Careers Information
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ORAL SURGERY CAREERS
The specialty of Oral Surgery deals with the diagnosis and management of pathology of the mouth and jaws that requires surgical intervention. Oral Surgery involves the treatment of children, adolescents and adults, and the management of dentally anxious and medically complex patients.
Primary care-based General Dental Practitioners (GDPs) are expected to undertake routine Oral Surgery care, such as dental extractions, as part of their general dental services contracts. More complex Oral Surgery care is provided by specialists in Oral Surgery and by Oral Surgery and Oral & Maxillofacial Surgery consultants (including academics) who may work in primary care or secondary care settings. Secondary care-based Oral Surgery consultants would not normally be found in stand-alone units; rather, they would be integrated with OMFS units with the opportunity for skill mix and multi-disciplinary team working. Postgraduate dental trainees working under consultants may also provide Oral Surgery care.
Oral Surgery care is provided by Oral Surgeons and by Oral & Maxillofacial Surgeons as the clinical competencies of these two specialties overlap. The UK General Medical Council recognises ‘Oral & Maxillofacial Surgery’ as a medical specialty.
Given the overlap between Oral Surgery, Oral & Maxillofacial Surgery and Oral Medicine, the workforce within local areas may comprise a variety of performers from different specialties.
Depending on the decisions and information provided by the referring clinician, patients with similar Oral Surgery/ Oral Medicine conditions may be seen by a specialist in Oral Surgery, Oral & Maxillofacial Surgery or Oral Medicine.
Careers in oral surgery are many, varied and often interchangeable. Career pathways can be fluid depending upon local and individual requirements. The basic definitions and requirements of the most common roles include:
NHS Consultant in Oral Surgery – Registration on the GDC specialist list for Oral Surgery is a requirement for these posts. Other qualifications that may be helpful, but are not mandatory, in being successfully appointed include:
- CCST
- ISFE
- Leadership and management training
- Extended clinical training
Honorary (academic) Consultants in Oral Surgery – are employed and paid by higher education institutions; usually Universities (hence ‘honorary’). These posts demand the same requirements as an NHS Consultant, as well as a higher degree, usually a PhD.
NHS SAS Grades (Specialty Doctor, Associate Specialist and Staff Grades)– are commonly employed in OMFS units throughout the UK. Depending upon the unit within which they work, these individuals will carry out, often on an autonomous basis, surgeries listed in the Oral Surgery Curriculum. They may also have OMFS extended competencies.
SAS clinicians may or may not be on the GDC specialist list. Specialist List Assessed Application (SLAA) is currently only available to this group by evidencing Academic Equivalence. Further information about this can be found on the GDC website.
Primary Care- Specialist Oral Surgeons can also practice in Primary Care either as part of an NHS contract, or privately.
Some GDPs who are not on the GDC specialist list for Oral Surgery, have enhanced skills and experience in Oral Surgery. They are sometimes called ‘Dentists with Extended Skills’, or DES. In England and Wales, these individuals can perform Level 2 procedures within a Managed Clinical Network (MCN). Guidance documentation towards this Tier 2 accreditation has been developed by NHS England, however, currently the precise definition of this process is open to local interpretation and therefore accreditation criteria differ between regions.
Further information regarding Levels of Oral Surgery procedures can be found in the Oral Surgery CommissioningGuide https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/09/guid-comms-oral.pdf
Updated October 2021 JB/KG
Career Pathways in Oral Surgery View here
DCT
Drug Prescribing for Dentistry 2016: View online
Current Junior Representative: Lauren Crowder
My name is Lauren Crowder and I am currently working in Dundee, Scotland. I have loved oral surgery from undergraduate level and have continued to make it part of my Core Trainee jobs since then.
