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Dr Elhami Nicolas.

Since his arrival in the UAE, Dr Elhami Nicolas has been a prominent figure in bringing postgraduate dentistry to the Gulf. He tells MED how he brought big name professors to Dubai; that the burgeoning insurance market is threatening standards and how, 17 years on, he still enjoys living the Dubai-life.

What first brought you to the UAE?

I was working in Saudi and I stayed there for five years and then it was time to make the next move. One of the places I considered for setting up my practice was Dubai and this was because of its reputation at the time for attracting people to the city because of a boom.

There were a lot of people living here and a big Western community, although not at the scale it is today.

How has the market changed since then?

There have always been good dental clinics in Dubai, although some might not have been [as] focused on quality as others. I think many people, given the option, would use their dentists back home and only use their dentist here for limited jobs.

Not many people used their dentists for their whole family. By about 1994 we started to see a change of heart and people had a more positive view of the dental services that were offered and the ability of the dental community to respond to their needs.

The Department of Health has played a very important role in pushing quality up, by scrutinising the dentists licensed to work in Dubai.

This has helped to create the right atmosphere here in Dubai. At the time people may have thought that it was all far too rigorous, but when you look back, you can see that they were not on the wrong track.

Dubai's populations, and its dentists, come from all over the world - how do you make policies that are appropriate for everyone?

I think it is a really hard task. We have different segments in the community and we have different clinicians serving those different segments. It is very hard to set your parameters for quality when you are trying to deal with those segments at the same time.

You cannot have an American dentist serving people in Karama - you need a certain price tag. Economically, it is not feasible to just focus solely on western standards. Having said that, I do think [the Department of Health] did a good job in ensuring the maximum quality within the full range of the community - and this is a tall task indeed.

One of the biggest changes facing the region will be implementing universal health insurance - how will that affect dentistry?

By definition, insurance companies make their money by not paying. Practices and hospitals can only do well when they get paid. This is a dilemma and I hope we don't get to the stage, as in some western countries, where this conflict has led to a deterioration of services.

We have been approached recently by an insurer who has offered to reimburse us mediocre prices for our services and we have decided not to go with that insurer.

There is no way on earth we will sign an agreement that will adversely affect the quality of the services we offer. With the community trying to push the legitimate need for everyone to be covered by insurance, like in a modern state, then we have to bear in mind that it must not affect our quality of service.

What prompted the establishment of the Nicolas & Asp College of Postgraduate Dentistry?

The idea had been on my mind for a number of years, considering the difficulties I have encountered myself when I was seeking implantology education overseas. I am Egyptian in origin and I had to travel to Italy and then to the States to get proper implant education; this was back in 1986.

There is a need for our communities to get international standards of education, in order to carry those communities forward. It has become evident over the past 15 years that dentistry is taking the same route that medicine has taken into specialisation.

The good old general dentist, who could do everything, is an idea of the past. With the sophistication of each area today, then specialisation is a must in dentistry.

Won't Gulf dentists just continue to train in the US or in Europe?

You have to bear in mind that after September 11 our sons and daughters did not have full access to Europe and the States, and also that postgraduate dental programmes are usually extremely competitive to join. This left the region very vulnerable to having a shortage of specialists in the long run.

The idea of setting up of the college came at the same time as the idea of Dubai Healthcare City (DHCC) as a leading health resource for the Middle East. It was an obvious venue for me and we were one of the first people to approach DHCC.

The goal for the college is to bring international standards of postgraduate education to Dubai. We looked at the universities in Europe and found a department that was very strong at Malmo University in Sweden. We made ties with it to offer their programme here in the UAE.

Has it been hard to attract quality professors to Dubai? Or do you have guest lecturers?

Our model is to have our fully-fledged faculty based here in Dubai - we don't want just to have teachers visiting, we want them to be teaching from here on the ground.

We have Professor John Bennett from England, whose books are taught across the world - it happens that he is teaching his new book here with us. We have Dean Donald J. Ferguson, who used to be head of orthodontics at Boston University and he is known worldwide.

These people are teachers at heart and they all wanted the challenge.

Knowledge is the human heritage and you can't contain it in one place. We have real teachers who want to make this work in this part of the world. We have waiting lists for all of our programmes - with us it is highly competitive. But [dentists wishing] to do orthodontics; there is very little chance today that they will be accepted in Europe or the US.

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