It was a breezy afternoon in the middle of the week, April 2018. I popped out from the Russian Healthcare Ministry building located in the very center of Moscow. I had just handed to the authorities the Young Russian Orthodontists’ Manifesto and been through a useless debate on if we need any improvements to the orthodontic education in the country. The authorities made it quite clear to me: they are not going to move a finger to make any change.
Few months ago, I made a promise to myself to stop writing on the post-Soviet orthodotniya. This only steals my time and ruins my mood. However, the topic of orthodontic education is a global and critical issue which affects the most vulnerable: the young specialists. This is my excuse for writing this piece.
For more than a decade we have a well-defined guidelines telling us how an orthodontic postgraduate program should look like. However, the post-Soviet healthcare system implies that a quality orthodontic education is not really necessary. In turn, it provides us with alternatives to gain “knowledge”. Being a mixture of an aggressive marketing and a Soviet bureaucracy, the post-Soviet orthodontiya derives its pseudo-intellectual grounds from two major sources: short-term courses sponsored by the manufacturers and government-established postgraduate programs called ordinaturas. The former is nothing new for a westerner. The latter, on the other hand, is a local phenomena: the programs run in a native language by self-proclaimed professors and phDs who never publish papers in the peer-reviewed journals and deny obvious orthodontic facts, claiming, for example, that extractions are not necessary, mandibles can be grown and wire-bending is a thing of the past.
The situation is clearly not alright. However, we have to admit that the orthodontic education has challenges not only around the post-Soviet world. The shortage of academic staff, the impingement of the market and the rising number of orthodontists per capita are, in my view, the major factors contributing to the inadequacy of orthodontic education globally. My sincere belief is that the manifesto mentioned above contains the measures that may be applicable anywhere around the world.
The establishment of mentorship in orthodontics can not be overestimated. Some of our knowledge can only be transferred through in-person communication. We also have to be confident in the expertise and academic achievements of the mentors.
2. Board Certification
Board certification is a great form of self-education. It makes a clinician observe the treatment retrospectively and learn from one own’s past mistakes and inaccuracies. I hope that one day the orthodontic specialty will develop a united international board.
3. English language
It is surprising how many people who want to become orthodontists are still deprived of the most essential asset. A language. The great wealth of orthodontic literature has been written in English. Thinking that you can study orthodontics in Russian, Ukranian or Kazakh language is treacherous and naive.
Despite the problems laid down above, I don’t think the young orthodontists should waste their time trying to enhance the poor orthodontic infrastructure we are surrounded by. Truth to be told, this is beyond our abilities. We should delegate this responsibility to the powerful organisations, such as the WFO, AAO, etc. Meantime, we have to spend our efforts on our immediate responsibilities – diagnosing, treatment planning and proper care of our patients. I urge young folks to keep distance from the post-Soviet orthodontiya and focus solely on ourselves, on becoming better clinicians. And if this requires to move abroad – let it be.
For those interested in the in-depth issues of orthodontic education, I highly recommend getting acquainted with this book.