A Week In The Life of A DCT... OMFS at Northwick Park with Sancia Fernando

Next entry for my DCT competition... with Sancia Fernando

Sancia Fernando, DCT1 in OMFS at Northwick Park Hospital, London

I work in the Oral and Maxillofacial Surgery Department at Northwick Park Hospital, one of the busiest units in London. With the unit taking on referrals from over 13 other hospitals in the region - including it's own A&E department, when armoured with the 'on call bleep' you're in for a busy day. 

I went into this post with a desire to throw myself into the deep end, to build on my clinical knowledge and surgical skill. Little did I know how much this post would really teach me. 5 months in, I've been surrounded by a world of gory lacerations, major oncology cases, and the opportunity to learn from some amazing leaders in the field. 

No week is ever the same for an OMFS DCT. Some weeks we're placed in our spoke sites (mine being Hillingdon hospital) helping with clinics, minor oral surgery under LA and GA. We also have a Northwick Park 'Clinic week', seeing everything from 2 week cancer referrals, head and neck skin lesions and trauma follow-ups. I also have a Friday theatre list assisting with oncology cases - involving everything from flaps, parotidectomies to neck dissections. Since I've just come out of an on-call week; I thought I'd give you a summary of the week's events!


Monday: Armoured with a cup of coffee I arrive at 7am for handover from the night fellow. The secret to being a good OMFS DCT is the ability to work well in a team. There are always two DCTs on call and we're updated with a list of OMFS inpatients, and given a list of patients expected to come into A&E that have been referred from other hospitals. 

Being organised is essential! After the 8am ward round, the OMFS on call shift can be unpredictable, you could be writing up a patient's drug chart one minute and suturing up a laceration the next! Teamwork makes all the difference - delegating tasks between the other DCT on call makes the day go a lot smoother, ready for a 7pm (hopefully) handover to the night fellow. 

Tuesday: As exciting as OMFS sounds, the harsh reality of being faced with patients at the end of their life can be heart breaking. After making a referral to palliative care for one of our joint OMFS/ENT ward patients, I spend some time to recollect my thoughts and get reay to power through the A&E referrals. A few sebaceous cysts, ZMC fractures and bleeding sockets later - the 7pm handover couldn't have come at a more perfect time!

Wednesday: Wednesday mornings involve our MDT meetings. We're required to sit beside the consultants, radiologists and pathologists and discuss the management of patients diagnosed with head and neck cancer. Back on the on-call shift I manage to successfully place a NG tube for one our ITU patients, and after helping suture up a man attacked with a machete, it's safe to say my day has been nothing short of eventful. 

Thursday: The stress on our A&E department can be immense, and it's our duty to make sure patients are being prioritised appropriately. A sad case of an elderly lady coming into A&E after a road traffic accident made me realise how grateful I was to be working in my local hospital. I attended to her lacerations after making sure she was cleared of other head, neck and spinal injuries and she was extremely grateful for the care she received. Our NHS receives a lot of varied press in the media, but this DCT post has helped me witness first-hand the resilience our hospital staff show to fight for our patient's safety and care. 

Friday: After a long 48-hour week I manage to catch up on my sleep and prepare myself for the week of clinics and MOS coming up.


If someone told me a year ago that I'd be able to drain infected cysts, suture lacerations and take on complex wisdom teeth cases, I would have never believed them. DCT has helped me understand hospitals and referrals, resilience in times of pressure, but most importantly the value of empathy and teamwork. A DCT post can not only provide you with knowledge that you can take into practice/speciality training, but it gives you a chance to give back to a wonderful NHS and all its patients.



Thank you for your entry Sancia. I don't think I want to know what a machete laceration looks like! Look out for still more entries to come. There's also still just enough time to enter if you are a DCT...


To ENTER: email your submission via the contact page on the blog
DEADLINE January 31st 2020

Winner to be announced in February

And GOOD LUCK!



Do you have any questions about DCT or the competition ? Let me know in the comments below. 


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