Professional Documents
Culture Documents
Critch Low 2012
Critch Low 2012
specialist training
EDUCATION
process of applying for specialist training.
• Outlines the MFDS and MJDF
examinations, master’s degrees and other
postgraduate qualifications.
S. Critchlow1 and L. Nanayakkara2 • Deals with the potential financial
implications of specialist training.
• Covers other aspects of CV building in
preparation for application to the dental
specialties.
Dental graduates have a number of career pathways to choose from, one of which is to train as a specialist. It is sometimes
difficult to obtain good advice on entering the specialist training process. This paper, aimed at recent dental graduates,
gives an overview of what is required of applicants who wish to obtain a specialty registrar (StR) position in one of the 13
dental specialties recognised by the General Dental Council. The potential financial implications of specialist training are
outlined, along with information on dental foundation training, MFDS and MJDF examinations and postgraduate degrees.
The importance of gaining experience in clinical governance and research is outlined. Advice regarding the application
process and interview technique is also included. It is the authors’ intention that, having read this paper, recent dental
graduates will have increased knowledge of the various career paths that lead to specialisation and those interested in
specialising will have improved knowledge of how to begin their journey.
INTRODUCTION of the existing specialties. Some may have Table 1 List of current specialties
recognised by the GDC4
Application to the dental specialties can a clear idea of which specialty they wish
Dental specialties currently recognised
be a daunting process and one which takes to enter, or may be unsure of whether they by the GDC
dedication and commitment. The amount wish to ultimately pursue specialist train-
Paediatric Dentistry
of information freely available on what ing, preferring to follow an initial career
is necessary to obtain entry to the dental plan which keeps the options open. Special Care Dentistry
specialties is limited and the introduction If you are undecided, it is important to Restorative Dentistry
of new curricula by the General Dental reflect on which aspects of dentistry you
Prosthodontics
Council (GDC)1 and the publication of the enjoy and which you feel you have an apti-
dental Gold guide to specialist training2 tude for. For example, if you have never Periodontics
means significant changes to entry crite- enjoyed performing extractions it is unlikely Endodontics
ria have occurred since the previous paper that you will make a good oral surgeon.
Orthodontics
on this subject was published.3 Specialist Conversely, if you are fascinated by ortho-
trainees are now referred to as specialty dontics it is likely you will succeed as an Oral Surgery
registrars (StR), rather than specialist regis- orthodontist and your innate interest in the Oral Medicine
trars (SpR) and all dental specialist training subject will drive you through the training
Oral Microbiology
programmes are a minimum of 3 years in process. Choosing a specialty is an impor-
length, in line with European legislation.4 tant decision and the determining factors Oral and Maxillofacial Pathology
A list of dental specialties currently rec- should always be your passion and interests. Oral and Maxillofacial Radiology
ognised by the GDC4 is shown in Table 1. With regards to oral and maxillofacial
Dental Public Health
Dental graduates will of course be famil- surgery (OMFS), dentists can work within
iar in broad terms with the nature of each this discipline at a junior level. OMFS is,
however, a medical specialty and will and encouragement to any dentist inter-
therefore not be discussed further in this ested in joining their specialty. Former lec-
1*
Specialist Registrar in Restorative Dentistry, The Royal
London Dental Hospital, New Road, Whitechapel,
article.5 Those thinking of a career in turers and tutors from dental school are
London E1 1BB; 2Consultant in Restorative Dentistry, OMFS will need to adopt a very different useful people to speak to, as are consultant
The Royal London Dental Hospital, New Road,
Whitechapel, London E1 1BB
career path to those entering the dental colleagues and current specialty registrars.
*Correspondence to: Simon Critchlow specialties and are advised to seek advice These discussions will provide an insight
Email: simon.critchlow@bartsandthelondon.nhs.uk;
from their OMFS colleagues. into life as a specialist and will be invalu-
Refereed Paper The next step should be a discussion able in deciding whether to commit not
Accepted 10 November 2011
DOI: 10.1038/sj.bdj.2011.1100
with an existing specialist in the field. just to specialist training but also to the
© British Dental Journal 2012; 212: 35-40 Specialists will be happy to give advice career that follows it.
