Wednesday, 11 April 2018

PG Diploma in Special Care Dentistry RCSEd: My Experience

Back in March, I sat my PG Diploma in Special Care Dentistry (which I have mentioned in a previous post). For those of you who want to know a little bit more about the exam and how to apply keep reading!

You sit the exam at the Royal College in Edinburgh - An excuse to explore this beautiful city!

What is the PG Dip in SCD?

The PG diploma was developed recently with the Edinburgh Royal College to formally recognise the expertise of dentists who work with Special Care patients. Often the diploma can be taken during specialist training but it is not necessary to sit the exams. 

Who can apply?

There are some requirements to sit the exam:

  1. GDC registration
  2. A minimum of 2 years post-qualification
  3. A minimum of 1 year of experience of full time postgraduate experience working with special care patients (or part time equivalent if completed over 4 years)

Format of the Exam

There are 4 parts to the exam:

  1. Log book of clinical experience relevant to special care dentistry (50-100 cases over a 6 month period)
  2. Case presentations x 2 of special care patients (in differing categories of patients)
  3. A written SBA exam
  4. Unseen cases x 7 

Ready to go into the exam! Candidate 1!!

What was the exam like?

So after submitting my cases and portfolio (which was a lot of work - if you want to view my portfolio click here, I can't share my cases online due to consent issues) 3 months prior to the exam date, I made my way up to Edinburgh to sit the exam. 

The exam was held over 2 days (they sometimes have them over 3 days) so I stayed a few nights. There was only me and another lady sitting the exam!

Day 1

Firstly, was the written exam. It was good to get it out the way. On the RCSEd website you can find a full curriculum to go through when you are revising but the exam was 150 single best answer questions covering topics including:
  • Medical conditions and dental manifestations
  • Medication interactions, classifications and contraindications
  • Pathophysiology of diseases
  • Audits, research and clinical governance
  • Epidemiology
  • Embryology 
  • Mental Health 
  • Immunology
  • Theory of sedation and GA

After a couple of hours break and recharge, we then had the first of the oral exams where the 2 examiners asked questions about our logbook and our clinical cases. Although it was a bit intense, they were my patients which I knew well. Tips I would give include:

  • Know how to justify your treatment plan
  • Know your patients conditions and medications side effects
  • Be ready to discuss problems you experienced and how you overcame them
  • Know alternative treatment options and why you didn't chose them
  • Dental impact of conditions that your patient has
And that was day 1 done! Phew! 

Day 2

After a good nights sleep the final hurdle was the unseen cases. This was the part as a student I used to feel most anxious about, but surprisingly on the morning I didn't feel that anxious. I think the reason why was because you have the same people examining you as Day 1 and during the first oral exam I felt like I had almost built up a rapport. Plus it was the last bit of the exam left! Here are examples of sorts of patients came up in the unseen cases (there were 7 in total). 

  • Dementia patients
  • Parkinson's patients 
  • Physical disabilites
  • ADHD/challenging behaviour
  • GA/sedation options
  • Bleeding e.g. NOACs
  • Transplant patients
  • Oncology patients 
  • Diabetes
  • Obesity
  • Sleep apnoea

And with that, I was done... and I'm pleased to say I PASSED!! Woohoo, now I have more letters to add after my name - but more importantly, a formal recognition of the skills I have learnt during the past 2 years working with special care patients.

To read more about the exam, see the RCSEd website

Are you thinking of taking the diploma? Do you have any questions? Let me know in the comments below. 

Friday, 23 March 2018

Avanti Aesthetics Academy: One Awesome Raffle Prize!

Back in the autumn at the Make A Dentist Party unbelievable I won in the raffle at place on the Avanti Aesthetics Academy Foundation Botulinum Toxin Course! I never win anything so I was very excited and I'd heard some fab things about the course...

My Expectations

I had heard lots about the Avanti Course before I won this place and all feedback was positive. One of my close friends had recently been on the course and she stayed with me for the weekend of the course and it seemed like a very intense few days. 

