Building the foundations

Queen’s University Belfast graduate William Maguire discusses his experiences going through the North East General Practitioner Trainee (GPT) Scheme in England

I graduated from Queen’s University Belfast in July 2015 and obtained a place in the North East General Practitioner Trainee (GPT) Scheme, which I started in September 2015. I am writing this article to discuss my experiences so far as a GPT, for future graduates to have more knowledge when

applying for Dental Foundation Training (DFT) or GPT schemes.

Firstly, as any recent post–graduates will be aware, the applications for DFT and GPT schemes are now through a national recruitment process. The recruitment process is led by Shared Services on behalf of Health Education

England and COPDEND, and the application form is available at http://www.oriel.nhs.uk

When I was practising for my interview I found the GDC document, ’Standards for the Dental Team’ particularly useful, as well as discussions with other dental students and more experienced clinicians. Following my interview, I ranked my choices and placed the North East GPT scheme first, which I was informed via email a few weeks later I was successful in obtaining. I then travelled to England and met with the six dental practitioner trainers, which I then ranked and subsequently was matched with a dental practice.

The GPT scheme, in a sense, combines DCT 1 and DFT, in that the training is one week in dental practice and one week in various hospital departments over two years. I chose the GPT scheme as I knew that after foundation training I would like to apply for further hospital training, and this allowed me to have a position for two years and not worry about applying for a job in between.

GPT training is not available in Northern Ireland, so I knew I had to apply to England and Wales for this opportunity. My girlfriend Mabh, who was in my year in dental school, was also applying to the North East for a job, so I knew I would like to stay in the same area. I will now discuss some of the advantages and disadvantages of the GPT scheme.

Advantages

I will have lots of varied dental experience – different to DCT 1 as I am in many different clinical departments over the two years.

I have just finished my first rotation, which was in the children’s dental hospital. During the past four months, I have personally managed some complex treatment cases which included administration of inhalation sedation, stainless steel crowns, emergency splints, extirpation and obturation of open apex upper incisors as well as new patient clinics. Following my undergraduate training, I had some limited experience with most of this, however I had only read from lectures and textbooks about trauma cases, so I found these particularly useful.

Newcastle Dental Hospital Children’s department has a trauma meeting once a week over a lunchtime where all of the dental clinicians discuss the treatment plans for the patients in their treatments sessions of that week. I was quite apprehensive during my first experience with putting on an emergency splint with brackets and arch wire; however I knew I had the support from consultants and other hospital support staff. I felt a great sense of achievement when this patient came in for a review appointment, and the brackets had all remained in place! I now would like more skills working with orthodontic cases, and I can now try to get more experience both in the hospital and during my dental practice environments.

Before I applied to this scheme, I had not realised that it has study days built into the timetable for either the MFDS or MJDF. I sat part one of the MFDS examination in October and passed; however I would feel more confident now following the hospital study days. I plan to sit part two of this examination in November 2016, which is the earliest opportunity.

It also must be said that it is a positive to have guaranteed work and indeed remuneration for two years. This allows me the opportunity to have at least a few months where I do not need to think about applying for a job, so I can concentrate on other projects like audits and other learning opportunities. I also have 27 days annual leave, which is more than the 21 days that foundation dentists are given.

Finally, I should also mention that the support I receive from hospital and practice is co–ordinated by from two educational supervisors, who each have a lot of clinical dental experience and can help me with any queries or questions regarding my training. I also have two training programme directors (TPD) who co–ordinate all of the study days, as well as support our training throughout the two years. I have also enjoyed working with all of the different nursing staff, both within the hospital and practice, as I have always viewed my work to be a team effort and without their support I would not have been able to manage some of the treatments as efficiently.

Disadvantages

Joining into a hospital setting straight after undergraduate training has been challenging; with severe cases in secondary care setting requiring a steep learning curve, dictating approximately 20 letters a week from new patient consultant lead clinics. I also had to discuss treatment plans involving general anaesthetic and multiple extractions for quite young patients, which can be difficult to manage parental expectations for which teeth are restorable when very young patients are, as expected, not entirely co–operative. When I compare this to my week in general dental practice, it is more demanding as I have not had much experience with complex treatment plans. It took a few months to feel more confident on the clinic, and now I have changed clinic, so it will likely take some time again. That being said, the dental emergency clinic patients are similar in presentation to what I have been treating as emergency appointments in dental practice, so I do feel it should be manageable, especially with the support from the oral surgery and restorative senior staff available.

The dental foundation portfolio is an online record system that includes the results and feedback from your trainer in dental practice. It is also used to reflect on study days, tutorials, case–based discussions as well as personal reflections. This system, whilst it has its difficulties with its user interface and blocks with only allowing you to open one reflection at a time that has to be signed off by both your ES and your regional TPD, will be useful in at the end of our training to have a full record of our work and feedback throughout. We have been informed they are updating this system, so this should be more user–friendly soon. The hospital portfolio logbook is in paper format, and as such is harder to organise however it is manageable.

The pay over year one in my scheme is approximately £3,000 less than DFT, with our hours fixed at 40 per week in the hospital and 37.5 hours in general practice. This is because we are paid in line with year one foundation doctors in the hospital. As you may have read in the news recently, the junior doctors face planned pay cuts. This will not affect me as my hours are fixed, but any junior hospital dentist undergoing further training will likely be faced by this.

Finally, the time commitment could be seen as a disadvantage – staying in one location for two years with restrictions on scheduling annual leave. Being organised with a calendar is important, and I have found my time management skills are slowly improving. In the hospital, we are required to submit requests for annual leave at least six weeks in advance with the appropriate signatures, but the staff and indeed the other GPT in the year ahead of me are very helpful with the paperwork.

Conclusions

I would stress this has all been my personal experience, and others may have other positives and negatives throughout the training process. I have very much enjoyed my time so far in Newcastle, and look forward to future opportunities and challenges further dental training will bring.


References

Oriel website for applying to dental training. Available online (Accessed: 09 January 2016).

COPDEND UK Committee of Postgraduate Dental Deans and Directors. National Recruitment to Dental Foundation Training. Available online (Accessed Jan 2015)

DFT online portfolio. Available online (Accessed: 09 January 2016).

GDC. Standards for the Dental Team. General Dental Council, 2013. Available online (Accessed)

HENE GPT 20 DFT Autumn programme. Available online (Accessed: 09 January 2016).

HENE GPT 20 MFDS Autumn programme. Available online [Accessed: 09 January 2016].

HESL. DFT National Applicant Guide– 2015. Available online (accessed).

DFT 2015 recruitment report data. Available online (Accessed: 09 January 2016).

Published: 24 February, 2016 at 17:35