Table 3 Comparison of the MFDS and MJDF postgraduate qualifications Emphasise that although you are pri-
marily interested in one specialty, you
MFDS MJDF have a wide range of experience. This is
Awarding body The Royal College of Surgeons The Royal College of Surgeons an advantage when undertaking multi-
of Edinburgh of England disciplinary care; something which is of
The Royal College of Surgeons particular importance in a secondary care
of Glasgow
environment. Attendance at conferences
Eligibility criteria Successful completion of 24 months Successful completion of work-based or courses related to your chosen specialty
full time postgraduate experience in experience and submission of
dentistry required for award of the Portfolio of Evidence will enhance and demonstrate your knowl-
diploma edge and be sure to mention your most
Exam format Part 1: Written examination contain- Part 1: Written examination recent basic life support course and other
ing multiple choice questions and a containing multiple choice questions, core CPD.
separate short answer paper. single best answer questions and
extended matched item questions
Membership of specialist societies is an
Part 2: OSCE examination
Part 2: OSCE examination advantage as it not only shows willing-
ness to learn but also affords an opportu-
Fees (2011- UK Part 1: £555 Part 1: £475
based examination) Part 2: £675 Part 2: £600
nity to meet others with shared interests
Portfolio: £50 and to build on their knowledge base.
Although membership is not free, many
Total cost £1,230 £1,125
offer reduced membership rates for recent
graduates. Any lectures or seminars you
in Ireland. This two-part examination has firmly recommend one over the other. It have given, or posters you have presented,
full reciprocity between both parts of the may be that one sounds easier to obtain, will add the finishing touches to this sec-
MFDS qualification offered by the Royal one is more convenient in terms of the loca- tion of the application form.
College of Surgeons of Edinburgh and the tion of the college, or the cheaper of the
Royal College of Physicians and Surgeons two diplomas may seem the most attractive. PERSONAL ATTRIBUTES,
of Glasgow. The MFD qualification will not Further information regarding MFDS and
SKILLS AND ATTITUDE
be dealt with in further detail in this paper. MJDF exam syllabuses, sample questions Some of the criteria listed in these sec-
Full details are available through the Royal and examination timetables can be found tions are difficult to demonstrate on an
College of Surgeons in Ireland’s website.7 on the respective Royal College websites.9–11 application form or at an interview, such
Although now listed in the desirable col- as having the ability to establish profes-
umn, it would be unusual to be appointed TRAINING AND ABILITY sional relations with patients. Much of this
to a specialist training position without Following DFT there is the additional information will come from your referees.
one of these postgraduate qualifications. option of undertaking a 1 or 2 year Dental However, the application form may con-
Therefore, obtaining MFDS or MJDF is still Career Development Post (DCDP) to gain tain specific fields such as:
the first step on the road to specialisation. additional experience in a specific spe- • Give a recent example of a situation
While closely related, there are some sub- cialty. Further information on DFT and where you used your initiative
tle differences between the two. A com- DCDP can be found on the COPDEND web- • Tell us about a recent difficult situation
parison of the two qualifications is shown site.12 Simply by undertaking DFT, or DFT you have managed
in Table 3. plus a DCDP, many candidates will acquire • Give a recent example of when your
The usual pathway for candidates the items listed in the desirable column in communication skills were tested.
wishing to obtain MFDS or MJDF is to Table 2. However, it is in the completion
undertake 2 years of dental foundation of the application form and at the inter- These often have a strict word limit.
training (DFT). This will involve comple- view where these skills are demonstrated, In some respects the actual scenario you
tion of vocational training and then one so be sure to include all your experience choose to describe is less important than
year spent in a dental hospital, a general in these areas. how you structure your answer. Firstly,
hospital undertaking a job in oral and Particularly relevant in this section is the scenario should be briefly outlined.
maxillofacial surgery or working in the audit and it is worthwhile undertaking Secondly and most importantly, your
community dental services. During DFT, additional audit projects to flesh out this role in how the situation was successfully
candidates for MJDF can build their port- section of your application. Completion of resolved should be described. Finally, what
folio of evidence8 by undertaking addi- an entire audit cycle is an advantage as you learned from this experience should
tional projects under the supervision of it shows that not only has an audit been be stated. There is no need to feel your
their consultants and educational super- completed but also that changes have been scenario is trivial or may compare unfa-
visors. Alternatively, candidates can fulfil implemented as a result. A well-presented vourably to other applicants. These fields
the requirements for MJDF while working log book also makes a good impression. are designed to demonstrate your ability
in general dental practice. Inclusion of details of any specialist skills to describe a scenario succinctly and show
Choosing which examination to take is acquired, with reference to your log book, you have learned and grown as a result
somewhat difficult and there is little to will demonstrate an interest in the specialty. of your experiences. These questions may
also come up at an interview so be pre- Table 4 Estimated average cost of undertaking a clinical masters degree at a UK
pared to expand on what you have written dental school
on your application form. Course duration Average tuition fees Average living expenses Total
This section also deals with teamwork
One year full-time/ £19,617 £9,000 £28,617
and it is therefore useful to mention two years part-time
any multi-disciplinary clinics you have
Two years full-time £39,233 £18,000 £57,233
attended to demonstrate this. Any addi-
tional responsibilities you have undertaken,
such as committee membership, manage- We strongly advise that you publish any degree (MPhil). Potential applicants have
ment experience and organisational roles, research you have done. Publications are the option of obtaining a master’s degree
should also be mentioned here. an important method of contributing to the before applying for a speciality training
profession’s knowledge base, to the spe- position. This is of particular relevance to
PUBLICATIONS cialty of your choosing and for the benefit those specialties where a master’s degree
Publications are a useful way of demon- of patients and the public. Indeed, research is an expected, as opposed to a manda-
strating motivation, knowledge and organ- is only useful if it is published as it is only tory, requirement of the training. A mas-
isational skills. Writing a book review or through disseminating knowledge that the ter’s degree will undoubtedly enhance your
a letter to a journal can be an effective profession can benefit. Do not be discour- CV although it will require significant per-
introduction to the publication process; aged if you feel your research project is sonal and financial commitment.
