pharmacology dropped from fourth to sixth.

A high percentage of seniors reported excessive time devoted to instruction in several areas. These areas included: basic sciences-medical (17.9 percent), behavioral sciences (17.2 percent), periodontics (12.9 percent), and prevention/oral health promotion (12.6 percent). The percentage of seniors reporting excessive time for each of the other areas of instructions was less than 10.

In Figure 5⇓, the ratings of time devoted to instruction in dental public health and community dentistry are displayed. The area for which the most seniors reported inadequate instruction time was health services organization and financing, for which 37.5 percent of seniors reported inadequate time. Many seniors also reported inadequate instruction time in hospital dentistry (28.7 percent), dental health policy (22.8 percent), gender-related issues (22.5 percent), and cultural competency (22.2 percent). The areas most often reported as excessive included ethics (15.9 percent) and dental public health (12.7 percent).

Seniors were asked to rate their level of preparedness to enter private practice in twenty-five subject areas using a 5-point Likert scale (1=Not well enough prepared; 5=Well prepared). The areas in which the highest proportion of seniors reported that they were not well enough prepared (1 or 2 on the Likert scale) were practice administration (58.9 percent), orthodontics (47.5 percent), implant dentistry (46.8 percent), and oral health care for disabled patients (33.0 percent) (Table 20⇓).

Twenty percent of the seniors indicated they did not feel well enough prepared in therapeutics and prescription writing. Between 18 and 19 percent reported they sensed not being well enough prepared in the following areas: anesthesiology, sedation, and pain control; endodontics; oral health care for patients with HIV/AIDS; interacting with medical colleagues; and oral health care for rural areas. Almost 18 percent of the seniors reported that they sensed not being well enough prepared to provide geriatric oral health care. Adaptive treatment planning for low income populations and individuals was another area where 17.4 percent of the seniors reported not being well enough prepared. At least 90 percent reported they were prepared to well prepared in patient evaluation, radiology, diagnosis and treatment planning, preventive practices and patient education, operative/ restorative dentistry, fixed and removable prosthodontics, and oral surgery.

Practice Plans Immediately Following Graduation

Seniors were asked a series of questions relating to their plans following graduation from dental school. The percentage that planned to immediately enter private practice, either solo, as part of a partner/group practice, or as an associate/employee, rose slightly to 51.6 percent from 50.4 percent in 2004 (Figure 6⇓; Table 21⇓). The increase in students entering private practice was primarily due to an increase in the percentage entering as an associate or employee (40.3 percent in 2004; 41.8 percent in 2005). Just over 6 percent of seniors planned to enter a partner or group practice, and 3.7 percent planned to pursue solo private practice immediately following graduation. The percentage of seniors entering government service declined slightly from 7.5 in 2004 to 6.1 in 2005. The percentage pursuing advanced education (38.6 percent) remains unchanged; the percentage pursuing teaching/research/administration (0.8 percent) continues to be less than 1 percent.

Immediate Plans by Respondents’ Gender and Race/Ethnicity

When plans immediately following graduation were evaluated by gender, minor differences in the activities pursued by males and females became evident. A higher percentage of males (52.1 percent) than females (50.8 percent) planned to immediately enter private practice (Table 22⇓). Alternatively, a slightly higher percentage of females (39.5 percent) than males (37.9 percent) planned to immediately pursue advanced education. Government service was reported by 6.6 percent of males and 5.4 percent of females. Similar percentages of males (0.6 percent) and females (0.9 percent) reported plans to pursue teaching, research, or administration.

The percentages are generally similar to those reported in 2004. In 2005, a slightly higher percentage of females reported plans to enter private practice, while slightly less reported pursuing advanced education. The percentage pursuing government service declined in 2005 for both males and females.

Plans immediately following graduation were also evaluated by race/ethnicity. In 2005, the percentage of black/African American seniors planning to enter private practice immediately following graduation increased from 29.3 percent in 2004 to 35.3 percent in 2005, and the percentage of Native American/Alaska Natives increased from 56.7 percent to 70.6 percent. The percentage of Asian/Pacific Islanders, Hispanics, and whites entering private practice increased by smaller amounts. The percentage of seniors pursuing advanced education decreased slightly for every race/ ethnic group except Asian/Pacific Islanders, which increased by 0.5 percentage points. The percentage of seniors pursing government service decreased within every race/ethnic group. The largest one-year declines were among Native American/Alaska Natives (13.3 percent in 2004 to 2.9 percent in 2005), black/African Americans (13.3 percent in 2004 to 7.5 percent in 2005), and Hispanics (8.6 percent in 2004 to 4.7 percent in 2005).

