Choices and Reasons for RSGM Baiturrahmah Co-ass Student Batch 2018 in Continuing Specialization

Background: The dentistry profession continuously presents information aimed at improving its discipline consistently and measurably to improve the oral health of patients. Specializes in any field that is known to be associated with higher productivity. The same is true for the health sector in general and specifically for dentistry where general practice is being matched by the search for demand for specialists. Purpose: This study aims to look at students' choices and reasons for pursuing a dental specialist at RSGM Baiturrahmah. Methods: This is a descriptive study consisting of 71 college students at RSGM Baiturrahmah. Subjects and methods: consisting of students filling out a questionnaire containing 4 questions, the research time was in October 2020 using a questionnaire. Statistical Analysis: The data analysis in this study used the SPSS program with descriptive analysis. Results: showed that the specialist that students were interested in was periodontics as much as 22.22% and the reasons for students to continue to specialize at most were having skills/talents in specialists as much as 38.03%.


INTRODUCTION
The dentistry profession continuously carries out self-assessments aimed at improving its discipline consistently and measurably to improve the oral health of patients, increasing efficiency in the health care system, and ultimately improving society as a whole. 1 Specialization in any field is known to be linked to productivity. 2 The same applies to the health sector in general and specifically for dentistry where general practice is being competed with by increasing demand for specialization. Dental specialization plays an important role in improving dental health. education and practice, stimulate research, and define quality expectations in various areas of expertise. 2 Various specializations exist in the field of dentistry intending to improve oral health care and several studies have shown that there are a variety of factors that contribute to choosing a particular area of dental specialization. 2,[5][6][7] These factors may be due to advice from friends or family, 8,9 admiration for a particular mentor in the field or a genuine interest in the specialty. 8,9 Although, motivation varies by specialization, additional factors may include lifestyle choices, the possibility of personal practice, interest in a particular disease, space varied scope of practice, interest in research and teaching, financial benefits, perceived remuneration, how attractive this course is at undergraduate level or exposure level to specialization at the undergraduate level. 10 A study conducted in the same locality noted gender bias as a factor and the ability to be with families influencing the choice of specialization. 11 Globally, research has been carried out at both the undergraduate and postgraduate levels. to assess reasons for preference in specific areas of dental specialization. 2.4-7,12,13 Increased socio-economic conditions and factors such as flexible working hours, financial benefits, good job opportunities abroad, selfemployment, and having a family doctor teeth have been identified as significant predictors of career preference and specialization. 12,14,15 Besides, personal interest in specialization and the challenge of the complexity of cases or intellectual content were also among the predictors of specific choice.
In Nigeria, there has been concern about the skewed distribution of dental specialists and its potentially harmful impact on dentistry education. 4,5,13 Previous research has linked this imbalance to the degree of interest biased by dental graduates towards particular dental specialties, as they do not the availability of specialists in less favorable specialties. 4,10 There is, therefore, a need to understand the various factors influencing the choice of dental specialization among interested dentists to identify the reasons for the asymmetric distribution as well as explore ways of providing solutions for the distribution of specialists teeth that are angled on one side thereby increasing awareness of dental care. Based on the foregoing,

RESEARCH METHODOLOGY
This type of research is descriptive with a cross-sectional research design using a questionnaire. The research time was in October 2020. The sampling technique used was the total sampling technique, as many as 71 students agreed to participate in this research. The questionnaires were distributed to co-ass students of the 2018 class at the Baiturrahmah University Dental Hospital, the questionnaires that had been filled in by the subjects were collected, then data was grouped, data processed, and analyzed. The questionnaire consisted of student data, choice of specialization, and reasons for continuing to specialize, names, and other personal information were removed from the questionnaire to ensure confidentiality.

DATA ANALYSIS
Descriptive statistics were performed using SPSS version 24.0 on collected data.