this can be achieved by contacting popular not a large, groundbreaking study; these Master’s degrees vary in subject, dura-
dental journals. While book reviews and are few and far between. Instead draw tion and design (full-time, part-time or
letters are not equivalent to peer-reviewed satisfaction that you have contributed distance learning). Thirteen UK dental
articles they are recognised as publications to the overall knowledge of your chosen schools offering clinical postgraduate
and do show initiative. Case reports are profession; not to mention enhanced your taught master’s degree programmes were
another useful way of gaining a publica- job prospects. contacted and asked to supply details of
tion and it is recommended that as soon You will undoubtedly be asked a ques- their tuition fees. Ten schools responded.
as you see an interesting case, take it to tion about the principles and practice of For EU graduates, total fees ranged from
your educational supervisor and ask if it research in your interview. Make sure you £14,000 to £50,000 depending on the pro-
is suitable for publication. Educational have familiarised yourself with different gramme. It should be noted that non-EU
supervisors are there to support you types of research methodology, the hier- citizens usually pay a higher rate of tui-
and are generally delighted to help with archy of scientific evidence and keep in tion fees. Non-clinical master’s degrees
such projects. mind a specific paper you have read in are also available; for example, in dental
case you are asked to give an example. public health. Tuition fees are considerably
RESEARCH Reading one of the many books avail- lower for non-clinical master’s degrees.
Research has been defined as ‘perform- able on critical appraisal technique will Specific details of the courses available
ing a methodical study in order to prove be advantageous. Those candidates who at each university can be found on their
a hypothesis or answer a specific ques- have completed a master’s degree or PhD respective websites.
tion’.13 It is difficult for recent graduates to will have had research experience and are Full and part-time master’s degrees
get involved with large research projects. at an advantage in this area. will involve taking time out of full-time
Junior staff generally undertake one year employment. Therefore, living expenses
rotations and research projects often take POSTGRADUATE DEGREES: must be taken into account when calculat-
a year to plan and approve before they
MASTER’S DEGREES ing the total cost. It is difficult to obtain
even begin. Analysis of results, writing Most specialty trainees are expected to exact figures; £9,000 per year has been
up and preparation for publication are all undertake a master’s degree as part of their quoted as an average, although this relates
time consuming processes. It is not there- training. It is a mandatory requirement for to undergraduate living expenses.14 Many
fore realistic to complete a substantial some specialties but not others; although postgraduate students’ living expenses
research project as a DFT. However, this there is usually an expectation that one may be significantly higher than this, with
does not mean you cannot get involved in will be undertaken. For example; restora- additional outgoings such as mortgages to
research. Volunteering to help with some tive dentistry has no specific requirement consider. For the purposes of this paper,
of the more labour-intensive aspects of for a master’s degree, whereas special- we have used the figure of £9,000 and the
the research process, such as the ethical ist training in orthodontics will always estimated average cost of undertaking a
approval process, will often be welcomed involve a master’s degree. clinical master’s degree in the UK is shown
by senior staff and will give you exposure Master’s degrees available include in Table 4.