Influence of Educational Debt on Plans Following Graduation

Over 22 percent of 2005 seniors reported that educational debt played a major role in determining their plans following graduation. Nearly 40 percent indicated that debt influenced their plans upon graduation, but had only “little” or “somewhat” of an influence. The remaining 37.7 percent of seniors reported that debt did not influence their plans following graduation from dental school. This distribution is similar to the response in 2004.

As may be anticipated, the influence of debt varied based on plans following graduation. Among students entering private practice, 29.4 percent indicated that debt was a major factor in their decision (Table 24⇓). The percentage was higher for those entering private practice as an associate/employee (29.6 percent) or in a community clinic (36.0 percent) than for those starting a solo private practice (17.1 percent) or joining a partner/group private practice (19.6 percent). Just under 41 percent of seniors entering private practice reported that their debt did not play a role in their plans following graduation. Educational debt also played a major role in determining plans following graduation for students entering government service (51.7 percent). Many of these students likely participated in loan/scholarship programs associated with a service commitment following graduation. Almost 29 percent of those entering government service indicated debt was not a factor, an increase from 19.1 percent in 2004.

Seniors entering advanced education or teaching/research/administration were less likely to report that debt played a substantial role in their decision: 8 percent and 10 percent, respectively. Nearly 73 percent of those pursuing advanced education and 57 percent entering teaching/research/administration reported that debt was not a factor in their decision. The percentage pursuing advanced education that indicated debt was not a factor increased from 52 percent in 2004 to almost 73 percent in 2005.

Students with higher levels of debt were much more likely to plan to enter private practice upon graduation (Table 25⇓). Of those without debt, about 40 percent planned to immediately enter private practice. Nearly 54 percent of 2005 seniors with $100,000 to $149,999 in debt and 55.2 percent with at least $150,000 in debt planned to enter private practice upon graduation. Generally, the decision to enter private practice appears to be influenced, in part, by the amount of students’ educational debt.

Since the year 2000, seniors with debt have been less likely to report plans to pursue advanced education than those without debt. In 2005, 47 percent of seniors with no debt planned to obtain advanced education compared with 38 percent of seniors with debt. For the second year, seniors with $80,000 or more in educational debt were slightly less likely to pursue advanced education than students with under $80,000 in educational debt.

Seniors were also asked to identify the primary activity they would have pursued following graduation if not for their educational debt (Table 26⇓). Nearly one-third of seniors reported that they would have pursued a different activity were it not for their debt. Of students with plans to enter solo private practice, 84 percent still would have pursued solo private practice even if not for their level of educational debt. Over 4 percent would have pursued advanced education, and 1.4 percent would have pursued government service instead of entering solo private practice if it were not for their debt. Among students planning to enter a partnership/group practice, nearly three-quarters (73.5 percent) reported they would have pursued the same activity regardless of their educational debt. Of those entering a partnership/ group practice, 5.6 percent would have pursued advanced education, 1.7 percent teaching/research/ administration, and 0.4 percent government service if not for their level of debt. Nearly 13 percent would have pursued solo private practice.

Greater percentages of students entering private practice as an associate/employee or as an employee at a community clinic reported they would have pursued a different activity upon graduation if not for their debt. Only 55 percent planning to be an associate/employee and 37.2 percent planning to be employed at a community clinic would not have changed their plans upon graduation. Many of these students reported that they would have pursued advanced education, including 12.9 percent of those employed as an associate/employee and 12.7 percent of those employed by a community clinic. Among those planning to pursue a position as an associate/ employee, 12.5 percent would have pursued solo private practice, 11.9 percent partnership/group private practice, 1.3 percent teaching/research/administration, and 0.7 percent government service. Of those employed by a community clinic, 11.8 percent would have pursued solo private practice, 16.4 percent a partnership/group practice, and 13.6 a position as an associate/employee were it not for their educational debt. Another 12.7 percent of those planning to be employed by a community clinic would have pursued advanced education. Teaching/ research/administration and government service would have each been pursued by 1.8 percent of seniors employed by a community clinic.

