Sir, the British Association of Oral Surgeons (BAOS) welcomes the article A survey of self-assessed competencies... (BDJ 2010; 208: 65–69), although unfortunately it is factually inaccurate on a number of points:

  1. 1

    Prior to reconfiguration of the surgical dentistry and oral surgery lists in 2007 extended competencies were legitimately practised by those individuals on the oral surgery list which did not consist solely of academic oral surgeons but many others still practising today. It must be remembered, however, that the use of a specialist title does not restrict the right of any registered dentist to practise in any particular field of dentistry, including extended competencies

  2. 2

    The oral surgery curriculum which included all of the extended competencies was defined by European Directives in 19981

  3. 3

    The PMETB report quoted does not specify, as claimed in the paper, a requirement for dual qualification prior to the practice of any specific competencies. Rather it indicates that dual qualification is desirable for registration on the OMFS specialist register.2

The article seeks to question the appropriateness of some registrants on the oral surgery list practising within their areas of competency without 'formal' training, and as such might be misconstrued as an attempt to denigrate oral surgery and oral surgeons. BAOS feel, however, that it is quite valuable in highlighting several important things, although whether it is truly representative of the scope of practice of oral surgeons is unknown due to the low response rate.

Importantly it shows that many singly qualified oral surgeons practise the whole spectrum of oral surgery (core and extended competencies).

What is revealed is that neither all the singly, nor dually qualified registrants are comfortable with the whole of either the core or extended competencies. It is reassuring that surgeons practise only procedures they are comfortable with irrespective of single or dual registration. Curriculum specifications cannot be prescriptive in nature for any surgeon whether singly or doubly qualified.

Many oral surgeons carry out extended competencies despite having had very limited formal training availability since 1984 (none outside of AACOMS). This lack of training opportunities is an issue and BAOS fully endorses the urgent setting up of training programmes to address this.

BAOS recognises the value of this paper in highlighting the need to increase competency based postgraduate training opportunities in oral surgery that will ensure those gaining a CCST will be appropriately trained to sustain the valuable workforce that will be required in the future.