SPECIALTY TRAINING CURRICULUM

ORAL SURGERY

February
2014
Specialty Advisory Committee for Oral Surgery
The Faculty of Dental Surgery
The Royal College of Surgeons of England
35-43 Lincoln's Inn Fields
LONDON
WC2A 3PE

email: [email protected]
TABLE OF CONTENTS

Introduction 3
Standard 1: Rationale 4
1.1 Purpose and context of training 4
1.2 Linkage to subsequent stages of education and training 4
1.3 Criteria for entry to specialty training 4
1.4 Structure of specialty training programmes 5
Standard 2: Content of learning 7
2.1 General professional content (see Appendix) (18-39)
2.2 Specialty-specific content (see Appendix) (40-57)
2.3 Methods of assessment 7
Standard 3: Model of learning 10
Standard 4: Learning experiences 11
Standard 5: Supervision and feedback 13
Standard 6: Managing curriculum implementation 14
Standard 7: Curriculum review and updating 15
Standard 8: Equality and diversity 15
Glossary 16
References 17
Appendix 18-57

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INTRODUCTION
Oral Surgery in the UK is a dental specialty recognised by the General Dental Council. The title
Oral Surgeon is limited to registered dentists included in the specialist list in Oral Surgery. The
award of the Certificate of Completion of Specialist Training (CCST) will require evidence of
satisfactory completion of a broad training in Oral Surgery as outlined in this curriculum.

Introductory notes taken from the 2010 version of the curriculum

The curriculum takes, as its guidance, the Postgraduate Medical Education and Training Board’s
(PMETB) Standards for Curricula. It has been developed from the Joint Committee for Specialist
Training in Dentistry Specialist Advisory Committee (SAC) for Oral Surgery Guidelines for the UK (a)
and represents a modern flexible approach to training. The SACs contain members representing the
key specialist societies for that discipline. It has been developed with reference to other curricula
already developed for medical, surgical and dental specialties and the ethos within the NHS (b). The
new curriculum has been written to PMETB/SDEB standards by the current SAC in Oral Surgery
following discussion by the committee and specific feedback from the Dental Faculty
representatives, committee representatives of The British Association of Oral Surgeons, The
Association of British Academic Oral & Maxillofacial Surgeons, The British Association of Oral &
Maxillofacial Surgeons, SDEB and trainees in Oral Surgery.

The key elements of the training programme include pre-registration specialist training (standard
3) with the future potential for modular credentialing. The latter will allow flexibility of training such
that trainees may take an approved break (in accordance with the sections on taking time out of
training in the Dental Gold Guide (currently paragraphs 6.55 – 6.79)). Alternatively, individual
modules could be available to those seeking to complete their training and achieve a CCST. In
other words, it develops the availability of a ‘skills escalator’. This will be in partnership with other
educational and health bodies (e.g. local universities and nationally such as Royal
College/Faculties). Those who wish to follow an academic route can incorporate a research
degree as well as an expanded teaching role – possibly as an Academic Clinical Fellow (ACF) or
Clinical Lecturer (CL).

An introductory note on the 2014 version of the curriculum

The curriculum was subject to minor amendments in 2014 to demonstrate clearer mapping to the
various assessment methods. The clinical content remains unchanged.

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STANDARD 1: RATIONALE

1.1 Purpose and context of training

The purpose of this curriculum is to guide the training of an Oral Surgeon to the core level of
competence required for a UK specialist. This training will produce dentists who are specialists in
the field of Oral Surgery who will become registered on the GDC Specialist List on completion of
training. In future this core curriculum will be used as the framework for evaluation of prior
training, experience and skill in the development of top-up training in Oral Surgery.

The GDC report on specialist lists published in December 2005 approved a series of
competencies for the oral surgery curriculum (c,d). The core competencies are considered a
minimum requirement to be achieved by all trainees and would lead to the award of a CCST.
Specialists in Oral Surgery may also gain extended competencies, which represent additional
aspects of specialist clinical practice (included in EU document XV/E/8385/3/95-EN) and may
form other elements of development (see below). The function of the GDC is to oversee core
specialist training and to make the award of the CCST. The curriculum set out below is therefore
limited to the core competencies in Oral Surgery.

1.2 Linkage to subsequent stages of training and education

It is recognised that CCST holders employed as substantive and honorary consultants in the NHS
in Oral Surgery are required not only to practise core specialty skills but also to possess a range
of extended competencies. These are detailed in ‘Career Development Framework for Consultant
Appointments in Oral Surgery’, available from the SAC in Oral Surgery (d).

1.3 Criteria for entry to specialty training

Access to the Oral Surgery specialty training programmes will be competitive. All appointments
should follow the guidance of the new Dental Gold Guide.

A specialist trainee (StR formerly SpR) must be registered with the General Dental Council prior
to commencement of training. A minimum requirement for entry to specialist training is 2 years of
postgraduate foundation training or equivalent. It is desirable that during the early training years
the individual has experienced work in as many sectors of dental provision as possible. Training
should also include a period in secondary care in an appropriate cognate specialty. Evidence of
excellence in terms of attributes such as motivation, career commitment will be expected, as will
an ability to demonstrate the competencies required for entry to specialist training either by
successfully completing a period of agreed dental foundation training or by demonstrating that
those competencies have been gained in another way.

