What is CT1?

CT1 is usually undertaken in your second year post-qualification.  It is an excellent means of further expanding skills gained as an undergraduate and a VT.  Generally, the posts are split over 2 blocks of 6 months each, usually between the salaried dental service (SDS) and hospital dental service (HDS).  The salaried dental service post is often in a community centre and there you will provide general dental services to a wide range of patients.  I had sessions of sedation (IV and Inhalation), sessions with patients who had additional needs and children, especially anxious children.

Patients are referred to the SDS by GDPs as it is possible to spend much more time with patients, acclimatising them and allowing them to reach their treatment goals in more acceptable ways.   The centre I worked in had excellent provision for patients in wheelchairs – there was both a wheelchair ramp and a hoist and domiciliary visits are commonplace, both within patient’s homes and care homes.  

Anxious children are often referred for treatment as well.  Sometimes just having the available time to spend and explain procedures can be enough to give them the confidence to accept treatment, and other times inhalation sedation can do the trick.  In more advanced cases, dental extractions under general anaesthetic is the only viable treatment and I spent one session per week treating up to 10 children per morning in Crosshouse Hospital Day Surgery Unit.

You are allocated a trainer, much like when you are a VDP.  Your trainer is on hand to help out with treatment planning and discussing cases where patients may have complex medical histories.  There are continuous assessments: Direct Evaluation of progress (DEPs) and  Case Based Discussions (CBDs).  You complete a set number of these online assessments over the course of 6 months.

Within the HDS, there are posts either in the Dental Hospitals or within OMFS units.  I completed my HDS post in Crosshouse Hospital in Kilmarnock.  This was an ideal way to consolidate all of my undergraduate oral surgery and oral medicine training.  You work as part of a team of CT1s and SHOs under the guidance of consultants and specialist registrars.  There is a 2 day “On the Ward” course to be completed before starting where you are taken on a whistle-stop tour of being a junior doctor!  Taking bloods and placing cannulae are commonplace and daily activities.  This job involves a mixture of consultant clinics, treatment under local anaesthetic and general anaesthetic, with treatment ranging from surgical removal of wisdom teeth to orthognathic surgery and major cancer resections and reconstruction.  The patients are often admitted to a ward, and you are required to care for these patients as well, with “on call” night and weekend shifts regularly.  In addition, there can be calls from A&E to assess patients on presentation following trauma, that’s where you will often see mandibular and zygomatic fractures first hand, along with lacerations and dental abscesses.  There are other clinics throughout the week too, like IV sedation, orthodontics, and orthognathic planning clinics.