Of students pursuing advanced education, only 13.4 percent reported they would have pursued a different option following graduation were it not for their level of debt. Most of these seniors would have immediately entered private practice. Of students pursing an academic career in teaching/research/ administration, over 17 percent would have pursued advanced education if not for their debt. An additional 9.7 percent would have immediately entered private practice. Of students entering government service, only 35.1 percent would still have pursued government service were it not for their educational debt. If not for their debt, 17.8 percent would have pursued advanced education and 39.6 percent would have pursued solo private practice rather than government service.

Using the number of respondents rather than percent of respondents, based on the reported activities if not for level of debt, an additional 288 seniors would have pursued advanced education, and forty would have pursued a career in academia. Alternatively, if not for their debt, 203 individuals pursuing advanced education and twelve pursuing an academic career would no longer have done so.

Future Practice Plans

Seniors were also asked to report the activity they intended to pursue ten years following graduation from dental school (Table 27⇓). Most seniors reported plans to practice in a partner/group private practice (50.8 percent) or a solo private practice (36.5 percent) ten years later. Together, 87.3 percent plan to be in either a solo or partner/group private practice, slightly greater than the 86.6 percent in 2004. This reflects the continuation of a trend towards a rising percentage with plans to pursue these activities since 81 percent reported such long-term plans in the early 1990s. Most of the increase is due to a greater percent of seniors with long-range plans to pursue a partner/group private practice. However, historically a far larger number of seniors report plans to be in partnership than actually practice in a partnership, more around 14 percent.

Slightly more than 4 percent of seniors planned to be employed in private practice as an associate/ employee or at a community clinic. These percentages fluctuate from year to year, but have not substantially changed in recent years. The 0.9 percent with long-term plans to practice in a community clinic is less than the 2.8 percent with plans to be employed in a community clinic immediately following graduation. This indicates that many of the students who plan to practice in a community clinic do not intend to do so for a long period of time. Alternatively, a greater percentage of students reported plans to be in academia ten years following graduation (1.8 percent) than the percentage that planned to do so immediately upon graduation (0.7 percent). Additionally, 44.8 percent of seniors reported that their long-range plans include teaching on a part-time basis. This is similar to percentages reported in previous years.

Long-range career plans were also evaluated based on gender. Similar percentages of males and females planned to be in private practice ten years following graduation (92.8 percent of males and 89.9 percent of females), but males were much more likely to plan to practice in a solo private practice (42.2 percent of males; 29.5 percent of females). Higher percentages of females than males reported plans to pursue private practice in a partner/group practice, as an associate/employee, or in a community clinic. Slightly more females reported plans to pursue academia: 1.6 percent of males compared to 2 percent of females. Similar percentages reported long-range plans for government service. These differences are similar to those reported in previous years.

In 2005, over two-thirds of the seniors reported plans to practice in a metropolitan area with a population of at least 50,000 people (Table 29⇓). Over 31 percent planned to practice in a metropolitan area with a population of at least one million. Nearly 25 percent planned to practice in a metropolitan area with a population between 100,000 and 999,999. The remaining 31.8 percent of seniors planned to practice in an area with a population of less than 50,000 with 20.1 percent planning to practice in an urban/suburban area with a population of between 25,000 and 49,999. Almost 7 percent planned to practice in an urban/suburban area with a population between 10,000 and 24,999; 5 percent planned to practice in an urban/rural area with a population of less than 10,000.

Some variations were reported in practice location plans based on race/ethnicity (Table 30⇓). When considering these differences, it is important to note that some cells contained a small number of responses. In general, minorities were more likely to report plans to practice in a metro area with a population of at least one million. The percentage with plans to practice in an area with between 100,000 and 999,999 residents was slightly higher for white and Hispanic/Latino respondents than for black/African Americans and Asian/Pacific Islanders. There was a slightly higher percentage of whites reporting plans to practice in urban/suburban/rural areas.

