Mileurism looms in the mythologized dentistry career: "I never imagined such a situation"

“I entered the Dentistry degree with an 11,714 [sobre 14] and in October I will start a master’s degree for nothing more and nothing less than 24,000 euros… one of the cheapest there is, although it seems surreal, but in this career everything is like that”. Whoever speaks from anonymity chose these studies “by vocation”. “No one in my family has a clinic,” he explains. And, after a five-year career at the University of Valencia, he wonders if he has really been worth it: “They take away your desire and enthusiasm.” “Your whole career listening to: ‘When you leave you’re going to have a lot of work and you’re going to get paid even more,’ so that in the end the most you can do is drag yourself along and settle for a disastrous job that barely pays you rent and food.

“Many clinics have called me from which I have not received a response, not even to tell me that in the end they do not have me,” says this dentist who cannot imagine emigrating, like his colleagues who are in the Netherlands or France. He has worked in three clinics and the balance is exasperating: “In the first they told me that I would have a few days of trial and then they would give me a contract, it was two months and the contract never came, in addition to the fact that the treatment of the worker and the patient was appalling”. He continues: “Both in the second and in the third, they offered me to work as a freelancer, something that is very normal in the world of dentistry, but which, as is well known, is a case of false self-employment.” With that figure, he reasons, they save “Social Security and a decent salary and they offer you a colaboration contract that you never sign and charge a percentage. Very low, moreover, because ‘since you just graduated, how am I going to offer you a higher percentage?’ Perhaps billing 3,000 euros for the clinic, you charge 750 and subtract the IRPF [Impuesto sobre la Renta de las Personas Físicas]…”.

Most of this dentist’s colleagues, he says, “are self-employed by quota and not very satisfied with the effort involved in getting a degree to see how dental hygienists [con un título de FP superior] they charge more. Those who have found something decent, or have been very lucky, or have family dentists”. Six out of 10 dentists are under 40 years old and 56% of the total are women.

From the United Kingdom they tempt new dentists with offers ranging from 50,000 to 100,000 euros per year

Jorge (not his real name), a graduate of the private CEU-Cardenal Herrera University of Valencia, presents a much more optimistic face. “It is not a profession to make you a millionaire unless you become an entrepreneur,” he maintains. Setting up a clinic costs about 100,000 euros. Neither he, he says, nor his companions, have felt the precariousness. He graduated in 2021, earns 1,600 euros and has always found a job on the Valencia school job bank. He now has “a little candy” for salary and facilities. So he rules out going to the United Kingdom for the time being, from where he is tempted with offers ranging from 50,000 to 100,000 euros a year, but “just in case”, he is going to enroll in the British National Health System. CEU-Cardenal Herrera held a talk for graduates and seniors, and many showed their interest in leaving.

In 2000 there were 17,000 collegiate dentists in Spain. Now there are 39,000 and calculations say that their number will double in 20 years. 1,700 university graduates a year (1,100 in the private one) and, although a large part of the foreigners enrolled – in some of the 23 faculties they account for half of the student body – return with their families, the truth is that in a country in which there is no Visits to the dentist are widespread – the average cost per Spaniard is 300 euros a year – there are too many graduates and precariousness is expanding. Salary differences are overwhelming and difficult to find in other sectors: according to the study Current situation of the profession and image of the CollegeIn Madrid, 7.4% earned less than 1,000 euros net per month in 2021, compared to 25% who entered more than 3,000. 30% of the members did not answer the question of the survey and 10.2% were in the range of 1,000 to 1,500 euros.

Entrepreneurs outside the sector open businesses and hire dentists as false self-employed”, complains the president of the union

According to that report, 4.5% of dentists in Madrid do not work and 9.4% are employed in another activity, twice as many as in 2019 (4.7%). However, moonlighting in various clinics (57.6%) remains stable. Óscar Castro, president of the General Council of Dental Associations, recognized mileurismo and exploitation in a recent report in this newspaper: “The figure of the salaried worker did not exist until the arrival of the big chains. Entrepreneurs outside the sector open businesses and hire dentists as fake self-employed. Hence the scandals we have had with Vitaldent, iDental… They have schedule obligations, but not seniority rights, vacations… They are exploited. Many dentists are working for less than 1,000 euros”.

Fleeing low wages and seeking better working conditions, hundreds of dentists settle in other European countries -those who have worked in the United Kingdom can practice in Australia- with the idea in many cases of saving to set up their own clinic in Spain. Emigration is not a recent phenomenon, but it is increasing. The General Council of Dentists issued 5,389 certificates of good conduct in the practice of the profession between 2007 and 2016 (nine years), and 3,501 between 2017 and 2021 (four years).

Ebby Fragoso had problems getting her dental degree from Mexico approved in Spain, so she has always worked in management. A year ago, a French dentist who highly values ​​teaching in Dentistry in Spain hired her to recruit professionals for her country. This month – unusual because many graduate – they have closed agreements with French clinics or hospitals for 90 Spanish dentists to practice there. They help them with administrative procedures or learning the language. Fragoso points out that they also “go seniors, with their families and some even had their own clinic” or there are dentists who travel two days a week, for example from Barcelona by train to Perpignan. A junior He does not earn less than 3,500 euros per month, works 35 hours a week and has an indefinite contract.

Teresa, Madrid dentist.
Teresa, Madrid dentist.

Teresa, a dentist, has been in the Netherlands for four and a half years. At first she worked in a town – the demand for professionals is greater in the countryside – and now she lives in Amsterdam. As long as she practices, she has no intention of returning to Madrid. She earns in the range that is offered in the United Kingdom ―from 50,000 to 100,000 euros―, but working only 30 hours a week and in a country where “there is a great culture of taking care of your mouth”. Until the age of 18, the treatment is covered by the State. Although she is self-employed, she does not pay a fee, her social security is covered by taxes. And the fees are priced, so there is no Spain’s fierce price fight that has led to fraud in low-cost dentistry.

Teresa never imagined having to leave, but in 2008 she began to see how colleagues from her faculty emigrated to the United Kingdom. She graduated in 2010, but she was slow to make the decision, despite working in “unfortunate conditions in clinics with few patients doing many kilometers.” She was fake autonomous, she was kicked out and she filed a lawsuit which she won. To exercise, she took an intensive three-month Dutch course. In the Netherlands, as in France, explains Teresa, there are numerus clausus to study dentistry. “The Dutch do better than other European countries to train dentists [no cuesta menos de 70.000 euros] and work in your country.

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