Dental Core Training by Bethany Rushworth

DentaltownUK Magazine - Dental Core Training
by Bethany Rushworth

Bethany Rushworth discusses the pros and cons of dental core training

Bethany Rushworth

Within a month of starting my first job as a dentist (and possibly before I had even picked up a handpiece), I was asked whether I would be applying for dental core training (DCT) for the following year.

I felt as if I had only just finished the national recruitment process for my current job, and now I was being told it would all be starting again in just three months’ time. I applied for a DCT post in oral and maxillofacial surgery and got the job.

Around a month into my second job, I was asked whether I would be applying for a second year of DCT. I was having to make this decision and begin preparation of a portfolio before I had even completed the induction!

To perhaps make this decision process easier for colleagues considering DCT or interested in learning more, I’ve put together some pros and cons of the job and an insight into what the role of a DCT may involve.

First up: What is DCT?
DCT is a year-long training post in a single or mixed dental specialty, meant to improve a dentist’s skills and broaden experience in this field. Trainees can complete up to three single-year posts, DCT1 to DCT3, and must apply for it each year they wish to continue their training.

Training posts include restorative dentistry, paediatrics, community and special care dentistry, oral surgery, maxillofacial surgery and oral medicine. It is a structured pathway with portfolios and reflective and teaching sessions, often completed before beginning specialist training.

As a student, feedback was always given to us as a ‘positive sandwich’, so I will use that approach here, as overall (as you will see), I am very much in favour of completing DCT during your early dental career.

From my experience in oral and maxillofacial surgery, and from speaking to colleagues who completed DCT in other specialties, structure is a definite advantage of this training pathway. The Committee of Postgraduate Deans and Directors (COPDEND) website specifies which specialty-specific competencies should be demonstrated after completing each year of DCT.

The pathways are tailored in a way that trainees should be able to achieve these competencies, allowing for development of skills in a controlled and organised way, providing fairly consistent outcomes in terms of what experience has been obtained over each year of training.

For anyone interested in research, presenting at conferences or even getting published in a scientific journal, DCT is an excellent way to get involved.

Whilst there certainly are other ways to achieve this, working in a dental/general hospital setting exposes you to opportunities to collaborate with other members of the team, and most people who work hard will get what they’re looking for out of the job. There are study days and conferences targeted at DCTs, with the possibility of presenting orally or taking a poster.

The job is salaried; depending on the level of core training and on-call requirements, this can be anything between around £30k,000 (DCT1 with no on-call) and £57k (DCT3 with a high proportion of on-call). There are no specific totals to achieve and there isn’t a UDA in sight! This can be great in terms of financial planning, and it does take away some of the uncertainty for young dentists who are unsure how quickly they’ll be able to meet targets in general practice.

Team experiences teach more
Another advantage is working as part of a large team.

Whilst some jobs have only one DCT position available, it’s still likely you’ll be working with more people than if you had stayed in general practice for the year. This allows you to learn from others, and to become aware of other available options in terms of career pathways.

I enjoy being part of a team and working together to achieve an end goal. This can test your communication skills and there is a need to prioritise tasks and delegate, which are valuable attributes that can be developed, preparing you for a career as a dentist.

In oral and maxillofacial surgery posts, you’re likely to be expected to work some weekends and nights. I think this is a positive of the job—most of the time!—and with fewer people around to help in terms of senior staff, it increases the amount of work being done independently, improving your confidence and decision-making skills.

Another specific advantage of oral and maxillofacial DCT in a hospital with oncology patients is improved diagnostic ability and awareness. I believe this job gave me insight into different presentations of cancer and conditions of the oral environment. Oral cancer is rarely seen in practice, but the DCT job increases exposure to these conditions, making dentists better informed as to what needs an urgent referral and how to better support these patients in general practice.

Time in theatre also improved my knowledge of head and neck anatomy, because there’s nothing like seeing it firsthand and being quizzed about it by a senior in the process!

Now for the downsides ...
I believe there are three main negatives to the job.

  1. Long hours. This may not apply to other specialties, but oral and maxillofacial surgery core trainees work days of 12 hours or more about half the time, and then often have work to do in the evenings—projects, papers, audits, etc. This can be tiring and makes it difficult to have much of a social life. It can make having a routine difficult, too, when you keep switching between weekend shifts and night shifts, or days with longer or shorter hours. This isn’t a big issue—and you do get used to it!—but for those who would have a long commute or have children, for example, it’s something to consider when deciding which specialty to do core training in.
  2. You do a lot of administration and ‘box-ticking’. The requirements vary dependent on region, but this can involve: observed clinical exercises; case-based discussions which you reflect on via an online portfolio; mandatory study days; essays and presentations; compulsory audits; educational supervisor meetings; and an online record of all achievements through the year. Most people also complete a log book of experience or procedure numbers for their portfolio. Toward the end of each year, a meeting determines whether you’ve met expectations and fulfilled requirements to successfully complete the training year.
  3. The application process is competitive and takes a long time. All dental core training applications are through national recruitment, which takes around 6 months to complete. There is an online form, then an invitation to interview, ‘preferencing’ of jobs, a situational judement test (done at a test centre regionally) and a standardised interview with three stations (such as communication skills). For DCT2 and DCT3, there’s one more portfolio station. That’s followed by a further ‘preferencing’ opportunity before job offers are released. More information about this is on the COPDEND website, but the process requires a lot of preparation and isn’t a simple local interview. This system can be quite draining—especially if you have been through it several years in a row for DFT, DCT1–DCT3, then for specialist training as well! It can feel like you’re constantly being interviewed and assessed and the uncertainty of where your job offer will be can be a concern, especially if you have a home, children or want to stay close to friends and family.

The verdict: Definitely worth a try
I believe that dental core training is an amazing opportunity, and would recommend it to anyone who feels able to do this, even for just a year.

The support available is excellent, and to develop experience and confidence in a structured way is invaluable. I believe my training in oral and maxillofacial surgery helped prepare me for all aspects of general dentistry. I rapidly gained skills in managing complex cases (medically or situational); I have more confidence in ‘breaking bad news’ and tactfully discussing sensitive issues; I’ve improved my surgical and diagnostic skills; I’m better at interpreting radiographic images; and I’m a safer prescriber and a much more well-rounded clinician.

Dental core training is not just for those wanting to specialise! It’s worth the possible pay cut, compared with general practice, in exchange for the experience you’ll receive in return.

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