Motivations of orthodontic residents in Canada and the United States to treat patients with craniofacial anomalies, cleft lip/palate, and special needs.

OBJECTIVES: To determine the motivation of orthodontic residents in Canada and the United States to treat patients with cleft lip/palate (CLP), craniofacial anomalies (CFA), and special needs (SN). METHODS: In March 2009, an e-mail with a link to a 41-item survey was sent to all orthodontic residents in Canada and the United States (n  =  944). RESULTS: Of 944 residents contacted, 339 viewed and 208 completed the survey (22.03%). Using a seven-point Likert scale, residents recognized the importance of treating patients with CLP/CFA/SN. When asked if they plan to treat patients with CLP/CFA/SN, 54.48% responded yes, 13.46% no, and 36.06% were unsure. A total of 38.05% said they would charge the same fee as a typical multiarch case, while 58.05% would charge more, and 60% of fourth-year residents would charge twice the fee. Of the respondents, 43.00% were aware of the established fellowship programs in CLP/CFA/SN. Canadian residents (67.9%) were more enthusiastic about completing a fellowship than Americans were. Of the respondents, 29.33% would complete a 1-year fellowship, while 70.67% would not. A total of 78.4% of male respondents and 77.4% of American residents indicated they would not pursue a fellowship. CONCLUSIONS: Residents supported the importance of treating patients with CLP/CFA/SN, and more than 54% indicated they plan to treat these patients. Residents who indicated that they would not treat these patients sited limited experience and inadequate expertise as the reasons. Less than 30% indicated a willingness to pursue a fellowship program.

Motivational factors and future life plans of orthodontic residents in the United States.

INTRODUCTION: The purposes of this study were to investigate factors influencing career choice and identify future life plans of orthodontic residents in the United States. METHODS: Program chairs and directors of all 65 orthodontic residency programs in the United States were contacted by e-mail and telephone for permission to e-mail their residents and invite them to take part in on online survey. A total of 335 residents from 37 programs were invited to complete an anonymous 57-item questionnaire in May 2007. Data were categorized, and basic statistics including chi-square comparative analyses were performed. RESULTS: A total of 136 (40.60%) residents completed the survey. A "passion for orthodontics" emerged as the most important factor (20.29%) influencing the decision to pursue orthodontics as a career, followed by "intellectual stimulation or challenge" (18.12%). Most residents decided to become an orthodontist before they were in dental school (44.93%). Most residents (89.05%) plan to engage in private practice, and only 2 intend to pursue primarily an academic career. The average resident debt was $165,226 at the end of their program. CONCLUSIONS: The decision to become an orthodontist is often made early in life, before dental school, and a passion for orthodontics is the motivational factor. Residents plan to enter private practice and not pursue a career in academia. The current shortage of academics and orthodontic researchers will not be resolved from the current pool of orthodontic residents. A possible solution to the academic crisis is to change the selection criteria in programs to accept orthodontic residents who develop a passion for orthodontics while in dental school or to recruit primary researchers and teachers to the specialty. Residents plan to practice in an urban setting. Rural and underserviced areas will probably continue to experience shortages of orthodontists in the future.

Future practice plans of orthodontic residents in the United States.

INTRODUCTION: The purpose of this study was to investigate the future clinical practice plans of orthodontic residents in the United States. METHODS: All program chairs and directors of the 65 US orthodontic residency programs were contacted by e-mail and telephone and asked for permission to e-mail their residents and invite them to take part in an anonymous 57-item questionnaire online. A total of 335 e-mails from 37 programs were obtained, and the survey was sent in May 2007. Basic statistics including chi-square comparative analyses were performed by sex, age, and year of program. RESULTS: A total of 63.04% of orthodontic residents plan to use self-ligating brackets; 84.06% plan to use Invisalign (Align Technology, Santa Clara, Calif); 92.03% plan to use temporary anchorage devices, and 72.26% plan on placing them themselves; 28.26% plan to use cone-beam computerized tomography; 92.75% plan to use a digital imaging program; 45.65% plan to use indirect bonding; and 10.87% plan to use lingual orthodontics. A total of 70.07% plan to use 2-phase treatment, and 61.59% said they will use functional appliances. A total of 81.16% plan to become certified by the American Board of Orthodontics, but only 18.12% thought certification should be mandatory for licensure; 36.50% indicated that a master of science degree should be required in their program, and 77.94% believe that a 24- to 30-month program adequately prepares them for future orthodontic practice. CONCLUSIONS: Newer orthodontic technologies such as self-ligating brackets, temporary anchorage devices, and Invisalign as well as functional appliances are expected to grow in popularity in the United States because of projected future use by orthodontic residents. Two-phase orthodontic treatment with functional appliance mechanics will continue to be used. Most orthodontic residents will become certified by the American Board of Orthodontics but do not believe it should be necessary for licensure. Orthodontic residents in the United States believe that a 2-year program adequately prepares them for private practice.

