With the amount of debt that dental students accrue on the rise, Neel Kothari considers whether young people are being deterred from entering the dental profession by finance.
As I return from my 20-year dental school reunion in the wonderful city of Bristol, it strikes me that much has changed over the past two decades and the challenges faced by our newer members are almost unrecognisable from my own experiences.
Perhaps the most staggering is the amount of debt new graduates are facing, where student loans of around £100k are now commonplace amongst those who have had to self-fund their studies. The compound interest on this debt starts from year one, which means that students on courses of a longer duration like dentistry and medicine are disproportionately affected.
Several new graduates have reported to me that, despite paying back their loans for the past few years, the current interest rates (linked to inflation) mean that their loans just keep growing.
One could argue that a loan linked with inflation means that it doesn’t actually grow, however student loans aren’t your typical loan where repayments are made based on what you owe, but rather a percentage of what you earn above a threshold amount (currently £25k). For this reason, money saving expert Martin Lewis suggests one should consider student loans more like a graduate tax, stating: ‘In practice what happens is you effectively pay an extra 9% tax on your income for most of your working life.’
Okay, so perhaps the word ‘crippled’ in the title is a bit misleading, but a graduate tax of 9% on top of income tax we all pay is a hefty burden and certainly not inconsequential.
NHS tie-in proposal
A recent government proposal (May 2024) to tie in dental students to NHS dentistry states: ‘Dental students in England receive a fantastic deal, with access to high quality education and training supported by a significant investment by the taxpayer.’ While in part accurate, there is no doubt that much of this investment is now absorbed by the individual and to suggest they are receiving a ‘fantastic deal’ borders on delusion.
Recent graduate Lottie Bailey tells Dentistry.co.uk: ‘Becoming a dentist was always my ambition. However, coming from a low socio-economic background meant that I had to rely fully on student and maintenance loans to fund my five-year studies. Now, four years qualified, I find myself approaching £110,000 worth of debts that seems to rise year on year due to the levels of interest.
‘Whilst dentistry has afforded me financial privilege, there is a big difference between graduates like me and those whose families were able to financially support them. It doesn’t feel like a level playing field.’
When asked how this has affected her career and personal progression, Lottie goes on to say: ‘I have not been in a financial position to attend all the post-graduate training courses I want to, which leaves me feeling that my career progression is slower and is potentially capped. I feel the heavy taxes on colleagues of my generation are a leading factor to what feels like a mass exodus to working in other countries (Australia in particular) – it simply doesn’t feel worth all the hassle to work in the UK system.’
Does debt affect how many people study dentistry?
It stands to reason that high student loan debts may impact on graduates’ decision-making, incentivising areas of dentistry that pay well whilst at the same time making it harder for some students to consider further studies, specialising or even working in lower paid areas of dentistry that they would have otherwise chosen to do.
It’s plausible that if the government do push ahead with an NHS tie in, dental students may come to the conclusion that it’s just not worth becoming a dentist if they are to be restricted for years after they graduate.
Of course, many in my day also struggled with finances and debt, this is nothing new, but the scale of change certainly is. Recent research published in the BDJ carried out by the BDA shows that the mean total debt of final year dental students and recent dental graduates has more than doubled, from £24,734 in 2013 to £52,922 in 2022. It’s safe to say that for those who come from lower socio-economic backgrounds who need to take the maximum loan available, these figures will be far higher.
The article reports that three in five (60.2%) respondents were experiencing financial difficulties while studying and over a quarter (28.2%) nearly did not come to university due to concerns about debts.
‘The thought of a £100k debt would have been enough to have put me off’
So why am I writing about this topic? Well put simply, dentistry has been good to me, both financially and otherwise. I like being a dentist, I like owning a dental practice and having the ability to afford my own house – but I can honestly say that if I had to choose to be a dentist in today’s climate, I am almost certain that from my background, I probably wouldn’t have done it.
The thought of a £100k debt would have been enough to have put me off even though I accept the overall financial outlook for dentistry is still good. Perhaps there is a hint of rosy retrospection but in my opinion graduate dentists today are in a far worse position than 20 years ago, particularly those from poorer backgrounds.
Read more from Neel Kothari:
- Is the dental profession biased towards water fluoridation?
- Are retention fees for departing associates being abused?
- Will 2025 be an economic disaster for the dental sector?
- The dangers of ‘bad science’ in dentistry
- What exactly can we say on social media?
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