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The dentist speaks part II

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    I realise that my long post was overwhelmingly negative. I apologise for that. I do genuinely want to help people though through the experiences I've had.
    Of course there are many positives to this career. However, I can see my younger self in so many of the people on here..naive (in a nice way), starry eyed and dreaming of untold riches and status and I had to burst that bubble for you as I really wouldn't want you to find out the hard way. Dentistry right now is in chaos in England.

    So, let me just get one last thing off my chest and then I'm gonna write some positive thoughts peppered with some reality lol. Someone thinks its easy to earn 60K + a year and thinks I'm exagerrating. It's ok..I wouldn't have believed that either before I understood the system.
    The NHS works via the UDA system so..usually a UDA is worth approx £9-10. Although be aware, there are dentists who will undercut you and work for less than that. An employer will ask why should I pay you £10/uda if I have someone to work for 8?

    Assuming a uda rate of £9-10

    band 1 (1 uda) checkups/emergencies (1.2)/simple clean...you get £9-10
    band 2 (3 UDAs) fillings, root canals, extractions..you get £30
    band 3 (12 UDAs) crowns, dentures..you get £120

    60K a year....so thats 6000 UDAs. Someone with 4-5 years of experience would find that quite tough. Working 5 days a week..you'd need to do about 30 UDAs a day. That would often mean 30+ patients a day. Don't forget you must pay lab fees, tax, professional reg fees/indemnity and NHS pension from that as well. Your take home pay will be less than you think. Ask a dental accountant, they'll say the same.

    You won't know what kind of dentist you will be after uni..you might be able to take 45 patients in your stride. However, many many cannot (myself included) and that's why so many newly qualified people hide away in hospital jobs for 3-4 years before reality hits them.

    The current system works great if everyone just needed 1 thing done. They don't!! English teeth are atrocious and many people need multiple work done. It does depend on the area you work in. But remember you get paid per treatment COURSE not per item. So, you wont get your money until you have done all the fillings, so you can work at a loss. Anyway, I don't wanna bore people with the minutiae of the new contract, you get the picture. Take home message: you'll have to see tons of patients, which doesnt allow you to spend the time you'd like on things and loads of things will have to be done as part of goodwill (ie free of charge). That can get very trying.

    Xmb's post about the VT being slow and having a chilled out day made me smile becuase that's exactly how most of us were lol..it's gonna hit like a freight train though when he realises just how much faster he will have to work for 50-60K. The target for VT is 1875 UDAs/year. Most do about 12-1300. That would earn you about £13000/year in a non VT environment. Don't believe what the press say..100K a year...thats probably before you've given 50-55% to the practice owner and then paid all the above expenses. That's assuming you can get full time work and want to do that 5 days a week from 8 til 5.30.

    Anyway, positivity time.

    1. Dentistry teaches you so many different skills. It's not just about teeth. People skills, practical skills, business management skills. Some of the best friends I ever made were in dental school. Unfortunately, I don't see them much now as we are scattered all over the place.

    2. No other career allows you the freedom and autonomy that you have so soon after graduating. You're the boss, you can decide the treatment and you are the head of the dental team in your surgery. What goes on in your surgery is up to you (though you'll have a boss/practice manager to answer to). Most nurses are very good and I would certainly be lost without them. But the rude, lazy ones need to be read the riot act at the earliest opportunity.

    3. The course may be long, but the feeling of accomplishment upon completiton is indescribable. If only you could bottle that and sell it!

    4. It's arguably the most portable career I can think of. Should you wish, you can work virtually anywhere, except North America. In reality, most rarely venture outside Aus/NZ. Yes, you can work in any EU country, but it's rare as you need to get through the language barrier, labyrinthine beaurocracy and then the task of actually finding someone who will employ you! Incidently, I have heard anecdotally that dentistry is lucrative in Australia, where the whole system is largely private. Don't expect to get a job in central Sydney though...a country town is more realistic.

    5. I am a people person. I love talking to people about their jobs, where they come from and the issues of the day. You meet some interesting people especially in central London. The only trouble is you're always looking at the clock so you can't talk for long.

    6. It's great helping people overcome their dental anxiety. Most people just need a bit of TLC and they will trust you. If you can master the art of painless injections you're onto a winner! But..almost every patient starts by saying how they don't like dentists and they don't want to be there.

