Our latest DCT survey shows very worrying trends, particularly among trainees in Northern Ireland. Over half of respondents rated their morale as low during their training post. Pay disparity was a major factor, with many finding it demoralising to take a pay cut at the same time as trying to take the next steps on the career ladder.
As part of the hospital committee, I've taken the opportunity to get involved and understand more about the issues facing trainees. I believe it must be stripped back and reworked into something that is fair for everyone.
Starting out as a young dentist
After qualifying, dental student's complete a year of compulsory training as Dental Foundation Trainees (DFTs). After this, Dental Core Training (DCT) gives students the opportunity to spend up to two or three years learning different specialities.
The process to gain a DCT place is highly competitive, each time you go up a tier of DCT, fewer places are available. Candidates must be able to excel at exams, undertake interviews and in some cases also take part in Situational Judgement Tests to show their practical skills. The DCT programme is run by Health Education England and is centralised across all four devolved nations.
Many are feeling underappreciated, doing the same job as peers for significantly lower pay.
Through our survey we have learnt that over 70% took a pay cut when moving from a DFT to a DCT post in Northern Ireland, with three in four not being aware of the pay cut before taking the post. Trainees also report feeling very demoralised. Many are feeling underappreciated, doing the same job as peers for significantly lower pay. This is leaving dentists who are right at the start of their careers, already facing health and wellbeing issues.
An unfair system
The UK-wide system is competitive no matter which nation you work in. Many assume that this means you receive the same pay, for the same role, no matter the location. However, this isn't so. Any potential trainee enters the process rightly expecting complete transparency in job adverts. Unfortunately, the system is neither transparent nor fair.
In 2016, there was a change in the contracts, affecting pay scales. This resulted in increases being awarded at each DFT/DCT level depending on experience. In Northern Ireland however, the starting pay point for graduating students was set much lower, resulting in speciality training salaries being lower the whole way up the DCT scale. Incredibly, DCT trainees experience a pay cut from their Foundation year. Trainees in Scotland face similar issues.
Trainees moving from DCT to speciality training are losing up to £10,000 a year compared to those in other nations.
This disparity is completely unjustifiable. Trainees moving from DCT to speciality training are losing up to £10,000 a year compared to those in other nations. This is a huge loss of potential earnings over the course of your training. Students are being let down because of the way the banding has been set up despite achieving the same competencies under a national recruitment process.
Some young dental trainees want to stay in Northern Ireland because of family commitments, friends and because it is home. Others have mortgages to pay, making it difficult to up sticks for better pay. Some trainees feel cheated, especially as, in some cases they only discover the lower pay once they have signed the contract and started the job. The refusal to put pay scales on job adverts unnecessarily misleads and demoralises trainees.
What we're doing
Young dentists are feeling undervalued and underappreciated. We've made clear that this is a dangerous trajectory that cannot be allowed to continue.
We've raised the situation with the Department of Health and the postgraduate Deanery. I've personally sent letters to the Minister of Health in Northern Ireland, and we have met with the Department of Health. Each new conversation brings excuses and lost information or files rather than answers. Each time a deadline has been set to take things forward, it has slipped.
Lack of parity isn't right and to resist resolving the issue shows a complete institutional disregard for trainees. At one time the Department of Health stated that the pay is not equal because you do not need to be as competent to work in Northern Ireland. The statement has since been softened, but many trainees remember the comments and the damage has been done. Our team are persistent, doing as much as possible to negotiate on this issue.
Looking ahead
In Northern Ireland, a gap in trainees is beginning to open. Students are moving away, and talent isn't being retained. This is the inevitable consequence of such an unfair system. We will keep working and lobbying to ensure we can close this gap with more than a sticking plaster. HEE must face up to the reality of the situation.
We have calculated the cost of living in major cities, mapped against potential earnings to help you make an informed decision about where to apply for training. We are aware trainees are facing similar pay disparity issues in Scotland too, including a pay gap between junior dentists and doctors. We are currently gathering more data on pay disparities across all UK nations and will keep you updated with our progress.
I encourage any trainees, students, and young dentists to join the BDA and work with us to make sure your voice is heard. Young dentists are our future, and we will continue to fight to make your voices heard and speak up about the issues that are important to you. Stand up and be counted.