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.

Last 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. Ignácz 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 education.

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 (see graph).

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, following Hungary’s 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.

The NYU-Hungarian Connection
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.