HEE East of England

Information for potential registrants is available from the General Dental Council (GDC). It is possible to work in this country as a dentist only if you are registered with the GDC. There are two types of registration;

• Full registration(usually just called 'registration')
  • This allows you to practice dentistry without supervision. 
     
•  Temporary registration
  • oIf you are not eligible for full registration this will allow you to practice dentistry in the UK in a supervised post for training, teaching or research purposes only, and for a limited period of time
  • You are eligible for temporary registration if you hold a dental degree certificate from a University/Institute recognised by the GDC for the purposes of temporary registration and the ORE.

You can apply for full registration with the GDC if:

• You are a national of the European Economic Area (EEA) or Switzerland and you qualified as a dentist in the EEA,

or

• You are a national of the EEA who qualified as a dentist outside the EEA, and your qualification has been recognised for unrestricted registration by an EEA state,

or:

• You are married to an EEA national (other than a British national) who is in full-time employment in the UK, and have qualified as a dentist in an EEA state,

or:

• You hold one of the following qualifications:
  • BChD MEDUNSA, BDS Malaya – awarded between 1 January 1997 and 31 December 2000
  • BChD Western Cape – awarded before 31 December 1997
  • Awarded before 1 January 2001: BDS Adelaide, BDSc Melbourne, BDSc Queensland, BDS Sydney, BDSc Western Australia, BChD Pretoria, BChD Stellenbosch, BDS Witwatersrand, BDS New Zealand, BDS Otago, BDS Hong Kong, BDS Singapore,

or

• You qualified as a dentist overseas and have passed the Council’s International Qualifying Examination – see below.

If you wish to apply for registration, please complete the Request for Registration with the General Dental Council form, which can be obtained from the GDC.

The ORE is held only in English. All applicants are required to demonstrate their competence in the English language by means of the International English Language Testing System (IELTS). The IELTS test is administered by the British Council in 105 countries including the UK

For information on where to sit the test contact:

British Council
IELTS Enquiries
Bridgewater House
58 Whitworth Street
Manchester M1 6BB

0161 957 7755
email: general.enquiries@britishcouncil.org
website: http://www.ielts.org/

• N.B. In accordance with Law, Nationals of European Economic Area (EEA) States, or persons who are entitled to be treated no less favourably than EEA nationals, cannot be required to take the IELTS test unless they are going to work in an NHS general dental practice.

Candidates are required to submit an Academic IELTS Test Report Form before their application to sit the ORE will be accepted. The form must:

• Be no more than 2 years old on receipt at the GDC
• Show a minimum overall band score of 7.0
• Show no score lower than 6.5 in any section.

The ORE has 2 parts which must be taken – and passed – in order. The purpose of Part 1 is to test the candidates’ application of knowledge to clinical practice. This is a written exercise. Part 2 is designed for candidates to demonstrate practical clinical skills and includes manikin, diagnostic/treatment planning and medical emergency exercises.

There is also a prior clinical experience requirement for all new applicants. The key purpose of this is to ensure patient protection as the new examination will not include a test on a patient.

The overseas dentist must have at least 1600 hours of clinical experience where they have personally treated patients. This will need to be verified, and the GDC will request signed references from university Dental Deans for the undergraduate experience and from employers for the post-qualification experience. The employers must include their registration number.

All sittings of the ORE at present will be held in London.

Part 1

A successful ORE candidate will :

Biomedical Sciences and Oral Biology

• have knowledge of anatomy, physiology and biochemistry relevant to dentistry
• have knowledge and understanding of biomedical sciences and of oral physiology and craniofacial, oral and dental anatomy in the management of their patients

Behavioural Sciences

• be competent at communication with patients, other members of the dental team and other health professionals
• be familiar with the social and physiological issues relevant to the care of patients.
   

Human Disease

• have knowledge of the scientific principles of sterilisation, disinfection and antisepsis
• have knowledge of the pharmacological properties of those drugs used in general dental practice including their unwanted effects
• be familiar with the pathological features and dental relevance of common disorders of the major organ systems
• be familiar with the role of therapeutics in the management of patients requiring dental treatment
• be familiar with the general aspects of medicine and surgery
• be familiar with the main medical disorders that may impinge on dental treatment
• be familiar with the work of healthcare workers
• be familiar with the place of dentistry in the provision of healthcare.

