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.

The specialty of Oral Microbiology involves the diagnosis and assessment of facial infection, typically bacterial and fungal disease. This is a clinical specialty undertaken by laboratory-based personnel who provide reports and advice based on interpretation of microbiological samples.

In the following article, Deborah Lockhart, Specialist Registrar in Microbiology, discusses how you can establish a career in this field.

 

Deborah Lockhart BSc(Hons) BDS(Hons) MFDS RCSEd FRCPath

MRC Clinical Research Fellow / Specialist Registrar in Microbiology
Division of Molecular Microbiology, College of Life Sciences
University of Dundee
Email: dealockhart@dundee.ac.uk or d.lockhart@nhs.net
 

Where have you worked and studied?

Istudied dentistry at the University of Glasgow and loved microbiology so much I intercalated a BSc in the subject. After graduating I completed VT in a small town on the East coast of Scotland and then two subsequent 6-month posts as (i) SHO in paediatric dentistry at Dundee Dental School and (ii) community dental officer in Aberdeenshire. During this time I obtained MFDS from the Royal College of Surgeons in Edinburgh, an essential pre-requisite for higher specialist training.

 

Next I moved back to Glasgow to take up the first NHS Education for Scotland funded oral microbiology Specialty Registrar post based at the Royal Infirmary. In addition, I became an Honorary Clinical Teacher at the University of Glasgow. Towards the end of my training I took 3-years out of programme to pursue a PhD at the University of Dundee having been awarded a prestigious MRC Clinical Research Training Fellowship. Right now I am writing up my thesis and will hopefully obtain my PhD and CCST in autumn 2014.

What is Oral Microbiology?

Oral microbiology is a clinical and academic specialty concerned with the diagnosis and management of oral and maxillofacial infections, systemic and nosocomial infection arising in patients attending outpatient or in-patients services. The specialty has a key role in the provision of infection prevention and control education and training for undergraduate and postgraduate dentists and members of the dental team.

The specialty of oral microbiology is closely linked to medical microbiology under the auspices of the Royal College of Pathologists (RCPath) and there is a combined oral & medical microbiology training curriculum. All oral microbiologists have successfully completed the FRCPath examination in medical microbiology enabling them to undertake the range of activities associated with clinical medical microbiology in addition to their specialised role in the management of oral and maxillofacial infections.

A typical day…

There is no “typical” day… Come and see for yourself if you are considering the specialty, as there could be an outbreak brewing or an exciting experimental breakthrough. A ‘routine’ day as a clinical microbiologist might involve:

A handover meeting summarising overnight developments with the on-call microbiologist and, yes, that could be you! Mid morning, authorisation of laboratory reports including the request of any relevant additional tests by considering the clinical picture of patients and liaising with laboratory staff. Urgent results and updates will be telephoned e.g. positive blood cultures from patients with suspected septicaemia. You may also be responsible for taking incoming calls from clinicians and/or preparing for a ward round by ensuring all laboratory results are updated. In the afternoon, there will be Consultant-led ward rounds where individual patients are discussed; the microbiological results and management communicated with the relevant teams e.g. intensive care, max-facs or orthopaedics. Alternatively, there may be journal clubs or teaching duties. If you happen to be the on-call microbiologist then you will not want to venture too far from the telephone!

SPECIALITY PATHWAY

Entry Requirements

Entry to an oral microbiology training programme requires satisfactory completion of: 

(i) Two year period of postgraduate dental training that may include general dental practice (VT) and a period of training in secondary care in an appropriate cognate specialty. I would definitely advise spending time in oral & maxillofacial surgery or another specialty that involves in-patient management to gain an appreciation of ‘life on the wards’. 

(ii) The possession of the FDS, MFDS or MJDF of the UK Surgical Royal Colleges or an equivalent qualification.

(iii) Candidates without FDS, MFDS or MJDF may be admitted to a programme but will normally be expected to possess an appropriate higher degree and/or to have had appropriate experience in a related discipline. 

Training pathway:

Following appointment at Specialty Registrar or Clinical lecturer level, for those already in possession of a higher research degree, dentally qualified trainees work alongside their medical colleagues primarily based in large teaching hospitals. It is important to emphasise that the current GDC approved competency based curriculum is the same as for medically qualified candidates with additional sub-specialty components in oral microbiology. 

Training is for a minimum of 5-years full-time with candidates required to pass a Year 1 OSPE (Objective Structured Practical Examination) and a two-part FRCPath examination in medical microbiology that is usually taken in Years 2 and 4. There is no standalone examination in oral microbiology. Candidates without a higher research degree will be required to enrol for a PhD and may be required compete for external Fellowship funding.  This will increase training by a further 3-4 years.

Career options after specialising…

Oral microbiology is an evolving specialty with only 7 registrants on the GDC specialist list and all currently hold academic appointments in UK Universities. Oral microbiologists have contributed to over 300 papers in the literature.

Traditionally trainees have aspired to senior clinical academic positions with honorary consultant status. To date there are currently no NHS funded consultant posts.

FURTHER INFORMATION:

The GDC specialist list in oral microbiology provides up-to-date contact details of those in the specialty and the ACOM website is also a very good resource. Interested students may also contact the following directly for further information:

  • Dr. Riina Rautemaa-Richardson, Senior Clinical Research Fellow & Honorary Consultant Medical Mycologist, Wythenshawe Hospital, University of Manchester. (Riina.Richardson@manchester.ac.uk)
  • Dr. Noha Seoudi, Clinical Lecturer in Oral Microbiology, Queen Mary’s School of Medicine & Dentistry, University of London. (n.seoudi@qmul.ac.uk)
  • Prof. Andrew Smith, Professor of Clinical Bacteriology & Honorary Consultant Microbiologist, Glasgow Dental School, University of Glasgow. (Andrew.Smith@glasgow.ac.uk)
  • Dr. Melanie Wilson, Senior Clinical Lecturer & Honorary Consultant in Oral Microbiology, School of Dentistry, Cardiff University. (WilsonMJ@Cardiff.ac.uk)

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