COPDEND Dental Foundation Training Policy Statement

Introduction

1 This policy statement has been agreed by COPDEND and aims to provide clarity about its current position, aims and aspirations for dental foundation training in the UK

Definition of Dental Foundation Training

2 A period of training following initial qualification that builds on the achievements of the dental undergraduate curriculum as defined in “The First Five Years” (General Dental Council) that aims “to produce a caring competent reflective practitioner able to develop their career in any branch of dentistry to the benefit of patients” (A Curriculum for UK Dental Foundation Programme Training) and to demonstrate a level of competence appropriate for independent practice.

Background

3 In February 2003 the UK Health Departments published a policy statement on “Modernising Medical Careers” which outlined principles for the reform of postgraduate medical training. The policy contained details about the management of early postgraduate years in medicine which included a two year foundation programme broadly comparable to the structured two year General Professional Training Programme then available for a proportion of dental graduates in the UK.

4 The Department of Health England document “Creating the Future” was published in 2006 and proposed a two-year period of foundation training for dentists as part of a defined career structure. In 2006 “A Curriculum for UK Dental Foundation Programme Training” was published by COPDEND with the support of all four UK Health Departments and in 2008, the Department of Health (England) Modernising Dental Careers Board established a Dental Foundation Steering Group

Length of Dental Foundation Training

5 The curriculum describes outcomes in terms of achieved competences, knowledge, skills and attitudes. There is a complex relationship between outcomes, performance and experience which is time dependent.

6 Dental Foundation Training should be undertaken within two years full time, normally completed within the first three years following graduation.

Primary Aim of Dental Foundation Training

7 To enable acquisition and demonstration of dental foundation training competences, the evidence of which could, in the future, contribute to that required for a first validation with the GDC following initial registration.

Relationship with Dental Specialty Training

8 Completion of a dental foundation training programme may not be the sole entry requirement to dental specialty training programmes, but is likely to be an essential element.

How the curriculum can be delivered

9 There must be a minimum of one year full time, or part-time equivalent, spent in primary care, providing NHS general dental services, to allow completion of statutory Vocational Training. This may take place within a two year period as part of an integrated dental foundation programme.

10 The remainder of the two year programme can be completed in a variety of primary and secondary care settings and should complement (not duplicate) Vocational Training experience.

The curriculum and areas of dentistry in which training might be delivered

11 As part of Deanery approval processes, individual Dental Foundation Training posts/ placements should be considered as part of a comprehensive programme and hence demonstrate which foundation competences they can support.

12 Even though some posts may offer training opportunities out with these defined competences, they should ensure that basic Dental Foundation Training competences are obtained.

13 Patient safety is paramount and in order to comply with clinical governance requirements, trainees should not undertake procedures without direct supervision for which they have not previously been trained and should not be expected at any time to work beyond their level of competence.

14 It is likely that exposure to a variety of different clinical and other environments will maximize opportunities to cover the full range of competences.

15 It is essential that a broad coverage of competences is obtained, rather than in-depth exposure to a particular specialty area.

16 Dental Foundation Training programmes should be designed to deliver all the major competences, but these may be delivered flexibly in different ways in alternative settings

Expectations of Clinical and Educational Activity

17 Throughout the programme there should be a structured, educationally valid, full time programme of appropriate dental activity that addresses the major competences in the Dental Foundation Training curriculum and meets individual identified learning needs.

18 Foundation Trainees should also complete specific educational activities as required by the Deanery (e.g. clinical audits, clinical case presentations, research and audit projects).

19 During DF1 year, trainees must attend 30 study days arranged by the Deanery that provide an educational programme addressing the major curriculum areas.

20 Deaneries may require DF2 trainees to attend particular study days arranged for this group. Other study leave should be agreed in advance with the both the Educational Supervisor and the department as part of meeting appraisal objectives and personal development plans.

21 During DF2 year and whilst employed by an NHS Trust, the foundation dentist should be allowed study leave and expenses according to HC (PC)(77)12 (England and Wales) and “Guidelines for Study Leave” NES (Scotland), geared to the individual’s learning needs as part of foundation training.

22 Clinical dentistry is a highly skilled practical discipline requiring significant practice to acquire and maintain consistent competence. Although the Dental Foundation Years 1 and 2 represent a continuum in training, they may be very different in terms of experience gained and the type of work being undertaken.

23 In foundation training in primary care (which will either be carried out entirely in the first year of the programme or part time across two years), the foundation dentist is expected to consolidate practical experience gained at dental school and to both improve on and broaden the scope of that experience.

24 The setting of the second year may be different and the emphasis will be on building additional competences and learning from a range of dental specialists.

Appendix 1 gives details of requirements

Quality management and approval of programmes and posts

25 This is a Deanery responsibility, working within published national guidelines and with appropriate external advice and input.

Quality Assurance of Dental Foundation Training

26 It is anticipated that a new national body (Dental Foundation Training Advisory Committee) of the Joint Committee for Postgraduate Training in Dentistry (JCPTD) will oversee the development of and agree quality assurance mechanisms for dental foundation training. It is expected that PMETB quality assurance standards will be adopted and applied by Postgraduate Dental Deaneries.