RESULTS
Based on the research that has been conducted, 71 respondents participated in the study with 6 men (8.45%) and 65 women (91.55%). Describing the specialization that respondents interested in, periodontics had the highest number (22.22%) and the least amount of interest was Prosthodontic respondents (1.39%). (Table 3) The reason for selecting specialization by respondents, the reason has most often chosen to continue the specialization is "Having skills/talents in the specialization" (38.03%), followed by the intellectual content of specialization (14.08%), the existence of role models, and mentors in specialization (12, 68%), financial income (11.27), personal desires (9.86%), job opportunities (8.45%), opportunities for private practice (4.23%), flexible working hours (1.41%) and the remaining reasons were not chosen by the respondents. (Table 4)

DISCUSSION
In this study, it was reported that the student data at RSGM Baiturrahmah were more than 65 people (91.55%) of the female sex, namely 6 people (8.45%). The specialization options that were of interest to men were oral and maxillofacial surgery by 1 person (12.5%), pediatric dentistry as much as 1 person (7.7%), Orthodontics by 1 person (9.1%), Community dentistry. as many as 1 people (16.7%), Periodontics as much as 1 person (6.3%), Conservation of dentistry as much as 1 person (14.3%), and specialties that were not selected were Oral Pathology, Oral Disease, Prosthodontics, Dentistry family (0. 0%). While the specialties that most women interested in were Periodontics as many as 15 people (93.8%), Pediatric dentistry as many as 12 people (92.3%), Orthodontics as many as 10 people (90, 9%), Oral and maxillofacial surgery as many as 7 people (87.5%), Conservation of dentistry as many as 6 people (85.7%), Community dentistry as many as 5 people (83.3%), Oral disease as many as 4 people ( 100%), family dentistry as many as 3 people (100%), oral pathology as many as 2 people (100%), and the least chosen is prosthodontics as many as 1 person (100%). A total of 6 men (8.5%) and women 65 people (91.5%) voted.
The specialization that most students interested in continuing their specialization in Denta, Jurnal Kedokteran Gigi Periodontics, namely 16 people (22.22%), whereas, Pediatric Dentistry as many as 13 people (18.06%), Orthodontics as many as 11 people (15.28%), Oral Surgery and 8 people (11.11%), dental conservation as many as 7 people (9.72%), community dentistry as many as 6 people (8.33%), oral disease as many as 5 people (6.94%), Family teeth as many as 3 people (4.17%), oral pathology as many as 2 people (2.78%), and the least number is chosen by students in continuing specialization in prosthodontics as many as 1 person (1.39%).
The choice most favored by students in continuing their specialization at RSGM Baiturrahmah is Periodontics as many as 16 people (22.22%) and the least chosen by students, namely Prosthodontics as many as 1 people (1.39%) this may be because in the prosthodontics section there are many difficulties. and the length of completion, while in the periodontic section student work is easier and faster to finish.
In this study, it was reported that the reasons students continued to specialize were more, namely having skills/talents in the specialization of 27 people (38.03%), while the intellectual content of the specialization was 10 people (14.08%), the existence of role models and mentors in the specialization. 9 people (12.68%), financial income 8 people (11.27), personal desires 7 people (9.86%), job opportunities 6 people (8.45%), personal practice opportunities 3 people (4.23 %), Flexible working hours for 1 person (1.41%) and the remaining reasons are not chosen by students.
Students' reasons for continuing with more specializations are having skills/talents in specialization 27 people (38.03%), while what students do not choose (0.00%) is the variety of activities and procedures, undergraduate exposure to specialization, undergraduate readiness adequacy in specialization, complex and challenging procedures within a specialization, the possibility of passing examinations on time, availability of resident space, peer pressure, patient diversity, not much clinical work, lifestyle, less stressful work style, areas of special needs, research opportunities abundant, and family stress.
An assessment of these multiple factors may explain the underlying reasons behind the skewed distribution of dental specialists in a particular field of dentistry to curb trends and improve overall oral health care. The age and average age ranges observed in this study are similar to previous studies conducted in Nigeria, namely in 2018 students at the Baiturrahmah Dental Hospital, having skills/talents in specialization was reported as the most reason for the choice to continue specialization. This can be explained by the fact that people are intrinsically motivated towards their skills/talents compared to other external factors. This is also similar to previous research.
Family pressure or others has proven to have little or no influence on students in the reason for continuing to specialize, this further reinforces the fact that having the skills/talents possessed by the student in addition to other contributing factors are very important in influencing the choice of specialization for students who are interested in continuing specialization.

CONCLUSION
Based on the results of research on the reasons for students of class 2018 in continuing to specialize in questionnaire-based studies at RSGM Baiturrahmah, it was concluded that the most popular specialization was Periodontics, and having skills/talents in specialization was the most reason for the choice of continuing specialization from students of class 2018 at RSGM Baiturrahmah.
For dental clinic students, choosing a specialization at RSGM Baiturrahmah, so that more knowledge about the specialization will be selected so that the study is carried out easier and can be completed on time even faster.