    7. If you were able to get a practice (it'll probably be somewhere far from London), you could potentially make a lot of money. You'd need several people working for you. The trouble is, it's not that easy anymore. The greedy corporates have bought so many and practices cost a fortune to buy and maintain. Banks aren't exactly lending enthusiastically now are they?

    8. A new contract is supposed to be on its way. No one knows exactly what it'll be like. It might be better. But expect practice owners to take a bigger share of your earnings than ever before. A lot of the proposed changes centre around
    health and quality indicators...expect much more paperwork. You'll spend longer typing than with your hands in someone's mouth. There's so many dental graduates around that employers can pick and choose who they want and impose their own conditions. They know you'll have nowhere else to go.

    9. In terms of flexibility, it's extremely good. You can easily work part time, have a day off during the week or take holidays. But remember...you don't work, you don't get paid. Many people are part time not through choice but because they
    can't find a practice to give them full time work.

    10. There are loads of courses and meetings that could help you improve your skills. This also allows you to meet other dentists. But they can be prohibitively expensive and be very theoretical. In my opinion, the best dentists are those who are self taught.

    11. Last but not least...Scotland and Northern Ireland still have the pre 2006 NHS system so you don't have to worry about UDAs there!


    Like I said, I genuinely want to help. If anyone wants me to write a post on a particular topic..I'm more than happy to do so.
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    (Original post by muchomungo)
    I realise that my long post was overwhelmingly negative. I apologise for that. I do genuinely want to help people though through the experiences I've had.
    Of course there are many positives to this career. However, I can see my younger self in so many of the people on here..naive (in a nice way), starry eyed and dreaming of untold riches and status and I had to burst that bubble for you as I really wouldn't want you to find out the hard way. Dentistry right now is in chaos in England.

    It's quite ignorant of you to assume that most of us are in it for the money and status. You applied over 5 years ago right? Times have changed since then, a lot more people are gaining long-term experience in dental related settings and actually know more about the profession prior to sending an application off compared to 5 years ago. Why do I say this? Well I'm 24 and considered applying whilst in college. Alot of people did 1-2 weeks general work experience only, didn't bother with specialities and hardly knew anything about the profession. With the increased competition, more and more people are gaining shadowing placements in the community, hospital dentistry, dental labs, private, oral and maxfax and are reading around the dental contracts before interviews. You'd be surprised at how much in depth applicants nowadays know about the profession.

    So, let me just get one last thing off my chest and then I'm gonna write some positive thoughts peppered with some reality lol. Someone thinks its easy to earn 60K + a year and thinks I'm exagerrating. It's ok..I wouldn't have believed that either before I understood the system.
    The NHS works via the UDA system so..usually a UDA is worth approx £9-10. Although be aware, there are dentists who will undercut you and work for less than that. An employer will ask why should I pay you £10/uda if I have someone to work for 8?

    Assuming a uda rate of £9-10

    band 1 (1 uda) checkups/emergencies (1.2)/simple clean...you get £9-10
    band 2 (3 UDAs) fillings, root canals, extractions..you get £30
    band 3 (12 UDAs) crowns, dentures..you get £120

    60K a year....so thats 6000 UDAs. Someone with 4-5 years of experience would find that quite tough. Working 5 days a week..you'd need to do about 30 UDAs a day. That would often mean 30+ patients a day. Don't forget you must pay lab fees, tax, professional reg fees/indemnity and NHS pension from that as well. Your take home pay will be less than you think. Ask a dental accountant, they'll say the same.

    They're getting rid of the UDA system in the new contract (2013/14) aren't they? Yes, it's not very good, dentists were focusing on quantity, rather than quality because of it.

    You won't know what kind of dentist you will be after uni..you might be able to take 45 patients in your stride. However, many many cannot (myself included) and that's why so many newly qualified people hide away in hospital jobs for 3-4 years before reality hits them.

    You can say this for any job. Practise makes perfect, obviously it's going to be daunting seeing 40 patients a day, but that's why you do VT, to improve your skills under the guidance of a senior dentist.

