Marley’s post

Dr John Marley, dean of the Faculty of Dentistry at the Royal College of Surgeons in Ireland (RCSI) outlines his past, gives his hopes for the future and highlights the forthcoming Annual Scientific Meeting (ASM)

Belfast consultant oral surgeon, Dr John Marley, who was recently elected ı8th dean of the Faculty of Dentistry at the RCSI, is clear about his aims. He wants a dynamic and responsive faculty that meets the needs of members and fellows, and puts patients first.

A graduate of Queen’s University, Dr Marley assumed his role earlier this year, succeeding Dr John Walsh. He spoke to Ireland’s Dental magazine about his career so far, his hopes for the future and what to expect from the faculty’s upcoming ASM

Why did you decide to study dentistry in the first place?
I would love to say that I always wanted to be a dentist, but that wasn’t the case. I was really quite frightened of dentists as a child.

Actually, my mum and dad ran a funeral director business, as well as a pub, so at an early age I used to help my dad prepare the coffins and work behind the bar. I suppose you could say I was already used to working with my hands (albeit with bigger drills) and managing people under the influence of an anaesthetic!

Most of my siblings were teachers, and I think that environment triggered my own interest in teaching and learning. I drifted into dentistry, as a lot of my generation of dentists did, on the advice of careers teachers. I was quickly captivated by the idea of oral surgery though, its immediacy was appealing and because it required an understanding of so many other aspects: systemic disease, microbiology, pharmacology, orofacial pathology and psychology. What’s more, I really liked the interaction with patients in that environment.

Tell us about your work history
I qualified at Queen’s University Belfast in 1988 after an intercalated year studying medical microbiology. After a junior house officer post in Belfast, I applied for a Yorkshire Cancer Research Campaign studentship and moved to Leeds in 1989 to study for my PhD at the Leeds Dental Institute. I also worked part-time in general practice in Northern Ireland and England for three years, so I know the pressures and rewards general dental practice brings.

In 1992, I finished my PhD studies developing predictive molecular markers for oral cancer progression through cDNA library construction and screening. In my supervisor, Phil Robinson, I had a dedicated and hardworking guide and friend who had given up industrial research and took a cut in pay to follow his passion for academic research. We felt we were working at the forefront in this field at the time. Sadly, Phil passed away all too early from cancer. I will always remember his Yorkshire-inspired attitude. He was a true rational sceptic and I miss him.

After finishing my PhD, I applied for a lecturer’s post back in Queen’s University Dental School.

Fortuitously, at that time there was a recognised need for academics in oral surgery. Through the pragmatism and far-sightedness of the leaders in OMFS at the time, it was acknowledged there was a need to train a small consultant academic cadre to be based in dental schools. After my fellowship in the RCS (Eng), I was appointed to a specialist training programme in oral surgery. I took my Intercollegiate Specialty Fellowship Examination (ISFE) examination in ı999 and became a consultant in 2000.

I was lucky to be exposed to many things during that time, training as I was towards the end of the ‘Troubles’. I got great experience in established and new methods of surgery, which helped my day-to-day management of patients. I am grateful to all my trainers of the time who were generous and patient with me. In particular, I have to single out my friend and colleague, Gerry Cowan, for his wisdom, help and humour. I learnt very quickly that you have to have a good sense of humour in what can be a stressful job.

I was certainly busy, but never bored, because I also had to undertake my lecturer duties. I learnt a lot about time management and people skills, listening, teaching and learning from my senior colleagues and very bright students!

Later, I returned to St James University Hospital, Molecular Medicine Unit in Leeds for a six-month post-doctoral research attachment. At the same time I met my good friend Raj Patel in Sheffield when I completed the Sheffield ı8-month one-to-one course in implantology.

Raj subsequently became our mentor in Belfast and, along with Simon Killough, has helped us build on the hard work of past dean Sean Sheridan to develop our multidisciplinary implant service.

I was appointed Associate Head of School for Teaching in 2003 and continued my learning journey, working in the senior management team with responsibility for curriculum development and programme provision, and preparing for external QA visits, including by the GDC.

It seemed natural to bring these skills to the postgraduate arena as NI Training Programme Director for Oral Surgery, and RCS (Eng) Speciality Advisor for Oral Surgery. I was also appointed by the Department of Health as the dental representative on our NI Postgraduate Deanery where I contributed to oversight of postgraduate training in medicine and dentistry.

I strongly believe you should grab with both hands every opportunity to learn from others, especially in other units and in areas you might not expect to be relevant. Focus is really important, but you have to be careful it does not blind you to opportunity.

I was invited to be an external examiner for several dental schools during this time, including Leeds, London, Aberdeen, Cardiff and Dublin. I met and learnt from so many great people on the way.

Similarly, I was the Belfast academic representative for the BDA, and got to see the workings of our professional association at close quarters, including the challenges it faced with contract changes at the time.

In 2016 I graduated from the Institute of Health Improvement, Quality Improvement (QI) Advisors Programme and would recommend this to all my dental colleagues. There are many free open forums from which to learn, including collaboration with the American Dental Association (ADA). I have also worked with the NI simulation network using high fidelity mannequins in undergraduate teaching for medical emergencies, which is really exciting.

