OMFS training revisited

Sir, as a group of London based trainees in Oral and Maxillofacial Surgery (OMFS), we would like to register our deep concern regarding the comments by L. W. McArdle (BDJ 2006; 200: 2) who is not an OMFS trainer.

We unreservedly reject the assertion that OMFS trainees lack the 'appropriate training and clinical experience' because OMFS units are 'failing to deliver' training opportunities. This is factually incorrect as demonstrated by the RITA process which is rigorously executed by the London Deanery. For further factual accuracy RITA stands for Record of In-Training Assessment,1 not 'Registrar In Training Assessment' as quoted by L. W. McArdle.

Specialist Registrars (SpR) accepted on to OMFS training programmes typically have had significant experience of dentoalveolar surgery even prior to entry on to a second degree course and often continue such work during their studies as a necessity of being self financing students (most, if not all, have held Surgical Royal College approved OMFS SHO training posts prior to reading for said second degree). Add to this the validated exposure during SpR training and it becomes readily apparent that senior OMFS trainees are well beyond 'acquiring the necessary skills in surgical dentistry required for inclusion on the GDC's specialist lists'.

Furthermore, as far as we are aware, within the London Deanery no OMFS trainee has failed to pass through the final RITA interview as a consequence of not being exposed to adequate training in surgical dentistry. Successfully completing annual RITA interviews is just one element of the requirements necessary to obtain a CCT in Oral and Maxillofacial Surgery which is recognised by the GDC for inclusion on its Oral Surgery and Surgical Dentistry Specialist lists.

The suggestion that we will become 'consultants lacking proficiency in this clinical field' is clearly incorrect and damaging to our professional reputation both within the dental community and the public at large and we therefore request the author retract his comments.

Mr McArdle replies: As a trainer in surgical dentistry, I consider that it is reasonable for me to comment on training in this specialty for all who should be undertaking it.

I believe that the OMFS SpRs have missed my point as my comments are not directed at any specific group of individuals. A significant number of the signatories and other OMFS trainees are already on the GDC's specialist list for surgical dentistry. I have always been fully aware of this and my concerns have never been directed at those who have demonstrated competencies in this way.

My opinion, however, remains the same. It is my observation that competency in surgical dentistry is assumed and my concern therefore is one of complacency. It cannot be presumed that OMFS trainees will have achieved competency in surgical dentistry skills before entering OMFS training and it cannot be presumed that these skills will be a by-product of OMFS training. It is my opinion and, in my experience, the opinion of other oral surgeons and OMFS surgeons, that surgical dentistry training for OMFS trainees needs to be emphasised if they are to continue to provide these skills when consultants.

The assessment of OMFS training programmes is under the mandate of the SAC in OMFS and, based upon G. D. Wood's comments ( BDJ 2005; 199: 249), they too have noted the importance of this issue. As I stated in my original letter: deficiencies in surgical dentistry training will have implications for future consultant led services.

L. W. McArdle is senior specialist clinical teacher and honorary associate specialist in oral surgery at Guy's Hospital. He is programme director for the MClinDent (Surgical Dentistry) degree at Kings College London and Hon Secretary of the British Association of Oral Surgeons based in Edinburgh.

Editor's note: The postscript from Mr McArdle makes clear his reason for writing to the Editor from an address in Edinburgh. We quote the name of the correspondent and the city/town as given in the address from which the letter originates as a reference at the foot of each letter we publish (or 'by email' if received electronically). In the instance of Mr McArdle's previous letter ( BDJ 2006 200: 2), we received a complaint about this practice with the accusation that we were negligent in not pointing out the location in which Mr McArdle worked, rather the location and position from which he sent his letter. We are therefore grateful to Mr McArdle for clarifying the matter.

The correspondence over this subject has clearly touched on important issues affecting the profession and I believe that the BDJ is the appropriate place for such topics to be debated. However, on this matter and on others which readers have already raised and will wish to raise in the future, I would put forward a reminder that the BDJ is a journal which represents us as a profession and that part of the privilege of being a profession involves being respectful of the opinions and standing of others. I would therefore urge future correspondents to be mindful of this and to guard carefully against making remarks that may be, rightly or wrongly, construed as personal or derogatory to individuals, specific fields of practice or the profession in general.

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Cameron, M., Visavadia, B., Heliotis, M. et al. OMFS training revisited. Br Dent J 200, 361–362 (2006). https://doi.org/10.1038/sj.bdj.4813448

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