Dental Foundation Trainee? Here are a few tips on how to make the best of your first year in general practice.
DCT1 General Duties
Liverpool University Dental Hospital
Shakil graduated from Glasgow Dental School in 2015 before completing his Dental Foundation Training in Eccles, Manchester. He is now working as a General Duties Dental Core Trainee at the Liverpool University Dental Hospital, alongside a part-time associate position in general practice.
Hopefully you’re all settled in to your new post by now and finally getting the opportunity to put all those years of studying to good use! Your DFT year is the time to refine both your skills and put them into practice. As such you may find that you will actually learn more in this year than your all of undergraduate years put together. Having just completed my DFT year, here are some of the tips I’ve picked up along the way to help make the most of dental foundation training.
Just focus on the quality of your work. Although speed is eventually important for preparing for an associate position (especially in the current UDA based climate), it is something that will come naturally, as you become more experienced and subsequently more efficient.
Although it’s undoubtedly important to recognise your limits (as I’m sure you recall from the GDC standards you memorised back to front for the interviews) don’t be too hesitant to push your them and step out of your comfort zone. Don’t shy away from surgicals, re-root treatments and other more complex procedures that should all be within the scope of general practice. Some GDP’s may shy away from them and be more inclined to refer, which could be attributed to financial feasibility and clinical need. However, you have the luxury of not having to worry about targets and speed this year, so push yourself and hone your skills in this protected environment. As my TPD once told me “you don’t want to become a glorified therapist”.
Following on from the previous point, although you should push yourself, clearly you shouldn’t just jump in gung-ho! Recognise your limits, and first discuss the case with your trainer or even do it as a hands on tutorial session. That’s what your trainer is there for, so make the most of it.
Also, take the opportunity to shadow your trainer on occasion. You don’t know what you don’t know, and it’s surprising how much you can learn for even the most simplest of treatments.
If you have other associates in your practice, get their opinion on cases as well. As they say “ask 5 different dentists and you’ll get 5 different treatment plans”. Your first port of call should be your trainer, but it’s occasionally it can be beneficial to get another perspective. Dentists all have different philosophy’s in managing cases, and you need to find your own.
On the note of teamwork, I’m sure you’ve already learned that the mood of your nurse can be the difference between a smooth, productive day, and a stressful one resulting in you wanting to throw the chair out the window! (Although that might just be me. Maybe another tip should be to take up yoga. Wooo-saah!). So build a strong working relationship with your dental team. This includes the reception staff.
Also, the nurse is a crucial cog in the dental team for everything from 4-handed dentistry to communicating with patients. They have a wealth of experience that is available to you and that you should take advantage of. On the other hand it’s important to establish clear boundaries, such that they do not overstep their remit or contradict you in front of a patient. As the dentist you are the leader of the team and this position should be clear. Which can be difficult, particularly as a young, fresh, ‘newbie’ having to manage an older experienced nurse.
Speak to your lab and tell them to give you constructive feedback if there’s ever an issue with anything, such as the quality of your impressions or bite records, or if they think another treatment would be more suitable (material selection, denture design etc.). Otherwise they’ll just make do with what you’ve provided and you could even end up needing a remake. You could take this a step further and visit your lab. They will also have plenty to teach you and will ultimately improve the standard of your work. Finally, feedback goes both ways so let them know, not only when they could have done better, but also when they’ve done a good job.
Use this year to practice your clinical photography skills. It’s great for personal reflection (buzzword alert!), and will also allow you to discuss more cases with your trainer, as they may not always be available to come into your surgery. Furthermore, it will improve your communication with both the patient and laboratory (shade taking, denture try-ins etc.), which can improve case acceptance and the aesthetic result of lab work. It will also be useful for building your portfolio. I would recommend investing in your own camera, even if you have a shared practice camera. A basic easy to use set-up would include a DSLR camera body, macro lens and ring flash. Having your own camera on-hand will make you much more likely to make use of it.
The sooner the better! I’m sure you’re already well aware of the benefits of good magnification and illumination. However, you have the luxury of getting used to them this year and not feeling the financial impact of them slowing you down during the inevitable initial learning curve. In fact, they will eventually make you quicker, as you can actually see what you’re doing and the clarity will improve your decisiveness.
Although the ePDP is a pain in the backside, make a log of interesting cases and where you’ve learned something. This will ensure you remember what you’ve learned and avoid making the same mistakes twice.
You will have probably heard your colleagues argue about the benefits or lack there-of of these post-graduate exams. They’re not cheap and many claim it to be merely a tick-box exercise, with it no longer being something to differentiate yourself from others as it is becoming almost as common as your BDS. Essentially the relative benefits of the qualification come down to your career plan. If you wish to pursue the hospital based training pathway, then these qualifications are now almost essential for a successful application. As such you should register for them ASAP to avoid missing the early deadlines or risk of oversubscription.
Also, if you’re planning on doing a masters program, entry can be competitive and having these qualifications will demonstrate personal development and strengthen you application. Furthermore, some more experienced practitioners see the examinations as an opportunity to motivate themselves to brush up on their knowledge.
On the other hand, if you plan to stay in general practice, it is not so clear cut. Some practice principles may give it significant worth to boost a candidate’s application. Others, however, may disregard it as mentioned above and may give more significance to a portfolio comprising of evidence of further training courses and personal development.
You will have to deliver a case presentation towards the end of the year, so it’s best to be prepared and have a few cases to choose from. My case presentation was due in March and I hadn’t completed the case I had planned by the submission date. However, I had fortunately taken photographs of plenty of other cases and so it wasn’t difficult to find a back-up option to present.
Create your own set of personalised templates to make record keeping more efficient, and make life easier for yourself and your nurse. Templates will reduce the chances of forgetting to include specific details, as well as improve your time-management.
Also, templates should not to be confused with ‘auto-notes’ as indemnity providers are all too keen to highlight. If you are ever in the unfortunate situation of having your clinical notes scrutinised, ‘auto-notes’ will stand out a mile and highlight that you’ve merely copy and pasted your notes. Rendering them worthless. Templates on the other hand should be set out such that they are merely a framework to be personalised to each appointment as required.
Keep your CV updated throughout the year. An associate opportunity can present at any time so be prepared.
This doesn’t mean learn how to ‘Bash the Nash’! In the latter few months, if you’re planning on staying in practice, ensure you’re comfortable with the remit of NHS dentistry. There will be issues you may not have considered as an FD, so you need to know the NHS rules and regulations and ensure you understand how to work within these parameters. There are other elements that you will need to understand in preparation for working as an associate, such as the financial aspects of being a self-employed GDP. Speak to your trainer or more experienced associates and consider the services of an accountant.
As you approach the end of DFT, if you intend to continue to work within an NHS practice, ensure you update your LAT (Local Area Team) with where you will be working using an ‘NPL3 form’. You should correspond with the LAT to which your prospective practice belongs. This should be done as soon as you receive your DFT Certificate, as recently there have been notorious delays in practitioners awaiting there performer numbers, leading to delays in starting employment and even withdrawal of job offers!
Also, if you’re planning on working in hospital as a DCT, it’s a good idea to still stay on the performers’ list under a ‘locum’ status. As it will be easier and avoid any delays if you decide to go back to general practice or work as locum dentist on weekends alongside your DCT post.
Although they may seem tedious, don’t lose the good habits drilled in to you at dental school (such as bullet-proof record keeping!). It’s easy to slip into bad habits in general practice, more so when everyone else seems to be doing it and you may not even realise it.
To conclude, the stabilisers are finally off (kind of) and what you put in is what you get out. So make the most of your DFT year and enjoy!