I was also familiar with other courses available by other providers which had varying training programmes. One of the reasons why I hadn't already pursued one of these aesthetics courses before was confusion about what I wanted to get out of an aesthetics course, especially since a lot of my day to day dental practice is limited to purely NHS work. 

Previously, I had provided Botulinum Toxin injections in a oral surgery NHS department treating myofacial TMJD and Frey's syndrome and I mostly just observed and assisted in the procedure as a junior and therefore my perception of using toxin was a little scary as we were often injecting very deep in tissues (e.g. into the body of the masseter). 

Who are Avanti Aesthetics Academy?

The Avanti Aesthetics Training Academy train doctors, dentists and nurses in non surgical aesthetic treatments. The training is provided by the fabulous Dr Rikin Parekh and the academy has recently introduced a 5 day training course 'The Fundamental Five' which covers a range of aesthetic training:

Day 1 - Upper Face Botulinum Toxin
Day 2 - Lower Face Botulinum Toxin and Hyperhidrosis
Day 3 - Cheek Augmentation
Day 4 - Nasolabial Folds/Marionette Lines (Cannula and Needle)
Day 5 - Lip Augmentation (Cannula and Needle)

Practising injecting each other N.B. with saline, not actual toxin!

How was the day?

I won the first day of the course which was Upper Face Botulinum Toxin. The morning was spent learning about the theory of Botulinum Toxin, mechanism of action and important anatomy. Botox is a term which the majority of people use is a brand name for the protein Botulinum Toxin.

Rikin recommends using the UK leader in the field Azzalure. We then learn about the practical application of toxin in the upper face, indications as well as cautions e.g. heavy eyebrows or compensation from the frontalis and after a quick bite to eat the exciting part of the day: injecting real life models!

Each delegate had their own model to inject. Some of these models were regulars to the academy and knew exactly what they wanted down to the exact dose! Others it was their first treatment with toxin. My model was the only male of the group and it was his first treatment. I really enjoyed the practical element. Once you got over the initial trepidation of injecting extra-orally for a change, by the time you got round to the last dose it came naturally. 

It was useful to observe the analysis for each of the other delegates models also so you could analyse each individual to their specific injections sites and doses. We also had a practise on each other (injecting only saline!) so we knew what it felt like. I was expecting it to have a similar feeling to local anaesthetic injection, but it was nothing in comparison! 

What I learnt

The day was an intense learning experience as I had anticipated but not only did I learn lots of clinical and theoretical skills, Rikin also taught us the business opportunities surrounding facial aesthetics. 

This was something that I found particularly useful as most of my clinical work wouldn't allow for me to offer any of the skills I had just learnt; however, facial aesthetics can open up a flexible and fulfilling business alongside your day to day profession. With the use of clever marketing including social media, I have already seen some clinicians thrive with this style of working and it would be interesting to pursue this approach myself.  

Many thanks to Rikin and the Avanti Aesthetics team for a fantastic day! I would definitely recommend the course to anyone who wants to explore other options in dentistry. 

And for anyone who wants to sign up to the Fundamental Five Course if you quote my name and code AAA100NB then you will receive £100 off the total cost of the course! 

Have you been on any Avanti Aesthetics courses? What did you think? Let me know in the comments below. 

Tuesday, 20 March 2018

Dentaltown Article: The Hall Technique

Have you read the latest edition of Dentaltown UK...?

Who are Dentaltown UK?

Dentaltown UK are the branch of Dentaltown, an online dental community publishing an e-magazine every month with the latest news as well as lifestyle. It is unique by providing not only clinical advice and cases, but personal and lifestyle pieces. 

In the most recent March edition, I was approached to write a case report to contribute to the publication. Of course one of the treatments I provide most frequently are Hall Crowns. I often get lots of queries about this treatment modality - which cases are appropriate, how do I do them, how do I place separators? This technique is becoming more and more common, with many advantages and now a strong evidence base.

To read the March edition of Dentaltown and my article click here. 

A snapshot of my article

Many thanks to the Dentaltown team for publishing my article!

Do you use the Hall Technique? What challenges do you encounter? Let me know in the comments below. 

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