Andrew I. Spielman,
DMD, PhD (left) Associate Dean for Academic Affairs and Professor
of Basic Science and Craniofacial Biology, New York University
College Of Dentistry
Tivadar Zelles, DMD, PhD Dean, Faculty of Dentistry, Semmelweis
University, Budapest, Hungary
University Dental Education Curriculum
The year is 1918. Following the defeat of the Axis powers, the Austrian-Hungarian
Empire collapses and is dismembered into myriad nation-states. Fast forward
to 2004, and a remarkable event occurs. After 44 years under Communism and
15 years after the demise of the Soviet Union, Hungary rejoins the European
community as a unified nation and full partner.
March I was privileged to witness Hungary’s European rebirth first-hand,
when I accepted an invitation from Dr. Tivadar Zelles, the two-term Dean
of Semmelweis University (SU) Faculty of Dentistry in Budapest, to visit
his campus. In addition to presenting several lectures and seminars,
I had an opportunity to meet with faculty and students and to learn how
SU is adjusting to the new educational standards required for recognition
by the European Union (EU), which went into effect following Hungary’s
admission into the EU in May 2004.
A relative newcomer compared to other
European universities, SU was established in 1769, in honor of Dr.
Semmelweis, the noted Hungarian physician who became famous as a result
of observing that many women who were dying soon after childbirth had
been treated by doctors who were working both in obstetrics and gynecology
and in pathology without washing their hands between assignments, thereby
becoming cross-infected and transmitting the infection to the new mothers.
After that, doctors started washing their hands and the incidence of
maternal deaths decreased dramatically.
Approximately 100 years later,
in 1854, dental education was introduced at SU as part of medical
education. The current Faculty of Dentistry, established in 1955,
followed the European model in effect at that time: a post-baccalaureate,
five-year dental program, but with a focus still on medical
Then came the collapse of the Berlin Wall in 1990,
and Hungarian dental educators used their newfound freedom
to rethink both the quality and the quantity of curriculum topics.
In 1998, Zelles, et al. published a study entitled “Basic Science
Teaching in Dentistry in Central/Eastern Europe: Toward Harmonization,” which
compared the hours of basic science education taught in Central/Eastern
European dental schools with those taught in the EU, and concluded
that the EU schools were devoting one-third less time to the basic
sciences and to clinical medicine, and a third more time to courses
in clinical dentistry.
With the impending entrance of Hungary into
the EU, it became especially urgent that a similar rebalancing
at SU be achieved and achieved quickly. Accordingly, new departments,
including oral biology, oral medicine, and oral diagnosis, were
added to the curriculum, along with such new topics as preventive
dentistry and health promotion. Overall, the new curriculum at
SU was rebalanced to emphasize more clinical dental practice.
SU’s current dental education curriculum consists
of 5,000 hours distributed over 10 semesters. The academic year
begins in early September and ends in June. At the end of each academic
year, students spend two to four weeks in the summer working in
hospitals (as nurses), in dental labs, or in private offices practicing
clinical dentistry. Academic courses, which are never less than
one full semester in length, are offered every week on a highly
structured basis. Overall, basic sciences account for 40 percent
of the curriculum. Clinical medical subjects account for another
nine percent. Dental foundation knowledge and clinical dentistry
account for 47 percent of the total time. The remainder of the curriculum
(four percent) is devoted to health promotion and medical informatics
Most of the over
100 faculty members at SU are full time. Part-time faculty
positions are quite unusual. Collectively, the SU faculty has
published 100-plus textbooks and several thousand articles. The
350 students can choose to study a Hungarian-, English-, or German-
language curriculum. Each year foreign students from 36 countries
apply for the five-year dental programs that are taught in English
and German. Tuition is $10,500 per year. This past summer,
admission into the EU, 100 students from Germany alone applied
for the 25 to 30 spots available in the German-language program.
Since its founding, SU has graduated 5,000 dentists, of whom
800 are graduates of the English- and German- language programs.
Most recently, SU received a grant of approximately $22 million
to build a new dental school – clear
evidence of the importance that today’s
Hungary places on dental education.
In the past, students
from Hungarian universities were not allowed to practice
independently after graduation unless they
had completed a two-year General Practice Residency program.
At the request of the EU, this requirement has been waived.
In addition, in order to conform to specialty requirements
across Europe, five official specialties were established
in Hungary: restorative dentistry and prosthodontics, pediatric
dentistry, orthodontics, periodontics, and dentoalveolar
surgery. Although a DMD degree allows a dentist to practice
in any area of dentistry, insurance companies require board
certification for reimbursement at specialty-practice rates.
In addition to finding the experience
of visiting modern, democratic Hungary very
personally rewarding, I was also on a professional mission
to explore the potential benefits of a collaboration between
NYUCD and SU. One of the most compelling reasons for choosing
that path is that Hungary offers the opportunity to see
and treat a significantly larger population of oral cancer patients
than one sees in the U.S. Ironically, while NYUCD is the
leader in fostering oral cancer awareness and prevention
in the U.S, the lower incidence of oral cancer in our nation
means that there is less opportunity to teach our student
population as much as we would like them to learn about
the disease. In Hungary, however, an unfortunately large segment
of the population is at risk for developing oral cancer
due to heavy use of alcohol and tobacco. Therefore, NYUCD students,
residents, and faculty would benefit greatly from a connection
with SU that would expose them to a dental education program
that focuses more on oral diagnosis, oral pathology, and
oral surgery because of the specific needs of a population
with a higher incidence of oral cancer. Indeed, I believe
that a “Hungarian
Connection” offers a unique opportunity for NYUCD to
expand its national oral cancer awareness and prevention
campaign to the international level. And what better training
ground for our student body than exposure to different cultures,
patient populations, and clinical experience? This is particularly
true when it can take place in such a pleasant European city
as Budapest, with its well-deserved reputation for warm hospitality
and great food.