1. Nationals of the European Union/European Economic Area

ULRIKE MATTHESIUS provides an overview of the different ways in which dentists who qualified outside the UK can register and be employed

The European Union comprises 25 states: Austria, Belgium, Cyprus*, Czech Republic*, Denmark, Estonia*, Finland, France, Germany, Greece, Hungary*, Ireland, Italy, Latvia*, Lithuania*, Luxemburg, Malta*, Netherlands, Poland*, Portugal, Slovakia*, Slovenia*, Spain, Sweden, UK. Three additional states, Iceland, Liechtenstein and Norway join the EU states to form the EEA. Switzerland also has signed treaties with the EU entitling its nationals to the same rights as EU/EEA citizens.

[*denotes EU members states that gained entry on 1 May 2004]

Registration

EU/EEA nationals with EU/EEA qualifications have access to three registration routes, depending on where and when they qualified and whether their degree complies with the EU dental directive. These principles apply only to EU/EEA nationals, not to nationals from outside the EU who have studied within the EU/EEA.

a) Automatic recognition

Automatic recognition applies to dental degrees that comply with the EU dental directive - this includes degrees from most countries, which were EU member states before 1 May 2004. It is possible that graduates from some of the new EU member states can register under this category; the GDC can confirm whether qualifications are recognised. Dentists from these countries will need to have a compliance certificate from their regulatory authority to register in the UK.

b) Non-compliant diplomas

Graduates with degrees gained in the new EU member states that do not comply with the directive must provide evidence of a 'substantial period of practice' in order to be registered. They require a certificate from their regulator to confirm that they have 'lawfully practised dentistry for at least three consecutive years during the five years preceding the date on the certificate'.

c) Individual assessment

If graduates do meet the above requirements, the GDC can undertake individual assessments, which take no longer than three months. The applicants need to provide evidence to support their application for registration for consideration by the assessors, who are independent and external, not GDC-based. The three-month assessment period starts from the date a formal application is submitted.

Dentists from EU/EEA countries are not usually asked to sit the IQE. This route is open to them, however, if their application has otherwise failed - it may be easier than to go through any of the suggested procedures.

EU/EEA nationals are now able to have their degree and experience assessed if they have studied outside the EU/EEA. The assessment panel may make recommendations for further studies before registration is granted.

Language assessment

EU/EEA nationals are not assessed for language proficiency by the GDC. However, if they find work within the NHS General Dental Services as an associate or as a practice owner, the Primary Care Trust will need to establish their ability to speak and write English to a high standard. The International English Language Testing System (IELTS) is the current required standard and candidates must achieve level 7 in each of the four test modules (listening, academic reading, academic writing, speaking). If level 7 is not achieved, PCTs will not issue a dental list number.

Dentists who do not pass the IELTS will be able to work as assistants or locums and join the supplementary lists, for which PCTs set their own language requirements.

There are plans for the GDC to require proof of language proficiency at registration under a proposed directive, which may come into force in 2005.

The IELTS standard is currently under review by the Department of Health.

Vocational Training

EU/EEA nationals can apply to the Dental Vocational Training Authority for a VT number, without having to undertake the vocational training course. Many EU graduates are interested in undertaking VT, however, and can apply for posts through the postgraduate deaneries.

Immigration

Nationals of the EU/EEA can work and remain in any EU/EEA state without limitations. Nationals of the eight Eastern European states which joined the EU in May 2004 are required to register with the Home Office under the Workers' Registration Scheme. The relevant forms can be obtained from Work Permits UK.

2. Nationals from non-EU/EEA countries

Nationals of non-EU/EEA member states follow a different route to register their dental qualifications and work in the UK, which is governed by regulatory and immigration laws.

Registration

Dentists without residential rights in the UK are required to sit the International Qualifying Examination held by the GDC, regardless of where they qualified. The examination is held several times per year and is in three parts. Part A involves written and oral examinations in the basic sciences and human diseases and an oral examination in clinical dentistry. Part B involves an operative test on a dental manikin. Part C involves written examinations in all aspects of dentistry, an examination in clinical dentistry, an oral examination in general dentistry, a practical clinical examination and an examination in medical emergencies. The GDC has recently increased the number of places available to allow more dentists to join the UK workforce sooner. More information is available from the GDC.

'temporary registration only allows for postgraduate study in approved hospital positions; it does not allow a dentist to work in general practice.'

An overseas dentist whose qualification is not accepted for full registration is eligible for temporary registration. Employers must understand that temporary registration only allows for postgraduate study in approved hospital positions; it does not allow a dentist to work in general practice. The National Advice Centre for Postgraduate Dental Education (NACPDE) oversees these arrangements.

Language testing

Before dentists enrol for the IQE, they need to pass the IELTS. The exam is organised by the British Council and is available worldwide, so could be taken in the applicant's home country.

The GDC is currently reviewing the IELTS requirement.

Work permits

The majority of overseas nationals without residency rights in the UK will require a work permit. The prospective employer should apply for this permit on behalf of the individual, and explain the reasons for employing an overseas dentist. Details of advertisements, applications and reasons for not accepting any UK or EU graduates should be given. Dentists needing work permits must be employed by the practice owner and cannot work as self-employed associates.

Vocational training

Overseas nationals who require a work permit are not entitled to work as self-employed dentists until they have full residency rights in the UK. They are therefore unable to obtain a VT number until they have full residency rights, when they can either undertake a year's vocational training or apply for a VT number under the equivalence route.

USEFUL CONTACTS:

GDC 37 Wimpole Street London W1G 8DG Tel: 020 7887 3800 Web: http://www.gdc-uk.org

Dental Vocational Training Authority Temple Grove Compton Place Road Eastbourne East Sussex BN20 8AD Tel: 01323 431 189 Web: http://www.dvta.nhs.uk

Work Permits UK Immigration and Nationality Directorate Home Office Level 5 Moorfoot Sheffield S1 4PQ Tel: 0114 259 4074 Web: http://www.workingintheUK.gov.uk

NACPDE The Royal College of Surgeons of England 35-43 Lincoln's Inn Fields London WC2A 3PE Tel: 020 7869 6804 Web: http://www.rcseng.ac.uk/dental/fds/nacpde/

IELTS British Council Bridgewater House 58 Whitworth Street Manchester M1 6BB Tel: 0161 957 7000 Web: http://www.ielts.org