Career choice and future design of dental students in China and Japan

Abstract

The purpose of this study was to compare career choice and future plans of dental students in China and Japan. Information was derived from a self-answered questionnaire. Significant differences were detected for eight items between the two countries. Regarding motivation towards career choice, 41% of Japanese students indicated positive motives related to helping others, achieving self-worth and health-care related interests, whereas Chinese students indicated that their choice was mainly for financial and prestige reasons, and for 32% of them, dentistry was a passive choice. More Chinese dental students (74%) wanted further education compared with Japanese students (22%). The majority of Japanese students (56.9%) planned to work as general dentists. Conversely, Chinese students were more likely to specialise (50%). More than 50% of Japanese students wanted to work in dental offices, but the majority of Chinese students (65%) preferred university hospital. We found it is strange that nearly one-fourth of the Chinese students did not want to be a clinical dentist mainly because of the poor health-care environment. This study provides a description of the perspectives of Japanese and Chinese dental students and enables a better understanding of career choices and future course design issues.

INTRODUCTION

The motivation of dental students to choose their career has been reported extensively1., 2., 3., 4., 5., 6.. However, few cross-cultural comparisons7., 8., 9. have been made of dental students’ career choice and future plans in Eastern countries especially in the two most important Eastern countries, China and Japan. Large differences may exist in attitudes about career options and future plans among dental students who live in diverse societies. Kuusela et al.¹⁰ compared the career choice and future plans of dental students in Tanzania and Finland. They reported that the observed difference in the preferred career options most probably resulted from differing practical opportunities for a graduating dentist in the two countries. Karibe et al.¹ reported that there were many differences between Japan and Sweden in career choice among dental students. Japanese dental students showed more oriental features, such as their motivations being influenced more by their family. Therefore, it would be informative for dental educators to investigate the attitudes of dental students in different nations about their career choice and future plans and explore whether these perceptions are influenced by cultural and social background.

The population of Japan in 2012 was about 126 million and the number of dentists in 2010 was 101,576; the ratio of dentists per 100,000 population was about 79.311., 12., 13.. In recent years, dental education in Japan has faced large pressures from the rapidly ageing population and oversaturation of dentists14., 15.. In contrast, in 2010 the population of China was approximately 1,340 million and in 2009 the number of dentists was 182,100; the ratio of dentists per 100,000 population was approximately 13.6¹⁶. This ratio shows that, compared with Japan and other developed countries, dentistry in China is in its infancy. However, the distribution of dentists is in disequilibrium in China, with most highly educated dentists concentrated in the big cities, which caused dentist over-saturation in these developed area and deficiency in poor areas. Furthermore, the health-care environment of China is getting worse and being a doctor or dentist has become a dangerous profession¹⁷.

In this study, we investigate dental students’ perspectives using a questionnaire we designed. We hypothesised that differences in the cultural and social background of the country would influence students’ perspectives of career choice and future plans.

MATERIALS AND METHODS

Fifth-year dental students of the School of Stomatology, China Medical University Shenyang, China and 6-year dental students of the Faculty of Dental Science, Kyushu University, Fukuoka, Japan, participated in this study. All participants were exposed to clinical practice in their university hospital at the time of the study. Participation was voluntary and anonymous. Students were asked to remain after their class if they were willing to complete a survey about their perspectives on career choice and future design. All participants were the remaining students who had given verbal consent to join this study. The questionnaire was administered to Chinese dental students in May 2013 and to Japanese dental students in June 2013. The study was conducted in full accordance with the World Medical Association Declaration of Helsinki. The Human Research Ethics Committee (or its equivalent) involved in this project approved the study protocol.

Information was derived from a questionnaire consisting of two parts: four questions for career choice and six questions for future design (Table 1). A translated questionnaire was distributed in class.

Table 1.

Questionnaire for dental school students

1. What is the reason that you want to become a dentist?

2. Do you have interest in dentistry before entering the dental school?

Yes No Undecided

3. Did you have difficulty in gaining admission to dental school?

Yes No Undecided

4. Do you feel it is difficult to pass the examination for a dental license?

Yes No Undecided

5. Do you have a plan to be a Master or learned scholar after graduation?

Yes No UndecidedIf you want to be a Master or learned scholar, then what is the reason for this choice?

6. What kind of dentist would you like to be in the future?

General dentist Specialist Researcher Educator Others Undecided If you want to be a specialist dentist, then what career you prefer?

