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‘One size fits all’?
One of the compelling reasons that we were told we had to move to National Recruitment was that this is ‘the way it is done in Medicine’, therefore we had no choice. I never had any truck with this argument, as I always considered orthodontic training in the UK, for the most part, was way better than that.
I have a relative who is a junior doctor currently involved in training at one of London's finest medical establishments. Theoretically ‘training’ has been provided by five Consultants, for the last 11 months. Apart from one hour of dedicated training time during that period from just one of these Consultants, neither ‘hide nor hair’ has been seen of any of them. I can understand why these five Consultants couldn't really care less which Tom, Dick or Harriet ended up on ‘their team’ for so called training. As a consequence they obviously feel no need for involvement in the selection process of said trainees. In another month my relative will leave the 5 Consultant trainers and may never, ever see them again.
Contrast this to the conscientious DGH Orthodontic Consultant who, together with the trainees, sees each and every patient, every visit, but only for their entire three year (or five year) training period. This enables them to decide together what has happened since last visit and what needs to be done this visit to ensure further progress with the case. The trainee then attempts to do what was decided and the Consultant sees the case again with the trainee, 30 minutes later, to ‘quality assure’ the treatment episode, the trainee's comprehension of the requirements, and also to ensure the instructions were actually followed to the letter. Clinical photographs are often also taken for future discussion between the trainee and trainer, as required, as to why the particular case progressed as it did. Do you not think that this Consultant might have a vested interest in selecting an appropriate trainee for his/her style of unit?
To disenfranchise these dedicated trainers through National Recruitment is an enormous retrograde step, in my view. It will undeniably make us more like the Medical model of training … but is that really a worthwhile goal of this whole exercise?
This National Recruitment process has, on so many occasions, demonstrated that it is totally ‘unfit for purpose’, culminating in the recent debacle where 1500 Physicians were told on the Friday afternoon of a Bank-holiday weekend in May that their appointments were all null and void (https://doi.org/10.1136/bmj.k2038).
The only chink of light is that, following discussion with the Orthodontic Training Grades group to ascertain their views on the disincentives to pursue Senior Registrar training, there is a reversion to more local recruitment for the Post CCST trainees who wish to pursue a Hospital career. Finally the ‘penny has dropped’, at least with those responsible for training this particular group. I only hope that following the inevitable success with recruitment to this particular trainee group, that consideration will be given to rolling out this tried and tested local recruitment to all orthodontic trainees. This will then facilitate re-engagement of this dedicated group of trainers so that this valuable resource is not completely wasted. Only then, by returning ownership of the candidates selected to the trainers, will orthodontic training in the UK become as good as it possibly can be.
One size most certainly does not fit all!
In this current issue we have an update on local anaesthesia from the Bristol group, which will provide a timely reminder to all of us of some of the potential complications of a technique which we are all prescribing on a daily basis. Another timely reminder is provided by Drs Hemmings and Noar about our GDPR responsibilities for data management and how the rules and regulations have shifted up yet another gear. Ignore these at your peril! Sophie Barber compares and contrasts the UK approach to managing the orthodontic workload with the use of Therapists, with the approaches taken by some of our near neighbours on mainland Europe and it is interesting to see the different regulations between supposedly very similar countries. The other clinical challenges many of us face on a daily basis: that of classification of orthognathic patients (currently a hot topic in the South East of the country) and the variety of approaches to management of hypodontia patients, are discussed in detail by extremely experienced clinical teams.
I hope that this latest issue of Orthodontic Update has something of interest to appeal to all readers. Enjoy the Summer!