Medical Emergencies

• be competent at carrying out resuscitation techniques and immediate management of cardiac arrest, anaphylactic reaction, upper respiratory obstruction, collapse, vasovagal attack, haemorrhage, inhalation or ingestion of foreign bodies, and diabetic coma
• have knowledge of diagnosing medical emergencies and delivering suitable emergency drugs using, where appropriate intravenous techniques

Law, Ethics and Professionalism

• be competent at maintaining full, accurate clinical records
• have knowledge of responsibilities of consent, duty of care and confidentiality
• have knowledge of patients’ rights
• have knowledge of the regulatory functions of the General Dental Council
• be familiar with the legal and ethical obligations of registered dental practitioners
• be familiar with the obligation to practice in the best interest of the patient at all times
• be familiar with the need for lifelong learning and professional development.

Health Informatics

• be competent at using information technology
• be familiar with the law as it applies to records.

Introduction to Clinical Dentistry

• be competent at obtaining a detailed history of the patient’s dental state
• be competent at obtaining a relevant medical history
• be competent at using laboratory and imaging facilities appropriately and efficiently
• be competent at clinical examination and treatment planning
• be competent at arranging appropriate referrals
• be competent at maintaining an aseptic technique throughout surgical procedures
• be competent at obtaining informed consent
• have knowledge of managing patients from different social and ethnic backgrounds
• have knowledge of dental problems that may manifest themselves in older patients and of the principles involved in the management of such problems
• have knowledge of working as part of the dental team
• be familiar with the complex interactions between oral health, nutrition, general health, drugs and diseases that can have an impact on dental care and disease.

Restorative Dentistry

• be competent at diagnosing and planning preventive, non-operative care for the individual patient who presents with dental caries, periodontal disease and tooth wear
• be competent at completing a periodontal examination and charting, diagnosis and treatment plan
• be competent at supragingival and subgingival scaling and root debridement, using both powered and manual instrumentation, and in stain removal and prophylaxis
• be competent at knowing when and how to prescribe appropriate anti-microbial therapy in the management of plaque-related diseases
• be competent at completing a range of procedures in restorative dentistry including amalgam and tooth-coloured restorations, endodontic treatments of single- and multi-rooted teeth, anterior and posterior crowns, simple bridges, and partial and full dentures
• be competent at deciding whether severely broken down teeth are restorable
• be competent at designing effective indirect restorations and full and partial dentures
• have knowledge of when periodontal surgery might be advised
• have knowledge of how missing teeth should be replaced, choosing between the alternatives of no replacements, bridges, dentures or implants
• have knowledge of the design and laboratory procedures used in the production of crowns, bridges, partial and full dentures and be able to make appropriate chairside adjustment to these restorations
• be familiar with the diagnosis and management of temporomandibular joint disorders
• be familiar with dental implants as an option in replacing missing teeth.

Dental Biomaterials Science

• have knowledge of the science that underpins the use of dental biomaterials
• have knowledge of the limitations of dental materials
• be familiar with those aspects of biomaterial safety that relate to dentistry.

Paediatric Dentistry

• be competent at diagnosing active caries and planning non-operative care
• be competent at fissure sealing, preventive resin restorations, and pit and fissure restorations
• be competent in undertaking approximal and incisal tip restorations
• have knowledge of preformed stainless steel crown and pulp therapy in primary molar teeth
• have knowledge of the role of sedation in the management of young patients
• have knowledge of the management of trauma in both dentitions.

Orthodontics

• be competent at carrying out an orthodontic assessment including an indication of treatment need
• be competent at managing appropriately all forms of orthodontic emergency including referral when necessary
• be competent at making appropriate referrals based on assessment
• have the knowledge to be able to explain and discuss treatments with patients and their parents
• have the knowledge to be able to design, insert and adjust space maintainers
• have the knowledge to design, insert and adjust active removable appliances to move a single tooth or correct a crossbite
• be familiar with contemporary treatment techniques
• be familiar with the limitations of orthodontic treatment

Preventive Dentistry

• be competent at oral hygiene instruction, dietary analysis, topical fluoride therapy and fissure sealing
• be familiar with an evidence –based approach to treatment

Dental Public Health

• be familiar with the prevalence of certain dental conditions in the UK
• be familiar with the importance of community-based preventive measures
• be familiar with the social, cultural and environmental factors which contribute to health or illness
• be familiar with the principles of recording oral conditions and evaluating data
  Comprehensive Oral Care
• be competent at working with other members of the dental team
• have knowledge of providing a comprehensive approach to dental care

