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A Career in Dental & Maxillofacial Radiology

The GDC currently recognises 13 various fields of dentistry with regards to their specialist register. You are not required to join a specialist list to practise a specialty, however, only dentists on these specialist lists have the right to use the ‘specialist’ title. In this series of articles you can find out more about each specialty from experts in their respective fields, with advice on the career pathway as well as sharing their experiences as a specialist.
Dental & Maxillofacial Radiology involves all aspects of medical imaging which provide information about anatomy, function and diseased states of the teeth and jaws.

In the following article, Kirstyn Donaldson, discusses how you can establish a career in Dental & Maxillofacial Radiology.

Miss Kirstyn Donaldson | BDS, MFDS RCPSG

StR/Honorary Clinical Teacher in Dental and Maxillofacial Radiology

Dundee Dental Hospital & Glasgow Dental Hospital

I qualified from Newcastle Dental School in 2010 and subsequently moved for a Dental Foundation year (DF1) based in Glasgow Dental Hospital. During that year, I spent time in Oral Surgery, Oral Medicine, Restorative and Dental Radiology and it was then I realised that I wanted to explore Dental and Maxillofacial Radiology as a career. I completed my VT year in 2012 in the West of Scotland and within that year, I completed my MFDS. For just over a year after VT, I undertook a couple of SHO jobs in Oral and Maxillofacial Surgery, Orthodontics and Endodontics.

I started my Specialty Training in DMFR in November 2013 and my training is split between both Dundee and Glasgow Dental Schools. I am also honorary clinical teacher for both Dundee and Glasgow universities. Separate to my StR training, I am completing an MSc in Diagnostic Imaging through Sheffield Hallam University.

A Career in Dental & Maxillofacial Radiology (DMFR)

DMFR is a small dental specialty which encompasses all aspects of dental radiology that you are taught about as an undergraduate but also the head and neck where there is cross–over with medical radiologists by looking at trauma, ultrasound, Cone Beam CT, Medical CT and MRI. The amount of cross-over varies depending on where you work. DMFR also allows for the possibility of carrying out interventional techniques such as ultrasound guided biopsies or removal of salivary stones by endoscopic techniques.

A career in DMFR is incredibly varied and no two consecutive days are the same. Most days are a mix of seeing patients for various types of scans and reporting radiographs. There is also a large component of teaching undergraduate dental and therapy students either in lecture or seminar format. Postgraduate lectures on various topics, particularly legislation (IRMER) courses for Core CPD can make up part of your week. You can also take on additional work by reporting private dental Cone Beam CT scans if required once you are a consultant.

DMFR is an enjoyable and rewarding but challenging career which provides a varied job allowing patient interaction, teaching and research.  As nearly all dental specialties require radiographs, a career in DMFR allows you to keep up to date in changes in other fields and therefore you are constantly learning.

It is useful to be organised and comfortable multi-tasking as it is a common occurrence to be interrupted mid-radiographic report to see a patient or give an opinion. You have to be a team player with good written and verbal communication skills as you take part in numerous multi-disciplinary team meetings. It is equally important that you are motivated and happy to work independently as most of your day will be reporting radiographs. I think the key feature would be someone who enjoys problem solving and has a passion for anatomy and dental pathology; in DMFR we regularly piece together clinical and medical histories with current and previous radiographic images to create a differential diagnoses.

Getting my StR job is probably my highlight as it felt like all my hard work in the years running up to the interview had been worthwhile.

In radiology, we rarely see patients for multiple appointments unless there is significant pathology that requires monitoring. For me, the most rewarding patients are the ultrasound patients who attend due having noticed a neck lump and prior to attending, they have been on the internet to read that “a neck lump means you have cancer.” It is incredibly rewarding to carry out a simple non-invasive investigation such as ultrasound and to be able to put their mind at rest and relieve the anxiety that was building prior to the appointment – there are usually a lot of tears!

Cone Beam CT (CBCT) has revolutionised 3D imaging for dentistry in the past decade. In less than 20 seconds (for the units I use), you can see the patient’s bony anatomy and pathology in three dimensions for a fraction of the radiation dose of Medical CT.

There have been multiple consultants within DMFR who have inspired me due to their passion for the specialty, their outlook/reflection on their careers and their willingness to support the trainees, both prospective and currently training. I also try and take something positive away from everyone that I have worked with both during StR and my previous jobs.

A typical week…

There is no such thing as a typical week and my rota changes every 4-6 months. I currently spend three sessions a week in general hospitals doing neck ultrasounds, reporting MRI and attending a head and neck oncology MDT. My dental hospital sessions are varied and I can’t predict what I will be doing in particular sessions.

Specialty training pathway

Only dentists registered on the GDC held specialist list have the right to use the ‘specialist’ title in the UK. To be granted entry to the list an applicant must have been awarded a Certificate of Completion of Specialist Training (CCST) as a result of completing a GDC approved training programme, with a dedicated national training number (NTN).

Entry Requirements

You must hold a BDS degree and be registered with GDC. A minimum of 2 years post graduate experience preferably in a combination of both primary and secondary care settings is required and ideally the secondary care should be split between different dental disciplines to allow for a full rounded knowledge.

To strengthen your application for an StR post you should:

  • Complete audits and presentations
  • Become a member of societies related to the specialty (e.g. BSDMFR) and attend conferences as this shows a genuine interest in the specialty and will allow you to speak to current trainees if you have questions.

It is strongly recommended to check the essential and desirable criteria listed in the person specification provided for specific specialty training posts (StR). An exemplar person specification can be found in the ‘Further Information’ section at the bottom of the page.

Training Pathway

Completion of DMFR Training includes:

  1. Satisfactory Completion of a 4 year full time DMFR Training pathway (there will be alternatives if only able to work part time) with an National Training Number (NTN). This time is split between dental hospitals and general hospitals along with a physics lectures within the first 6 months of training.
  2. Completion of the Diploma of Dental and Maxillofacial Radiology (DDMFR) from the Royal College of Radiologists.

There are 3 exams to sit throughout training at specific time points:

  • FRCR Part 1 Physics Exam (after 6 months of training): Multiple Choice Physics Exam (same exam that the Medical Radiology Registrars sit)
  • DDMFR Part A  (after 18 months of training): Short Answer paper on Anatomy, Radiographic Techniques and Physics and an anatomy spotter using radiographic images.
  • DDMFR Part B (after 3 years of training):  Written paper on Dental and Maxillofacial Radiology, Reporting session and an oral exam

Advice to anyone aiming to set off on the path to a career in DMFR

Get as much experience in DMFR as possible, by shadowing or attending conferences, as it’s important to understand what the job entails before pursuing it.
Speak to current DMFR trainees/consultants and ask questions about their career. If you show genuine interest you will be surprised how many people are willing to give up their time to talk to you and support you towards your career goals.

Further Information

Kirstyn Donaldson

Kirstyn qualified from Newcastle Dental School in 2010 and subsequently moved to Scotland for DF1, VT and SHO positions. She is currently in the process of completing her Specialty Training in DMFR and is also an honorary clinical teacher at both Dundee and Glasgow Universities. As well as her StR training, Kirstyn is also completing an MSc in Diagnostic Imaging through Sheffield Hallam University.

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