08 • Careers


DENTISTRY I


THE SCIENCE OF


The small specialty of oral microbiology has had a big impact on the way the profession approaches infection prevention and control


T may be the smallest dental specialty in terms of the number of practitioners on the General Dental Council specialist list, but its impact on everyday clinical practice has been huge. The fi eld of oral microbiology off ers a fascinating and varied career


that goes well beyond the expectations of many dental graduates, combining both the clinical and academic spheres. The results of the


work carried out by specialists can be seen in practices across the country – a prime example being the major overhaul of dental decontamination procedures in 2009. The Royal College of Surgeons of England describes oral microbiology as a clinical dental specialty, undertaken by laboratory-based personnel, which is concerned with the diagnosis and assessment of diseases of the oral and maxillofacial region. It is a branch of medical microbiology and, in common with medical microbiologists, oral microbiologists provide reports, advice and clinical liaison based on interpretation of microbiological samples. Most specialists are senior academics with honorary consultant


status based in dental schools and these are the posts most trainees will be competing for. As such, trainees will be required, for their academic advancement, to obtain higher academic degrees related to profi ciency in research (PhD), as well as specialist training in oral microbiology.


Entry and training Dental graduates looking to develop their career in this specialty must have at least two years general professional training in dentistry – including a period of training in secondary care – and have obtained the FDS, MFDS or equivalent. Clinical training lasts for fi ve years and competition for places can be fi erce. Specialty trainees must pass the fellowship examination of the Royal


College of Pathologists (RCPath) in medical microbiology – part one of the FRCPath can be taken after a minimum of 18 months training. On completion of part one, further training is required in medical microbiology before being eligible to sit part two – usually after approximately four years. As there is no specifi c RCPath examination in oral microbiology, specialty trainees will need to obtain adequate experience in a specialist oral microbiology facility. A certifi cate of completion of specialist training (CCST) in oral


microbiology is awarded by the GDC on the recommendation of the local postgraduate dental dean following evidence of satisfactory completion of the FRCPath examination and the oral microbiology curriculum. In


accordance with other specialties, trainees must also achieve a successful outcome in the annual review of competence progression (ARCP) process as outlined in A Guide to Postgraduate Dental Specialty Training in the UK (Dental Gold Guide). In recent years, training programmes have been based in Glasgow


and London: these must have the approval of the RCPath and the Specialty Advisory Committee (SAC) for the Additional Dental Specialties.


The skills trainees are expected to develop over the fi ve years include:


• Specialised factual knowledge of the natural history of the infections underpinning medical and oral microbiology


• Interpretative skills so that a clinically useful opinion can be derived from laboratory data


• Antimicrobial stewardship and advice • Research and development experience


• Technical knowledge gained from close acquaintance with laboratory personnel, so that methodology appropriate to a clinical problem can be chosen, and so that quality control and quality assurance procedures can be implemented.


It should be noted that specialty trainees without a higher research degree will be expected to apply to the deanery to undertake three years out-of-programme research experience and enrol for a PhD. The GDC maintains a specialist list for oral microbiology and anyone


wishing to practise as a specialist in this fi eld must be registered on this list. Those with academic aspirations will also be required to provide leadership for the training of undergraduates and postgraduates in the key disciplines of Infection prevention and antimicrobial stewardship.


The job Excellent communication skills and the ability to liaise with a range of healthcare professionals are key to the job of a microbiologist. The move from clinical dentistry to oral microbiology has been described


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