The Life Story Experience of "Migrant Dentists" in Australia: Potential Implications for Health Workforce Governance and International Cooperation

Abstract

Background: The migration of dentists is a major policy challenge facing both developing and developed countries. Dentists from over 120 countries migrate to Australia, and a large proportion are from developing countries. The aim of the study was to assess the life story experience (LSE) of migrant dentists in Australia, in order to address key policy challenges facing dentist migration. Methods: A national survey of all migrant dentists resident in Australia was conducted in 2013. Migrant experiences were assessed through a suite of LSE scales, developed through a qualitative-quantitative study. Respondents rated experiences using a five-point Likert scale. Results: A total of 1022 migrant dentists responded to the survey (response rate = 54.5%). LSE1 (health system and general lifestyle concerns in home country), LSE2 (appreciation towards Australian way of life) and LSE3 (settlement concerns in Australia) scales varied by migrant dentist groups, sex, and years since arrival to Australia (chi-square, P < .05). In a logistic regression model, migrants mainly from developing countries (ie, the examination pathway group) faced greater health system and general lifestyle concerns in their home countries (9.32; 3.51-24.72) and greater settlement challenges in Australia (5.39; 3.51-8.28), compared to migrants from well-developed countries, who obtained direct recognition of qualifications. Migrants also are more appreciative towards the Australian way of life if they had lived at least ten years in Australia (1.97; 1.27-3.05), compared to migrants who have lived for less than ten years. Conclusion: Migrant dentists, mainly from developing countries, face challenges both in their home countries and in Australia. Our study offers evidence for multi-level health workforce governance and calls for greater consensus towards an international agenda to address dentist migration. Better integration of dentist migration with the mainstream health workforce governance is a viable and opportunistic way forward.

An exploratory study of perfectionism, professional factors and psychological well‐being of dentistry academics

“…Contrary to findings from previous research on country of qualifications, 36,37 and level of education and specialization, 39 there was no significant association between these professional factors and stress in this study. Other research in New Zealand showed that overseas-qualified dentists felt more isolated than domestically trained dentists, and attributed this to the public's negative reactions to overseas-trained clinicians.…”

“…However, older migrant dentists have previously been shown to have higher levels of job satisfaction than younger migrant dentists. 38 Dentists without postgraduate qualifications and without a speciality have poorer well-being than their counterparts. 39 A teaching role might contribute to poor well-being, 39 although Rutter et al 40 reported that teaching might mitigate stress because of lessened isolation, increased self-esteem and autonomy and added interest in patients as a source of teaching opportunities.…”

“…Female dentists have been reported to have a higher prevalence of occupational health-related conditions, including anxiety and depression, than male dentists. 9,[42][43][44][45] Younger dentists have been reported to have poorer well-being than older dentists, 9,38,46,47 with one study attributing this to differences in experience. 41 Dentists who are single, divorced, separated or widowed have poorer well-being than their counterparts.…”

“…In New Zealand, overseas‐trained dentists have poorer well‐being than domestically trained dentists 36 . In a survey of migrant dentists in Australia (N = 1022, 54.5% response rate), Balasubramanian et al 37 found that those who trained in developing countries face greater challenges than dentists who trained in developed countries and obtained direct recognition of their qualifications, which increased risk of stress. However, older migrant dentists have previously been shown to have higher levels of job satisfaction than younger migrant dentists 38 .…”

The Practice of Dentistry by Australian- and Overseas-Trained Dentists in Australia: Discriminant Analysis of key Predictors

“…9 Prior research has suggested a tendency to ‘time-based’ mobility patterns, with migrant dentists changing to work more in the public sector or rural and remote or disadvantaged areas in their initial stage of migration to Australia, but gradually preferring to work in the private sector or in major cities as they become more familiar with Australian life. 10 …”