Seniors were asked to estimate the percentage of their patients that they expected to be from underserved race/ ethnic populations based on their intended practice location. The responses are displayed by race/ethnicity of the respondents in Table 31⇓. Black/African Americans (27.6 percent) and Hispanic/ Latinos (20 percent) were most likely to anticipate that over 50 percent of their patients would be from underserved minority populations. Just over 9 percent of Asian/Pacific Islanders and 5.9 percent of Native Americans anticipated at least half of their patients would be underserved minorities. Only 3.4 percent of white seniors had such expectations. Over 50 percent of whites and Native Americans reported that they expected 10 percent or less of their patients would be from underserved race/ ethnic populations. This was true for 15.5 percent of black/African American, 29.6 percent of Asian/Pacific Islander, and 23.5 percent of Hispanic/Latino seniors. The reported differences continue to support historical trends that the practice locations of minority graduates, particularly black/African Americans and Hispanic/Latinos, tend to be areas that care for a greater number of underserved minorities.

Community-Based Dental Education

Since 2003, seniors have been asked a series of questions regarding community-based dental education and extramural clinical rotations. These questions were designed to document students’ perspectives of changes in the amount of time devoted to providing care through extramural clinical rotations. The distribution of seniors based on the number of weeks during their senior year that they anticipated providing care (not just observing) on extramural clinical rotations is displayed in Table 32⇓. In 2005, 11.5 percent reported they would not spend any time in extramural rotations, down from 14.5 percent in 2004. Over 45 percent anticipated providing care on extramural clinical rotations for between one and four weeks during their senior year, a decline from 2004 but similar to the percentage reported in 2003. Over 43 percent of seniors reported providing oral health care during extramural rotations for at least five weeks, with 27.3 percent spending at least seven weeks providing care. The percentage providing at least five weeks of care, 43.2 percent, is greater than the 36.9 percent and 34.2 percent reported in 2003 and 2004, respectively.

Seniors were asked to report whether the length of time spent providing care was inadequate, appropriate, or excessive. The responses by number of weeks spent providing care are reported in Table 33⇓. In 2005, there were substantial drops in the percentage of seniors reporting the time spent in extramural rotations as inadequate between one and two weeks, 41.6 percent to 28.8 percent, and between two and three weeks, 28.8 percent to 21.4 percent. Only 17.2 percent of seniors spending four weeks in extramural rotations felt it was inadequate. Of seniors spending no time in extramural clinics, 56.5 percent felt it was inadequate. The most substantial increase in the percentage of seniors reporting that the time spent in extramural clinics was excessive occurred between five (7.6 percent) and six weeks (16.2 percent). Even among seniors spending twelve or more weeks in extramural clinics, less than 20 percent felt it was an excessive length of time.

Most seniors, 65.3 percent, felt that they were more productive when working in extramural/off-site rotations than the main school clinic with 42.3 percent reporting that they were “much” more productive. This is a slight increase over 2004. Almost 15 percent reported that they were equally productive in both locations, providing similar amounts of care during comparable periods of time. The remaining 19.8 percent reported greater productivity in the school clinic than at extramural/off-site rotations with 11.3 percent reporting that they were “much less” productive in the extramural rotations.

In 2005, 8.7 percent of seniors reported that their experience in extramural clinical rotations was “negative” or “very negative.” This is a slight increase from the almost 8 percent of seniors reporting a “negative’ or “very negative” experience in 2004. The reported extramural experience was “neutral” for 27.5 percent of seniors, while 58.3 percent of seniors reported a “positive” or “very positive” experience in their extramural rotations.

Seniors were asked to rate how good they considered the technical quality of care received by patients at the extramural/off-site and main clinic locations (Table 34⇓). Almost 76 percent of seniors reported that they felt technical care was “very good” or “excellent” at the main clinic, whereas only 59.7 percent reported technical care as “very good” or “excellent” at extramural clinics. Seniors were asked to rate their perception as to how well patients were treated as people at both extramural/off-site and main clinic locations. A slightly greater percentage reported the treatment of patients as “very good” or “excellent” at the main clinic (68.1 percent) than at extramural clinics (63.6 percent).