27 In due course, and subject to agreement about validation and revalidation processes for dentists, it would seem logical that parallel and integrated QA systems are introduced for dental foundation and specialty training.

Completion of Foundation Training

28 Postgraduate Dental Deans and Directors have responsibility for certifying completion of foundation training/vocational training within the current regulatory frameworks.

29 COPDEND would wish to move towards a system of satisfactory completion of Dental Foundation Training, as is already the case in Scotland for Dental Vocational Training by introducing a formal robust assessment framework comprising a series of formative assessments which combine to deliver a summative assessment at the end of the foundation training period.

Supervision arrangements

Scheme Adviser/Foundation Programme Director

30 Each Foundation Scheme/Programme should have an appointed Adviser/Programme Director who is responsible for managing the scheme/programme, commissioning educational courses, supporting Educational and Clinical Supervisors, arranging rotations, recruitment and selection of trainers and trainees and faculty development.

Educational Supervisor

31 Each Foundation Dentist should be assigned a nominated Educational Supervisor who is responsible for overseeing the educational progress of the trainee, agreeing a learning plan, undertaking tutorials, appraisals, 3 monthly progress reviews, carrying out workplace based assessments, providing regular feedback on progress to the trainee, advising the Deanery about progress and providing evidence and recommendation for completion of training.

32 S/he should require the trainee to regularly complete the Dental Foundation Training Portfolio and use the educational tools provided to support the trainee.

33 Many educational supervisors in secondary care settings are responsible for three or more trainees and all should have appropriate time made available for their educational role.

Clinical Supervisor

34 The trainee will also have a number of clinical supervisors throughout the period of foundation training. They will be responsible for day to day clinical supervision, facilitating and carrying out assessments, supporting the trainee, ensuring appropriate workload, liaising with Educational Supervisor and Scheme Adviser/Programme Director, providing progress reports.

Combined Educational/Clinical Supervision

35 In general practice/primary care, the Clinical and Educational Supervisor roles are often combined (e.g. as a Vocational Trainer) and may also be carried out by two trainers as a joint responsibility.

Educational Portfolios and Personal Development Plans

36 Each foundation dentist must complete an approved learning and development portfolio to provide evidence of educational and training activity and submit this to the Deanery for approval as part of the sign off process. This may be in either paper or electronic format, as provided by the Deanery. Some Deaneries already have an e-portfolio. COPDEND believes that an e- portfolio that is web-based is the ideal format.

Assessments

37 A COPDEND Foundation Training Assessment Framework is under development and is expected to be published in August 2009

Relationship between Dental Foundation Training and MFDS/MJDF Examinations

38 The end point of the Dental Foundation Programme is achieved by demonstrating the competencies as stated in the “Primary Aim” above over the prescribed time period. It does not require the passing of any academic examination or achievement of any external qualification as its end point.

39 COPDEND would wish to adopt a structured system of formative and summative assessments to demonstrate satisfactory completion

Completion of Dental Foundation training will include providing a portfolio which may assist trainees to prepare for general professional dental examinations and provide a portfolio suitable for trainees to present as part of the requirements for the MJDF examination.

Appendix 1 - Weekly Core Requirements for Dental Foundation Training Clinical and Education Sessions

DF1 (General Dental Practice Placement - minimum one year full time or equivalent)
8 hands-on personal treatment sessions per week, when attending study days (30 days per year) Time should be allowed for tutorials, Workplace Based Assessments and attachments/observerships
10 hands-on personal treatment sessions per week, when not attending study days Time should be allowed for tutorials, Workplace Based Assessments and attachments/observerships

 

DF2 (Minimum of one year full time or equivalent with maximum of two 6 month placements)

 10 sessions per week that comprises a rounded experience/introduction to the work of the specialty/department and offer the trainee maximum opportunity to acquire competence in agreed areas of the curriculum.

This should include scheduled attendance at Deanery Core Study Days

4 Hands-on sessions (e.g. MOS, personal clinical treatment, operating under GA etc) with a designated trainer undertaking teaching
4 Other clinical /professional sessions (e.g. Joint clinics, review clinics, new patient clinics and ward work, dental public health or research projects with a designated trainer undertaking teaching
1 Teaching session (i.e. bleep free education half-day)
1 Study session to include experience of other dental disciplines (if available), Workplace Based Assessments, personal study

 

DF2 On-Call Commitments Recommended on call shifts

On-call commitments may form part of these posts which should be European Working Time Directive compliant.

On-call duties should be appropriate for the level of the knowledge and experience of the trainee and offer structured training and supervision. Overnight on call is not an essential requirement for DF2 training and the introduction of Hospital at Night schemes should reduce the need for DF2 trainees to be involved in rotas.

On call experience can be gained during daytime working which should offer greater access to supervision and structured training.

e.g. Day time A and E cover
5-10pm twilight cover

 

Appendix 2 - Abbreviations used in Dental Foundation Training

Dental Foundation Training terms are often abbreviated and there are a number of alternatives abbreviations in use:

It is proposed that the following be adopted:-

Term Abbreviation
Modernising Dental Careers MDC
Dental Foundation Training DFT
Foundation Dentist FD
First Year Foundation Dentist DF1
Second Year Foundation Dentist DF2