Ask Plymouth: MSc Restorative Dental Science – a Taster Session

- So my name is Tim O'Brien. I'm the program lead for this course. I'm also the acting head of dental to all post-graduate programs at Plymouth University.

The other programs that we provide are MScs that use blended learning model rather than online. And they run in periodontology, oral surgery, endodontics, orthodontics, and another just slightly different course in restorative dentistry. So this is one of a sort of suite of courses that we offer at Plymouth.

As for my background, you may be able to tell, but I've been in dentistry for a little while now. So when I first started, I literally just went straight into practice. And at that stage, I wasn't terribly focused on learning more. But as I progressed in my career, I became more interested in learning, really, about the science that underpinned the work that I was doing, to understand why I was doing the things that I'd been taught. And that really started me on my postgraduate journey.

So the first thing that I did was I did my specialty training in fixed real prosthodontics. I did that at the Eastman part time, as well as working in practice. And then after that, I've subsequently did a second lot of specialty training in restorative dentistry.

So my role now is one as a consultant in restorative dentistry. I'm currently working clinically at the Eastman Hospital in London, part of UCLH. And my academic role is an associate professor leading the postgraduate programs for Plymouth University.

So I'll talk first about the sort of clinical skills that you develop. It's really set up to take you through an encounter with a patient, which is something we're all used to doing in practice. And the idea is that we really strip it back to the beginning. And we teach you how to perform a very, very thorough examination. We teach you how to choose what different tests to use, what different approaches to use when examining patients, in order to get the most from the examination.

But as importantly, we then teach you how to interpret that material and how to feed the conclusions that you've drawn into formulating diagnoses and, as importantly, prognosis because they really are the fundamental building blocks of any comprehensive management plan. And so it's very much focusing upon that. And again, as Sam quite rightly pointed out, there's a real emphasis on using the literature and understanding why you're doing and also the limitations.

Again, one of the things I've learnt in my postgraduate teaching career is that people often don't understand the evidence behind the decisions they're making. And that can actually lead them into drawing false conclusions. So we really try and make sure that our students do understand that.

Apart from that, the other generic skills that you learn are, really, again all about the literature. So you will learn how to develop a focus question. You'll learn how to look for papers, how to sort through the papers that you need. It is a learning curve.

When I first started doing evidence-based dentistry properly, I would sit down, formulate a question, then end up with results of 7 and 1/2 thousand papers to sift through. Well, we teach you how to avoid things like that and how to focus your questions, how to get the answers that you need from the literature, and then be able to then think about how much you can apply them, again, which is another art in itself.

When you look at the literature in greater depth, you realize that not every paper is necessarily as applicable to your patient as it could be. So they're the sort of skills that we view as really, really important because whichever course you may do in the future, as soon as you leave that course, you are probably going to stop learning at that point, unless you possess the skills to carry on and develop. And so by teaching you how to do this, how to develop questions, how to research papers, how to synthesize them and draw conclusions, we're really setting you up for the rest of your career.

With our graduates who've done similar courses and learnt these skills, a lot of them have gone on to quite demanding jobs. We've had several who have gone into academia. We've had several who have gone on to become consultants. We've had a couple of people who are now working actively in research.

Now, don't get me wrong. The course itself doesn't necessarily lead to that. But as part of a comprehensive training path where these people are doing, it does help provide these essential skills that you need to work and function at a higher level.

I still teach people who are training to be specialists and consultants chair side. And one of the most important lessons that comes from that is that, with dentistry, you have to realize that the knowledge of what you're doing and the evidence is absolutely crucial. A lot of dentists think it's just a practical skill and application. Well, it's not because we can probably teach someone off the street to do that.

What really counts is actually having the knowledge about the disease processes, the pathogenesis, making those decisions, and also things like the technical aspects. For example, which material are you going to use? How would you need to prepare a tooth in order to do that? Because without that, just learning practical skills like an apprenticeship isn't really going to get the job done.

The analogy that I'd often use is often-- is really that of airline pilots because we all think of airline pilots, who'll maybe have a bit of time in a simulator and then set off into the wild blue yonder flying planes. Well, of course, before they get anywhere near an aircraft, there's a huge amount of theoretical knowledge that they have to do. And that is essential to them delivering when it comes to performing their job in the sky.

And it's the same with dentists. We need to understand what we're doing before we can actually do it. And so again, going back to my experience, I do find that the trainees that I'm teaching, the ones who have really researched it and know the theory actually perform better on clinic.