The level of seniors’ participation in quality assurance activities, such as chart audits, critical incident reviews, and casting control, was also reported for both the main clinic and extramural clinics (Table 35⇓). Over 70 percent of seniors reported that they “never” or “seldom” participated in quality assurance activities at extramural clinics; only 35.1 percent reported “never” or “seldom” participating in such activities at the main clinic. These percentages were similar to those reported in 2004.

Seniors used a five-point Likert (1=low; 5=high) scale to rate the emphasis given to preventive orientation and services in both the extramural clinic and the main clinic (Table 36⇓). A higher emphasis was reported at the main clinic, with 56.7 percent of seniors rating the emphasis as 4 or 5. With respect to extramural clinics, 32.7 percent of seniors reported the emphasis on preventive orientation and services as 4 or 5 (high). These percentages are similar to those reported in 2004.

Seniors were asked to report the effect of their extramural experiences on their ability to care for racially, ethnically, and culturally diverse populations (Table 37⇓). On a five-point Likert scale (1=low; 5=high), 75.3 percent of seniors reported a somewhat (3) to high (5) impact on their ability to care for diverse groups. Using the same scale, 41.3 percent of seniors reported that their extramural experiences had a “somewhat” to “high” effect on their practice location plans. These percentages are quite similar to those reported in 2004.

Seniors were asked to report how well they agree with a series of statements using a four-point scale ranging from “strongly agree” to “strongly disagree.” With respect to the statement “the cultural and social environment of your school promotes the acceptance and respect of students and patients of different races, ethnicities, and cultures,” 81.8 percent of students “agreed” or “strongly agreed” (Table 38⇓). A greater percentage of minority students, including 29.1 percent of Native Americans, 21.6 percent of Asian/Pacific Islanders, 32.8 percent of black/African Americans, and 19.1 percent of Hispanic/Latinos, reported that they “disagree” or “strongly disagree” than did white students (15.2 percent).

When asked whether they felt that low-income underserved individuals and populations are more challenging to serve because they present with so many problems, 61.5 percent agreed or strongly agreed that this statement was true. A greater percentage of black/African American (57.9 percent) and Hispanic/Latino (40.3 percent) respondents disagreed or strongly disagreed than did Asian/Pacific Islander (37.3 percent), American Indian/Alaskan Native (38.7 percent), and white (37.2 percent) respondents.

The 2005 survey also included a series of statements related to access to oral health care using the same scale. The first asked students whether they agreed with the statement that “access to oral health care is a societal good and right.” Nearly 22 percent of students disagreed or strongly disagreed with the statement (Table 39⇓). Native American (40 percent) and white (23.6 percent) students were much more likely to disagree that access to oral health care is a societal good and right than Hispanic/Latino (18.5 percent), black/ African American (18.4 percent), and Asian/Pacific Islander (16.9 percent) students. This is consistent with 2003 and 2004, the first years in which the question was included in the annual survey.

Over one-quarter (27.4 percent) of seniors reported that they disagreed with the statement that “access to oral health care is a major problem in the United States” (Table 40⇓). This is slightly lower than the percentage reported in 2004, 28.6 percent. In 2005, the percentage of Asian/Pacific Islander, Hispanic/Latino, and white students who disagreed or strongly disagreed was similar, ranging from 25.1 to 27.7 percent. The percentage of black/African American seniors disagreeing or strongly disagreeing was lower, 19.4 percent. The percentage of Native Americans who disagreed or strongly disagreed was 38.8 percent.

When asked whether “ensuring and providing care to all segments of society is an ethical and professional obligation,” 18.6 percent of seniors disagreed or strongly disagreed (Table 41⇓). Hispanic/Latinos were the least likely to disagree/strongly disagree (9.3 percent). Asian/Pacific Islanders (16.4 percent) and black/African Americans (14.7 percent) were also less likely to report disagreeing or strongly disagreeing. Among whites and Native Americans, 20.4 percent and 29.1 percent respectively reported that they disagreed or strongly disagreed that “ensuring and providing care to all segments of society is an ethical and professional obligation.” These percentages are similar to those reported in prior years.

