Tilly Weerasuriya, a fifth year dental student at King's College London, shares her experience of taking her studies around the world, and the valuable insights she gained from it.
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An elective is a placement for dental students to undertake towards the end of their studies - between fourth and fifth year of dental school. The aim of this is to explore and further your knowledge in an area of dentistry that interests you or that you receive little exposure to on your academic course. This can be done within the UK or anywhere in the world.
I chose to focus on oral and maxillofacial surgery (OMFS) as I enjoy oral surgery and, due to my previous undergraduate studies (Applied Anatomy BSc – University of Bristol 2020), I have a keen interest in human anatomy and surgery. However, OMFS is a specialty that dental students aren’t frequently exposed to.
A lot of thought went into the location in which I would like to undertake my elective but due to my familial background I chose Sri Lanka. My aim was to complete some shadowing in OMFS departments in both Colombo and the UK, in order to complete a comparative elective between the two locations.
I set out to do three days of shadowing in the UK and three days of shadowing in theatre in Sri Lanka. I hoped this would provide an insight into understanding the career pathway for OMFS and also to appreciate any clinical and cultural differences between both locations. Additionally, in Sri Lanka, I planned to serve a community of underprivileged children by delivering oral hygiene instructions.
This experience highlighted the difference in approach to preventative dentistry across the world. Factors such as the economic crisis in Sri Lanka, for example, act as a major barriers to this, as resources are finite and less easily accessed compared to the UK. A consultant I shadowed mentioned how she independently purchases resources including fluoride varnish to deliver preventative care to children and high caries risk individuals, as government dental funding cannot afford this.
Additionally, during a visit to an orphanage, I learnt that the children had not received any explicit oral hygiene advice before, indicating that such services are not regular practice at state schools - dissimilar to the UK where initiatives are present to educate and promote oral health from a young age.
Despite financial differences which affect the resources and the facilities available in the OMFS departments respectively, I observed brilliant surgeries in both locations.
In the UK, I was privileged to witness several cases including a major head and neck cancer case. This involved the resection of a squamous cell cancer originating from the right maxillary antrum which required a right maxillectomy, removal of the orbital floor, neck dissection and anterolateral thigh (ALT) flap repair.
In Sri Lanka, I witnessed a lot of potentially malignant disorders such as oral submucous fibrosis and resultant squamous cell carcinomas. Reflecting on the prominent cultural habits in South Asia, such as betel quid chewing, explained the prevalence and nature of the cases I was seeing.
Overall, this elective was an invaluable clinical and cultural experience and now I have a greater appreciation for cultural, socioeconomic and epidemiological differences globally, in addition to a greater understanding of what it takes to be an OMFS specialist.
Q&A:
What do you wish you’d known before your elective?
- To do some wider research into the socioeconomic background of the place you are doing your elective in, as this will help with your understanding of why things are done the way they are.
What’s your biggest piece of advice for someone planning an elective?
- To go into your placement with an open mind. The second half of my elective didn’t go exactly as I had planned because the department I was shadowing only had one day in theatre. However, this proved to be invaluable as instead I was placed on a specialist oral med/oral surgery consultant clinic, which is where I saw a lot of interesting oral conditions and pre-malignant lesions.
How long would you give yourself to plan your elective? / How long did it take you to organise everything?
- As electives are self-organised by the students, I would say approximately six to nine months as there are a lot of things to organise aside from liaising with a dental department abroad to organise the placement. This includes things such as vaccines, travel insurance, flights and accommodation, so you want to leave enough time to organise these things. Luckily, organising my elective indemnity was quick and simple with Dental Protection. You can apply for your elective protection here.
Would you recommend doing an elective? And why?
- I would 100% recommend doing an elective if you can as it is a great way to broaden your clinical knowledge while also being able to explore the culture and sights of a new place.
What’s one of your biggest highlights of your elective?
- The orphanage visit in Sri Lanka. It was a heart-warming experience to really spend time with the children, educate them on oral hygiene and to provide them with basic resources that they otherwise would struggle to get access to.