Resident evaluation of orthodontic programs in Canada.

The purpose of this study was to investigate the satisfaction of Canadian orthodontic residents with their programs and determine the scope of their training. An anonymous online questionnaire was sent to all Canadian orthodontic residents in November 2006. Data were assembled and categorized by different variables, and chi-square comparative analyses were performed. Forty-four out of fifty-four residents responded, giving a participation rate of 81.48 percent. Overall, 86.36 percent of responding residents were satisfied with their program. Respondents said they felt they received the appropriate amount of formal didactic teaching sessions and dedicated and protected academic time. All residents indicated their programs offered training in numerous treatment philosophies: 93.18 percent said they have sufficient clinically based training, and 72.73 percent indicated that their research-based training was sufficient. All responding residents indicated they will complete more than thirty patients from start to finish, and 25 percent estimated completion of more than seventy patients by graduation. Residents said they will complete on average five orthognathic surgery, twenty-four extraction, thirty-one non-extraction, eight adult, and thirteen patients in the mixed dentition. Only 50 percent said their programs contained care for disabled or underserved patients. Most (86.36 percent) said they feel they will be adequately prepared to provide unsupervised orthodontic care after graduation. These orthodontic residents indicated they collaborate most with the disciplines of oral surgery, periodontics, and prosthodontics. However, only 52.27 percent indicated they have a formal interdisciplinary program for treating patients. We conclude from the study that Canadian orthodontic residents are satisfied with the didactic, clinical, and research aspects of their programs. They receive comprehensive instruction with the opportunity to complete a significant number of patients, employing a variety of treatment approaches.

Resident evaluation of orthodontic programs in the United States.

The objective of this study was to investigate the satisfaction of orthodontic residents in the United States with their programs and determine the scope of their training. Program chairs/directors of all sixty-five U.S. orthodontic graduate programs were contacted for permission to email their residents. A total of 335 residents from thirty-seven programs were invited to complete an anonymous, online, fifty-seven-item survey in May 2007. Data were categorized, and basic statistics were performed. A total of 136 (40.60 percent) residents completed the survey. Overall, 75.74 percent were satisfied with their program. Residents said they feel they receive appropriate didactic teaching sessions and dedicated academic time (60.29 percent). Most residents (92.70 percent) indicated their program offers training in numerous philosophies, while 80.29 percent said they have sufficient clinically based training and 59.85 percent said they have sufficient research-based training. A total of 57.66 percent said they will not complete more than thirty cases from start to finish and on average treat two orthognathic surgery, thirteen extraction, twenty-four nonextraction, and nine adult patients. Most (92.70 percent) said their program contains care for disabled or underserved patients; most (92.70 percent) said they feel they will be adequately prepared to provide unsupervised orthodontic care after graduation; and 54.41 percent said they think other specialties have a positive view of orthodontics. Only 58.09 percent indicated they have a formal interdisciplinary program for treating patients. We conclude that U.S. orthodontic residents are satisfied with their programs. They receive training in a variety of approaches; however, inadequacies in exposure to interdisciplinary teaching and a limitation of the number of cases started and completed were identified. These observations may be a result of program length due to the preponderance of twenty-four- to thirty-month programs.