Seniors were also asked whether they agreed or disagreed with the statement that “everyone is entitled to receive basic oral health care regardless of ability to pay.” More than one in four students (27.5 percent) disagreed or strongly disagreed (Table 42⇓), slightly less than the 28.7 percent reported in 2004. In 2005, the percentages of Asian/Pacific Islanders, black/African Americans, and Hispanic/Latinos disagreeing or strongly disagreeing were similar (18.5 percent to 20.9 percent). The percentage of white and Native American students who reported that they disagreed/strongly disagreed was higher, 31.4 percent and 38.7 percent respectively.

Plans for Postdoctoral Education

In 2005, 47.5 percent of the responding seniors applied to a postdoctoral dental education program (Table 43⇓). This is the lowest percentage since 2000, when 47.2 percent applied for postdoctoral education and 1.5 percentage points less than the peak of 49 percent in 2003.

Seniors were asked to report their opinion as to whether students should be required to complete a year of postdoctoral dental education. In 2005, 27.5 percent supported a required year (Table 44⇓). This is substantially less than the 47.5 percent who applied for postdoctoral training, indicating that many who choose to pursue advanced education do not believe such training should be mandatory. The 27.5 percent who supported mandatory postdoctoral training in 2005 is more than reported in 2004, but remains less than the 28.5 percent reported in 2003. Overall, the percentage has fluctuated between 25.6 and 31.6 percent since the question was first asked in 1996.

Of students who reported whether they had applied to one or more postdoctoral dental education programs, 30.4 percent had applied to a general practice residency (GPR) program or advanced education in general dentistry (AEGD) program, and 23.9 percent applied to a specialty program (Table 45⇓; Figure 7⇓). These percentages are consistent with those reported in prior years. The percentage of students applying to specialty programs dropped from the percentage reported in 2004, but remains above the percentage reported in 2003. Based on the overall percentage of students applying for postdoctoral education, it is apparent that some students applied to both GPR or AEGD programs and specialty programs.

At the time they completed the survey, 27.2 percent of seniors had been accepted by at least one GPR or AEGD program; thus, 89.5 percent of applicants to GPR and AEGD programs were accepted. This is an increase from the past several years and similar to the percentage reported in 2000. An additional 3 percent of applicants were still under consideration at the time they completed the survey. An additional 3.3 percent of applicants withdrew their applications, and 4.3 percent of applicants were not accepted to a GPR or an AEGD programs.

In 2005, 23.9 percent of seniors reported applying to one or more specialty programs. While this percentage is less than in 2004, it is similar to percentages reported in 2002 and 2003. At the time of the survey, 17.6 percent of seniors, or 73.6 percent of those who applied, had been accepted to at least one specialty program. This is greater than the prior four years when between 69.1 and 70.9 percent were accepted. In 2000, 76.6 percent of specialty program applicants reported being accepted by at least one program. In 2005, an additional 4.6 percent of applicants were still being evaluated by at least one specialty program. Over 18 percent of applicants were not accepted to a specialty program, and 3.3 percent had withdrawn their application.

Over 71 percent of specialty program applicants reported that programs in orthodontics (30.7 percent), oral and maxillofacial surgery (20.9 percent), or pediatric dentistry (20.1 percent) were their first preference. These programs have historically been the specialties most often pursued by seniors. An additional 11.2 percent reported endodontics and 8.2 percent periodontics as their preferred specialty program. The percentage pursuing orthodontics or oral maxillofacial surgery increased in 2005. The percentage pursuing pediatric dentistry, endodontics, and periodontics slightly decreased.

Over 200 seniors reported that they had applied to dental school-sponsored advanced dental education programs offering certificates or degrees that were not accredited by the Commission on Dental Accreditation. The most frequently reported programs were operative/restorative dentistry (thirty-three applicants) and oral biology (twenty-nine applicants). Eleven students applied to oral medicine, ten students to anesthesiology, and eight to oral science programs. Other types of programs to which dental students reported applying included biomaterials (five applicants), geriatrics (four applicants), and preventive dentistry (two applicants). Additionally, 103 students reported applying to another type of advanced dental education program that was not listed.

In 2005, 106 seniors reported a nondental education program to which they had applied. The most common types of nondental education programs were basic science (twenty-four applicants) and behavioral science (twenty-three applicants). Eleven applied to programs in business administration and nine to programs in medicine. Six respondents applied to law programs and four to education programs. The remaining twenty-nine reported applying to some “other” type of nondental education program.