How did you become dean?
I can only do the job through the support of wife and family  and my colleagues in Belfast. I am also really lucky to have the firm foundation I have in the Faculty of Dentistry (FoD), built through the hard work of the recent past deans, John Walsh, Gerry Kearns, PJ Byrne and Sean Sheridan, as well as the CEO Peter Cowan, board members and administrative team.

I had been doing a fair amount of work with our sister colleges prior to my association with RCSI.

I was a member of the Oral Surgery Specialty Advisory Board in RCS Edinburgh and examined in the Intercollegiate Fellowship Specialty Examination (ISFE) in Oral Surgery on behalf of the Glasgow College. This is how I got to meet past dean Gerry Kearns for the first time and where my connection with RCSI grew.

A few years ago, I got involved in the RCS (Eng) Education Leadership Programme for surgeons and was subsequently appointed a member of their faculty. I felt very honoured, but a bit daunted as the only dentist on faculty!

I was an examiner for the Tricollegiate Examination in Oral Surgery at the RCS (Eng), the examination required for entry to the specialist list in oral surgery in the UK, before I took over as chair of the board of examiners there.

Around the same time, I was examining for the FoD at the RCSI for a few years for Fellowship of the Faculty (FFD) and then ISFE, and was deeply honoured to be proposed for an FFD ad eundem by the board.

The last few years seem to have flown. I was elected to the RCSI FoD board for a second time in 20ı4 and subsequently elected vice dean and then dean, taking up my post in February of this year.

It is a great honour and great responsibility to be in a position to help with the development journey for all dental team members, whether it be accreditation through examinations or postgraduate education provided from a wide range of experts in their respective fields.

We are so excited that the college has invested more than 80 million in the development of a modern, practical and sophisticated facility at 26 York Street. The 120,000 square foot development, spanning 10 floors, will comprise, among other aspects, a world-class surgical and clinical training suite containing a flexible wet lab, mock operating theatre, simulation, IT and library facilities. I would like to see our Faculty make as much as use of these state-of-the-art facilities as possible.

I consider our commitment to postgraduate education as one of the pillars of what we do. Both through taught courses and our ongoing development of online resources and connectivity with our members and fellows. In turn, I think it is vitally important that we continue to listen to our membership, so we can continually improve what we do as a Faculty. With our new IT system this should be increasingly easier.

What does the future hold for the FoD under your direction?
In the new building in York Street, Dublin, there is a remarkable artwork installation that consists of clay bullae ‘time capsules’, each representing a specific student.

Every capsule contains an etched metal scroll outlining the personal ambitions of a 20ı7 graduating student as they become healthcare professionals, enabled through their education with RCSI. The clay symbolises RCSI as the custodian of education, supporting and protecting the ambitions of students from the start of their professional journey and throughout their careers.

The installation will remain intact until a 40-year reunion in 2057 when the time capsules will be opened, revealing the career and life reflections that each had when graduating in 20ı7. I wonder what the class of 20ı7 have in store for them?

The FoD has a similar role to play in nurturing the development of our current and future postgraduate Members and Fellows through education provision, validation through examination, and guidance on training to allow them to become the best they can be.

We have seen from recent events that you can’t be certain about anything. Mark Twain summed it up well when he said: “It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.”

The Faculty must continue to be dynamic and responsive to the needs of our Members and Fellows in Ireland and abroad. I would hope to be in a position, during my time as Dean, to help oversee the expansion of our online education repertoire and develop hands-on courses as well as simulation-based training, utilising the College’s state-of-the-art facilities.

You still have to look for a touchstone though, in a complex and challenging world. I believe I see it in George Walsh’s beautiful, middle stained glass window in the Albert Theatre at the RCSI, where the inscription from the Hippocratic oath reads: “The regime I adopt shall be for the benefit of the patients.”

This sums up what should continue to be at the centre of all we do. The FoD’s function as a provider of learning, and advisor on training and quality assessment through examination, should always have the patient at its heart.

The Annual Scientific Meeting

3-4 November 2017, RCSI.
(For booking information, visit asm2017.ie)

This year’s ASM will look at the risk of clinical practice as informed by the current data held by the Defence Organisations in the UK and Ireland and how we can limit risk in these areas.

As members of the dental team we face risk in our working lives. We can’t escape it. The sources of this risk and the effects on our working practice are varied and not solely confined to the techniques of clinical practice we use but touch our relationships with patients and colleagues.

Early recognition and adopting processes and procedures help limit the risk of harm to the patient and our team. They also mean that, for the most part, individuals are not to blame when something goes wrong, but system errors usually are.

Dr John Marley, dean of the Faculty of Dentistry at RSCI, said: “I am increasingly fascinated by complex working systems and how these can allow unintentional catastrophic events to occur through an accumulation and eventual alignment of latent or silent failures to produce actual harm to patients or team members.

“In addition, our scientific committee thought it would be interesting to explore the contributors to this complex world such as team and patient communication /interaction, work environment issues, work processes, situational awareness, and the adverse effects on us as practitioners if we get it wrong.

“We also wanted to help colleagues to prepare for the occasion where they might have to deal with litigation or present themselves to the Dental Council.”

There is a constellation of great speakers with a fantastic breadth of experience from home and abroad and it is a highly recommended event for all members of the dental team.

Published: 22 August, 2017 at 13:10