7. What kind of work unit you prefer?

8. What is the objective factor that most influenced your job choice?

9. After graduation, if possible, would you like to work in a foreign country?

Yes No UndecidedIf you would like to work in a foreign country, what is the reason?

10. After graduation, do you have any plans not to be a clinical dentist?

Yes No Undecided If you do not want to do clinical dental work, what are the main reasons?

There were six multiple choice questions (2, 3, 4, 6, 7, 8) and four descriptive questions (1, 5, 9, 10). The questionnaire was originally developed by the authors in English by bilingual faculty members whose mother language was Chinese. We then translated the English questionnaire into Chinese and Japanese with the assistance of Chinese–English and Japanese–English bilingual faculty members whose mother language is Chinese or Japanese. To confirm that the questionnaires had the same contents, the Chinese and Japanese translation was checked by colleagues whose mother language was Chinese and had studied dentistry for more than 10 years in Japan. The Chinese and Japanese translations were back-translated into English by four other bilingual colleagues whose mother tongue was Chinese or Japanese, who had not participated in the previous phase. The questionnaires were back-translated for the purpose of checking for discrepancies between content and meaning of the original and translated versions. All versions were analysed and compared by the authors, and a final version was obtained. To assess the equivalency of the language, the test–retest method was used and the results indicated good equivalency between the two versions of the questionnaire. The Chinese version was used for Chinese dental students and the Japanese version was used for Japanese dental students.

Statistical analysis

To evaluate the cross-cultural difference in the perspectives of dental students between the two countries, simple frequency tables for group comparison were developed; Wilcoxon signed-rank tests were applied. In items 5 (further education), 6 (future career options), 9 (working abroad) and 10 (give up being a clinic dentist), students were classified again based on their responses as item 5a, 6a, 9a and 10a. Statistical significance was based on probability values of <0.05. Data were analysed by the GraphPad Prism 5 Project (Kyushu University, Fukuoka, Japan).

RESULTS

The response rates to the questionnaire by the Chinese and Japanese students were 96% (54/56), and 94% (51/54), respectively. In this survey, because of the voluntary and anonymous participation, information regarding the demographic details or social backgrounds of the participants was not obtained.

Table 2 presents the responses from dental students of each country to the questions regarding the motivation towards career choice. For choosing dentistry as an occupation, the reasons were categorised as follows: (1) ‘Help & Value’ included the motivation of helping the others, health-care related jobs, achieving self-worth and interest, etc.; (2) ‘Money/Social’ included financial and job security aspects, status, prestige, qualified occupation, etc.; (3) ‘Family’ included dental parents or needing their family dental offices, etc.; (4) ‘Passive’ included those for whom dentistry was not their own choice and who only entered dentistry because of their scores or they were directed by their university, etc.; (5) ‘Flexibility’, covering flexibility in scheduling work, etc.; (6) ‘No answer’ included uncertainty or no reasons were specified. The majority of the Japanese dental students chose ‘Help & Value’ (41%) as the motivation, whereas in Chinese students it was ‘Money/Social’ (35%) and ‘Passive’ (32%). A number of Japanese dental students more frequently indicated ‘Family business’ (24%) but few Chinese dental students (6%) had such a reason.

Table 2.

Comparison of motivation of choosing dentistry in China and Japan

Questionnaire Item No.	Chinese students (n = 54)	Japanese students (n = 51)	P
1. Reasons to choose dentistry
Help & Value	10 (18.5%)	21 (41.2%)	0.001*
Money/Social	19 (35.2%)	7 (13.7%)
Family	3 (5.6%)	12 (23.5%)
Passive	17 (31.5%)	8 (15.7%)
Flexibility	2 (3.7%)	0 (%)
No answer	3 (5.6%)	3 (5.9%)
2. Interest in dentistry before entering the dental school
Yes	10 (18.5%)	25 (49.0%)	0.004*
No	30 (55.6%)	17 (33.3%)
Uncertain	14 (25.9%)	9 (17.6%)
3. Difficulty in gaining admission to dental school
Yes	20 (37.0%)	21 (41.2%)	0.5679 NS
No	14 (25.9%)	16 (31.4%)
Uncertain	20 (37.0%)	14 (27.5%)
4. Difficulty in passing the dental licence examination
Yes	5 (9.3%)	32 (62.7%)	<0.001*
No	39 (72.2%)	11 (21.6%)
Uncertain	10 (18.5%)	8 (15.7%)

If the amount of any item of the both countries was ‘0’, it is not listed in the table. Wilcoxon signed-rank test.

