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To DCT or not to DCT? That is the question.

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To DCT or not to DCT? That is the question.

Hannah qualified from Peninsula Dental School in 2015 and went on to complete her DF1 on the Oxford Scheme.

Today she is a DCT1 in Paediatrics and Oral Surgery at Birmingham Dental Hospital, but she found the choice of applying for DCT a difficult one to make.

 

 

"In Dentistry it appears that you always have to be thinking one step ahead..."

It seemed like only a few short months into DF1 before everyone started asking the question: 'So what do you want to do next year?' What to do after DF1 is a very big decision – one which I personally felt unprepared for - and I actually decided to apply for DCT at the same time as looking for associate jobs.

Eventually I realised I wanted to gain experience in oral survery, especially the chance to perform surgical extractions, and fortunately I was able to secure a DCT1 position in Paediatrics and Oral Surgery (far less scary, in my opinion, than MaxFax).

If you're still deciding whether your career lies in private practice or hospital, below are some useful insights which hopefully might help.

Top 10 things you need to know about DCT 

1) Know the application deadlines – this seems fundamental but people do miss the deadline!

2) It's not all about MaxFax - there are lots of different DCT roles. Although MaxFax jobs are abundant there are posts available in Oral surgery, Paediatrics, Community, Restorative, Public Health and various combinations of each! Take a while to have a look on each of the Deanery websites, or even better, speak to people in current DCT posts.

3) You could be required to change location – this year DCT applications are through National Recruitment so very similar to the DF1 process. This means that you should to be prepared to move unless you rank highly enough for your preferred location. The alternative is only ranking the area you would like to work at application – however this may reduce your chances of being offered a post.

4) Pay – yes, you will earn less than you could potentially earn as an associate BUT you do get paid whether your patients turn up or not! Plus, any on-call you do significantly bumps up your salary.

5) It is a requirement if you want to specialise - however by doing DCT you are not committed to specialising and you have the option of going back to practice at any point. So it is a choice that keeps your options open. DCT can either be used as a learning experience and CV builder before heading back to practice, or as an essential stepping stone into a specialist pathway. One downside of being a DCT is the pressure you may feel from senior colleagues and by other DCTs regarding your career plans. Some DCTs know exactly what they want to do and how to get there, and so seem miles ahead in terms of getting published and winning prizes. Don't allow yourself to be rushed into making decisions about your future and if you are unsure, keep your options open.

6) You won't be able to escape Clinical Governance – that means audits, posters, presentations etc. Don't worry if you don't feel you know enough about this, there is lots of help.

7) 'De-skilling' – taking a DCT job means that your skills in routine dental procedures will decrease, right? Not necessarily. In Paediatrics I am still performing a variety of dental treatments and of course, those in restorative posts will be undertaking very complex work. However, I can understand the worry if the DCT role is less 'drilling' based. I have spoken to many colleagues about this and they have said that although it can be slightly scary going back to it, as soon as you've seen a couple of patients it feels completely normal again. DCT's do get a generous number of study days and a study budget, so this time can be used to attend hands-on courses. You can also opt to work part-time in Practice whilst doing a DCT job.

8) What happens day to day? - A typical day is varied and often involves a mixture of Consultant-led new patient clinics followed by an afternoon of treatments. Working with Consultants to assess and treatment plan for patients with a wide-range of problems has definitely improved my practice. I have also performed complex interventions that I wouldn't necessarily have had the opportunity to complete in practice e.g. MTA obturation and inhalation sedation sessions. The main challenge is probably the administrative side of things – getting used to dictating letters, chasing up lab work, ensuring patient appointments are made etc.

9) There is a curriculum – the training programme runs very similarly to DF1. You are expected to attend Deanery study days and are also required to complete a portfolio with reflections, work-based assessments and much more in order to pass the year. At your hospital you will have an allocated Educational Supervisor with who you can discuss your aims for the year and how to achieve them, as well as raise any issues you may have. You won't feel completely abandoned!

10) You will have a social life – working in a hospital you are party to a sociable and active environment. There are numerous activities to get involved in – charity fundraising, departmental parties, staff club etc. I enjoy the range of different people you get to work with and the possibilities this provides to learn and develop. Working in a teaching hospital will also mean you are part of a group of other DCTs of a similar age and mind-set, which creates a great communal atmosphere.

In conclusion...

Although I experienced a broad range of treatment and patients in my DF1 year, I felt there were gaps in my clinical knowledge which led to a lack in confidence in my clinical decision-making. As  a DCT, the opportunity to work with consultants and registrars, take part in multi-disciplinary team clinics, and have regular teaching sessions/journal clubs, has really improved my dental knowledge and skill set.

So, if you find yourself unsure about whether or not to apply for DCT, then I would say to you go for it! It is not a "forever decision" and it will stand you in good stead to continue with secondary care or return to general practice. I have already learnt more than I thought I would in the few short months that I have been a DCT. I feel much more confident in my own abilities and I believe this year will really benefit me in the long-run, whether my future lies in general practice or down the specialist route.

Good luck!

Hannah Pugh


 

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