Surinder Poonian graduated from Sheffield in 2011 and completed her DFY1 placement on the Whipps Cross Scheme based in London. After this she worked as an oral surgery DFY2. She has since worked as a locum GDP and is now doing a CDP post in restorative dentistry. Surinder is one of the young dentist representatives within the Metropolitan Branch of the BDA.
Surinder summarises her presentation to the Young Dentist Conference 2013.
As a young dental professional stepping out into the working world there are many things we need to consider and be aware of. On occasions we find ourselves in situations that dental school did not quite prepare us for. These incidents can be seen as learning curves which are experiences to grow from. It is always useful to share insights with colleagues in order to develop and become more self-aware on both a professional and personal level.
Having undertaken years of education and examinations and finally reaching graduation day many of us are under a false pretence that 'we have done it'. Indeed we have those magic letters after our name qualifying us to inspect human oral cavities (and get paid for it), but what next? During the early stages of practice, discoveries are made of the many options available to us and where we can progress.
Being bombarded with information and options can be quite overwhelming, particularly if you are unsure of where you would like to take your career next.
Times are changing
The only thing that is constant is change and with change comes opportunity. On-going pilot schemes are modifying the face of the NHS, heavy competition is affecting job availability and more corporates are buying out independent practices. Despite these factors, we need to survive in the workplace and develop our career to a level that we are happy with as individuals. You set your own potential. With change in mind, author Stephen Covey describes two circles that we generally operate in - a 'circle of concern' (this may be anything from the weather to what we are wearing that day) and a 'circle of influence'( those things we can have a direct effect on). We cannot possibly have a direct effect on everything so with this awareness, we can place our resources and efforts into the 'circle of influence' to make things happen. From there we really can do the best we can with what we have.
Options
After working so hard you have secured a great degree and you are ready to move forward. So what are the options? There are so many and we are in a privileged position to explore these further. You could become an associate in a NHS, private or mixed practice. Specialisation, hospital positions, salaried dental services, working abroad, the armed forces and academic routes are also other options that you may wish to consider.
Deciding your career path
Although the following questions may on the surface seem vague, they will help you to uncover what your aspirations are and how you can tailor your career around what you enjoy with the future market place in mind.
What do I value?
What am I really passionate about?
What is right for me?
Interests, flexibility, career aims, experience, location, travel, relationships and your own priorities may give you further indication of how you wish to progress.
The answers to these questions will give you some direction of if you would like to specialise or if you would like to be a general practitioner. Dentistry is such a broad area and finding your niche can be determined by what you really enjoy doing. You can bring almost anything into dentistry. As an example, if you are interested in nutrition, working with children or aesthetics, dentistry can provide you with an avenue to go down.
Think about what you want to make you happy. This is different for everyone and there is no need to feel pressured to venture one way or another. If a colleague is heading in a certain direction remember that although this decision may work for them, it may not work for you. Do not let other people's definitions of success dictate your journey.
You have the rest of your life to spend in general practice so if you want to do additional training, doing it now may be a good time. Even if dentistry is not your passion, it most definitely will fund and facilitate projects and endeavours that are. If you are unsure, do some dentistry and see what it is that you enjoy. Explore your options.
Challenges
Common questions we ask as young dentists may include what do I want to do? How do I move forward in my career? Where do I want to live? How do I get a job after foundation training? There is often a lot of pressure placed upon us and some of us carry the extra burden of expectation from family members and/or dependents. Use all of the resources available to you - mentors, tutors, colleagues, professional bodies, articles and forums. You can also request to shadow professionals to gain exposure and experience to the areas you are interested in.
Look after yourself. As we know a day in the surgery can be very intense. Invest in yourself with dental loupes and a good chair. Mistakes often occur when we are stressed, tired, hungry and not focussed. Good nutrition, rest and exercise will really help with maintaining vitality. Make time for doing something that you really enjoy outside of work as it is easy to let work consume you at times. Maintain a balance between work and play - this will optimise your mood patient care.
Communication
In their Annual Review 2002 Dental Protection quotes that 70% of complaints are due to poor communication. Soft skills are key both in and out of the surgery for success with building relationships with people. Listening, understanding and empathising are essential areas that we need to develop in order to be successful practitioners. Ensure that when you have given an explanation that the patient completely understands what you have said. This is mandatory for valid consent and excellent for building good rapport.