NS, not significant.

^*Indicates significant difference between the two groups.

Regarding interest in dentistry before entering the dental schools, about half of the Japanese students had a proactive approach, which was very different from the Chinese students (19%). From the responses of dental students about the difficulty in entering a dental school, 37% of Chinese dental students felt they had a difficult time gaining admission to their dental school. Similarly, more than 40% of Japanese students thought that entering their dental school was difficult. The majority of the Japanese dental students (63%) responded that it was difficult to pass the dental licence examination. In contrast, the Chinese students (72%) felt that gaining a dental licence would not be very difficult.

Table 3 shows the percentages of responses in each country about the future plans of the dental school students. For further education, item 5, many more Chinese students (74%) wanted to get a higher degree than did Japanese students (22%). However, there were many differences in reasons (item 5a). We categorised the responses into six reasons: (1) ‘Job’ included easier to find jobs, better or secure jobs, etc.; (2) ‘Professional skills’ included desire for advanced clinical skills, etc.; (3) ‘Promotion’ included getting more promotion opportunities in the university or higher status, prestige, etc.; (4) ‘School’ meant being accustomed to school life or not yet ready to enter society, etc.; (5) ‘Parents’ indicated the requirements of family, etc.; (6) ‘Research’ indicating interest in research work, etc.; (7) ‘No reason’ included uncertainty, concepts of destiny and no answer, etc. Chinese dental students wanted to receive further education mainly for the reason of ‘Job’ (38%). More Japanese students (64%) chose ‘Research’ than did Chinese students (13%). There was not much difference in the reasons ‘Professional skills’ and ‘Promotion’, but more Chinese students (5% and 8%, respectively) chose ‘School’ and ‘Parents’.

Table 3.

Comparison of future plans of Chinese and Japanese dental students

Questionnaire Item No.		Chinese students (n = 54 )	Japanese students (n = 51)	P
5. Do you plan to be Master or learned scholar after graduation?	Yes	40 (74.1%)	11 (21.6%)	<0.001*
	No	12 (22.2%)	23 (45.1%)
	Undecided	2 (3.7%)	17 (33.3%)
5a. Reason for wanting to be a Master or learned scholar after graduation Chinese students (n = 40) Japanese students (n = 11)	Job	15 (37.5%)	0	0.029*
	Professional skills	8 (20.0%)	3 (27.3%)
	Promotion	5 (12.5%)	1 (9.1%)
	School	2 (5.0%)	0
	Parents	3 (7.5%)	0
	Research	7 (17.5%)	7 (63.6%)
6. What kind of dentist would you like to be in the future?	General dentist	11 (20.4%)	29 (56.9%)	<0.001*
	Specialist	27 (50.0%)	13 (25.5%)
	Researcher	12 (22.2%)	3 (5.9%)
	Educator	2 (3.7%)	1 (2.0%)
	Others	2 (3.7%)	0
	Undecided	2 (3.7%)	7 (13.7%)
6a. Future career as specialist dentist (plural answers) Chinese students (n = 27) Japanese students (n = 13)	Oral Surgeon	6 (22.2%)	5 (38.5%)	0.542 NS
	Prosthodontist	10 (37.0%)	5 (38.5%)
	Periodontist	2 (3.7%)	1 (7.7%)
	Paedodontist	2 (3.7%)	1 (7.7%)
	Orthodontist	9 (33.3%)	1 (7.7%)
	Endodontist	2 (3.7%)	0
	Others	1 (1.9%)	1 (7.7%)
	Undecided	1 (1.9%)	2 (15.4%)
7. Work unit (plural answers)	University hospital	35 (64.8%)	9 (17.6%)	<0.001*
	Scientific institute	10 (37.0%)	5 (9.8%)
	Community hospital	7 (13.0%)	11 (21.6%)
	Dental office	4 (7.4%)	28 (54.9%)
	Medical corporation	2 (3.7%)	1 (2.0%)
	Uncertain	1 (1.9%)	2 (3.9%)
8. What is the objective factor that most influenced your choice of job? (plural answers)	Nature of unit	45 (83.3%)	29 (56.9%)	0.033*
	Money	42 (77.8%)	11 (21.6%)
	Working strength	3 (5.6%)	8 (15.7%)
	Location	14 (25.9%)	8 (15.7%)
	Continue learning	16 (29.6%)	13 (25.5%)
	Promotion	2 (3.7%)	1 (2.0%)
	Family	11 (20.4%)	4 (7.8%)
9. Want to work in a foreign country?	Yes	10 (18.5%)	19 (37.3%)	0.011*
	No	38 (70.4)	21 (41.2%)
	Uncertain	6 (11.1%)	11 (21.6%)
9a. Reason for wanting to work abroad Chinese students (n = 10) Japanese students (n = 19)	Money	3 (30%)	2 (10.5%)	0.008*
	Environment	4 (40%)	0
	Medical care system	4 (40%)	1 (5.3%)
	Around the world	1 (10%)	6 (31.6%)
	Study	4 (40%)	6 (31.6%)
	No answer	0	6 (31.6%)
10. Want to be a clinical dentist after graduation?	Be clinical dentist	26 (48.1%)	37 (72.5%)	0.040*
	Not to be	13 (24.1%)	6 (11.8%)
	Undecided	15 (27.8%)	7 (13.7%)
	No answer	0	1 (2.0%)
10a. Reason for not wanting to be a clinical dentist (plural answers) Chinese students (n = 13) Japanese students (n = 6)	Laborious	1 (7.7%)	1 (16.7%)	0.036*
	Money	6 (46.2%)	0
	Medical care system	7 (53.8%)	0
	Diploma	2 (15.4%)	0
	Research	4 (30.8%)	4 (66.7%)
	No answer	0	1 (16.7%)