as to exactly what goes into a research Master of Science (MSc), Master of One look at this table may be enough to
project and something to talk about at your Clinical Dentistry (MClinDent) and Master put many young dentists off a career in the
interview. Involvement in critical review or of Dental Science (MDentSci). Research- dental specialties. The figures involved are
journal club meetings will also increase based master’s degrees are also available indeed daunting. The average debt from
your insight into research methodology. in the form of a Master of Philosophy BDS courses was £25,545 in 2010 and this
will certainly rise in the coming years as to non-academic training posts, although
THE INTERVIEW
tuition fees increase.15 It remains to be seen tailoring your application by placing more Most people only undergo the arduous
whether this will have an impact on the emphasis on any research and teaching process of a formal interview a handful of
number of dentists choosing a career in the experience you may have is advisable. times in their working lives. However, giv-
dental specialties. Conversely, undertaking In many respects it is very difficult to ing a good interview is a skill and as such
a master’s degree as part of your specialist ascertain when and where these academic can be honed and improved with practice
training programme can be financially less StR positions will appear and as such it and preparation. When you receive the
arduous, although there is additional work is often difficult for aspiring dental aca- news you have been short listed, arrange
involved in balancing your clinical train- demics to plan their career with any cer- a mock interview with a consultant col-
ing with your academic study. tainty. This is something to be mindful of league with experience of the special-
There is no doubt that undertaking a before committing to an academic career. ist interview process. This will provide
master’s degree will greatly increase not Further information on academic StR posi- an invaluable insight into what sort of
only your knowledge base but your clinical tions can be found on the Committee of questions you are likely to be asked and
skills as well. This is a great advantage in Postgraduate Dental Deans and Directors some immediate feedback on your per-
applying for a specialist training position. (COPDEND) website.12 formance. The interview format will vary
If having undertaken a Master’s degree you from deanery to deanery; some may have
decide specialist training is not for you SHORT LISTING more than one panel and some will expect
then the degree will equip you with the We recommended that as soon as you decide candidates to have prepared something in
skills necessary to enjoy a successful and specialist training is right for you, apply for advance. This could take the form of a
fulfilling career in general dental practice. any and all positions that become available. short presentation or simulated seminar/
Your first application or interview may not lecture. Clearly asking a senior colleague
POSTGRADUATE DEGREES: be successful so be prepared for this and do to help rehearse the presentation will be
RESEARCH DEGREES not be disheartened. You will gain useful of benefit.
For those interested in dental academia, a experience of the application and interview Reading one of the books available to
postgraduate research degree is an essen- process which will stand you in good stead our medical colleagues on interview tech-
tial requirement. Postgraduate research for your next opportunity. nique is strongly recommended. Many of
degrees usually take the form of a Doctor Great efforts have been made in recent these books can be applied to the dental
of Philosophy degree (PhD). Like masters years to make the interview short list- specialties and contain much invaluable
degrees, PhDs can be obtained before or ing process as transparent as possible. information on interview technique as
during specialist training. Those undertaken Applications are passed to a short list- well as detailed information on favour-
before entry into specialist training can be ing panel and each application is scored ite interview topics, for example, clinical
self-funded, or funded as part of a junior according to certain pre-set criteria based governance.
lecturer’s position, such as a clinical fel- on the person specification. The scoring There is an enormous amount of material
lowship. After obtaining a PhD, academic system will vary and some deaneries will available to the potential interviewee; to
specialty registrar positions are available, publish it alongside the person specifica- outline it all in detail is beyond the scope
whereby you complete your specialist train- tion. It is absolutely invaluable to have this of this paper. We would direct candidates
ing while undertaking the research and information as it allows applicants to tailor to the World Wide Web and to bookshops
teaching responsibilities of a dental aca- their application to score as many points in order to make the most of the wealth
demic. This pathway may sound attractive; as possible. If the short listing criteria are of information that exists in this area.
however, undertaking a PhD as your first not available, try to obtain a copy from In summary; the better prepared you are
major research project is extremely chal- another deanery or a colleague so you at for the interview the more likely you are
lenging and will be doubly so if you have least have a general idea of what will be to succeed.
no previous research experience at all. Some expected at the short listing panel.
involvement in research during your foun- A potential pitfall is to rely solely on the CONCLUSION
dation training is therefore advised if you are more substantial aspects of your CV. If you Healthcare by its very nature is in a con-
interested in an academic career. Those who have a master’s degree, this may only be stant state of re-organisation and reform.
have already completed master’s degrees will worth the same amount of points as any It is impossible to predict the future in
be at an advantage due to the research com- and all of the other criteria; for example, terms of the number of hospital and com-
ponent that master’s degrees contain. shows initiative or has computer skills. munity specialist positions, training path-
Alternatively, 7 or 8 year StR posts Do not assume that you do not need to ways, the economy and job opportunities.
with integrated PhDs are also available. spend as much time on these other criteria This should not put off those wishing to
Although these posts are salaried it is up as you may fall foul of the short listing specialise; rather those seeking a specialist
to the trainee to secure research funding scoring. This means that those without career should be flexible with their over-
for their PhD from external sources, such postgraduate degrees have an excellent all career aims and recognise that dealing
as the Wellcome Trust, with the support of chance of being short listed providing with reform and change is part of being a
their supervisors. The criteria for entry to they fulfil the other criteria outlined in the specialist. This should be seen as an oppor-
these academic positions are often similar person specification. tunity rather than an obstacle.
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