A Career in Oral & Maxillofacial Surgery

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.

Oral & Maxillofacial Surgery deals with the diagnosis and treatment, both surgical and non-surgical, of diseases affecting the mouth, jaws, face and neck. Unlike the 13 specialties mentioned above, Oral & Maxillofacial Surgery, is recognised as a medical specialty in the UK and as such it is regulated by the GMC.

In the following article, Tom Handley discusses how you can establish a career in Oral & Maxillofacial Surgery.

Tom Handley | FRCS(OMFS), MRCSGlasg, MFDSRCPS, MBChB(Hons), BDS(Hons)

Final Year Specialty Registrar Oral & Maxillofacial Surgery

West of Scotland

I studied dentistry as my first degree in Newcastle, and this is where as a second year student my interest in this specialty was born following a series of lectures on the scope of the specialty. I knew from that point on this is what I wanted to do as a career. I went on to complete a VT year in the same region. My subsequent training moved to Glasgow, where I spent a couple of years as a senior house officer in a regional Maxillofacial unit, before returning to Dundee University to study medicine. During this period of additional study I continued to work in the specialty, gaining further experience as well as earning a living. I completed my foundation medical training in Tayside before returning to Glasgow to complete my core surgical training and my surgical membership exams. I am now almost near the end of my higher surgical training, and I have never looked back.

A Career in Oral & Maxillofacial Surgery

Oral & Maxillofacial Surgery is the specialty that deals with the diagnosis and treatment both surgical and non-surgical of diseases affecting the mouth, jaws, face and neck.

  • Management of facial trauma – Hard and soft tissue
  • Head and Neck oncology
  • Rehabilitation of the face and mouth including reconstruction with local, regional, and microvascular free flaps
  • Orthognathic surgery
  • Management of salivary gland disorders
  • Surgical treatment of congenital facial abnormalities including cleft lip and palate/craniofacial deformity
  • Aesthetic facial surgery
  • Oral and facial implantology
  • Disorders of the temporomandibular joint
  • Dento-alveolar surgery including extraction of teeth
  • Oral Medicine
Pros & cons of a career in Oral & Maxillofacial Surgery
  • Fascinating, wide variety of pathology
  • Wide variety of surgical operations/techniques
  • Ability to change people’s lives
  • Always challenging
  • Collaboration with allied surgical & Medical specialties
  • Multidisciplinary team working
  • Subspecialty interest
  • Good job prospects
  • Good prospects for private practice
  • Multiple hurdles to compete at to get into higher surgical training
  • Long training path (– But it is comparable to other surgical specialties.)
  • Cost of second degree (– You can earn money as a second degree student)

If you have a love of surgery and medicine, enjoy constantly being challenged and pushed and have an interest in working in the head and neck region then this might be the specialty for you. The best way to find out is first hand by getting some experience of working in an oral and maxillofacial surgery unit, either as a dental student or during your general professional training.

I love surgery, and I love being challenged with constant problem solving, team working and striving to improve patient care. Working in the head and neck is also extremely rewarding. The face is important to each individual; it is our physical identity, something we cannot hide.  It conveys our emotions and innermost feelings, and we are often judged on the basis of our facial appearance. Therefore to work on someone’s face is a great responsibility, a challenge and is extremely rewarding.

Completing my Fellowship specialty exams in Maxillofacial surgery.

Whilst on call I had to treat a patient whose whole hair baring scalp had been torn off in an accident. This was reattached in the middle of the night with microvascular surgery to restore its blood supply

A typical day…

Every day starts with a ward round to review the surgical inpatients, this is followed by either outpatient clinics (general or subspecialty) or the operating theatre and this can range from day surgery minor oral surgery or skin cancer resection and local flap reconstruction, to major head and neck cancer resection and microvascular free flap reconstruction. However, in reality there is never really a typical day, each one is different, you never know what will be waiting for you in the morning following the previous nights on call, or what is going to come through the door as an emergency during the day. Its exciting!

Specialty training pathway

Entry Requirements

Oral and maxillofacial surgery is the only surgical specialty that requires dual qualification in medicine and dentistry. In addition completion of basic surgical training is mandatory with completion of the MRCS surgical examination. Further post-graduate diplomas (e.g. MFDS etc) are desirable, as are further degrees (e.g. BSc, MD, PhD).

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

Most oral and maxillofacial surgeons studied dentistry first and then medicine as a second degree, however, there is a rising number medical graduates now returning to study dentistry in order to achieve dual training.

On completion of the dental degree, time is usually spent in general professional training or oral & maxillofacial units as an SHO. Once a decision has been made to pursue a career in OMFS application to medical school is made (Ideally on a shortened 3 year course). On completion of a medical degree, medical foundation training of two years is required, during which the doctor will become fully registered with the GMC. At this stage the candidate will compete with other doctors for entry into a core surgical training program (usually two years) where they will rotate through a number of the surgical disciplines before completing their surgical membership exam, which is deemed the end point of core training. Finally the trainee will compete for entry into higher surgical training for a training period of 5 years, and towards the end will sit their exit fellowship examination.

Further subspecialty training in the form of a fellowship can be added onto the end of this training program to enhance the surgeon’s skills and experience, especially in some of the more specialised areas of practice, e.g. Cleft Lip & Palate, Craniofacial or Head & Neck Oncology.

For the academically minded trainee, a proportion of time may be spent in research, leading to a PhD or MD. But this is not mandatory for entry into specialist training. There is no alternative if you wish to practice the full scope of the specialty.

Career options after specialty training

For those completing a conventional training pathway, there are increasing numbers of NHS consultant posts available.  A number of consultants in Oral Medicine in the UK have gone on to take positions as Lead Clinicians and Clinical Directors as well as senior positions in Deaneries and Royal Colleges.

As soon as you have an interest in something, get out there and explore it, the earlier the better. Speak to people in the job at all levels, arrange special study modules, electives and if you can, get involved in audit and research. Look at ways to enhance your CV all the time, remember for all jobs, all eligible candidates will have the same essential requirements of the job, what you need to add is the desirables! Good luck

Further Information

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