During my DFT/DCT1 (longitudinal) year I was lucky enough to work under a very inspiring oral surgeon in primary care in Wales who showed me that women really can have it all! I also worked in the hospital setting which is where I knew I was meant to be. After 2 years I ended up back in Liverpool completing the Aintree/Alderhey programme, where I found my passion for paediatric oral surgery. Working with the cheeky children but getting to see and do a lot of minor oral surgery was really special. I then took a gap year and managed to travel for 4 months before the pandemic took hold. I managed to volunteer in Nepal in the Oral Surgery department of the dental hospital in Kathmandu. I also visited the OMFS department in Liverpool hospital in Sydney where I saw complex MDT’s as well as a lot of plastic’s cases. Coming back to the UK I moved to Glasgow for DCT3 in the paediatric department. Again I got involved with as much oral surgery as possible, asking for the submerged teeth and MIH affected molars. I am now working as a paediatric registrar with an interest in oral surgery. . .I am lucky to be in a unit where my Consultant’s do a lot of their own surgery so I plan to continue to keep oral surgery a theme of my paediatric career!
Dental Core Training
Dental Core Training (DCT) is a training pathway. For some it is a stepping stone to specialty training, and for others it is training to enhance and develop practical competencies for exit into primary or secondary care. The main purpose is for recent graduates to gain additional skills and competencies in particular specialisms. There are many benefits to doing Dental Core Training including enhancement of core clinical and surgical skills, working in multidisciplinary teams, learning to manage patients a variety of dental and medical conditions in a supportive environment, and for career progression and development.
The DCT curriculum can be found here:
https://www.copdend.org/wp-content/uploads/2018/09/2016-12-14-UK-DCT-Curriculum-December-2016.pdf
Recruitment to DCT posts in the UK is through a national selection process led by Health Education England’s East Midlands Office (The DCT National Recruitment Office). Their website (see below) has links to the Person Specifications for DCT1, DCT2 and DCT3 which outlines required and desirable criteria for applicants. Each year the jobs will be advertised in January, and the list of available placements will be on the East Midlands website.
https://www.eastmidlandsdeanery.nhs.uk/recruitment/dental/dental_core_training
Experiences of Current Trainees:
DCT in Oral Surgery: Eimear Doran
“In a dental hospital no two weeks were ever the same, which made the job that more interesting!
New patient assessments and reviews took place regularly on the consultant clinics, including referrals for suspected red flag referrals, intra or post-surgical complications or complex medical patients. Minor OS and biopsy clinics were a regular feature, with an opportunity to learn hands on, these were the settings I most enjoyed! From carrying out simple biopsies of polyps and mucoceles, to administering Botox, each day was so unique! Apart from surgical extractions, lists also regularly included exposures of ectopic teeth, cyst enucleations, OAF closures, managing head and neck cancer patients and surgical explorations.
Most treatment is carried out under LA, but there were some opportunities for GA and IV sedation lists.
On-call sessions consisted of treating emergency patients, e.g post-op complications, or calls with GDPs’ on how to appropriately manage patients or whether to refer.
In a dental hospital, DCTs also have the chance to teach undergraduate students, helping to enhance clinical knowledge and teaching ability.
There is the chance to carry out QIP/audits, create case reports and present locally. These of course could be publications, posters and presentations on a wider scale.
Oral surgery in a dental hospital is great to expand on new knowledge and skills. Not only can these be transferable to a primary care setting, but it provides excellent exposure and experience for progression towards a specialist route. “I enjoyed my time so much in the Oral Surgery department that I am lucky enough to be coming back to work here again as a DCT2.”
DCT in Oral and Maxillofacial Surgery: Sophie Mills
“A DCT year in OMFS is a fantastic year to develop surgical skills and medical knowledge in a secondary care setting. I have loved the exposure to procedures and conditions that I’d never seen before; it’s been amazing to assist head and neck cancer operations and get experience plating fractured mandibles. The job presents fantastic opportunities to get involved in audits and research projects which can broaden your academic or management and leadership skills. I’ve found that the surgical and medical knowledge I’ve learnt in this job will equip me with confidence to provide better care for patients in the future, both in primary and secondary care. It can seem daunting at first, especially being on-call and doing nights, but it is a unique opportunity to develop practical skills and confidence in a supportive and encouraging environment – I’d recommend it for everyone!”