    The current system works great if everyone just needed 1 thing done. They don't!! English teeth are atrocious and many people need multiple work done. It does depend on the area you work in. But remember you get paid per treatment COURSE not per item. So, you wont get your money until you have done all the fillings, so you can work at a loss. Anyway, I don't wanna bore people with the minutiae of the new contract, you get the picture. Take home message: you'll have to see tons of patients, which doesnt allow you to spend the time you'd like on things and loads of things will have to be done as part of goodwill (ie free of charge). That can get very trying.

    Xmb's post about the VT being slow and having a chilled out day made me smile becuase that's exactly how most of us were lol..it's gonna hit like a freight train though when he realises just how much faster he will have to work for 50-60K. The target for VT is 1875 UDAs/year. Most do about 12-1300. That would earn you about £13000/year in a non VT environment. Don't believe what the press say..100K a year...thats probably before you've given 50-55% to the practice owner and then paid all the above expenses. That's assuming you can get full time work and want to do that 5 days a week from 8 til 5.30.

    Anyway, positivity time.

    1. Dentistry teaches you so many different skills. It's not just about teeth. People skills, practical skills, business management skills. Some of the best friends I ever made were in dental school. Unfortunately, I don't see them much now as we are scattered all over the place.

    2. No other career allows you the freedom and autonomy that you have so soon after graduating. You're the boss, you can decide the treatment and you are the head of the dental team in your surgery. What goes on in your surgery is up to you (though you'll have a boss/practice manager to answer to). Most nurses are very good and I would certainly be lost without them. But the rude, lazy ones need to be read the riot act at the earliest opportunity.

    3. The course may be long, but the feeling of accomplishment upon completiton is indescribable. If only you could bottle that and sell it!

    4. It's arguably the most portable career I can think of. Should you wish, you can work virtually anywhere, except North America. In reality, most rarely venture outside Aus/NZ. Yes, you can work in any EU country, but it's rare as you need to get through the language barrier, labyrinthine beaurocracy and then the task of actually finding someone who will employ you! Incidently, I have heard anecdotally that dentistry is lucrative in Australia, where the whole system is largely private. Don't expect to get a job in central Sydney though...a country town is more realistic.

    5. I am a people person. I love talking to people about their jobs, where they come from and the issues of the day. You meet some interesting people especially in central London. The only trouble is you're always looking at the clock so you can't talk for long.

    6. It's great helping people overcome their dental anxiety. Most people just need a bit of TLC and they will trust you. If you can master the art of painless injections you're onto a winner! But..almost every patient starts by saying how they don't like dentists and they don't want to be there.

    7. If you were able to get a practice (it'll probably be somewhere far from London), you could potentially make a lot of money. You'd need several people working for you. The trouble is, it's not that easy anymore. The greedy corporates have bought so many and practices cost a fortune to buy and maintain. Banks aren't exactly lending enthusiastically now are they?

    8. A new contract is supposed to be on its way. No one knows exactly what it'll be like. It might be better. But expect practice owners to take a bigger share of your earnings than ever before. A lot of the proposed changes centre around
    health and quality indicators...expect much more paperwork. You'll spend longer typing than with your hands in someone's mouth. There's so many dental graduates around that employers can pick and choose who they want and impose their own conditions. They know you'll have nowhere else to go.

    9. In terms of flexibility, it's extremely good. You can easily work part time, have a day off during the week or take holidays. But remember...you don't work, you don't get paid. Many people are part time not through choice but because they
    can't find a practice to give them full time work.

    10. There are loads of courses and meetings that could help you improve your skills. This also allows you to meet other dentists. But they can be prohibitively expensive and be very theoretical. In my opinion, the best dentists are those who are self taught.

    11. Last but not least...Scotland and Northern Ireland still have the pre 2006 NHS system so you don't have to worry about UDAs there!


