Author: College of General Dentistry

Special care community dentist, Dr Heather Mitchell, is part of the Career Pathways Programme Board leading the development of the College’s Career Pathways, designed for each profession within the dental team. Here she describes the in-depth work that has been carried out to ensure the College’s professional framework and membership structure effectively support the career development of every member of the dental team.

I started my role as an Education Fellow with the College of General Dentistry in September 2020. My average week is two days working as a special care community dentist in Birmingham and three days working on the Career Pathways project. My work with the College has been from home this year and the hours are flexible with some evening meetings to allow us to meet with professionals who are working clinically during the day.

During the first meeting with Janet Clarke and Abhi Pal back in September 2020, they explained the College’s vision for the career pathways, how we would be setting out a professional framework for all seven of the dental professions covering five domains and within each of those there would be five different membership levels. After the meeting I felt excited about having the opportunity to be involved however also slightly daunted about the amount of work required to get there especially as these career pathways have never been defined before. When I joined the College the working groups for each profession had been established, they had been carefully selected to represent professionals from across the UK and who were at different stages in their careers.

There is very much a team effort approach with this project to ensure the framework is not reflective of just one person’s voice. I work alongside Kirsty McCulloch who is an education and quality assurance specialist with experience working within dentistry, Steve Stark an expert facilitator and whose company, Then Somehow, works with companies to increase their productivity, and finally Tara Williams (formerly Gus) who is helping with the organisational side and managing the huge spreadsheet of the framework. We have been working completely online so far, which means we have not been restricted by location when organising meetings. Also, for the members of the working groups we have been able to organise meetings far more easily than if we had to do it face to face, resulting in involvement of professionals from across the UK

Our initial working groups meetings were about introducing the concept and ideas of the Career Pathways framework, the College is unique because it is open to all dental professionals, this puts emphasis on the importance of a team-based approach to patient care and lifelong learning. To get the conversation started we asked the members of each working group to think about a colleague who they felt fitted into one of the different career stages. They were asked to describe their professional attributes by thinking about what they said and how they worked for example. From this activity a lot of general themes appeared across all the professions such as reflection, communication, awareness of their own competence and being patient focused. I took these themes and created a first draft of the framework using the language from each working group. The aim of the framework is to be inclusive and accessible for everyone therefore the use of language had to be carefully considered.

We then took the framework back to the working groups to highlight in traffic light colours which parts they were happy with and where there could be improvement. This allowed us to further shape the framework and populate all 5 levels of the framework for each profession. It is essential there is flexibility in the framework, to allow professionals to use it who have more than one job role or who have moved away from clinical work.

By this stage the framework across the professions were becoming more similar and actually for some domains, for example ethical practice and self-reflection, they were the same across each profession. This helps to support the collective voice of the profession which the College is aiming to create.

We are now at the stage where we have a prototype of the framework which we have taken to the Reference Group and a sponsor group for further feedback. During this process we have always thought about how professionals will evidence this framework, and we are now at the stage where we are starting to discuss this with the working groups. It should be evidence that is accessible for the whole team and not limited to postgraduate qualifications. The idea of the framework is that a professional can use it as a tool to plan how to move up the levels if desired or maintain where they are. It is not expected that every professional will be aiming to be an accomplished practitioner.

The College’s commitment to prioritise a patient-centred approach to oral health care, as well as provide a much-needed structure for skills and career development within the profession, will serve to improve professionalism in dentistry. In turn, this will hopefully strengthen patient trust in their oral healthcare, benefitting the oral health of the nation. Now that I have been in the role for ten months, I can really appreciate what a great opportunity this has been to work on such an innovative project so early on in my career, I feel proud of what we have managed to achieve and am looking forward to sharing it more widely.

You may also be interested in reading blogs from Career Pathway Reference Group members, Professor Avijit Banerjee, Chair in Cariology & Operative Dentistry at Guy’s and Andrea Johnson, orthodontic & maxillofacial laboratory manager.

Professor Avijit Banerjee sits on the College’s Career Pathway Reference Group. We asked him to share his own career path with us and set out how CGDent’s Career Pathways will benefit dentistry and the wider oral healthcare profession in the UK.

My personal career pathway

After qualifying as a dentist from Guy’s in 1993, I wanted to train as a specialist clinician, teach and carry out dental research. Thirty years ago, such formal career pathways were more varied, with no real roadmap available detailing what experience was required or what qualifications were needed etc etc. Thus, I forged my complex personalised career pathway in clinical academia by gaining advice and mentorship from key individuals in my career.