Teaching/Academic Fellow: Evelyn Rennie
“Whilst working as a DCT in Oral Surgery, I became regularly involved in the teaching of undergraduate students. Teaching students was so rewarding for me that it sparked a desire to become involved in the educational/academic side of Oral Surgery. I was fortunate to be offered a Clinical Teaching Fellowship position, which allows me to combine my interest in Oral Surgery with teaching.
My job has many different aspects to it. For the clinical side of my job, I am involved with each step of an undergraduate student’s treatment, from the screening and selection of suitable patients, to the supervision of the procedure itself and then the assessment and critical feedback of the treatment provided.
For the academic side of my job, I am involved in the teaching of seminars and clinical skills, I help with examination writing and marking, undergraduate entry interviews and mentoring. On top of all this, I have the opportunity to continue my own personal development, by being involved with research and undertaking postgraduate qualifications.
Each fellowship job can be different, depending on the needs of the university you are working for. However, the combination of teaching and self development within these jobs provide a truly unique opportunity for anyone who gets one. I would strongly encourage anyone who is thinking about pursuing a career in academics or education to consider a fellowship as the first stepping stone to that pathway.”
See also the latest “DCT Webinar on Dental Career and Development” on the website for more inspiration!
Career Development
After Dental Core Training, there are several pathways possible for career development in oral surgery:
- Specialty Training https://www.yorksandhumberdeanery.nhs.uk/recruitment/national-recruitment/national-oral-surgery-str-recruitment
- SAS Grade (aka. Specialty Doctor, Associate Specialist, Staff Grade) information here
- Masters in Oral Surgery
- Academic Fellow or Clinical Fellow posts
- Primary Care e.g Tier 2 provider
Logbook and Online Portfolio
Trainees, and prospective trainees, maintain a logbook of experience. Most trainees use a free logbook which has a dedicated Oral Surgery section. This logbook is available at the following link:
Courses
Teaching
- Postgraduate Certificate in Dental or Medical Education: A PGCert is a one year part-time course which enables you to develop and evidence your competence as a dental educator. It combines face to face, online and practice based learning opportunities to explore approaches to teaching, learning and assessment in both university and practice settings. The Peninsula School of Medicine at the University of Plymouth is now collaborating with the British Association of Oral Surgeons (BAOS) to provide a natural progression route onto the Masters in Clinical Education; this exciting development enables students who have completed the BAOS Teaching and Learning Course to progress onto the Postgraduate Certificate of Clinical Education (60 credits). For more information about the programme, please visit our programme webpages at: plymouth.ac.uk/courses/postgraduate/pgcert-clinical-education
- Training the trainers: A two day course hosted by the Royal College of Surgeons of England which combines e-learning and practical sessions to enhance your skills as a surgical educator and prepare you for dealing with common challenges encountered as a trainer. https://www.rcseng.ac.uk/education-and-exams/courses/search/training-the-trainers-developing-teaching-skills/
- Masters in Clinical Education: A masters course, full time one year or part-time three years, will set you apart as a leader and educator in your field. It is a great way to develop your teaching, support and supervision skills, so that you can help others to learn, whether in clinical practice or higher education.