    Like I said, I genuinely want to help. If anyone wants me to write a post on a particular topic..I'm more than happy to do so.
    A few comments in bold.
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    Ok, but there are obviously a good amount of dentists who still make 100k+, so how?
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    muchomungo PREACH

    I wish more professionals would do items like this on TSR

    i'll still continue my dream. I

    If you don't mind my asking, how long have you been a working dentist, and what is the difference between your pay at the beginning to what it is now ?
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    (Original post by combbrah)
    Ok, but there are obviously a good amount of dentists who still make 100k+, so how?
    I think they are few and far between.. for general practice anyway
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    bigbottle-I'm glad you're well informed..really glad. You know exactly what you're doing. It's for people who haven't done the shadowing you've done that I've written this stuff.
    A lot of people don't want to think about it. I've just tried to get people thinking. Shadowing is hard to organise now due to health and safety rules.
    You think VT trainers are all there to help you. They get paid 80k to have you there. Many of them are just there for the money. You don't always see that many patients in VT. You might be able to do 40+, but it's a gamble.

    combrah - There aren't a good amount of people earning 100k+. Those that do likely have to own practices and have people working for them. Read my earlier posts..that is getting harder and harder to do.

    I have a friend who earns 100k+ as an associate. He drives a fast car. But he sees 60 patients a day, does 5 min fillings and works from 8-8, 4 days a week and travels at least an hour to work. What sort of quality do you think he's giving his patients? Sounds easy when you're an A-level or dental student. Let's see how easy you find it when you've got a drill in your hand, 5 patients waiting, you're running 20 mins late and you're patient isn't numb yet.

    Like I said, I'm just trying to make you think.
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    I was just wondering, OP - do you regret your decision in becoming a dentist then? or are you just trying to show how hard/unglamorous it can be?

    Really appreciate your posts btw, gives some food for thought
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    This is very insightful; thank you very much for sparing the time to inform us all. However, for those looking to specialise, there is more hope. In all honesty, I've always been focused on ortho. It just so happens that it pays well too. I spent a whole week in ortho and the smiles on the faces of the children when they had their braces removed for the last times was priceless; for that reason, if ortho paid less than general, I'd still do it.

    Once again, thanks for your insight.
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    (Original post by PhoenixxX)
    I was just wondering, OP - do you regret your decision in becoming a dentist then? or are you just trying to show how hard/unglamorous it can be?

    Really appreciate your posts btw, gives some food for thought

    Honestly, the way things are right now, if I could have my time again, I would try a different path I think. But hindsight is a wonderful thing isn't it? There's no way in a million years I could have predicted the things I spoke about. These are issues you won't realise exist until you have worked as an associate for a couple of years. Many of them did not exist until I had completed the bulk of my training (eg UDAs, competition for jobs etc.) I wanted to be a dentist SO badly as I mentioned. Perhaps I didn't want to hear any of the negative aspects as it would shatter my dream. This is why I feel I have a duty of sorts to tell people how much associate dentists are being exploited by the system at this point in time. Incidently, I'm still not 100% sure what alternative career I would have done.




    (Original post by Bonzo10)
    This is very insightful; thank you very much for sparing the time to inform us all. However, for those looking to specialise, there is more hope. In all honesty, I've always been focused on ortho. It just so happens that it pays well too. I spent a whole week in ortho and the smiles on the faces of the children when they had their braces removed for the last times was priceless; for that reason, if ortho paid less than general, I'd still do it.

    Once again, thanks for your insight.

    Yes Bonzo10, Ortho is indeed an interesting speciality, but once again, please make sure you don't pin all your hopes on doing it. Bear in mind it is
    a) extremely competitive to get in - you need hospital jobs, extra exams (MJDF etc), publications if possible. It takes 3 more years as you probably know. It is usually salaried but still, you have to factor the financial implications in.
    b) You may have to be flexible with where you work. London is saturated as well. There is no guarantee of jobs.
    c) In terms of payment...you never know what may happen. Ortho is already being scaled back compared to 10 years ago. Only severe cases are treated on NHS (IOTN 4 and 5). I think Northern Ireland has already scaled it back even further. Look what happened to general practice.
    But if it is your dream...and it is a nice speciality...by all means go for it, but you'll have to be very dedicated to see it through.
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    The average take home pay for 2008 for the 19,586 registered dentists in England and Wales was £89,062.

    http://news.bbc.co.uk/1/hi/8183788.stm

    So potential earnings are very good still.
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    (Original post by Sharpshooter)
    The average take home pay for 2008 for the 19,586 registered dentists in England and Wales was £89,062.

    http://news.bbc.co.uk/1/hi/8183788.stm

    So potential earnings are very good still.

