Next entry for my DCT competition... with Molly Harte

I work in the Oral Medicine department at the Royal National ENT and Eastman Dental Hospitals, a specialist hospital in the University College Hospitals London Trust. The Eastman - which opened in 1931 - is today one of the largest providers of postgraduate dental training and teaching. In October 2019, we moved to a brand new building where our Dental services were combined with those of Ear, Nose and Throat (ENT) speciality. The Oral Medicine team comprises 5 consultants, 3 registrars, 3 speciality doctors and one Dental Core Trainee - me! 

Monday: After catching up on the previous week's letters, I spend Monday afternoons in the Oral Medicine Clinic. I see and manage a variety of new and follow up patients with diagnoses ranging from Oral Lichen Planus and Recurrent Aphthous Stomatitis to Pemphigus, Pemphigoid and pre-malignant conditions. 

Tuesday: Tuesday mornings are also spent in the Oral Medicine clinic. I prescribe topical and systemic therapy for patients, depending on the severity of their condition, and after 4 months in the job, I am fairly confident in the prescription of steroids and immunosuppressants. On Tuesday afternoons I have my own biopsy list where I perform biopsies under LA. On this list, I also provide cryotherapy for patients with vascular lesions, and carry out intra-lesional corticosteroid injections with lip enlargement associated with Orofacial Granulomatosis or refractory pyogenic granulomata. 

Wednesday: On Wednesday mornings I attend the Facial Pain Multidisciplinary Team (MDT) meeting. The team includes the Facial Pain consultants and Oral Medicine trainees along with our Clinical Psychology and Physiotherapy colleague. We use these meetings to discuss diagnosis and management of more complex facial pain cases. Our Psychology and Physiotherapy teams run a pain management programme which aims to help patients live better with chronic facial pain.I get the opportunity to go along to these sessions, which helps me when speaking to patients about their facial pain and management of it. After the MDT, I run a facial pain clinic with one of the Oral Surgery DCT1s. In this clinic, we see patients with diagnoses ranging from TMD to Trigeminal Neuralgia. I find facial pain the most challenging clinic of the week as our patients have often been seen by multiple specialities, given multiple diagnoses and tried multiple ineffective treatment, so are understandably often frustrated by the time they reach our department. 

Thursday: Every other Thursdays morning, I go to the joint Paediatric-Oral Medicine clinic where we see and treat paediatric patients with Oral Medicine conditions. By far the most common diagnosis seen on this clinic is Recurrent Aphthous Stomatitis, which we usually treat with topical corticosteroids. We do also see less common conditions on this clinic, such as oral Graft vs. Host Disease, and Localised Juvenile Spongiotic Gingival Hyperplasia - which I had never heard of before starting my job at the Eastman! 

Friday: Friday morning means time to finish my admin for the week. On Friday afternoons, I go to the joint Oral Medicine-Dysplasia clinic which is run by an Oral Medicine Consultant and an Oral and Maxillofacial Surgery Consultant. This is a surveillance clinic where we monitor patients with oral epithelial dysplasia. This clinic has certainly improved my intra-oral examination skills and my ability to spot early changes in oral lesions. And that is my week at work done!

I absolutely love my post at the Eastman - my job is varied, interesting and I work as part of a supportive and inspiring team. I would recommend it to anyone, whether they are considering a career in Oral Medicine or not. 

Thank you for your entry Molly. Sounds like you are learning a lot! Look out for still more entries to come. There's also still time to enter if you are a DCT...