If the amount of any item of the both countries was ‘0’, it is not listed in the table. Wilcoxon signed-rank test.

NS, not significant.

^*Indicates significant difference between the two groups.

Regarding future career options, the majority of the Japanese students (57%) and about one-fifth of Chinese students planned to work as general dentists. Chinese students were more likely to specialise (50%) compared with Japanese students (26%). Interestingly, more than one-fifth of Chinese students indicated their future career choice was a researcher, while only 6% of Japanese students indicated this (P < 0.001). When students from both countries who had chosen a specialism as a future career were examined, the majority had already decided their specific specialisation. Furthermore, prosthodontist (37%) and orthodontist (33%) were the most two popular specialisations in China, while in Japan it was oral surgeon (39%) and prosthodontist (39%). For choice of work unit (item 7), the top-rated unit for Chinese students was ‘University hospital’ (65%), whereas more Japanese students (55%) wanted to work in a dental office compared with Chinese students (7%). In item 8, the most influential objective factor was ‘Nature of unit’ in both the countries (China 83%, Japan 57%) whereas the Chinese students thought more of ‘Money’ (78%) and ‘Family’ (20%).

In item 9, 37% of Japanese students preferred to work abroad compared with 19% of the Chinese students. For the students who wanted to work abroad, we categorised the reasons as follows: (1) ‘Money’, which included earning more money abroad, etc.; (2) ‘Environment’, which included the desire for a clean environment, security and healthy food, etc.; (3) ‘Medical care system’, which included dislike the medical care system and medical environment of their own country, etc.; (4) ‘Around the world’ meant want to travel and work in many countries to study the language, etc.; (5)’Study’ meant that they wanted to do research work abroad or learn more advanced skills from other countries, etc. (6) ‘No answer’ indicated that one wanted to go abroad but had not given a the reason. It was interesting that for both sets of dental students wanting to work abroad ‘Money’ was not the main reason (China 10%, Japan 11%). The Chinese students’ reasons were mainly for ‘Environment’ (50%) and ‘Medical care system’ (50%) whereas the Japanese students wanted to work ‘Around the world’ (32%) and ‘Study’ (32%).

In item 10, 24% of Chinese dental students wanted to give up their clinical work after their graduation, while in Japan, 12% of the dental students wanted to work away from the clinic. The students who did not want to be clinical dentists had many reasons: (1) ‘Laborious’ included could not bear the workload, did not fit for the clinical work of dentist, etc.; (2) ‘Money’ included salary being poor, another job can earn more, etc.; (3) ‘Medical care system’ included dislike of the medical care system and medical environment, feeling that it was dangerous to be a clinical doctor, etc.; (4) ‘Diploma’ indicated those who only wanted to get a diploma from the university; (5) ‘Research’ meant wanting to do research work. (6) ‘No answer’ meant no reason or had not given an answer. The main reason in both countries was ‘Research’ (China 31%, Japan 67%) and although more Chinese students indicated that ‘Money’ (46%) and ‘Medical care system’ (54%) were also important.

