Abstract
Background: Saudi Arabia is a conservative country with a population of 32 million people. The country aims to build an indigenous health workforce, rather than relying on expatriates, through a policy of ‘Saudisation’; thus, there has been rapid expansion of dental schools, where education is segregated by gender. In 2013, only 26% of the dental workforce was Saudi, of which 36% were female.Aim: To explore the perceptions of Saudi females in dentistry on the motivation, expectations, influences, obstacles and facilitators for their professional career.
Methods: This sequential, exploratory mixed-methods project was approved by King’s College London Ethics Subcommittee (BSDMNMS LRS-14/15-0750), and consists of the following:
Interviews: Semi-structured interviews with a purposive sample of Saudi female dentists taking account of context, age, type of practice and current female dental students in the main cities. A topic guide informed by past research was used to guide the discourse. Interviews were recorded, transcribed and analysed using Framework Analysis, a systematic matrix-based iterative process that is grounded in the data.
Questionnaire Survey: Cross-sectional parallel questionnaire surveys of Saudi female dentists and final year dental students were conducted with the support and approval of the Saudi Dental Society and deans of dental schools respectively. The questionnaire instrument [GMI] from previous research, was adapted based on the qualitative findings and piloting. Descriptive, exploratory and confirmatory factor analysis and multivariate regression analysis of the career motivation, expectations, influences obstacles and facilitators were undertaken using SPSS (version 24) and STATA (version 15) to analyse combined data for dental students and dentists.
Results: Twenty-one interviews were conducted, one third of which were with students. Saudi females in dentistry reported being motivated to fulfil their interest in a professional, highly prestigious, continuously developing career while maintaining a family-work balance within a culturally accepted frame. Career aspirations were influenced by a range of factors acting as either obstacles or facilitators focusing on personal, professional and institutional aspects, rather than social domain. In total, 209 female dentists (28%) and 220 students across six dental schools responded to the questionnaire survey representing approximately one in five of the profession and students. Questionnaires with missing data were removed resulting in 286 completed responses for 131 dentists and 155 students. Dentists comprised specialists (34%), academics (31%) and general dentists (28%). A majority of students aspired to specialise (64%) and work in hospital settings (53%). Five motivational factors for a career in dentistry were identified, explaining 54% of the variability, including academic/scientific, practical/artistic professional career in public sector healthcare, experiences and careers advising, features of the job, autonomy and family and friends. Seven influential factors on professional careers in dentistry explaining 53% of the variation included institutional, personal characteristics, occupational circumstances, career achievement, family, financial influence and standard of living. Furthermore, five obstacles to females’ careers in dentistry were identified which explained 57% of the variability and included negative work and community environment, attitudes towards females in dentistry, domestic circumstances, difficulty of career development and legislation related to women. Lastly, four facilitators for females’ professional careers in dentistry were perceived as addressing the recognised obstacles and explained 56% of the variability including dental policy, positive work environment, opportunity for career development and legislative freedom for women. III Sociodemographic variables, most notably being a dentist or student, parents’ education, having a parent in dentistry, age and type of school, were associated with the career motivation, expectations, influences, obstacles and facilitators for Saudi females’ careers in dentistry. Dentists were more likely to report work-related and sociocultural influences, obstacles and facilitators for their careers, while students were more likely to anticipate legislative obstacles and suggest the change in legislation is a facilitator for their careers.
Conclusion: The findings suggest that Saudi females in dentistry aspire to fulfil their interest in a successful, professional, highly prestigious, progressive career, whilst recognising cultural expectations and maintaining a family-work balance and perceive this is possible through a career in dentistry. Saudi females participating in this research appear committed to develop their careers in dentistry, however, personal, sociocultural, professional and legal obstacles are suggested to hinder their career progression. Support for career development within social, professional and policy environments was important for the experienced dentists, while dental students showed optimism and professional uncertainty with career expectations that have important implications for the future workforce. Whilst the findings of this project share many similarities with females in dentistry elsewhere, however, the sociocultural context of Saudi Arabia, underpinned by political, religious and legislative foundations contribute to the differences that may arise.
| Date of Award | 1 Apr 2019 |
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| Original language | English |
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| Supervisor | Jenny Gallagher (Supervisor) & Wael Sabbah (Supervisor) |