OPENING SPEECH FOR THE SECOND READING OF THE DENTAL REGISTRATION (AMENDMENT) BILL BY DR KOH POH KOON, SENIOR MINISTER OF STATE, MINISTRY OF HEALTH, ON MONDAY 2 AUGUST 2021

1.    Mr Deputy Speaker, on behalf of the Minister for Health, I beg to move, “That the Bill be now read a second time”. 

Introduction and Rationale for the Bill

2.     Sir, the practice of dentistry constantly evolves with changes in population demographics as well as advancement in technology and materials associated with dental treatment. With Singapore having one of the world’s fastest ageing populations, one of its challenges is ensuring that the needs of a growing ageing population, including dental care needs, are well provided for. 

3.     The Singapore Dental Council (SDC) ensures that there is a steady supply of dentists each year, to meet the expected demand for dental services. In addition to local graduates from the Faculty of Dentistry of the National University of Singapore, the SDC also registers dental graduates from foreign universities. 

4.     The proportion of foreign-trained dentists in Singapore has risen steadily from 20% (302 out of 1,484 dentists) in 2008 to 36% (900 out of 2,475 dentists) in 2019. Against this backdrop, SDC undertook a review of the process for foreign-trained dental graduates to practise in Singapore, to ensure that they meet the same high competency standards as locally trained dental graduates.

5.      SDC assessed that 2 measures are needed to achieve this objective:

a.      First, the Dental Registration Act (DRA) will be amended by this Bill to require that foreign-trained dental graduates must pass a qualifying examination to be eligible for conditional registration; and 

b.   Second, the DRA Schedule will be revised, to list the foreign universities whose dental degree holders are automatically eligible to take the qualifying examination.

6.     This Bill gives effect to the first measure, relating to the qualifying examination, which I will explain in more detail now. The second measure, which I will touch on briefly later, will be effected by way of subsidiary legislation.
Qualifying Examination for Foreign-Trained Dental Graduates to be Eligible for Conditional Registration

7.     Under the current DRA, dental graduates from foreign universities looking to practise in Singapore will typically have to apply for conditional registration first. This means that they have to complete a period of supervised work (usually around 2 years) and be assessed to be competent, before they can apply to be fully registered dentists.

8.      For the purposes of an application for conditional registration, the SDC recognises dental degrees from universities in Australia, Canada, the Hong Kong Special Administrative Region, New Zealand, the Republic of Ireland, the United Kingdom and the United States of America, which are listed in the Schedule of the DRA. If an applicant has a degree in dentistry from a foreign university listed in the Schedule, and also meets the other prevailing criteria for conditional registration, the SDC may grant the applicant conditional registration. These criteria do not currently include a requirement to pass a qualifying examination. 

9.     The SDC may also grant conditional registration to applicants who have degrees in dentistry from other foreign universities not listed in the Schedule. The SDC evaluates such applications on a case-by-case basis and may require that such applicants pass an examination, to ascertain that they have the minimum skills and knowledge to practise and treat patients safely and competently in our local context. 

10.     Clause 4 of the Bill amends section 14A of the DRA to introduce a requirement that foreign-trained dental graduates must take and pass a qualifying examination to be eligible for conditional registration. This qualifying examination, which is currently already taken by foreign-trained dental graduates who do not have dentistry degrees in the Schedule, is administered by the NUS Faculty of Dentistry and overseen by SDC. It assesses a dental graduate’s clinical knowledge and procedural skills which are fundamental to the practice of dentistry. This is similar in scope and benchmarked to the standards of the final-year examination of the NUS Faculty of Dentistry.  

11.     Section 14A when amended will make it a requirement for foreign dental graduates, regardless of whether their qualifications are contained in the DRA Schedule, to pass a qualifying examination to be eligible for conditional registration. 

12.    Foreign graduates who have a degree in dentistry listed in the DRA Schedule will automatically be eligible to take the qualifying examination. Those not listed in the DRA Schedule are not automatically eligible to take the qualifying examination, but the SDC may permit them to do so on a case-by-case basis if the circumstances set out in section 14A(2) apply. The treatment of foreign graduates with degrees in dentistry not listed in the DRA Schedule will not be so different from that under the current DRA in that they already have to pass an examination to be eligible for conditional registration.

13.  This amendment will ensure that the competency standards of  foreign dental graduates who are granted conditional registration in Singapore, whether or not their degrees are listed in the DRA Schedule, are aligned with those of dental graduates who have a Singapore degree (which means someone who has obtained a degree in dentistry from NUS).

14.     This new requirement of a qualifying examination will also ensure that foreign dental graduates are familiar with the requirements for clinical practice here in Singapore. For example, the local dental curriculum has in recent times sharpened its focus on core clinical general dentistry skills, and more emphasis has been placed on geriatric dentistry considering the trends in Singapore’s demographics. 

15.     Under the current DRA, any foreign dental graduate with a degree listed in the Schedule is entitled to be registered as a dentist with conditional registration, if he has secured employment with a local dental practice. With the proposed amendment, the qualifying examination will  be applicable to graduates with degrees listed in the Schedule as well. 

16.    To be clear, there is no change to the regime for dental graduates with a Singapore degree. They continue to be eligible to apply for full registration directly. There is no requirement of a qualifying examination for local-trained dental graduates.

Revision of the DRA Schedule

17.    I now move on to the second measure which we will be implementing to ensure the continued quality of foreign-trained dental graduates who practise in Singapore.

18.        This will be a revision of the DRA Schedule, which contains the list of foreign degrees in dentistry that are recognised by the Singapore Dental Council for the purposes of conditional registration. This list is curated based on a review of dentistry degrees from foreign universities which the SDC deems prima facie to meet the standards for practice in Singapore, subject to the individual dental graduate’s proof of his skills, knowledge and competencies through the qualifying examination. 

19.       As mentioned earlier, foreign dental graduates who have a degree listed in the DRA Schedule will automatically be eligible to take the qualifying examination, unlike the foreign graduates with degrees not listed in the Schedule. Alongside these amendments introduced by the Bill, we will also be revising the Schedule to ensure that the list continues to reflect degrees in dentistry from foreign universities that give their holders this automatic eligibility to take the qualifying examination. The last revision of the Schedule was in 2008, and a review is timely to ensure the continued quality of foreign-trained dental graduates who practise as dentists in Singapore. 

20.     This revision will be done by way of subsidiary legislation and is not part of the Bill. But I have highlighted this as it complements the introduction of the mandatory qualifying examination that foreign-trained dental graduates must pass to be eligible for conditional registration. 

21.      There will be a transitional period after the revision of the Schedule, where qualifications in the current Schedule will continue to be recognised, and their holders (as well as students who are already enrolled or have secured places in courses leading to such qualifications) may apply for conditional registration under the DRA. 

Other Amendments to the DRA22.      The Bill also makes a number of miscellaneous amendments, which are to provide for payment of penalties and composition sums into the Consolidated Fund, as well as for better administration of the Act.

Conclusion

23.      Mr Deputy Speaker, this Bill will ensure the continued quality of foreign-trained dental graduates, and that their clinical skills and competencies are aligned with those of locally-trained dental graduates, so that they can effectively meet the dental needs of our population.
24.    Once passed, MOH and SDC will work closely with the dental community and other stakeholders to implement and operationalise these amendments. At present, the introduction of the requirement for the qualifying examination is planned for 1 January 2029. In the coming months, SDC will engage dental students who will be affected by these changes, to ensure that they understand the new requirements and to address any concerns they may have. 

25.    I seek Members’ support for this Bill. Mr Deputy Speaker, I beg to move.