DISCUSSION

Regardless of the educational philosophy, entry requirements and selection procedures, which varied enormously among schools and countries, all the means of education should be for the benefit of the students. For the whole dental education domain, to choose students who have a desire and positive motivation to become dentists, designing a curriculum guided by the students’ future plan seems more important than the education itself.

In this study, we were concerned with the career choice and future plan of dental students in China and Japan. Fifth-year (China) and 6-year (Japan) students were included. In China Medical University, the dental students undertake a 5-year programme and start their clinical practices at the beginning of the fifth year. In contrast, the programme for dental students at Kyushu University is 6 years, and the clinical practices start at the middle of the fifth year. All the students that participated in this study had been exposed to clinical practice in their university hospital for about 1 year at the time of the study. It was expected that dental students could identify their future plans, even though the time of exposure to clinical practice differed in each school.

Motivation for choosing dentistry

For motivation for choosing dentistry, most Japanese students chose ‘Help & Value’ (41%), which is similar to previous studies in Sweden, the UK and the USA1., 2., 3., 4., 18.. The ‘family’ is also another big reason for the Japanese students. In the studies of Benjakul¹⁹ and Karibe¹, they found that the Asian students were more affected by their families because of their culture of staying together with family members. In Japan, if the parents are dentists, the children are more likely to choose dentistry as a career. However, in China, ‘Money/Social’ is the first reason, which is similar to some European countries, including the UK²⁰, and Canada⁷. In these countries, the dentists’ status is socially recognised but in China, the situation is quite the opposite: doctors and dentists, in recent years, are distrusted and sometimes even injured by patients17., 21., 22., 23.. Because of their poor conditions, the proportion of doctors and dentists who hoped that their own children would enter the medical profession has decreased significantly²⁴. It is also strange that 32% of Chinese students were passive in choosing dentistry. In the college admissions system of China, all Chinese dental universities recruit students in the traditional way, which is based mainly on the scores of the National Matriculation Test. Some of the Chinese dental students may not have strong desire to learn dentistry but do so because of their scores or being streamed from other subjects by their university. In contrast, in Japan, the admission systems of dental schools varies among universities and most include an interview process, similar to European dental schools²⁵. In the interview, high motivation is one of the most important considerations. As dentistry involves intense mental and physical activities, the college admissions system of China needs to reform and recruit students with positive motivations as is done in Japan. This is imperative to improve the health-care system and environment of China, otherwise fewer students will choose dentistry as their career.

In this study, 41% of dental students responded that gaining admission was difficult, which is quite different from the results of Karibe’s research¹. It is much easier to gain admission to private dental schools if the students can afford the expensive tuition fees, which are about nine times more than those of the governmental/local public dental school tuition fees⁸. Because of the cheap tuition fees and guaranteed teaching quality, gaining admission to the best governmental/local public dental schools such as Kyushu University is very competitive.

There is considerable difference between the two countries in gaining a dental licence. Whereas 63% Japanese students thought it was difficult, only 9% Chinese students had the same opinion. In Japan⁸, the national government regularly monitors the number of dentists, as is done in Sweden and other European countries¹. For the last several years, the sufficiency rate of dentist has been about 150%²⁶ and it has become difficult to find a job as a dentist. To alleviate the employment pressure of graduate dentists, the Japan Ministry of Health has increased the difficulty of examinations for dental licences to reduce the pass rate year by year. For this reason, many Japanese students think it more difficult to get a dental licence. In China, there is also a national examination for dental licences but the pass rate is much lower (China 30–40%¹⁶, Japan 71%²⁶). Thus, in our study, Chinese dental students think it is not as difficult to gain a dental licence; therefore, the quality of dental education is uneven. There are 188 dental schools in China¹⁶, but half of these are middle-level dental schools or lower²⁷. Therefore, because of the differences in education quality of different schools, the pass rates are quite different. Some good dental schools can set a pass rate of more than 90%.

Further education

Regarding continuous learning after graduation, approximately 74% of Chinese dental students wanted to obtain a higher degree, and this was a much higher percentage than that for Japanese dental students (22%). Most of the Chinese graduate dental students began their Master’s degree right after their graduation. Without a higher degree, the Chinese graduate students would be in worse situation, as they would only find work in an ordinary dental office with a salary of average 400 dollars per month²⁸, despite China’s lack of dentists¹⁶. In contrast, in Japan, after graduation all the Japanese dental students have to take a mandatory internship in a postgraduate clinical training course for at least 1 year. After that, only a few of them go back to school for their doctorate and most of them usually get well-paid work or help to run their family dental offices.