The first stage started with what was then called “house jobs” in Queen Alexandra Hospital, Portsmouth in Oral & Maxillofacial Surgery followed by an18-month rotation at Mount Vernon, Hillingdon and Watford General Hospitals. I learned / osmosed so many surgical skills and patient management skills, working with hospital and primary care teams and making lifelong friends along the way. During these latter senior house officer (SHO) posts, I completed my primary and final FDS RCS (Eng), which in those days had a pass rate of only 10%!

It was at this stage, I started to look at my research career in more depth. After carrying out scientific research as a dental undergraduate and publishing my first research paper the year I qualified, I was bitten by the bug and wished to pursue this aspect of my career by studying for a PhD. So, whilst an SHO, I collaborated with my supervisors back at Guy’s and applied for a Medical Research Council Clinical Training Fellowship which would cover my 3 yr salary and costs for my PhD. I was extremely fortunate to win this national award (at that time only two other dentists had been awarded this prestigious MRC Fellowship in the past 30 yrs).

Between the years of 1995-98 I carried out my research full-time at Guy’s, which also included a masters in the first year, at UCL. I was acutely aware of the importance of maintaining wet-fingered clinical practice, so I also got a part-time job in primary care general dental practice, working two sessions/week, evenings and weekends. Forging such a career path involves much ball juggling and during this period, I became adept at this!

After finishing my PhD (in Cariology and Operative Dentistry), I was lucky enough to get a full-time substantive clinical lecturer’s position in Guy’s, in Conservative Dentistry. This role allowed me to develop my teaching, research and management/leadership skills. During the next 7 yrs, I completed my clinical specialist training in Restorative Dentistry, continued with my research (supervising masters and doctorate students, writing grants and papers, and lecturing at international conferences) and developed my teaching and management skills, leading clinical teachers and UG students.

From 2005, I was promoted with seniority, firstly to senior lecturer and ultimately, 10 yrs ago, to a personal Chair at Guy’s with an Honorary NHS Consultant contract with Guy’s & St. Thomas’ Hospitals Trust. I am now privileged to hold several senior national roles within the profession and have an international lecturing/research reputation in my discipline.

All this time, I have continued to work in private practice, reduced now to two sessions/month. It is always wise in my opinion, not to close off any opportunities during one’s career progression as you never know how things will transpire. It is the variety of experiences that develop and enrich one’s career until the day you retire.

The need for career pathways

I have learned a lot about myself (and others) during my career. Although hard work, but fulfilling, there was much left to chance and the support I received was welcome but hard-sought. The processes in those days were less transparent perhaps, but equally competitive as they are now.

The world has changed.

Therefore, the processes available to encourage, enhance and enrich career progression must also evolve.

The traditional qualification-based linear progression through one’s chosen discipline needs to be questioned with regards to its value, appropriateness and modern-day inclusivity. A more holistic, depth and breadth of quality of experience-based approach will empower individuals to take control of their training and allow inter-disciplinary cross-over.

The College of General Dentistry Career Pathway Reference Group was created with the remit to help develop and guide this structure and ultimately its implementation. We are collating the results from the working groups convened for each oral healthcare team member career pathway. The working groups consist of expert influencers within the specific professional stakeholder groups, including dental nurses, clinical dental technicians, orthodontic technicians, hygienists, dental therapists and dentists.

The Reference Group wisely has representation from all oral healthcare team members, accepting that “one size does not necessarily fit all” when considering career progression milestones. The CGDent challenge will be assessing, quality assuring and validating the huge variety of holistic evidence that could be attained for each of the seven oral healthcare clinical career pathways, to provide and align milestones to allow progression of team members from safe beginners to accomplished practitioners throughout their career.

This is a huge project with hugely positive implications for the oral and dental profession as a whole. Inclusivity of team roles, the appreciation of different forms of training and how it affects the individual, adaptation and quality assurance are all challenges to overcome, to allow a flexible, career-enabled and inclusive workforce to develop and deliver better oral health to our nation.

You may also be interested in reading blogs from Andrea Johnson, orthodontic & maxillofacial laboratory manager, and Dr Heather Mitchell community dentist, who are both part of the Career Pathways development team.