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The College's origins
Welcome to this special Royal College of Physicians and Surgeons of Glasgow (RCPSG) edition of Dental Update. The Royal College was founded on the 29 November 1599 with the grant of a charter from James VI given jointly to a distinguished surgeon, Peter Lowe (Figure 1), a physician, Robert Hamilton and an apothecary, William Spang, those three together covering the spectrum of medical practice at that time. The charter empowered them to establish a body to regulate medical and surgical practice and, as well as creating a body that surgeons could join, also allowed physicians to be members. This collaboration, which now includes dentists, remains unique in Britain today.
The College has had a number of different titles (Table 1) becoming the ‘Royal Faculty of Physicians and Surgeons of Glasgow’ in 1909 on the authority of Edward VII, then the ‘Royal College of Physicians and Surgeons of Glasgow’ by an Act of Parliament in 1962. A first property was acquired in 1697 and the Faculty moved into its second home in 1791. Then, in 1862, it acquired the magnificent historical building where it is located today.
| 1599 | No corporate title |
| 1629 | Faculty |
| 1657 | Faculty of Surgeons and Physicians |
| 1700 | Faculty of Physicians and Surgeons of Glasgow |
| 1909 | Royal Faculty of Physicians and Surgeons of Glasgow |
| 1962 | Royal College of Physicians and Surgeons of Glasgow |
Dentistry in the College: the early years
The Dentists Act of 1878 authorized the four surgical Colleges in the British Isles to establish an examination and qualification to be registrable in a Dentists Register held by the General Medical Council. The first examination for ‘the Licence in Dental Surgery (LDS)’ of the Faculty [sic] of Physicians and Surgeons of Glasgow was held in 1879. The Dentists Act and the College's decision to establish an appropriate examination were the stimuli that lead to the opening in 1879 of Scotland's first School of Dental Surgery, within the Medical Faculty of Anderson's College in Glasgow.
In December 1920, the Higher Dental Diploma (HDD) was recognized by the General Medical Council for registration as an additional qualification in the Dentists Register. This marked the beginning of the College's involvement in postgraduate dental qualifications.
The Dental Committee and Dental Council
In 1935, a Dental Committee was created to advise the College on dental matters, being superseded in 1967 by Dental Council. In 1968, the four Royal Colleges formed the Joint Committee for Higher Training in Dentistry and so began an era of enhanced communication on dental matters between the Royal Colleges of Edinburgh, England, Glasgow and Ireland. In 1992, they were joined by the Faculty of General Dental Practice based in London so that Faculty meetings of the Deans encompass all postgraduate training matters.
As the role of Dental Fellows increased, a Faculty was formed in 1990 and the position of Convenor of Dental Council was elevated to that of Dean.
In the 50 years since Dental Council was formed, its composition has changed to respond to new challenges. One important change took place in 1998 when regional UK representation on Dental Council was introduced in recognition of the College's UK charter and wide membership base.
Currently, Dental Council consists of the Dean, two Vice Deans, a Secretary, four Ordinary Councillors, two Councillors working in the UK but outside of Scotland, three Councillors within Scotland, but outside Glasgow, one Dental Fellow or member within 10 years of GDC registration, a lay adviser and an international adviser. In addition, the following are co-opted onto the Council – Director of the Dental Education and Professional Development Board, the Director of the Dental Membership Services Board and the Director of the Dental Examinations and Assessment Board. The President, the College Registrar/Chief Executive are ex officio. In 1981, Dental Fellows and, in 1997, Dental Members acquired the same rights, privileges and obligations as other Fellows and Members of the College.
Regional and International advisers
The roles of regional advisers in the UK and International advisers overseas were created in 2009 and 2012, respectively. There are nine Regional Adviser posts in England, four in Scotland and one each in Wales and Northern Ireland and four International Advisers. Their function is to facilitate postgraduate education, examinations and CPD courses in their geographical areas and publicize the work of the College.
