Following Graduation Day
My graduation from the University of Leeds left me feeling both excited, as I was about to begin a new chapter in my career, but also nervous about the forthcoming challenges in the dental world awaiting me.
Summer quickly passed and soon it was time to begin work at my allocated practice, situated in Greater Manchester.
Before commencing work, it was important to acquire the required documents, check the best journey to the surgery, meet up with my trainer (now known as an educational supervisor) and sign my contract. I shadowed my supervisor for a few days before beginning and this allowed me to familiarise myself with how the practice was organised, meet my fellow colleagues and acquaint myself with the surgery equipment - all important in making the transition to the practice setting.
The First Patient
When my first patient came in on my first morning, a simple history and exam had never been so nerve racking. My gloves didn't want to fit and I was feeling very nervous, but I managed to hold it together.
I soon found during my first day that treating patients in surgery was completely different to in a hospital setting with tutors watching your every move, and I began to relax into my role. Some people will prefer different techniques employed by their dental foundation educational supervisors, with some adopting the 'tutor' role - initially checking most things, and some going with the view of 'you have graduated now so get going and if you have any problems we can address them as you come to them.' Of course these differing approaches will suit different people, but whichever approach your educational supervisor adapts it is important to discuss how confident you feel and the level of support you would like initially. This helped with my own confidence during treating patients.
Difficult adaptations
What I found difficult over my first few weeks was the transition from dentistry in a hospital setting to practising dentistry in the community. Carrying out treatment in a completely different environment with new materials, patients and inputs from your educational supervisor is difficult to get your head around initially. For example after a few weeks, I had soon been taught a completely different way to produce copy dentures. At dental school you are taught dentistry and how to provide optimal treatments, but not necessarily how to deal with patients and their individual wants and needs. This can only be gained with experience which soon comes when going from seeing a maximum of 4/5 patients a day at dental school to 20 or more during your foundation training in a practice setting!
Challenges over the first few weeks
I have found pain patients difficult to treat, as diagnosing their problem during a short appointment is often difficult, especially when it is non-specific problem or poorly localised pain. In these cases you just have to use your judgement, do the simple or obvious things first and get advice from your trainer - don't go diving in if your not sure of your diagnosis! In trauma patients, particularly children, the dental trauma guide (dentaltraumaguide.org) online is a great help and a method of describing what has happened to both patients/parents as well as a way of recapping the optimal treatment for the particular trauma you are dealing with.
Helpful Tips
- Make most of tutorials - these really help recap things during the week. Get a notebook and as you see patients write down any questions you have for your trainer or any items you want to discuss and bring these up during your tutorials
- Download the BNF Online app, which is really helpful for looking up drugs quickly on your smartphone or tablet
- Make yourself aware of your practice's emergency drugs and make sure if the situation arose you would be ready and confident to use them appropriately
- Get used to the practice's way of note keeping, so that other members of staff can quickly and easily identify what treatment you have done/what the next appointment needs to be booked for
- If you're new to the practice area, speak to your colleagues or go online and learn some local knowledge so that you have topics to discuss with your new patients, which will help build up a rapport
- Consciously think to keep good posture and make the most of your nurse. I have found it difficult initially to use my nurse as effectively as I could; at dental school you don't get the opportunity to build an efficient working partnership with the same nurse
- Get to know what materials are available in your practice as these will almost certainly be different to what you have used in the past, take some books to work for use as reference if you get stuck or as a way of educating patients about their problems.
The future
My time so far in dental foundation training has been challenging yet rewarding to finally be able to treat my own patient list. I have found there is no point in worrying about what's coming in; it's all part of gaining experience so you may as well enjoy it. Worrying won't treat the patient for you. Get stuck in and make the most of having the time to enjoy treating your patients this year!
Dr James Tinning
DF1 Dentist, Pennine Scheme (North Western Deanery)
James Tinning graduated from the University of Leeds Dental School in July 2013. James currently works as a DF1 Dentist in a NHS practice in Greater Manchester, with a patient base that is predominantly exempt from paying for treatment.