Don't get me wrong. They still need a bit of guidance. And of course, within the course itself, we have things like reflective logbooks and things like that, where students can bring forth cases, and they can get feedback on them and things like that. So it is an important part of it, really.

Now, the course is online. And so what we don't do is sit beside you while you work on a phantom head. There are other courses in Plymouth that deliver that. And if that's what you really want to do, then there is the ability to do that as well as this.

But it really is-- as I say, it's an online course. So it gives you that knowledge. So with that in mind, just be prepared, that's what the course is all about. But that's the rationale for it.

Within dentistry in the UK, you are either a registered dentist, or you are someone who is on the specialist list. This does not open the door to the specialist list. But what it does do is it helps you if you're trying to improve your skills. Now, that can then be used in a number of ways.

So say, for example, you're working in practice, and you thought, actually, I just want to be better at what I'm doing. And particularly, say I want to change my practice and work, do more private work or want to develop something like that. Then, yes, this will help undoubtedly.

The other thing that's going on at the moment is very much a UK thing. So within the NHS, we have the introduction of a tiering system. So as well as specialists and generalists, we have this middle tier. And a lot of people are busy doing courses of this type in order to underpin an application to the NHS to work in that environment, what we call the Tier 2 services. So again, that's another avenue, but it is important to remember that this will be only one part of a package of evidence.

The other way in which people use our courses are if they're working in, say, a large practice or a corporate or things like that. And they just want something to differentiate themselves from the other people who work there, with a view to taking referrals within the practice or having a practice focusing with a special interest on something. That's something else that people have done with our courses. And so they use them for that aspect as well.

Other pathways that people have used, as I say, we've had people who have gone into academia, who we've been working as academics as well. We also have those who have gone on and become researchers with the skills that we've taught them, things like that. So I don't think it's a question that it opens the key to any specific door.

But by doing any course, an MSc course, really, it just helps adds to the portfolio that you have that will help differentiate between yourself and other applications that might be going for a post or things like that. So say I wanted to start out again on a pathway to specialty training. The way in which it's scored means that having additional things on my CV, like an MSc or things like that, actually would help with my application.

Sometimes people talk about certificates, diplomas, and MScs without really understanding the difference between them. And there is a big, big difference between certificates and diplomas than MSc because effectively, literally anyone, the guy down the road can produce a certificate or a diploma.

But to have degree-awarding powers in the UK, you actually need to be authorized to do that. And that comes from, I believe it's the Privy Council in Parliament. And so it's very tightly controlled. And what it means is that, if you undertake a degree program, it's very strictly, very closely monitored.

I mean, for example, we have external examiners. And we have a whole quality team who scrutinize the teaching and learning, who make sure that assessments are fair, who check the curriculum is being delivered, and all these checks and balances, which are absolutely fundamental to running a degree but are not necessary for things like certificates and diplomas that you can get from other institutions. And that's why the degree programs are fewer and farther between and require an awful lot more of students than some of these other programs.

People have to remember that undertaking a course like this, if you're going to get the most from it, it's a question of putting in the hours, not just cramming just to pass the assessment. You won't get the most from it like that. It's about really immersing yourself in the academic journey and reading through all the stuff that you can do, giving yourself time to go through that, assimilate it. That's where you get the most from this course, which is ultimately what people are wanting.

So I think it's having, one, that organizational ability and, two, having the absolute real motivation to say, I'm going to immerse myself in this and absolutely suck up like a sponge all my knowledge that I can do over this time.

The first thing to realize is that you need to be working in practice because, although this is providing a theory, we teach you to put it into practice. And some of the assessments, for example presenting case reports or reflective logbooks, require you to actually see patients and record what you're doing. So you do need to be working and carrying out restorative dentistry.

The second tip is organize your diary. So think about the type of patients that you might need. So if you sign up, you'll be able to find the types of patients you need for the assessments, and check those out, and keep an eye open for those, and try and locate those early on.

The next step is to look critically at your own equipment. You will need to be able to take radiographs that are of a decent quality. So ask yourself, are the images with the equipment that you're using actually presentable enough? Are they usable? Do you have things like the X-ray holders that you need and also things like photography as well? Do you have any facility for that?

And apart from that, I think it's really just making sure that you genuinely, really have put the time aside in order to do this, because this isn't about just jumping through hoops. This is about really learning the skills that are going to change your career and help shape it. And so you've got to be prepared to dive into this and get the most from it. That's what we really want people to do.