Overview of Specialty Training

Ian Sharp: My name is Ian Sharp. I'm the associate dental postgraduate dean with responsibility across Midlands and East, that is West Midlands, East Midlands and East of England. I look after specialty trainees that we have in the various dental specialties across that patch.

Dental Specialty Training is a series of different programmes across the 13 dental specialties which typically will take people from the end of their Core Training years through a process of 3 to 5 years of further refinement. Some of those people will end their training at 3 years, they'll be a specialist, and some will do further training for another 2 years, up to a total of 5, and usually that will end with consultant appointment.

There are 13 specialist lists which are recognised by the GDC and depending on where you are in the country there are different programmes. For example, in the Midlands and East, the training programmes include Orthodontics, Restorative Dentistry, Special Care Dentistry, Dental Public Health, Oral Surgery, or Maxillofacial Pathology.

The traditional way that most trainees have, and indeed still do, access Specialty Training is after 3 or 4 years of postgraduate training. They will have done their Foundation Training and then 2 to 3 years of Core Training. Increasingly we're finding that people who have been out in practice for a while are choosing to return; and with the flexibility of training pathways we are starting to see much more of that than we ever did in the past. The type of training will vary in its duration, it will vary in terms of its content obviously by specialty, but it would also vary in terms of the location of its delivery. I think that's quite important because again certain types of training location perhaps appeal more to certain trainees.

For each of the specialty areas there is a curriculum, and the curriculum clearly includes the syllabus in terms of the knowledge and skills that they need to learn and acquire but it also outlines the assessment processes and other aspects in terms of support for study leave, for additional courses, for additional training and so on.

The structures and processes around training are quite important and we have a line management structure that goes down and reaches into the training units and ends with the educational supervisor or the clinical supervisor; that will typically be a more senior dentist who is experienced or is a specialist and who will guide the individual trainee. We then monitor that progress of the trainee through a series of reviews that will check that the competencies the trainee is acquiring are being met. It's not about time served it's about skills and knowledge acquired.

When a trainee has completed Specialty Training the specialist can work in a hospital, but they can also work in a specialist practice. For example, Orthodontics or in Oral Surgery delivering an aspect of higher-level oral surgical care in community or in practice. Trainees that choose to go further up to 5 years typically will end up usually in consultant practice and depending on what specialty they are in that may be tied into a dental hospital. For example, Oral Medicine tends to be very much based in dental hospitals, whereas a specialty like Orthodontics there's a network across district general hospitals and dental hospitals as there is for Restorative Dentistry.

David Green: My name is David Green. I'm a specialty registrar in Restorative Dentistry. It's a 5-year training programme and I'm currently based at Birmingham Dental Hospital in the West Midlands. 

I love Restorative Dentistry - it's a great pathway and it's a great career choice in my opinion. It's very technique sensitive - you have to refine your trade and get very, very good and you also have to get good at different areas. So Restorative as a whole incorporates Prosthodontics, Endodontics, Periodontics.

Each of those disciplines, you have to refine your trade and technique and then you use that to treat patients with complex symptoms and findings. Part of who we treat are oncology patients so acquired maxillofacial defects, also patients with cleft lip and palate, patients who’ve undergone substantial trauma, and patients with hyperdontia or missing teeth. 

So it's a very, very interesting specialty, very dynamic. From the training programme as well, you develop leadership skills, you develop the ability to teach. I've also gained additional experience as well as clinical - so that would be sort of management positions, leadership positions. 

I think in Birmingham you have a really, really good standard of life. You can buy a nice house, you can enjoy yourself. And it's just a great, great city to be in - there's lots happening and lots going on. 

Because we don't have any competing dental hospitals, we get the whole broad array of treatment. I feel one of the real benefits of working the Midlands as well is we've got some beautiful purpose-built hospitals. Also, we're very lucky to work with maxillofacial colleagues and orthodontic colleagues, but particularly some of the maxfacs colleagues at QE, we develop very good relationships with them. We undertake MVT clinics, where we plan complicated patients like our oncology patients or hyperdontia patients, and that's a great learning environment. 

So I think Specialty Training is fantastic. I think it's an amazing experience. It pushes you to the next level. So part of the training is it's a peer review process - you constantly have people that want you to improve. There's some great opportunities to do some Dental Core Training. For Dental Core Training as a whole, you get exposed to different specialities, you can find what you're interested in. 

Other things I would advise before you pursue a role is to look at things like job specification or personal spec of registrar positions, because then you can look and actually see what skills and what your CV needs to consist of in order to get trained. 

I would advise contacting people perhaps a couple years ahead of yourselves or people currently in those positions, because it gives you a really good opportunity to learn first hand what the pros and cons of that training is. Some of the earlier Dental Core Training jobs tend to be split, so you could do 6 months in Oral Surgery, 6 months in Restorative and this is a really, really good opportunity to get an exposure to actually see which aspects of dentistry you like. 

I'm currently in my 4th year of registrar training, so I've got just over a year left. I've previously done my MRD in Prosthodontics in London and also submitted my MSc, so I've got some really, really good grounding.

Every single day is reflection, learning is developing. I will hopefully work as an NHS consultant which requires different skill sets. Restorative training in the Midlands has been an excellent opportunity.