Migrant dentists, health system responses and future challenges: a case study of the United Kingdom and Australia

Dentists, due to their high educational investment and technical skills in managing highly prevalent oral disease are in demand across the world and hence potentially highly mobile. Both the United Kingdom (UK) and Australia, continue to be favourable destinations for migrant dentists. This paper undertakes a comparative analysis of the professional integration of migrant dentists in the UK and Australia, and health system responses, while explicating implications for future health workforce governance in light of the wider context. In doing so, the paper adopts a system-thinking approach to analyse interactions between the migration system and other societal systems. This is the first multi-country study to analyse the professional integration of migrant dentists through the lens of health workforce and migration governance. The study draws on semi-structured qualitative interviews with migrant dentists in both countries, together with national systems registration and examination data and relevant policies, together with data from government and global datasets. Migrant dentists registering through dental registration examinations, who migrated from low and middle-income countries faced more challenges in professional integration compared to those migrant dentists who joined the register through bilateral mutual recognition routes. Both countries are high-income countries with a relatively large dentist to population ratio maintained through reliance on migrant dentists. The health systems and migration governance in both countries have responded to reduce the reliance on migrant dentists by increasing the number of local graduates over the past two decades with limited success in the UK, potentially due to organisational demands, reduced retention of domestic graduates in public sector and the multifactorial complex mutual influences between higher education systems, labour market, feedback loops and dentist migration systems creating a nexus.