For their reason for wanting further education, Chinese students chose ‘Job’ (38%) but none of the Japanese chose this. It seems that the Chinese students were facing much more severe employment competition, which is mainly caused by the concentration of dentists in big cities; most of Japanese dental students chose the ‘Research’ (64%) as their reason. This shows that, although only a few Japanese students want to be further educated, they had a positive motivation. It is interesting that a number of Chinese dental students chose ‘School’ (5%) and ‘Parents’ (8%). This indicates that, for the future, these students have no plan at all and just wanted to remain in school for a longer time and were not ready to enter society, or do as their parents wished.

Choosing work

For future career options, a majority of the Japanese students (57%) and about one-fifth of the Chinese students planned to work as general dentists. Chinese students were more likely to specialise (50%) compared with Japanese students (26%). After graduation, most of the Japanese dentists go to clinics as general dentists and only a few that work in the college hospital or will specialise. However, it is really difficult to be a specialised dentist even for college hospital dentists in Japan. In China the situation is similar, but the specialised dentist system has not been well established and expanded. Although most further-educated Chinese students may have already focused on their specialisation, they can only work as general dentists unless working in college hospitals or specialised dental hospitals. Research work is highly valued by the Chinese government and in the last several years, more students have designated their future career as researchers. However, for education neither Chinese nor Japanese students show interest in it, which is quite different from what occurs in European countries¹. The discounting of dental education may therefore cause major problems in the future for these two countries.

Of the students who hoped to become specialists in this study, 37% of Chinese students and 39% of Japanese students hoped to be prosthodontists. Other popular specialists are orthodontist (33% in China) and oral surgeon (39% in Japan). This differs from Weaver’s² study which found that orthodontics is the dental specialty most pursued by graduating dental students in the USA. For choice of work unit, the top-rated unit in China is ‘University hospital’ (65%) and more Japanese students (55%) would like to work in a dental office than would the Chinese students (7%). In item 8, the most influenced objective factor is ‘Nature of unit’ in both the countries (China 83%, Japan 57%) and Chinese students think more of ‘Money’ (78%) and ‘Family’ (20%). Working in college hospitals or social hospitals was thought to be an ‘iron rice bowl’ (lifetime job that cannot be easily fired) in China, even though the payment may not be good. This traditional ideology inherits from traditional Confucian values that have been unchanged for years. Like most European dentists, salary is more important for Chinese dentists²⁹.

Working abroad

Most of the Chinese students answered that they would work in their own country after graduation. There is no doubt that English is a big obstacle to working abroad for Chinese and Japanese students, yet nearly half of the Japanese students wanted to go abroad. Various opportunities are available such as participation in a specific postgraduate programme at an overseas university or hospital, working as a researcher in an overseas laboratory, international volunteer activity, among others. However, few want to be a dentist or run a dental office abroad for the reason that it would be difficult to obtain an overseas dental licence. In European countries, without the same difficulties of language and with the high standards of different European countries’ dental licences, more European dentists want to work abroad⁷. Because of the rapid development in recent years in China, most Chinese students that want to work abroad are not going for well-paid work but for a clean environment, security and healthy food that cannot be easily found in big Chinese cities. The poor medical care system and unsafe health-care environment are other main reasons for Chinese students to choose working overseas.

Giving up clinical work

To our surprise, approaching one-quarter of the Chinese dental students wanted to give up clinical work as a dentist and 11.8% of the Japanese students intended to this mainly by doing research work. This question has never been mentioned before. In China, both doctor and dentist are hard jobs but less well paid. Sometimes dentists need to face patients’ queries and be thought of as merely businessmen. After practise in a clinic, students may find that the real health-care environment was not as they previously imagined. Thus, more and more Chinese students have decided to abandon dentistry when they graduate. Such a high proportion of clinical dentists who have given up is a waste of the higher educational resources of China. Further research is urgently needed to investigate the reasons for this important phenomenon and find a solution in the Chinese dental field.

CONCLUSIONS

The perspectives of dental students were different between Japan and China. The results presented may contribute to our understanding of dental students in the two countries. This study can help educators to understand students’ perspectives of different cultural and social background, with the aim of improving the education system. This information will also be useful for mutual understanding between different countries and the internationalisation of dental education.

Acknowledgements

We express our appreciation to Professor Akifumi Akamine and Professor Yoichiro Miki, Faculty of Dental Science, Kyushu University, Japan, for their valuable support. The authors also would like to acknowledge the cooperation of students and their participating dental schools in the conducting of this study.