Role of the Dental Faculty
The Royal Colleges and their Dental Faculties serve the public by setting standards for medical and dental practice. This is achieved by prescribing programmes of education and training, approving how and where these may be delivered, assessing their outcomes through examination, and delivering programmes of continuing professional development. In 2006, to support Dental Council in achieving these aims, three functional units, each with its own Director, were created:
RCPSG dental examinations
General examinations
Significant demand for the LDS continued until 1947 when the University of Glasgow assumed responsibility for undergraduate dental education and subsequently awarded degrees in dentistry. It remained available through the College until 2000, when it became an intercollegiate examination but, within two years, because of the low demand, the RCPSG stopped holding diets and these continued to run only in the RCSEng.
Recognizing orthodontics as a rapidly developing specialty of dentistry, the College instituted a Diploma in Dental Orthopaedics (DDO) in 1949, the first postgraduate orthodontic diploma awarded by a medical corporation in the UK. Initially, a training period of one year was recognized. When three years full-time training became mandatory in 1989 in line with the requirements of the European Union, the diploma was replaced by a new qualification, the Membership in Dental Orthopaedics (MDO). It lasted for 10 years, being replaced in 2000 by the bi-collegiate Membership in Orthodontics (MOrth).
Although this was a rigorous examination and continued until 1966, it was eclipsed by the FDS, first established by the RCSEng in 1947. It was not until 1967 that an FDS was established in Glasgow. In its early days the FDS was the highest diploma in dentistry awarded by the Colleges, initially serving as a proxy for a specialist qualification but gradually providing a new role: that of an entry requirement to specialist training. In the RCPSG, although there was initially an emphasis on oral surgery, medicine and pathology, the FDS examination evolved to become a test of postgraduate knowledge of general dental subjects.
The Diploma of Membership in General Dental Surgery (MGDS) was introduced in 1982 followed by the Diploma of Membership in Clinical Community Dentistry (MCCD) in 1989. In each case, after an initial surge in candidates, the number of applicants declined considerably and the final diets of these rigorous examinations were held in 2007.
When, in 1993, the Calman report proposed a shorter, more clearly defined postgraduate training period for medical graduates, the Colleges decided that the FDS examination should be replaced by a new test of knowledge gained over two, instead of three, postgraduate years, one year of which was to be in approved posts. Parts A and B would comprise written intercollegiate examinations, while each College, following a common blueprint, would hold its own final examination, Part C. So the Diploma of Membership of the Faculty of Dental Surgery (MFDS) was established in 1998 and, until 2006, it was recognized by the GDC as an essential requirement for entry by UK applicants to specialist training.
In due course, a desire by all the Colleges to redesign the MFDS as a two-part examination, and not to restrict it to those who had undertaken training in approved hospital or community posts, led to a set of new examinations, sharing a common syllabus and similar formats but delivered separately by the RCSEng(MJDF) and the RCSI(MFD) and jointly by the two Scottish Colleges (MFDS). This bi-collegiate MFDS examination is the result of close co-operation with the RCSEd, the same examinations being held simultaneously by both Colleges at each College's various examination centres. A name-change for the qualification was adopted only by the RCSEng. The first diets of these examinations took place in 2007 and the MFDS is now firmly re-established as the RCPSG's highest general dental diploma. The RCPSG holds diets in a variety of centres in the UK and abroad. All Colleges offer reciprocity for their MFDS/MJDF/MFD examinations, such that Part 1 can be sat in one College and Part 2 at another.
Specialty examinations
After many years of discussion, intercollegiate specialty Fellowship assessments were introduced in 1995 for trainees in the hospital dental specialties following a pattern already established in surgery. The assessment focused on what candidates had achieved during their training and largely involved scrutiny of their written submissions. It was agreed that, although the assessments would be held at each College in rotation, they would be administered by the RCPSG and, under the stewardship of the Glasgow College, have evolved in harmony with a general drive to make all examinations educationally sound and capable of withstanding external scrutiny. Lest the title ‘assessments’ might suggest a lack of due rigour, they were renamed ‘examinations’ within three years of their introduction and, in 2007, a major overhaul was completed introducing modern methods of knowledge-based assessment. These are the only dental examinations that are truly intercollegiate – each examination involves all four Colleges – and the difficult challenge of delivering separate examinations to a common standard is thereby avoided.
