Introduction to Dental Core Training (DCT)
The program is designed to provide a structured learning experience that develops clinical and non-clinical skills in preparation for specialty training. These posts are mostly hospital or community based and offer the opportunity to develop skills in an environment that differs from general practice.
DCT usually lasts for one year and provides trainees with the opportunity to work in a variety of clinical settings. The initial one-year DCT post is called DCT1. DCT recruitment (UK wide) has been nationalised, with applications opening in January.
During DCT, trainees work under the supervision of experienced dental professionals, including specialists in different areas of dentistry.
DCT is a great option for specialisation and allows for progression while working in general practice. At the end of DCT, trainees may choose to apply for specialty training in a particular area of dentistry or continue working in general dental practice.
There are three entry levels: DCT1, DCT2 and DCT3.
What it’s like to work in a split DCT post
Kiren Kauser DCT1 shares what to expect working a split post: six months of Oral Maxillofacial Surgery (OMFS) and six months in Community Dentistry. OMFS is commonly referred to as ‘maxfax’, and also one of the most common DCT posts available.
Life as a maxfax DCT
My post started at a major trauma centre, the Queen Elizabeth Hospital Birmingham.
During the first few weeks I remember feeling ill-prepared but as time went on, I started to get into the swing of things. I knew what to expect on a day-to-day basis and soon, maxfax became the experience I never knew I needed.
Theatre/surgery days: This involves clerking patients in prior to their surgery and being the designated DCT to assist in theatre. In some cases, you are given the opportunity to carry out procedures such as suturing the different parts of the body, making incisions and draining large facial swellings or harvesting a split thickness skin graft!
On call ward ‘bleep’: You are looking after patients on the ward who have had or are awaiting surgery. Daily duties include taking bloods, cannulating patients, regular monitoring of their free flaps, liaising with other teams in the hospital ie the speech and language team (SALT) and writing discharge summaries.
On call trauma ‘bleep’: Jobs on trauma include assessing casuals from A&E who may have a swelling, infection or trauma. You may need to suture lacerations of the head and neck, excise sebaceous cysts and assess and plan treatment for broken mandibles (and many other facial bones!).
Clinics: You work with a registrar and/or consultant carrying out consultations for those patients who have been referred to secondary care. Referrals include those for suspected malignancy (two-week wait referrals), oral or skin lesions, diseases of the salivary glands, TMJD and extractions for those who are medically compromised.
Nights: Nights consist of holding both the trauma and ward bleep. There is usually an on-call registrar and consultant, so if you need any help it’s only a phone call away! The nights are often quieter than the days, so holding both trauma and ward bleeps are fairly manageable. The broken mandibles and dog bites, however, are enough to pass the 12.5 hour shifts over the weekend!
Life as a community DCT
Within the Community Dental Service in Birmingham, we see both paediatric (0-16 years) and special care patients (16+ years). My week is varied which keeps things interesting for me; being at different sites daily makes the week go faster. Having previously worked weekends in maxfax, my weekends off in community are so valued!
Mondays: At the start of the week, I work with the little rays of sunshine; our paediatric patients! I work alongside a consultant in a high needs community clinic, seeing my own list of patients. These patients are usually referred in by their GDP for reasons such as anxiety, a complex medical history or pre cooperative for the treatment they require. Treatment may include restorations or extractions, possibly requiring adjuncts such as sedation or GA for the necessary treatment to be carried out. I provide a whole range of treatment including taking impressions on special needs children, placing hall crowns, silver diamine fluoride application, extractions and much more!
It’s worth noting, there is the possibility to become sedation accredited (inhalation and/or intravenous) which is a fantastic skill to be able to take forward with you in the progression of your dental career.
Tuesdays: Next, I work in oral surgery at a different community clinic alongside a consultant. Here, we complete a minor oral surgery (MOS) list in the morning which usually consists of surgical extractions.
In the afternoon, we assess patients who have been referred in.
Wednesdays: Midweek is for special care! I see and treat the most vulnerable of our society along with a special care dentist. These patients have been referred to our service usually due to anxiety, complex medical history or another factor in their medical history, such as a physical or mental disability which means they cannot receive routine dental treatment. The dentistry isn’t usually the challenging aspect in special care, rather, the patient management is! We see patients from secure mental health units, residential care homes as well as domiciliary visits, where we travel out to see patients who can’t come into clinic. Special care dentistry isn’t like any dentistry I’ve experienced before and I really enjoy the challenges it brings.
Thursdays and Fridays: At the end of the week, I am based at the Birmingham Dental Hospital. Here I work in a variety of different roles:
- Telephone triage: providing urgent care telephone consultations for patients who have been referred by NHS 111 or their GDP
- GA: treating children on a general anaesthetic list with a senior dentist. On this list we usually extract unrestorable teeth both deciduous and, unfortunately, first permanent molars too
- National Dental Epidemiology: we are currently collecting data for the Oral Health Survey of 5-year-olds, and this involves school visits.
I have thoroughly enjoyed working in secondary care. I felt my maxfax post was great for my personal development as well as being a desirable aspect to add to my CV.
With community dentistry, I have found where my heart lays!
DCT application process
Applications are made through Oriel. The NHS Workforce, training and Education Hub holds all the up to date information on Nationwide DCT posts and application process.
The DCT National Recruitment webinar broadcast on 18 January 2024 can be found here.
