Addressing health workforce shortages: analysing dental students’ career choices and barriers to public health dentistry in Pakistan

BACKGROUND: The shortage of healthcare professionals, particularly public health dentists, in Pakistan, hinders the achievement of Sustainable Development Goal 3, which emphasizes good health and well-being. Dental Public Health (DPH) focuses on population-based oral healthcare, but it remains an underrepresented career choice among dental students in Pakistan. Understanding the factors that influence students' specialty choices is crucial for addressing workforce gaps and improving oral health outcomes. METHODS: This sequential explanatory mixed-methods study was conducted from February to June 2023 in Karachi, Pakistan. The quantitative phase involved a cross-sectional survey of 350 third- and fourth-year dental students and house officers from six randomly selected dental schools, with a response rate of 52% (n = 185). An adapted and validated questionnaire assessed attitudes toward pursuing DPH as a career. The data were analyzed using SPSS version 21. The qualitative phase included in-depth semi-structured interviews with 20 purposively selected participants to explore the motivations behind their specialty choices. A thematic analysis was performed on the qualitative data. RESULTS: Only 17.5% of house officers expressed an interest in pursuing DPH, compared to 39.2% of third-year students and 20.8% of fourth-year students. The majority preferred clinical specialties such as oral surgery. Students from private institutions showed slightly higher interest in DPH (37.3%) than those from public institutions (18.6%). Key themes from the interviews revealed that clinical specialties are favored for better financial prospects and relevance to private practice. DPH was considered a fallback option if clinical specialty was unattainable. Several participants acknowledged DPH's role in community service, research opportunities, and job security but felt that these benefits were insufficient to choose it in clinical fields. CONCLUSIONS: There is declining interest in DPH as students' progress in their dental education, with a strong preference for clinical specialties due to perceived financial and professional advantages. Strategies such as integrating public health principles into the curriculum, providing incentives, and raising awareness about the importance of DPH are recommended to address the shortage of public health dentists in Pakistan. Enhancing the appeal of DPH as a viable career option is essential to strengthen the public health workforce and improve oral health equity.