So You Want to be a Specialist...

So one of the career options out there is becoming a specialist... but is it for you and what do you need to do?

What can you specialise in?

There are 13 dental specialities recognised by the GDC in the UK, excluding Oral and Maxillofacial Surgery - this is a medical speciality. This includes:

  • Dental & Maxillofacial Radiology 
  • Dental Public Health
  • Endodontics
  • Oral & Maxillofacial Pathology 
  • Oral Medicine 
  • Oral Microbiology 
  • Oral Surgery 
  • Orthodontics 
  • Special Care Dentistry (the best dental speciality in my opinion!) 
  • Paediatric Dentistry 
  • Periodontics
  • Prosthodontics 
  • Restorative Dentistry 

Why should you specialise?

There might be lots of reasons why you would like to specialise in one area of dentistry, for example:

  1. You really enjoy, or are skilled at one area of dentistry or one type of procedure such as surgery 
  2. You wish to develop specialist skills and treat more complex cases
  3. You wish to work in certain environment such as hospital or as part of a multidisciplinary team (MDT) 

How do I specialise?

A question I get asked all the time is how to go about specialising. This will vary slightly depending on the dental speciality, but in general, there are 4 routes:

1. Funded StR Posts

These posts, funded usually by Health Education England (and equivalence in the devolved nations), or by NHS trusts, will involve receive a salary while training. The posts are advertised annually via National Recruitment via Oriel and for many specialities are very competitive! 

2. Academic Clinical Fellow Posts

Funded by the National Institute for Health Research (NIHR), these speciality training posts have time set aside (25%) specifically for research and academia. The aim of these posts is to equip the trainee with skills in academia and hopefully to enable the trainee on completion of their speciality training to carry out a pH D. Again the trainee receives a set salary. 

3. Self-funded University Courses

There are postgraduate university dental courses that are recognised as a pathway to become a specialist, most commonly, the restorative mono-specialities. This route is involves self-funding by the candidate and tuition fee costs vary hugely (I discuss the hidden costs of speciality training in this blog post). Courses can be full or part time - and it's not just the tuition fee cost that needs to be considered, but also potential lost income for the days that would've been worked. 

4. Mediated entry 

For some dental specialities, you can apply for mediated entry onto the specialist list by evidencing appropriate skills and experience equivalent to a specialist without having completed a recognised training programme. The instructions for mediated entry are available on the GDC website. 

For all these routes, there will be criteria you will need to meet when applying for positions or mediated entry. I would recommend doing your research, such as looking at the COPDEND Personal Specifications for the speciality you are interested in; but in general you will need:
  • At least 3 years experience post graduation
  • Experience relevant to the speciality you are applying to
  • Publications, presentations and audits
  • CPD/training relevant to the speciality you are applying to 
  • Teaching and Leadership/Management skills

Should I specialise?

Out of all the questions to ask about specialist training, this is the most important! There is no obligation to specialise in dentistry... in fact the majority of dental care in the UK (90%), is performed by generalists in primary care. There are plenty of options to enhance your skills and career without having to specialise.
My top tip when considering specialising is you need to be a good generalist first! Master the basic skills in dentistry such as treatment planning and communication, before going on to consider specialising. Also consider other aspects of your life other than your professional career - will they fit in with the training pathway options described above? Specialisation often comes with sacrifices, such as income (temporarily) and time dedicated for study and other work outside of your usual hours of dental practice. 

If you do decide you want to specialise, do not get disheartened if you have to apply several times to get into the training programme you want - these programmes are often very competitive and applications only happen once a year... I got into my training pathway on my third application! 

What reasons would you want to do specialist training? Please leave them in the comments below

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