Senior house officer training in oral and maxillofacial surgery: a national survey

Dental core training in oral and maxillofacial surgery: a United Kingdom survey of on-call provision

Introduction Dental core training posts within oral and maxillofacial surgery (OMFS) units often include on-call provision. There is a lack of current data demonstrating the variation of dental core trainee (DCT) involvement in on-call. This variation may influence trainees' experience of training.Aim To examine the provision of on-call cover in OMFS units across the United Kingdom, including trainee involvement, supervision and training.Method Online surveys were distributed in August 2019 to all DCTs, educational supervisors (ESs) and training programme directors (TPDs) in OMFS units to understand trainee involvement in on-call provision, including levels of supervision and perceived educational benefit.Results In total, 167 trainees responded from 69 OMFS units. Responses were received from 102 ESs/TPDs. All trainees experienced on call, with over 75% covering night shifts. Trainees reported minimal difference between support within hours and out of hours (OOH). Qualitative data from trainees and supervisors highlighted the educational value of on-call within normal hours. However, limited supervised training opportunities were reported OOH.Conclusion This survey highlights the educational value of on-call within hours. The perceived level of support does not vary significantly between normal hours and OOH. Some concerns were expressed regarding OOH supervision and prolonged on-call periods.

Improving visual assessment documentation in patients with periorbital trauma through an eye assessment teaching session and a proforma sticker

Up to 30% of patients who have periorbital trauma will have ocular injury with devastating consequences if missed. All staff working with acutely injured Oral and Maxillofacial Surgery (OMFS) patients should be competent in a basic eye examination with documentation of visual acuity, gross visual fields, eye movements, diplopia, and pupillary responses at a minimum. As a standard we adapted guidance published by the Emergency Care Institute New South Wales to assess the documentation of the eye examination in OMFS patients at King's College Hospital with any periorbital injury. After initial assessment we presented the data in the departmental audit meeting, then gave a detailed teaching session to junior doctors and introduced an ‘eye exam’ proforma sticker designed to act as an aide memoir. At baseline, 38 eye assessments across all clinical environments and by all seniority of clinician were assessed at random. Of these, 41% of these had visual acuity documented, 5% visual fields, 47% pupils, and 83% movements. After presentation of data, reaudit showed progress to 81%, 0%, 94%, and 100% respectively. Following the teaching session reaudit showed final progression to 83%, 46%, 83%, and 100%. Teaching sessions and use of an eye sticker proforma has been shown to improve rates of documentation of the eye exam for those OMFS patients presenting with periorbital injuries.

What is the role of senior house officer or dental foundation year two posts in professional careers? Exploring the motivations for, and perceived benefits of, undertaking SHO posts in two London hospitals

AIMS

To investigate the motivations for, and perceived benefits of, undertaking senior house officer (SHO) posts, and to explore the career pathways of those who do, examining trends in successive cohorts.

METHOD

Postal cross-sectional questionnaire survey of all dental and maxillofacial SHOs (DF2s) who had worked for two South London hospitals within the previous nine years (n=137). Respondents were grouped into three cohorts to enable responses to be examined in relation to respondents' entry to their first SHO post.

RESULTS

There were responses from 83 (61%) potential participants. The most frequent motivation for carrying out SHO posts from 79 (95%) of the respondents was the desire to 'learn from experienced clinicians'. The most common perceived benefit reported by those who had completed posts at the time of the survey was 'an improved understanding of the role of the hospital dental service' from 68 (97%) of those who answered this question. Difficulty in securing a job in general dental practice was not reported as a notable motivating factor, either before or after the implementation of the new dental contract. 'Fulfil approved training post requirements for postgraduate examinations' reduced as a motivator from 28 (88%) for the earlier cohort of SHOs to nine (36%) for the more recent cohort. Fifty-four of 78 (69%) respondents declared a definite plan to seek admission to the General Dental Council Specialist Lists in future, 24 (83%) in the first cohort, compared with 11 (46%) in the last (P=0.05). Of the males, 13 (52%) were significantly more likely to report that they were currently working in general practice compared with 15 (27%) females (P=0.028).

CONCLUSION

The findings suggest that multiple benefits are identified from undertaking SHO posts. However, some of the motivations for undertaking SHO posts may have changed over the nine-year period investigated. Possible influences are discussed. This paper highlights the perceived benefits of junior training posts at a time of significant transition within the profession.

The teaching of surgery in the undergraduate curriculum--reforms and results

In the past decade, the teaching of surgery in the undergraduate curriculum has undergone considerable changes in quantity, mode and method of delivery. This is a result of the radical reforms of higher education, the health service and the undergraduate medical curriculum. These reforms are often interrelated and are occurring in conjunction with major changes in healthcare delivery. In this article we discuss this reorganisation, the rationale behind it and the impact on surgical teaching.

The teaching of surgery in the undergraduate curriculum – reforms and results

In the past decade, the teaching of surgery in the undergraduate curriculum has undergone considerable changes in quantity, mode and method of delivery. This is a result of the radical reforms of higher education, the health service and the undergraduate medical curriculum. These reforms are often interrelated and are occurring in conjunction with major changes in healthcare delivery. In this article we discuss this reorganisation, the rationale behind it and the impact on surgical teaching.