After prolonged debate during the 1990s, the GDC established specialist lists that would enable specialist dental practice to be undertaken outwith the hospital dental service. Training programmes of three years' duration were required and the Colleges agreed to establish appropriate examinations. The RCSEd wished to run its own examinations, but RCSPG and RCSEng agreed to collaborate to establish a set of bi-collegiate examinations. The Membership in Restorative Dentistry (MRD), introduced in 1993, was modified in 1997, while the first sitting of the Membership in Surgical Dentistry (MSurgDent) took place in 1999 and the first sitting of the Memberships in Paediatric Dentistry (MPaed Dent) and in Orthodontics (MOrth) were held in 2000. Tri-collegiate collaboration between English, Edinburgh and Glasgow Colleges in 2011–2012 produced a Tri-Collegiate Membership in Oral Surgery (replacing the MSurg Dent) and Tri-Collegiate MPaed Dent and Tri-Collegiate Membership in Special Care Dentistry (MSCD) examinations. Many of the College examinations have also been held overseas.
Dental education and professional development
As the Dental Faculty has enlarged, its involvement in postgraduate education has grown and diversified and now encompasses: curriculum development through membership of the Joint Committee for Postgraduate Training in Dentistry and its Specialist Advisory Committees; lectures, symposia, including some in collaboration with the University of Glasgow Dental School, FDGP (Scotland), NHS Education Scotland, RCS Edinburgh and some of joint interest to primary and secondary care practitioners; preparatory and revision courses for MFDS; courses on mandatory CPD subjects; examiner training courses; and contributions to the intercollegiate e-learning programme for foundation trainees.
Many educational activities and events are supported by a fund that was established following the death, in 1980, of Professor Thomas Cyril White, who generously bequeathed his estate to the RCPSG ‘for the furtherance of postgraduate dental education and research’. The use of this fund has now been extended to some undergraduate prizes that are open to an increasing number of undergraduate dental schools in the UK. Professor White qualified LDS in Glasgow in 1933 and in Medicine and Surgery in 1935. After practising as a dental anaesthetist in Glasgow, he developed a practice limited to orthodontics, in due course joining the staff of the University of Glasgow Dental School. He was appointed Professor of Orthodontics in 1963, becoming Dean of the Dental School and later Convenor of the RCPSG Dental Council. Currently, an annual symposium, several awards and the T C White Medal for outstanding performance in the Part 2 MFDS examination are sponsored by the T C White Bequest Fund.
For decades there has been much emphasis on management in healthcare but much less consideration of leadership. This prompted the RCPSG, in partnership with the University of Glasgow Business School, to introduce an MSc course in Clinical Leadership (2008–11). An advanced certificate and diploma in clinical leadership is now evolving in partnership with the University of Dundee.
Conclusion
Although the College has existed since 1599, and held dental examinations for over two centuries, its Dental Council is celebrating 50 Years of existence in 2017. Whilst originally its members were largely based in Scotland, today it is truly an International College (with Members/Fellows in 88 countries). Since 2010, the number of Members has trebled and it now has examination centres based throughout the UK and abroad, offering its Members/Fellows value for money (not least in regard to competitive annual registration fees and free subscription to Dental Update.) Furthermore, it is not just a College for hospital or university-based dental surgeons, having GDPs involved at many levels and in most of the key dental committees. Currently, the incoming Chair of the Dental Education and Professional Development Board, the RCPS representative on the Editorial Board of Dental Update and the RCPS nomination for the National Dental Advisory Committee are all from a general dental practice background. We hope you will enjoy this special anniversary edition of Dental Update. Finally, the Royal College of Physicians and Surgeons of Glasgow welcomes Members and Fellows of other Colleges to join us.