The COVID-19 pandemic has brought routine dentistry to a halt, which leaves professionals in training programmes in unknown territory.
Impact on Training
The General Dental Council released a joint statement on 23rd March 2020 addressing the ‘arrangements for dental care professional students and recent graduates, while restrictions are in place to control the spread of COVID-19’.3 The guidance offers reassurance and outlines plans to be put in place to reduce the likelihood of delays in training and satisfactory completion of courses.
Dental schools cease to operate at their usual capacity due to university closures. As a result, dental students will miss out on the best part of a semester of clinical sessions, leading to an unavoidable deficit in clinical experience. The GDC stated that, in these cases, universities will identify those who may require additional support due to lack of experience. A development plan will be put into place for these individuals prior to starting dental foundation training (DFT).3
It is now compulsory for all dental foundation trainees to sit a clinical skills assessment prior to commencing training.3 The clinical skills assessment is an effective way to identify those key areas where more support is needed. This will enable educational supervisors to plan tutorials around those areas highlighted and focus on areas of weakness when completing ADEPTs (a dental evaluation of performance tool) to ensure progression is made throughout the training year.
Many universities utilize viva style examinations in final year. Vivas are face to face examinations which assess higher-level thinking. These exams can no longer take place in their usual format due to the university closures and restrictions that have been put in place.
Universities are exploring the idea of utilizing technology by enabling exams to be completed online. This allows students to sit their final exams as scheduled and prevents delays in qualifying. Whilst this is a practical solution, the different examination environment may disadvantage some students, as it is not the format to which they are accustomed.
The GDC statement suggests that universities are planning to organize multiple sittings of examinations for final year students.3 Due to the COVID-19 outbreak, it is entirely possible that some students will be ill due to the virus, impacting on their ability to sit exams as scheduled. Dental schools across the UK are working hard to determine what is feasible and whether multiple sittings can be arranged to mitigate this scenario.
Dental foundation training is an excellent training programme that is available to new graduates in the UK. Foundation dentists benefit from close supervision during their first 12 months of real world dentistry in NHS general practice. There are numerous learning opportunities available through a plethora of study days. These study days promote continued professional development and encourage interaction between fellow foundation dentists.
Foundation dentists will likely miss out on 12 or more weeks of clinical experience and multiple study days due to the COVID-19 pandemic. This will have a huge impact on DFT. The targets set for trainees will need to be revised due to the considerable reduction in clinical exposure. It could also have an effect on foundation dentists' confidence after completion of DFT due to the unavoidable reduced clinical experience during the year.
Health Education England is working hard to reduce the fallout from COVID-19 on DFT. Many study days are being held online, allowing foundation dentists still to benefit and learn from experienced and knowledgeable speakers. Tutorials between foundation dentists and educational supervisors are also still going ahead online. Training programme directors have been in contact with their schemes to assign tasks which can be carried out at home, ensuring time spent outside of clinics is productive and used to strengthen knowledge.
COVID-19 has caused many interruptions to training. Dental core training (DCT) interviews, for example, were postponed in light of the current situation. Face to face interviews are no longer going ahead. The selection process will be solely based on situational judgement test scores.4
Dental core trainees are expected to complete 24 supervised learning events (SLEs) throughout their 12 month placement.5 SLEs can be completed in numerous different ways such as direct observational procedures and clinical based discussions, etc. DCTs may no longer be able to reach these targets as a result of cancelled clinics and possible redeployment.
COVID-19 has also affected specialty training. The face to face interviews for recruitment are no longer going ahead. A self-assessment process will be utilized.4 Postponement of specialty examinations may result in delays in training progression. This may also lead to delays in the commencement of new trainees.4
The GDC has stated that each university and examining body is working hard to set up contingency plans to reduce the effect that COVID-19 has had on training and examinations.3
Many departments in the NHS are under additional pressures due to the COVID-19 outbreak. Redeployment of dental professionals into areas of need is an excellent way of helping the NHS in such unique circumstances. At the same time, it also allows dental professionals to experience different healthcare environments and gain new skills. This presents a unique opportunity for foundation dentists, DCTs and specialist registrars to work with healthcare professionals that would not usually be a part of the dental team. This is a chance for dental professionals to grow both professionally and personally.
With the uncertainty that COVID-19 brings, there is still hope. The pandemic has resulted in healthcare professionals from all fields joining together in a concerted effort to help those in need. People from all professions are working together in unity, helping however and wherever possible. It is a proud time to be a part of the NHS.