Tax
As young dentists this area can be poorly understood. It is a good idea to set up a separate current bank account for your earnings and for outgoings including work expenses, equipment and travel. This will enable clarity at the end of the financial year. Ensure that you save the necessary amount of money if you are self-employed to avoid any surprises from the HMRC when your tax bill arrives. A good accountant or independent financial advisor with experience in dental finances may be a good idea for advice as it is not always our strength.
Are you registered?
It is very important to be organised with annual retention and subscription fees and be aware of what registrations are mandatory in order to practice.
Essential memberships
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Optional memberships
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- GDC
- Indemnity (Dental Protection, Dental Defence Union, other providers)
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- Sickness insurance (Wesleyan, Dentist Provident)
- Memberships of subject interest
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Your indemnity is only valid when you are registered with the GDC and it is a criminal offence to be practising without GDC registration. Keep on top of your direct debits and annual retention fee (ARF) date as it is sometimes easy to overlook the correspondence from these important bodies. Make sure that payments are made when they are due – the stakes are high if they aren’t! Litigation may arise due to issues of complaints and negligence but also for practising when not being on the dental register. Your reputation is one of the most precious things you own as a healthcare professional and it is your responsibility to ensure you are practising within the relevant requirements.
Setting your standards
The GDC published 'Standards for the Dental Team' in September 2013. Expectations and requirements are laid out in this document and it is recommended reading for every member of the profession. These nine standards should create the basis of every decision each professional makes.
As young dentists section 7.2 identifies that you should 'work within your knowledge, skills, professional competence and abilities.' Know your limitations. Be willing to refer those over challenging cases to a specialist or secondary care for treatment if you do not feel confident undertaking it yourself. It is in the patient's best interests.
Speed comes with experience and confidence. Release the pressure from yourself and accept that when you are just starting out you may need two 60 minute appointments to complete a molar RCT and your examinations may take a little bit longer. Concentrate on maintaining a high standard of patient care. Keep in mind that your standards may diminish without you even realising so be keen to start out with a high level of performance and patient care. Avoid compromising on what you know is the right thing to do.
Talking about money
Providing an excellent service and discussing costs is not often spoken about openly. It is fine to have high aspirations to earn a decent amount of money in order to fund a suitable lifestyle for yourself. However, as young dentists it is equally important to get some experience. Find something you really enjoy or focus on what you are doing to the best of your ability and the money will come.
Remember the response you gave in your dental school interview when you were asked 'why do you want to do dentistry?' You may have replied with; serving and helping other people, working with my hands, it's a varied profession, I am passionate about teeth'. This may still be the case but whatever your motivation is, dentistry effectively provides a means to survival. This means talking about costs for treatment incurred with your patients openly and confidently. Be clear when discussing different options for NHS and private work. Your experience and where you are working may be an indicator of what you are comfortable charging for various treatments. Get some experience before you start carrying out good quality private work and always fully explain that the treatment may fail.
Feeling uncomfortable when discussing treatment costs is completely normal but remember you have gone through years of education, days studying, emotions, examinations and funds to be sitting where you are now. You are worth it. Do not sell yourself short but simultaneously do not lure patients into an unrealistic expectation or false sense of security where your experience is limited. You are a professional and patients are trusting your expert opinion and advice. Be honest with yourself and with them.
When things go wrong
Things do and will go wrong in the work place. When adverse situations arise; stop, evaluate the event, take immediate action if required and seek advice if necessary. This may be from your practice or indemnity. Give a full explanation to the patient if it is appropriate in that particular situation. Be honest. This will prevent further issues arising from that particular incident in the future.
Unexpected turns naturally have an impact on us particularly as newly qualified dentists building on experience. It often helps to know that it is not the event that actually personally affects us, it is our response to the event that is the bigger factor in how we feel and we always have a choice in our response to what happens.
Enjoy
Give thought to what you want and if you are unsure, gain experiences to help you to decide exactly what it is that you would like to bring into your career. Keep in mind that there is no right or wrong. When you have made your decision, focus upon it and take relevant action to make it happen. It is as easy and as difficult as that. Make your decision. Focus. Act.
Enjoy the early years or your career. Explore your options and remember that if you do not chase your dreams, you will never catch them.
Surinder Poonian