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Q&A


Dr Deborah Lockhart, specialist registrar in microbiology and MRC clinical research fellow


• What attracted you to a career in oral microbiology? I was taught by some inspiring clinical oral microbiologists at the University of Glasgow and thought their job sounded incredibly exciting. Stories of fl esh-eating superbugs completely captivated me although I was a little bewildered that a degree in dentistry could lead to involvement with such cases. Looking back I was incredibly naïve, but I loved my intercalated BSc in microbiology and thereafter sought every opportunity to get involved in small projects and to fi nd out more about the specialty. It was the combination of research and behind the scenes patient management that I found enticing.


• What do you enjoy most about the specialty? Microbiology infi ltrates all specialties and disciplines so no two days are the same. For example, I can be discussing a MRSA wound infection with a GP, visiting the intensive care unit and teaching dental students, all in the space of a few hours. Another exciting aspect is identifying clinical problems and taking these to the laboratory to fi nd solutions. This led me to join a group of talented scientists to evaluate new targets for antifungal drugs during my PhD. I am also very pleased to have recently been awarded a Wellcome Trust clinical postdoctoral research fellowship.


as something of a culture shock. It is often said to suit those of a more intellectual nature who have a clear interest in infection and enjoy investigative work. Training is broadly similar across the country although regional


variations can occur – some trainees may form close ties with oral medicine while others come to work closely with medical microbiologists (sometimes even fi nding themselves on the hospital’s on-call rota). Typical days can be hard to defi ne – especially in the event of an impending outbreak (such as the 2010 anthrax outbreak in Glasgow) or perhaps some kind of exciting experimental breakthrough. For a clinical microbiologist, the day might start with a handover


meeting summarising the overnight developments with the on-call microbiologist. Later, authorisation of laboratory reports including the request of any relevant additional tests by considering the clinical picture of patients and liaising with laboratory staff . Urgent results and updates will be telephoned, e.g. positive blood cultures from patients with suspected septicaemia. You may also be responsible for taking incoming calls from clinicians


and/or preparing for a ward round by ensuring all laboratory results are updated. In the afternoon, there will be consultant-led ward rounds where individual patients are discussed; the microbiological results and management communicated with the relevant teams, e.g. intensive care, maxillofacial or orthopaedics. Alternatively, there may be journal clubs or teaching duties. Those working as the on-call microbiologist would not want to venture too far from the telephone. With new and emerging infections popping up every year (SARS and Ebola as examples), it’s the hottest specialty on the GDC specialist list. We hope to one day see a consultant oral microbiologist in every dental school.


Useful links: • The Royal College of Pathologists - www.rcpath.org





The curriculum for specialty training in oral microbiology - tinyurl.com/q6zeqs4


Professor Andrew Smith is a consultant microbiologist based at the University of Glasgow. Dr Deborah Lockhart is a specialist registrar in microbiology and MRC clinical research fellow based at the University of Dundee


• What do you fi nd most challenging? One of the biggest challenges is that many people are unaware the specialty even exists. This could refl ect the fact that there are only eight registrants on the oral microbiology GDC specialist list. Consequently there are no clearly defi ned career pathways following completion of specialty training. NHS consultant posts in oral microbiology are non-existent at present (discussions are ongoing with the NHS commissioning groups). This, however, can be turned into an advantage as it aff ords the fl exibility to create your own niche area provided you can convince someone to fund your ideas.


• Have you been surprised by any aspect of the job? When I was initially appointed as a specialty trainee I had not fully comprehended that the oral microbiology curriculum covered the entire spectrum of medical microbiology. I never thought I would be providing antimicrobial advice for patients with endocarditis or attending outbreak meetings.


• What personal attributes do you feel are important in oral microbiology? This is a very challenging training pathway but hard work and perseverance will provide an intellectually stimulating and rewarding career. I think it is important for prospective trainees to demonstrate strong resilience, an ability to adapt to new working environments, multitask and liaise with a range of healthcare professionals.


• What advice would you give to a student or trainee considering the specialty? Dental graduates with an interest in infection might consider pursuing a PhD as a pre-requisite given the current scarcity of specialty training posts. In the last 10 years only three oral microbiology posts were available in the UK (two in London and the one I was appointed to in Glasgow). In addition, changes to the medical microbiology curriculum may impact future training of dentally qualifi ed candidates. I would strongly advise prospective oral microbiologists to contact someone on the specialist list for specifi c advice. We are a friendly group and would be delighted to hear from you.


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