Rooban Thavarajah
India’s dental education system is now at a critical point. The last major overhaul to the undergraduate (UG) dental curriculum occurred on July 25, 2007, based on the domain expertise requirements and evaluation (outcome-based assessment) framework of the time. Since then, the field of dentistry, teaching-learning (TL) methodology, and assessment characteristics have evolved rapidly. Over these years, Indian dental classrooms have seen students from the 1990s, the 2000s, and now the Gen Alpha generation. The gap between what is taught and what is needed in real dental practice in India has grown significantly.But the syllabus has failed to include landmark developments in dentistry. Digital dentistry, for example, is increasingly integrated into regular dental practice, becoming a mainstream tool in an average dental practice. Such advances offer greater precision, efficiency and patient comfort. Globally, there is also a fundamental shift from focusing only on treatment to emphasising prevention, behavioural changes and patient education. But the current syllabus still focuses on procedures and diseases.
Even well-known dental filling materials such as silver amalgam and gold fillings are replaced with composites and glass ionomer cement.
Important legal updates, such as changes in the Consumer Protection Act, the Clinical Establishment Act, and new rules
/guidelines
on infection control and antimicrobial resistance (AMR), have also not been incorporated into the basic structure of the curriculum. This leaves new graduates less prepared for real-world dental practice. The ‘COVID-19’ batch (the ones who did higher secondary schooling during the pandemic) and subsequent batches were forced to make a rapid shift to online and hybrid learning, opening newer dimensions in TL methodology. Today’s undergraduate dental students are digital natives, accustomed to fast access to information, interactive learning, and technology-driven environments. But the curriculum, education framework, and assessment, designed for a pre-digital era by such teachers, fail to engage students effectively or equip them for the realities of modern dental practice.Motor-skill transfer is a crucial part of learning in dentistry. It is at this training-delivery system that dentistry is unique. Studies evaluating multi-dimensional competency-based training for dental students have found such structured
skill-transfer
modules to be far more effective in imparting practical, real-world skills and knowledge than traditional methods. In India, the National Medical Commission has shifted medical education to a competency-based model. Yet, these innovations wait to be integrated into the dental curriculum. At the evaluation and assessment front, students are graded based on subjective impressions rather than objective competencies. This must be replaced by better options. Additionally, to produce better dentists, entrepreneurial training, financial literacy, and practice management content must be incorporated into the core curriculum.There have been attempts to update the syllabus and TL framework, but with limited success. Regulatory inertia, lack of consensus among stakeholders, and the sheer scale of the system have all contributed to this stagnation. The National Dental Commission Bill 2023, which is yet to come into full force, aims to replace the 75-year-old Dental Council of India (DCI) with a new regulatory body. The new commission promises reforms, including a National Exit Test for licensure and a standardized accreditation system. However, these changes are still in the pipeline and have yet to impact the day-to-day reality of dental education.Also, the Indian student’s shift in cognitive domain, attention span and fine motor skills have to be
accounted for while
updating the curriculum. The societal acceptance and use of edutainment, coaching classes and advanced digital TL aids transformed the entire domain of TL methodologies, none of which are taken
generally
into account during the curriculum development.The need for an immediate and comprehensive update to India’s dental education system is clear and urgent. It must begin with a comprehensive curriculum overhaul based on a multi-dimensional competency-based framework, enabling students to achieve the minimum EPA essential for modern dental practice. To ensure consistent quality, uniform standards and accreditation policies must be established nationwide, supported by robust faculty development programs, adoption of student-centric teaching-learning methodologies, and the implementation of best policy practices.It is imperative to shift away from the traditional time-bound, didactic teaching model toward a competency-based education system that focuses on real-world skills, including the precision and fine motor skill requirements unique to dentistry. Such a shift will prepare graduates to meet contemporary clinical demands and align Indian dental education with global standards.A major overhaul of the curriculum will require multi-domain expertise and inputs from education technology experts. Assessments should be realistic, continuous throughout the year, and cumulative rather than limited to a few exams. Digital tools for assessing knowledge and skills, as well as for maintaining academic records, should be used.The world of dentistry is evolving at a breakneck speed, and the curriculum must keep pace with it. The time for incremental change has passed; what is now needed is a bold and comprehensive curriculum overhaul.
Uniform educational standards needed
Unlike medical education, where nearly half of all colleges are govt-run, only about one in eight dental colleges in India is govt-run. The rest are private, with most being deemed universities. This has led to several challenges. Govt colleges often have better patient inflow and clinical exposure, while private colleges may focus more on research, innovation and rankings. Hence, striking the right balance between innovation and foundational core competencies for maintaining minimum educational standards across all institutions is the need of the hour. If an imbalance is created, it has the potential of skewing the profession’s core ability. Ensuring uniform dental educational standards across such a diverse and predominantly private sector is a big challenge for regulators.Globally, dentistry is moving towards Entrustable Professional Activities (EPAs), which focus on real-world competencies and essential fine motor skills for dental practice. Time for India to do the same.
(The writer is with the department of Oral & Maxillofacial Pathology/ Microbiology at Ragas Dental College & Hospital in Chennai)
