One argument that is presented against dentists leaving the profession is of it being a waste of training. This in turn implies a squandering of money and a personal loss of time and effort for the individual concerned as well as leaving a gap in society's oral care provision. No such pressures are expressed when graduates in, say, economics fail to get a job in anything remotely connected with, well, economics. By the same token, who has ever expected those with a successful maths degree to sit and do sums for the rest of their lives? The clincher is the adjective 'vocational'. Dentistry is a vocational course, and as such we have by concomitant motivation made a lifelong choice to have a vocation. This is what eager sixth-formers and their parents perceive as a golden opportunity, searching the application form for the box which says 'tick here for a job for life'.

There is a more than a touch of irony then in the dawning realisation for some colleagues that a job for life means exactly that. The consequence of this is frequently expressed as wanting to 'get out' as if the vocation had some type of prison quality, or at the very least a claustrophobic aura that cloaked the daily grind in a miasma of desire for a mystical yet ever elusive something else. Until fairly recently, indeed it is probably accurate to say within living memory, the notion of a job for life was an exact description of what was available. Until the advent of continuing professional development it was perfectly possible to walk out from dental school one day into a surgery or practice the next and do so every working day uninterrupted for the entire span of a career.

Take 1968 as an example, as I have previously on this page, when the first Adult Dental Health Survey in England and Wales was undertaken. The necessity of it was questioned and its actuality regarded as an interesting academic exercise, as there was just so much oral disease to cope with that the trail of unrelenting work stretched to the horizon and beyond. A job for a chain-gang of lives.

The spell of protective job security

But things are changing. With the recent disquiet from final year dental students over the allocation of places for Foundation Training (formerly Vocational Training) comes the spectre of new UK graduates not being able to work in the NHS. It seems likely that the immediate 'shortage' of places may be solved by various and as yet unexplained means so as to maintain the status quo and absolve consciences, political or otherwise. But in the longer term the number of eligible graduates from the UK and the wider EU will exceed the opportunities available and, more importantly, the places necessary to sustain the number of dentists (or performers in today's parlance) required to maintain NHS contracted services. The very uncomfortable, untimely and unthinkable collision of too many dentists, public economic restrictions and falling disease levels suddenly scatters debris all over the road to a job for life. Or does it?

Thanks to the wonders of the internet, the BDJ is now consumed online by more readers outside the UK than within it, a fact about which I believe we within British dentistry can be justifiably proud. What, I wonder, is their view on the hand-wringing and soul-searching over a less than certain future prospect of finding employment within NHS dentistry? A view from tens, dozens of countries and jurisdictions in which there is no hint of a state system or a public subsidy, never mind an assumption of a right to a job for life would be refreshing I suspect, and probably slightly quizzical.

Is it helpful, as we wake up to this new reality, to consider that like Sleeping Beauty we may have slumbered too long under a stultifying spell of protective job security? It seems that psychologically we find it difficult to accept, or even imagine that there is life beyond NHS contracts despite the actuality that for some years more than half of the income earned in dental practice in the UK has been derived from non-NHS sources. Are we an employment-shackled, dependent workforce of the nanny-state without realising it?

I want to make perfectly clear that, in this, I am not denigrating NHS dentistry, its achievements and aspirations now, in the past or indeed in what it may continue to strive for in the future. But what I think we need to consider is the extent to which we gear our education, our whole working lives and our vocation to it as we have in the past. If our reliance on jobs for life hitherto has served to define us personally and shape us as a profession then we need to acknowledge this if we are to seek a different path forwards. We are frequently told to approach change not as a threat but as an opportunity. Perhaps this interwoven tapestry of circumstances should serve to help us move away from the notion of a job for life towards the optimistic vision of a job for living.