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ADA task force seeks answers to questions on student debt

The mounting pressures of dental education debt are leading the ADA to examine the issue more closely.

In response to directives from the 2011 House of Delegates, the Task Force on Dental Education Economics and Student Debt was appointed to study the economics of dental education, including student debt and its impact on new graduates and access to care for vulnerable groups. The task force is in the process of developing a comprehensive analysis of these issues with short- and long-term recommendations. The 2012 House will receive a preliminary report from the task force with a timeline for completion of the study.

Image: Dr. Rich
Dr. Rich

“Student debt in itself appears to have far-reaching effects on our profession,” said Dr. W. Ken Rich, ADA 6th District trustee and chair of the task force, which includes members of the Board of Trustees, the Council on Dental Education and Licensure, and the New Dentist Committee.

“It potentially impacts everything from educational models to practice models to the cost of dental care itself,” he said. “Many of the issues we face today such as access to care are being driven to a large extent by economic forces. It is imperative that we understand the forces that shape our future, and hopefully this study will shed light on that.”

One thing is clear: the cost of dental education has risen dramatically. According to the American Dental Education Association, the average resident tuition and fees for first-year students at U.S. dental schools rose 57 percent, from $20,914 in 2000-01 to $32,934 in 2009-10. When expressed in constant dollars, student debt upon graduation has increased by almost $100,000 in the past 20 years and almost $20,000 in the past five years.

The cost increases mirror what’s happening in all of higher education, but what does it mean for dental education and the profession?

“We believe that it’s having an impact on practice models, and we will attempt to learn more about that through this study,” said Dr. Rich. “We want to know if educational debt affects who can go to dental school; whether it affects dental delivery systems; if graduates are still able to make choices on where they practice after graduation; whether private practice is a viable choice for students with high levels of debt; and whether the corporate practice model is growing because of debt or by choice.”

Right now, the task force is conducting research based on study questions that include: 

  • What are the operating costs of a dental school, how are the costs financed and how has it changed over time?
  • What are the trends in dental student debt and how does it compare to higher education in general?
  • What innovations have dental schools pursued to reduce operating costs?
  • How many loan forgiveness programs are available to students and how effective are they in reducing debt and improving access?
  • What impact does student debt have on graduates’ employment choices?
  • What is the role of educational institutions, students, residents and new graduates in the dental safety net and what innovations have happened in recent years?
  • What innovations could dental schools do in collaboration with ADEA to reduce student debt?
  • What are schools doing to teach debt management in regard to student loans?

The analysis will require data collected from ADEA, the Commission on Dental Accreditation, the American Student Dental Association and the ADA Health Policy Resources Center.

Ben Youel, an ASDA vice president, said the issue of educational debt is “big on ASDA’s radar” right now.

“An argument could be made that this is the most significant issue facing dental students,” said Mr. Youel. “Student debt levels are directly related to the practice choices we make after graduation and affect other professional issues like access to care and corporate dentistry. It’s a big issue that only seems to have increased in importance in recent years.”

The task force will meet in conjunction with the January 2013 National Roundtable for Dental Collaboration, an annual event that gives dental associations the opportunity to identify and assess common challenges in the delivery of oral health care and work collaboratively to address those challenges. Dr. Richard Valachovic, ADEA executive director, will chair the program.

The task force’s charges are based on House Resolution 66H-2011, requesting the study of the economics of dental education, and Resolution 91H-2011, which called for an investigation into a student loan repayment grant program for dentists working in a nonprofit community dental clinic. Many programs are already in existence, said Dr. Rich, but more information is needed on their availability and the impact they have on attracting dentists to rural and underserved areas.