Clinical
- Advanced Life Support: This is a great course to undertake to increase your confidence in handling deteriorating patients. ALS covers numerous essential skills in resuscitation, including delivery of adult CPR and recognition and management of the unwell patient. https://www.resus.org.uk/training-courses/adult-life-support/als-2-day-course-advanced-life-support
- Sedation: Intravenous or inhalation sedation training enables oral surgeons to increase treatments offered to patients and improve their comfort during procedures, whilst minimising the stress of treating anxious patients. The Sedation Training Accreditation Committee has compiled a list of accredited non-university and non-deanery courses in sedation, which can be found at this link. https://www.rcseng.ac.uk/dental-faculties/fds/publications-guidelines/standards-for-conscious-sedation-in-the-provision-of-dental-care-and-accreditation/accredited-courses-in-conscious-sedation-for-dentistry/
Management and Leadership
- Edward Jenner Programme: Run by the NHS Leadership Academy, the Edward Jenner programme is a great first step to build a strong foundation of leadership skills. It will help you to feel more able to deal with the daily challenges of working in healthcare, better equipped to care for patients, lead services and provide leadership for those around you. https://www.leadershipacademy.nhs.uk/programmes/the-edward-jenner-programme/
- Management and Leadership: Run by E-learning for healthcare (E-LFH) in partnership with Leeds and Yorkshire Partnership NHS Foundation trust and Health Education Yorkshire and The Humber. These are elearning modules are designed to develop your knowledge and understanding of a range of management and leadership topics. Each module covers real life examples that reinforce your understanding of the key principles and skills in that area.
- https://www.e-lfh.org.uk/programmes/management-and-leadership-skills/
Useful Links
DCT Training Curriculum: https://www.copdend.org/wp-content/uploads/2018/09/2016-12-14-UK-DCT-Curriculum-December-2016.pdf
DCT Applicant Guide: https://www.eastmidlandsdeanery.nhs.uk/sites/default/files/dct_applicant_guide_2021_part_1.pdf
DCT FRCP Checklist: https://www.copdend.org/wp-content/uploads/2020/05/DCT-FRCP-Checklist_COVID-2020-Final-1.pdf
Contact Details
Junior representative: Lauren Crowder – Lauren.crowder2@nhs.scot
Page last updated: 05/10/2021
Lauren Crowder and Sophie Mills
DCT News – coming soon
Bacterial Infections Management Guide View online
Dental antimicrobial stewardship toolkit: Gov UK: View online
Useful Dental Prescribing App: Link here
SPECIALIST TRAINING
Training and Education
National Recruitment
In line with COPDEND’s plan to enrol all specialities in the National Recruitment process for specialty training, National Recruitment to Oral Surgery commenced in 2017.
Information regarding the process, including the applicant handbook and personal specification are available at the following link:
Logbook and Online Portfolio
Trainees, and prospective trainees, maintain a logbook of experience. Most trainees use a free logbook which has a dedicated Oral Surgery section. This logbook is available at the following link:
It is essential for all trainees to register and maintain their online portfolio. This essential online resource is where trainees record all WBAs, maintain a portfolio and record ARCP outcomes. There is an annual cost which is tax deductible.
eLogbook Frequently Asked Questions FAQs link here.
Training Pathways, Curriculum and Progress
Documentation regarding training pathways in Oral Surgery are available at the following link:
Oral Surgery Training Pathways
Oral Surgery Career Development for Consultant Appointments 2010
Postgraduate Dental Specialist Training in the UK: View online
Oral Surgery Curriculum Feb 2014
BAOS Trainee Study Day
BAOS sponsors an annual National Trainee Study Day, attended by trainees who hold a national training number, or honorary training number. The study day aims to provide group teaching on subject areas of interest that are raised by current trainees. Location of the study group rotates around the UK.
