The U.S. dental industry faces declining numbers of new dentists, particularly in rural and underserved areas. Nova Southeastern University tackles the problem head-on.
On Friday, Oct. 28, Nova Southeastern University’s Clearwater campus dedicated its Drs. Kiran and Pallavi Patel International Dental Program, an initiative that aims to help overcome several challenges facing the U.S. dental industry.
Not only are not enough students pursuing careers in dentistry, but those who do graduate are much more likely to practice in cities and urban settings as opposed to rural communities and other areas of need. The problem has worsened to the point that nearly 60 million Americans live in places that are considered dental care health professional shortage areas (HPSAs). According to 2020 data that appears in a dental industry trade publication, it would take nearly 11,000 new dentists to eliminate the shortage.
“If you take a look at the number of dentists in Florida, they're so concentrated in the urban, highly populated areas,” says Dr. Hal Lippman, executive associate dean of operations at NSU’s College of Dental Medicine. “There are so many areas in Florida that are tremendously underserved. Opening this program in Clearwater hopefully will help solve some of the access to care problem.”
The shortage is exacerbated by the fact that foreign dentists, who’ve trained and met all qualifications in other countries, can’t pursue a path to practice in the United States unless they essentially start from scratch and go back to school as first-year dental students.
“You would cry over some of the stories, some of the journeys that they’ve taken,” Lippman says. “When they came to this country, they were basically forced into the profession as assistants and hygienists; there’s nothing wrong with that, but if you’re trained to do something, it can be frustrating.”
So how will NSU’s International Dental Program accelerate the graduation rate for international dental students without running afoul of federal regulations?
The answer begins with the “C” word — compromise. International students must still complete a 39-month program, but they essentially get to skip the first year of dental school.
“The unique situation here is that it’s basically a standalone international dental graduate program,” Lippman says, adding that more than 400 people applied but the program currently can accommodate only 38. After their first year, students will do the same coursework and training as the non-international students at NSU’s Clearwater campus as well as its main campus in Davie.
“I am excited — it is something that serves two purposes,” says cardiologist and health care entrepreneur Dr. Kiran Patel, who has donated $240 million to NSU, including the funds for its Clearwater campus and new dental program for international students. Patel famously bought WellCare in 1992 for $5 million and sold it a decade later for $200 million. Today, he’s one of the most prominent and generous philanthropists in the Tampa Bay region.
“First is the needs of society,” Patel continues, “and second is that we are providing opportunity to people who are well qualified and had training in other countries, but then we ensure they meet U.S. standards. We’ve met the community need, and at the same time, a professional who was trained somewhere else can become a productive citizen in the new home he has created.”
NSU President and CEO George Hanbury says the program mirrors the diversity of the United States and thus provides students with not only clinical skills, but knowledge that will help them settle in their new home.
“We’ve got 38 students from 16 different countries,” he says, “just like a melting pot, which America is. It gives them the opportunity to assimilate and not only get to know other students from other countries, but Pinellas County and the Tampa Bay region. I think that gives some cultural comfort to them.”
'We are providing opportunity to people who are well qualified and had training in other countries, but then we ensure they meet U.S. standards.’ Dr. Kiran Patel
One of those students is Jorge Quisoboni, a dentist from Colombia who immigrated to the United States in 2017 and worked as a periodontist in the Fort Lauderdale area, where his wife lives, before deciding to pursue a doctoral degree in dentistry.
“I’m very happy to be here,” he says. “We have brand new facilities; we’ve got great professors. We’re happy with the efforts the whole university is putting in here.”
Other than the long drive back to Fort Lauderdale, Quisoboni says, “everything is perfect.” He would like to practice dentistry either in Southeast Florida or the Tampa Bay region but, mindful of shortages, is open to exploring opportunities in smaller, underserved communities. “There are always opportunities out there. You just have to look for the right one for you.”
Upon graduation, Lippman says, international students will “have freedom of movement throughout the United States, with no restrictions for licensure.” Also, they’ll be encouraged to practice in underserved areas. “That was the original intent of the program,” he says, “to help the access to care problem.”
Best in class
NSU International Dental Program students will have access to a 19,000-square-foot training facility that features 64 dental chairs, three surgical suites, a simulation lab and supporting offices and classrooms. Beginning in May 2023, Lippman says, area residents will be able to go there for dental treatment. Until then, students will practice on artificial but extremely lifelike human heads and mouths.
The College of Dental Medicine also plans to forge partnerships with health care facilities in less-populated areas that will see NSU dental students provide care to residents who might otherwise struggle to get their dental health needs met. Lippman expects that initiative to go over well.
“This group of dental students, who are international dentists, are very community minded,” he says. “They come from various backgrounds and understand how important it is to develop that civic responsibility of giving back and helping all populations that are in need.”
Expectations for the students are high, Patel says, because all of them are already established, knowledgeable professionals.
“The majority would have been in practice for five, seven years, whatever it may be,” he says. “It’s not like they come straight from the college here. So, on the practical side, they may have a lot more experience, but we are making sure they are doing things to our standards.”
Lippman describes the applicant evaluation process as “rigorous.” The dean of admissions and a special committee "evaluate each application on its individuality. They look at them holistically.”
Lippman says international applicants can sometime be difficult to evaluate “because we don’t know the curriculum of each of the international programs.” Applicants will be required to take and pass a test of English as a foreign language, or TOEFL, exam, in addition to passing the comprehensive U.S. national board exam. They must also have their academic transcripts translated by a U.S. accreditation company.
“Once we credential them and deem them acceptable,” Lippman adds, “then we bring them in and put them through a rigorous bench test, basically testing their fine motor skills and their knowledge in the application of practical procedures in dentistry.”
That’s all well and good, but what about one of a dentist’s most important skills — making patients less afraid?
“A key word in not only dentistry, but in every other discipline, is communication,” says Quisoboni, the student from Colombia. “If you communicate a message correctly, and it gets out there, that's when you're doing the right thing. Once you really connect with people and you get the message across, and they understand what the whole thing is about, that's when you start to be successful.”