My life so far as a young dentist

I was lucky to be in a large practice, which had two foundation dentist trainees (we were known as vocational trainees then). My foundation dentistry year was such fun! A lot of my university friends were in my foundation dentistry scheme and we socialised a great deal and did not think about our future's much.

It was about the now for us. However, my first year as an associate was much more of a shock. I stayed in the same practice, but no longer had the opportunity to see my university friends once a week on our study days; gone were the Friday night socials. Instead I was stressing about laboratory bills and trying to get my head around my payment schedule and units of dental activity! Lots of my friends were in this position also and we all decided to look at doing some extra qualifications, meeting up on the pretext of revision clubs, and so decided on the membership of joint dental faculties.

In 2008 I was awarded the Membership of Joint Dental Faculties qualification at the Royal College of Surgeons in London. It was similar to sitting our finals, but in central London, with a lot more fun and less at stake. It was a good refresher of the theory we had learnt at undergraduate level, but not very relevant to daily practice.

I became increasingly isolated and frustrated at practice life. I had received my first complaint and it was really stressful; it came as a bolt out of the blue, and I felt much unprepared for it. Luckily it passed and was resolved amicably. I learnt about the complaint process, the value of good record keeping and I could focus on my work again.

I realised that I wanted to learn more, however felt totally unprepared to tackle a daunting masters course. How on earth could I do a masters degree when I had not even attempted a fixed-fixed bridge! How could I do a fixed-fixed bridge when I had not practised it? I didn't want to learn yet more theory. Hence I looked for a course to try and help with my restorative and practical skills.

My principals at the time had attended Paul Tipton's restorative course and they recommended that I try his course too. It was a leap of faith as a young dentist with a huge student debt. It was a lot of money, yet it was the closest thing that I could find to what I was looking for. I completed a year-long certificate in Restorative Dentistry. I still found it difficult to apply in practice, especially as a busy NHS dentist. My patients were high needs patients. The majority only attended in pain. They needed extirpations and extractions. As much as I wanted to practise a full occlusal examination on them, they looked at me as if I had gone mad when trying to manipulate their mandible, they just wanted reassurance and to be out of pain. I couldn't apply the theory, and it was driving me mad! I had not realised that I was addressing my needs and not theirs.

I was totally taken by Paul's teaching; I wanted to be as brilliant as him. He is an inspirational teacher and mentor, and so the following year I decided to take his year-long practical restorative dentistry, where I was awarded the 'Most Outstanding Student' award. I loved to prep and I had developed this love of restorative dentistry. I was going to change the world...I finally felt ready to do a masters degree!

The application for this degree needed referees and health checks and lots of money upfront...nobody had told me you needed to be super organised to get it in on time. I was still struggling with the work life balance so missed the deadline for application.

In my quest to stop myself from feeling this isolation in general practice, I had joined the BDA central counties, holding a number of roles including the 'Young Dentist Representative for West Midlands' BDA section and became an elected member of the BDA Central Counties Executive Council. It was a fantastic opportunity to network and meet dentists through events I helped to organise. The problem again was that everybody on the council were already very established dentists with whom I did not have much in common with.

I felt disillusioned with the 2006 NHS dental contract. I was faced with a culture of doing a lot of work for not much pay as principals began to scale back their units of dental activity payments. I found that I could not afford to take the time to apply all these new techniques or even what I had learnt at undergraduate level. Where was the surgical periodontics I was performing as an undergraduate, or the full mouth fixed ortho bond ups? All of a sudden the new units of dental activity contract did not provide for such treatments as a general dental practitioner. I felt confused and it added to my frustration.

I had always had a huge passion for cosmetic and restorative dentistry. Even as an undergraduate I had travelled internationally to conferences in Mumbai and Berlin to discover the latest techniques and advances in the art of aesthetics and smile design. I loved that one day I too may be able to transform a patient's smile.

With this in mind, I enrolled on the 'cosmetic dentistry and aesthetic restorative dentistry' course with renowned London dentist, Dr. Christopher Orr. A superb course, alas yet again, I was too young and inexperienced to fully apply in my practice.

By 2010, I had spent a lot of money on some fantastic courses, which enabled me to accelerate my learning and competence in practice.

Later that year I had an epiphany of sorts...maybe it was maturation into my late twenties. I learned to reflect on a day's work; on the good, the bad and the ugly. I learned what made me happy and what I was good at and what I wanted to work on to improve. This was a huge realisation and a pivotal point in my career. I now knew that more than anything, I wanted my own practice and that I wanted to teach. Through reflection, I recognised that, in fact, I had amassed a great deal of knowledge and experience and had a lot to share with young dentists. I thrived on knowledge and being around peers with a similar outlook.

Armed with a set of goals, I bought my practice in 2012, which was a crash course in business skills, human resources, accountancy and management! I worked a lot with phobic patients and became a mentor with the 'Society for the Advancement of Anaesthesia in Dentistry' (SAAD), educating dentists in the intravenous sedation technique. I was proudly awarded a 'Foundation Dentist Trainer' status with the West Midlands postgraduate deanery; a privileged and rewarding role. To this day, I continue to support the dental community, working with other dentists to further standards in the profession, and am Secretary for British Academy of Restorative Dentistry, BARD.

I wanted to share this story because as a foundation dentist trainer, I am asked questions such as "what should I specialise in?" or "will I get a job?", "what course can I do?" With an increasingly competitive employment market, young associates are feeling a lot of pressure upon graduation. They feel that they have to set themselves apart, quickly.

My advice

Specialising straight away is not always the answer. Practice your basic skills first. Do not jump to bridge preps and re-endo a 45 degree angle root canal treatment straight away. Learn how to do good crown prep and a predictable molar root canal treatment. Learn to love your patients and for them to love you back (you will receive a lot less complaints!). Learn your craft in general practice first before you take the step of specialisation. Learn, consolidate and reflect. You will be far more valuable to any principal if you can confidently perform all the tasks of a good general dental practitioner.

It is armed with this knowledge that I formed the Young Dentist Academy (YDA), with Martyn Amsel and Katharine Cordner. We recognised that many young dentists will go through what we did and so we have designed a bespoke, relevant and affordable post graduate course, aimed at dental graduates to bridge the gap between foundation training and advanced courses. It is a course I wish had been available to me at my early stage of my dental career!

We call the course "Confidence, Competence and Contentment in General Dental Practice". Its main focus is on relevant practical skills and day-to-day tips to improve your clinical, communication and business skills. It is a course that can help you in so many ways to become a more confident and capable all round general dental practitioner, whilst also offering a great foundation for you to embark on more specialised courses.

The course will be delivered in 14 days over one year starting in October 2014.

BDS (U.Birm) MJDF RCS (UK)
Principal Dentist