The paper in this issue by Greatrix and McAndrew comes at a very pertinent time.1 Providing great detail about the selection process for UK dental schools, it highlights just how complex this element of controlling entry to our profession has become in attempting to make it as objective and cross-comparable as possible.

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All of us remember very clearly the route to application that was current at the time we aspired to enter dental school. This has as many personal stories, twists and turns as our varied professional lives themselves, and each will have been guided by the system of entry during the particular period of applying. The current emphasis on objectivity is to be applauded. I recall going to an interview and waiting in the anteroom with fellow candidates; all male. 'Do you play water polo?' one asked me. I was tempted to give what struck me momentarily as a witty answer along the lines of not realising that horses could swim but thought better of it and said, 'no, why?' He raised his eyebrows (I was so pleased I hadn't tried to be smart) and said 'well this dental school is doing rather well in the regional league and if you do play you'd be pretty much assured of getting a place on the course.' I wasn't given an offer and to the best of my knowledge the school never achieved Olympic status in the swimming pool. Needless to say, thankfully, there is no mention of such requirements in the modern state of affairs.

Recent correspondence about the prevailing problems within the delivery of UK dentistry, especially in relation to NHS contracts, has frequently touched on whether young people are likely to want to join the profession. Yet, there is no indication whatsoever that the popularity of becoming a dentist is waning. Applications to dental school continue to outstrip the number of places available by several to one. The University and Colleges Admissions Service (UCAS) reported a 19% increase in applications for dentistry and medicine in 2021 with a growth in UK recruitment, a sharp decline in EU applications, and a focus on subjects allied to medicine education.2

So, with the tough competition, the stringency of the application process and, from within some cohorts of the profession at least, the pessimistic view of the future, what is driving this undiminished appeal? To answer this, one perhaps needs to consider the current demographics of the profession and the way in which they have changed in recent years. Of most striking significance is the percentage of women colleagues which has now tipped the balance, compared to men, in their numerical favour in the Dentists Register. Do the views of what dentistry is, or could be, influence female sixth-form students to apply in such numbers or does the selection process favour them? Either way, or a combination of both, their newfound dominance will undoubtedly continue to influence the course of our profession; which I hasten to add in case of accusation, is an observation not a judgement.

Young colleagues today seem to attract as much trust and loyalty from their patients as do my, older, generation of clinicians.

I think it is also significant to ask how the raising of entry grades (three A-level 'Cs or Ds' since the 1970s to at least three 'As' and more nowadays) has affected not only the academic quality of candidates but also their expectations. In medicine, there were many mutterings at the time this was brought into being that just because a person was good at exams didn't necessarily assure a similarly good bedside manner. Comparable doubts were cast on dental applicants and chairside manner, and yet as time has progressed, I do not detect any obvious problems. Young colleagues today seem to attract as much trust and loyalty from their patients as do my, older, generation of clinicians.

All well and good, but my next question concerns not so much the robustness of the current UCAS processes per se but the underlying assumptions behind the skills for which these requirements test. Are these a function of what dentistry will be like in 10, 20, 30 years, a professional lifetime? There is already a significant shift in disease prevalence and there promises to be even greater leaps forward brought about by technological change. Will the same situation apply? Just as the previous doubts over bright students failing to become practitioners with sufficient patient empathy have been proved incorrect, will the filters of today offer places to those who can adapt to whatever the rest of this century throws at them and make it work for patient care and improved oral health?

Whatever the questions, just as in interviews, it is the answers and interpretations that are of the greater interest and significance. However the process is conceived and managed, the most important application of all is that of reason.