Written by Sebastian Schreijer
Over the past five years, many dentists from all over Europe have found their way to the Netherlands. The reason for this is simple. While the job markets in countries such as Spain, Portugal and Italy were struggling to recover from the economic crisis, the dentistry sector in the Netherlands was facing a deficit of another kind. Propelled by a retiring generation of dentists, there was a growing number of vacancies, but not enough graduates to fill their shoes.
Several years and many hundreds of foreign dentist arrivals later, the problem has not just remained unresolved – it has been growing. But why?
Demographics & Retirement
In order to understand why the Netherlands – a country with high-quality dental care and a comparatively strong economy – is facing an increasing drought of new dentists, we first have to know how this situation arose.Demographic developments are a major factor in the growing shortage of dentists. Out of the approximately 10,000 dentists working in the Netherlands as of 2017, only 29% were below the age of 40. Furthermore, a majority of those under 40 (56%) were female. With Dutch women often working part-time in order to combine their careers with their families, the effective amount of FTE ready to rejuvinate the aging dentist population is not enough to saturate the market.
Even though Dutch dental clinics find it increasingly difficult to hire adequate new personnel, the three Dutch universities that offer a dentistry curriculum work with a numerus clausus. This means that, every year, no more than 240 dentists graduate and enter the job market. By comparison, the annual number of dentists who retire is 300.
In spite of this imbalance, the Dutch government has thus far not taken steps to adjust or abolish the fixed number of students who can enroll as dentistry students. A possible reason for their stance are the high costs affiliated with educating a dentist.
The prolonged deficit of Dutch graduates did open up opportunities, as it allowed dentists from other parts of the European Union to continue or even start their careers in the Low Countries. Holland became an especially attractive destination for professionals from Southern Europe, with countries such as Spain dealing with the reverse problem: plenty of dentistry graduates but not enough jobs.
Further motivated by the generally much higher salaries in the Netherlands, hundreds of dentists from other countries came to work in Dutch clinics each year.
Earlier this week, the Royal Dutch Dentistry Society (KNMT) rang the alarm bell in the national newspaper AD. In addition to the low number of new graduates, the amount of new arrivals of dentists from abroad has seen a sharp decline. The main reason is a language exam that, as of January 2017, all foreign dentists are obliged to take.
This language exam is a prerequisite for admission into the BIG, the national registry of all medical professionals working in the Netherlands. Without a BIG registration, a dentist is not allowed to exercise his profession without supervision.
In effect, this means that everyone who has a dentistry degree from a foreign university has to prove that they are able to speak Dutch at a professional (B2) level. In addition to language skills, the ability to communicate clearly with patients and colleagues is also evaluated.
A Drop In Applications
A year after the introduction of the language test, the effects on the arrival of dentists from other parts of Europe is noticeable. Only 109 foreign dentists applied for a BIG registration, compared to 390 a year earlier. While the influence of gradual economic recovery in Southern Europe cannot be ruled out, it does not account for a 72% drop in applications.
Ultimately, the effects of the growing shortage of dentists are the most apparent in the peripherical regions of the Netherlands. While clinics in the Randstad metropolitan area – which contains such major cities as Amsterdam, Rotterdam, The Hague and Utrecht – may still receive several applicants for a vacancy, dentists in the country’s more outlying regions struggle to find new colleagues.AD gives the example of a dentist in the Eastern province of Overijssel, who had to wait five years before he finally found a suitable candidate to take over his clinic – a dentist from Spain. This is not an exception, as most Dutch dentistry graduates prefer to stay inside the Randstad.
Even if the East and South of the Netherlands might not offer the big-city bustle of Amsterdam, working in these quieter, more rural parts of the country does come with its own array of advantages for professionals. Wages tend to be higher and housing prices lower, offering a sense of comfort that is much more difficult to come by in the urbanized West.
Despite the KNMT’s warning, the Dutch Ministry of Public Health has stated that it does not consider the recent developments in the dentistry sector to be problematic. However, they are still considering increasing the number of available spots for new dentistry students in the future.
Even with that prospect, the demand for dentists from other European countries is not likely to decline for many years to come. With the language exam, the bar for entry has become higher, but with the proper amount of preparation, it is a challenge that can by all means be overcome.
Out of the 109 non-Dutch dentists who registered with the BIG over the past year, 45 came through the DPA program. In response to the new legislation, DPA Dentistry adjusted its own course to optimally prepare the dentists for the language exam. These new additions to the program include a month of e-learning before the start of the course, custom-made study materials focused on dentistry-related Dutch, and intensive exam training near the end of the course.
Though the shortage of dentists in the Netherlands is a problem for clinics, it also comes with tremendous opportunities for European dentists who have the dedication to prove themselves in a Dutch dental clinic.
For more information on the DPA Academy, click here.