Masters in Clinical Education
We are delighted to announce that the Peninsula School of Medicine at the University of Plymouth is now collaborating with the British Association of Oral Surgeons (BAOS) to provide a natural progression route onto the Masters in Clinical Education. This exciting development enables students who have completed the BAOS Teaching and Learning Course to apply to progress onto the Postgraduate Certificate (PG Cert) stage of the Clinical Education programme with a reduced pattern of attendance and the completion of assessed coursework in order to obtain 30 M-level credits towards the Postgraduate Certificate (60 credits). For more information about the programme, please visit our programme webpages at: www.plymouth.ac.uk/courses/postgraduate/pgcert-clinical-education or contact us at meddent-admissions@plymouth.ac.uk
Membership in Oral Surgery (MOral Surg) Examination
The MOral Surg qualification demonstrates that candidates have attained the knowledge and understanding relevant to the practice of a specialist in Oral Surgery. This tri-collegiate examination composes multiple elements and further information on eligibility, applications and the format are available at the following link:
https://www.rcseng.ac.uk/education-and-exams/exams/search/membership-in-oral-surgery/
Trainee Group Membership
Oral Surgery Trainees have their own group. To contact them for information email: ostrainee@gmail.com
Assessment Tools
Appendix 2 Workplace Based Assessment
SAS GRADE
CONSULTANT AND SENIOR TRAINERS (CAST)
Guidance documentation:
Advisory Appointment Committees Person specifications
Consultant in Oral Surgery Information View online
Changes to the person specification for senior clinical (consultant) posts. Following the consultation process in relation to the “equivalence by experience” route for entry to the ISFE in Oral Surgery, the Deans of the English and Scottish Colleges took the decision this was not to be re-opened. It is appreciated that this presents a difficulty for Oral Surgery in the medium term, whilst they wait for trainees to finish recognised training programmes and complete the ISFE by the conventional route. It is the responsibility of employing authorities to clearly outline in the Person Specification the range of skills and competencies required to meet local service needs. It has been decided that possession of an ISFE be moved from the ‘Essential’ column to the ‘Desirable’ for all Consultant Job Descriptions and it will be the responsibility of the applicant to demonstrate how they meet the requirements for the post. The person specifications on the RCS (Eng) website have been updated accordingly.
CAST News – coming soon
PRIMARY CARE
Primary Care Services in the UK
Opportunities to work in Primary Care Oral Surgery differ greatly across England, Wales, Scotland and Northern Ireland.
Each country varies in how commissioners choose to procure Oral Surgery services.
Scotland – has no commissioners or Managed Clinical Networks (MCNs). Oral Surgery is performed in General and Dental hospitals or by General Dental Practitioners (GDPs).
Wales – has specialist Primary Care Oral Surgeons in Swansea and Cardiff on PDS (personal dental services) or SLA (service level agreement) contracts.
The North Wales Primary Care Oral Surgery service is delivered by the Community Dental (salaried) Service.
A Specialist Advisory Forum has recently been established to enhance standardisation of the service across the country.
Ireland – has four Oral Surgery practices with two satellite clinics. All the practices accept NHS and private patients. NHS patients are placed on a waiting list with priority given to those with medically urgent conditions and emergencies.
The NHS contract has been a pilot for 14 years but this expires in 2022. A new contract is unlikely due to limited funding available for Oral Surgery.
All patients are seen by either an Oral Surgery specialist, a GDP with a diploma in Oral Surgery or a GDP with a special interest in Oral Surgery.
England – typically services will be split into Tiers 1, 2 3a & 3b.
Tier 1 services fall within the remit and competency of a GDP and therefore within mandatory services of the GDS contract.
Tier 2 services may require a specialist Oral Surgeon or a Tier 2 accredited GDP. Information on becoming an accredited tier 2 provider is attached here https://www.england.nhs.uk/wp-content/uploads/2018/09/guidance-for-the-accreditation-of-performers-of-level-2-v24.pdf.
Applicants should note that there is no national system for accreditation – if you move to another part of the country, you will have to re-apply.
Tier 3a services require a specialist Oral Surgeon and will be of a potentially more complex nature that could be treated in either Primary Care or Secondary Care depending on local arrangements.
Tier 3b – secondary care based service.
Tier 2 Accreditation
Summarised here https://www.baoms.org.uk/_userfiles/pages/files/professionals/associate_fellows/guidance_for_tier_2_accreditation_for_oral_surgery_as_240620.pdf
CS Nov2021