Hiten Halai graduated in 2012 from Barts and The London. After foundation training he completed a Restorative and General Duties DF2 post at The Royal London Dental Hospital. He is currently working as a private associate in Singapore.
"I have written this article to share my experience of this particular training programme and the opportunities it can present to anyone looking to explore interests in a specific area of dentistry other than maxillofacial surgery."
Many of us young dentists find ourselves at a crossroad after completing DF1. I remember at the time many of my friends had decided to continue in general practice whilst others were keen to pursue hospital posts in oral and maxillofacial surgery. For me, I knew I wanted to continue on a training programme that allowed me to explore my developing interest in Periodontology. I consequently embarked on a restorative house officer (DF2) post at the Royal London Dental Hospital and I can honestly say it has been one of my most challenging and rewarding experiences to date.
A bit of background information
The DF2 year at 'The London' is essentially a general duties post with a heavy focus on restorative dentistry. There are two six-month rotations which are typically comprised of restorative treatment clinics, restorative new patient consultant clinics, sedation, paediatrics, oral surgery, oral medicine and dental emergency clinics. The working day was 9.30-5pm and was split into two clinical sessions of approximately three hours. The other bonus was no on-calls! On average one clinical session a day was spent on restorative treatment clinics. There is also one study session a week and weekly seminars after work on Wednesdays. So it was definitely well rounded!
There are six restorative house officers at the hospital (five DF2s and one CDP). Each house officer is assigned an educational supervisor with whom you have regular appraisals and have to sign off a mandatory electronic personal development portfolio.
A foundation training year in general dental practice definitely helped provide a sound basis which I was able to further develop in this hospital post. Aside from honing clinical skills it is also a great opportunity to improve communication and patient management. I usually saw two to five patients in each treatment session and had the freedom to control my appointment book. The cases ranged from advanced restorative dentistry and patients with complex medical histories to paediatric dental trauma and oral rehabilitation of head and neck cancer patients. There was also an element of dento-alveolar and soft tissue surgery which had helped me gain confidence in carrying out surgical extractions and biopsies.
We were able to identify a few cases that interested us during new patient clinics and take them on for treatment provided the supervising consultant agreed. Having developed an interest in Periodontology in the latter years of my undergraduate training, treating such patients allowed me to explore this speciality in a secondary care setting. Early in the year I started treating patients with advanced chronic periodontitis. The differences between primary and secondary care dentistry quickly became apparent. Being seen in a dental hospital evoked motivation in patients and most felt privileged to receive treatment in that environment. It definitely made my job easier when patients had good compliance oral hygiene instruction. As the year progressed I began to treat more patients with forms of aggressive periodontitis which in itself was extremely rewarding to educate and stabilise typically young patients with compromised dentitions. In addition to this, being supervised by some of the best restorative consultants in the country also offered the opportunity to discuss the latest thinking in the management of these types of cases.
The staff at the dental hospital were very friendly and approachable which helped establish an environment ideal for learning. For example, I did my first open flap debridement with direct supervision from an experienced periodontist, who was extremely patient and gave me confidence to complete the procedure successfully whilst gaining invaluable tips along the way.
This post had also opened avenues to become involved in research projects; many of the consultants have suggestions for research topics and the weekly study session can be used to assist in on-going research at the dental institute. I was able to draft my own research protocol looking at diabetic screening in periodontitis patients and also complete a literature review for a paper on the use of lasers in Periodontology with a supervising consultant. Carrying out clinical audit was also a key part of the DF2 training programme. I reported on the effectiveness of patient information leaflets within the Periodontology department, and subsequently won the BSP (British Society of Periodontology) audit award.
Aside from the clinical and academic aspects, working in a hospital provides a great sociable atmosphere to meet new people and network with colleagues. This year I have met people with whom I will undoubtedly remain good friends and hopefully work with again in the future. It has also given me the opportunity to speak to current postgraduate students in Periodontology to obtain a realistic perspective of this specialist training pathway.
Even though my account has been focused around my experiences in Periodontology, I would definitely recommend this post to anyone wanting to explore an interest in any area of Dentistry. Even then, if you are unsure about your career pathway, the general duties aspect also helps gain invaluable clinical and management skills in other areas of general dentistry. Other house officers in the same post had progressed into a variety of positions including private practice, restorative mono-speciality training and community dental officers.
There is sometimes lengthy paperwork associated with working in hospitals and the occasional difficult patient but one of the main advantages is that unlike many other posts, there is some flexibility to tailor your learning and experiences to your interests.
So if you're considering what to do next year, give Restorative DF2 a thought!
Dr. Hiten Halai, BDS(Lond) MFDS RCSEd, PG.Dip. on behalf of the British Society of Periodontology, Early Careers Group (ECG)