    A gross distortion of reality. Unless you have people working for you, you won't earn anything like that. I know dentists who have worked for 5-10 years and are doing 4500-5000 UDAs with a bit of private. That gets you roughly 50k
    I don't know where these figures come from but they certainly won't be associate dentists. Even the best people I know don't have a take home of £89,062. Do you really trust the average journalist to report things accurately?
    The truth hurts, dreams get shattered. I'll let you go to uni and learn the hard way. You can look forward to seeing 45 patients a day and getting £9/UDA.
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    (Original post by muchomungo)
    A gross distortion of reality. Unless you have people working for you, you won't earn anything like that. I know dentists who have worked for 5-10 years and are doing 4500-5000 UDAs with a bit of private. That gets you roughly 50k
    I don't know where these figures come from but they certainly won't be associate dentists. Even the best people I know don't have a take home of £89,062. Do you really trust the average journalist to report things accurately?
    The truth hurts, dreams get shattered. I'll let you go to uni and learn the hard way. You can look forward to seeing 45 patients a day and getting £9/UDA.
    But these are official facts and figures - im not sure what you're arguing here... It even says in the article that dentists who run a practice/have people working for them earn on average 126k, so the 89k figure is for regular dentists

    More than £300,000: 382
    £275,000-£300,000: 113
    £250,000-£275,000: 159
    £225,000-£250,000: 228
    £200,000-£225,000: 291
    £100,000-£200,000: 4,418
    £50,000-£100,000: 8,699
    Figures for taxable income, after expenses have been deducted

    Do you think they just made these numbers up or something, because the BBC just love getting dental students hopes up?
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    (Original post by combbrah)
    But these are official facts and figures - im not sure what you're arguing here... It even says in the article that dentists who run a practice/have people working for them earn on average 126k, so the 89k figure is for regular dentists

    More than £300,000: 382
    £275,000-£300,000: 113
    £250,000-£275,000: 159
    £225,000-£250,000: 228
    £200,000-£225,000: 291
    £100,000-£200,000: 4,418
    £50,000-£100,000: 8,699
    Figures for taxable income, after expenses have been deducted

    Do you think they just made these numbers up or something, because the BBC just love getting dental students hopes up?


    I'm only telling you what I have seen in real life. This was the kind of garbage we were fed in dental school. People lie, they make stuff up. Dentists have long been vilified. We don't make as much as footballers or bankers and most of us genuinely try to help people.

    89k? What does that mean? Sure, if you've got a 9000 UDA contract, maybe. But let's hope you can see a patient every 10 mins then (and complete the treatment course) or you won't get your money. You also have to make sure your clinical notes are written up meticulously. Sounds easy now, when you're at school or uni- the idea of actually going and doing it is so laughably distant you can worry about it when you get there.

    Lets say for arguments sake 89k is the average income. Well, you have to pay tax + student loan from that (deduct 35-38%), lab bills (probably up to 1k a month) and don't forget most of these so called figures don't factor in that you have to give 50-55% to the practice owner. Oh yeah and if you're an NHS associate, you have to pay NHS pension/superannuation at approx 6%.

    Your take home pay will be much less than you think. I've had dental accountants tell us this. It's the truth.
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    (Original post by combbrah)
    But these are official facts and figures - im not sure what you're arguing here... It even says in the article that dentists who run a practice/have people working for them earn on average 126k, so the 89k figure is for regular dentists

    More than £300,000: 382
    £275,000-£300,000: 113
    £250,000-£275,000: 159
    £225,000-£250,000: 228
    £200,000-£225,000: 291
    £100,000-£200,000: 4,418
    £50,000-£100,000: 8,699
    Figures for taxable income, after expenses have been deducted

    Do you think they just made these numbers up or something, because the BBC just love getting dental students hopes up?
    Listen to muchomungo, I am also a general dental practitioner and everything he is saying is so, so true.

    I know it's not what anyone wants to hear but you really do have to work to the point of exhaustion to make a decent living in dentistry.
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    I think one of the points to bear in mind here is there is more to being a dentist than dentistry. If you have a head for business you can increase your earnings...

    ...and if you have a head for business and little regard for your patients you can maximise your earnings!

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