Oral Surgery

• be competent at undertaking the extraction of teeth and the removal of roots where necessary
• be competent at undertaking minor soft tissue surgery
• have knowledge of the management of acute infection
• be familiar with the principles of assessment and the management of maxillofacial trauma
• be familiar with the diagnosis of oral cancer and the principles of tumour management
• be familiar with the principles of treatment of dento-facial anomalies including the common orthodontic/maxillofacial procedures involved
• be familiar with the basic principles of oral surgery practice

Oral Medicine

• have knowledge of the drugs commonly used in oral medicine and of their side effects and drug interactions
• have knowledge of appropriate special investigations and the interpretation of their results
• be familiar with the pathogenesis of common oral medicine disorders and their treatment

Oral Pathology and Oral Microbiology

• have knowledge of the role of laboratory investigations in diagnosis
• have knowledge of the pathogenesis and classification of oral diseases
• have knowledge of the aetiology and processes of oral diseases
• have knowledge of matters relating to infection control
• have knowledge of the causes and effects of oral diseases needed for their prevention

Dental Radiology

• be competent at taking and processing the various film views used in general dental practice
• be competent at radiographic interpretation and be able to write an accurate radiographic report
• have knowledge of the hazards of ionising radiation and regulations relating to them, including radiation protection and dose reduction
• be familiar with the principles which underlie dental radiographic techniques
   

Pain and Anxiety Control

• be competent at infiltration and regional block analgesia in the oral cavity
• be competent at when, how and where to refer a patient for general anaesthesia
• be competent at managing fear and anxiety with behavioural techniques and empathise with patients in stressful situations
• have knowledge of inhalational and intravenous conscious sedation techniques
• have knowledge of conscious sedation techniques in clinical practice.

Part 2:

Finalised information from the GDC examination board will be posted here in due course. It is anticipated that it will involve:

• an operative test on a dental manikin
• an Objective Structured Clinical Examination (OSCE) comprising 20 x 5 minute stations
• diagnostic and treatment planning involving an actor, but not involving an intra-oral examination
• an examination on medical emergencies

Dentists cannot be included in a Area Team (AT) dental list unless they have either completed a period of Foundation Training or have acquired experience and training that may be regarded as equivalent of such training or are within one of the specified categories of exemption from FT requirements. The Area Team is responsible for deciding if an applicant’s experience is ‘equivalent’ to that received during FoundationTraining. As of April 2006 the functions of the DVTA were taken over by the Business Services Agency (BSA). Some details on Foundation Training can be found on the COPDEND website (http://www.copdend.org/ and clicking on the Foundation Training link.

If you require information on working within in the hospital service, including their notes for overseas dentists, you should contact;

National Advice Centre for Postgraduate Dental Education
Faculty of Dental Surgery
The Royal College of Surgeons of England
35-43 Lincoln’s Inn Fields
London
WC2A 3PN

Tel: 020 7869 6804
http://www.rcseng.ac.uk/

The Home Office is the government department responsible for immigration and nationality. It is their job to regulate entry to, and settlement in, the UK.

http://www.homeoffice.gov.uk/passports-and-immigration

Recently (March 2006) the Department of Health Office announced changes to the immigration rules for postgraduate doctors and dentists. The changes mean that all doctors and dentists who wish to work in the UK from outside the European Union will need to meet the requirements of an employment category, such as the work permit provisions.

The current immigration rules allow the category of Postgraduate Doctors and Dentists to train in foundation programmes, senior house office and equivalent grades and in specialist registrar and equivalent grades. For immigration purposes they are considered as being in training and not In employment. However, in the future this will no longer be the case and these posts will be considered as employment posts for immigration purposes and therefore applicants will need to hold a valid work permit.
There are transitional arrangements to cover those dentists who are in training programmes which continue beyond their current leave to remain. These transitional arrangements will also cover those doctors who have been offered a post before the announcement that will start on or before 4 August. In brief, these doctors will be able to switch and into the work permit system without their employer needing to re-advertise the post.

This should not affect the position of dental foundation trainees. VDPs are already required to have work permits and will remain a shortage occupation. 

Latest news on changes in immigration policy within the NHS can be found at:

NHS Employers: Immigration Rules