Markers of completion of a two year foundation training period may include MJDF (Membership of
Joint Dental Faculties RCS England) or MFDS (RCSEd, RCPS Glasg and RCSI). Successful
completion of one of these quality assured membership diplomas of Royal College Dental
Faculties in England, Scotland and Ireland remains a useful indicator that an individual has
achieved the necessary level of competence for entry into specialist training. However it is
recognised that this will not be essential and that candidates may be able to demonstrate such
competence in different ways.

Entry to the specialist training programme may be at different levels depending upon proof of
competence. Proof of these competencies will be assessed after gaining entry and such training
will be judged by their clinical trainers by observing them treating patients.

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1.4 Structure of Training Programmes

Delivery of the programme

Oral surgery training will be delivered over the equivalent of a three-year full time programme. The
programme should lead to Membership in Oral Surgery of a Royal College (M Oral Surgery), a
CCST, entry onto the specialist list in Oral Surgery, and therefore eligibility to practise as a
specialist. This three-year programme comprises the “core competencies” in Oral Surgery. These
competencies, which will form the basis for the assessment leading to the award of the CCST,
may be supplemented by knowledge and experience in allied subject areas, and may form part of
a continuum of specialist training and post-CCST development (d).

The preferred training pathway is one which integrates experience gained in several
environments. For example, this could include periods of training in a dental teaching hospital with
relevant attachments in Oral Surgery or Oral & Maxillofacial Surgery departments in district
general hospitals, or specialist centres. It is desirable that several specialists in Oral Surgery
contribute to training. A minimum of two trainers - both on relevant specialist lists (for example,
Oral Surgery and Oral and Maxillofacial Surgery) - is required. These trainers must conform to the
requirements for educational and clinical supervisors outlined in the Dental Gold Guide (currently
paragraphs 4.16 and 4.19).

Structure of Specialty Training programmes

Training programmes should include suitable rotational arrangements to cover all the necessary
areas of the curriculum and may include an appropriate balance between teaching hospitals, a
dental school, district general hospitals and specialist units, such that each trainee gains the
breadth of training required for satisfactory completion of the curriculum.

Reduction in the length of the training period may follow accreditation of prior learning, training
and experience. Evidence of competence acquired through previous training and experience in
specialist Oral Surgery will be taken into account by the SAC and/or Deanery in setting the
required length of training.

The training plan must be structured and training should take precedence over service provision.
The training curriculum has been planned in modules linked to various topics. Modules need not
necessarily be studied in the order presented.

Duration of training
The usual training period is three years (WTE) but accredited prior experience gained in Oral
Surgery may be taken into account when determining length of training. Trainees will sit the
Speciality Membership in Oral Surgery (M Oral Surg) of the Royal Surgical Colleges of Great
Britain following successful completion of training.

In order to complete training and be recommended for the award of a CCST, trainees must have:

 satisfactorily completed the equivalent of at least 36 months of training (WTE).

 satisfactorily completed all areas of the curriculum
 passed the Speciality Membership in Oral Surgery
 obtained an Annual Review of Competence Progression (ARCP) Appendix 5 Outcome 6
(Dental Gold Guide).

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Less than full time training is permitted in accordance with the Dental Gold Guide. Current advice
is that less than full time training must be for a minimum of six sessions per week but local
circumstances may vary.

Approval must be obtained in advance from the local Deanery, possibly following advice from the
SAC, for periods of detachment from training programmes and for clinical experience abroad in
other centres for both full-time and part-time trainees.

Research

Trainees, who wish to acquire extensive research competencies, in addition to those specified in
the generic element of the curriculum, may undertake a research project as an ideal way of
obtaining those competencies. They may take time out of programme to complete a specified
project or research degree. Time out of programme will need prospective approval and the
support of the Postgraduate Dean. Funding will need to be identified for the duration of the
research period.

Distribution of Time within Training Programmes

In full-time training posts, the trainee should spend at least 6 sessions per week involved in
patient contact relevant to the oral surgery curriculum with at least three of those sessions
devoted to supervised operating i.e. work-based experiential learning.

A balanced programme will, for all trainees, comprise supervised personal treatment sessions,
diagnostic sessions, review clinics, formal and informal teaching, research and reading time.

Should the trainee additionally undertake a higher university degree during the training period, the
time devoted to that degree will depend upon university regulations and how the sessions are
dispersed over two or three years of the training programme.

Caseload

The workload for an Oral Surgery trainee - either in full or less than full time training - should be
sufficient to ensure that a full range of cases is experienced.

Trainer Training

The quality and ability of the trainers is an important element in successful training. Ideally they
should have completed specialty training in oral surgery themselves, and they must be on the
specialist list for Oral Surgery. Trainers must undertake Continuing Professional Education and
update clinical and teaching practice. This should be checked at their appraisal meetings

Award of the Certificate of Completion of Specialist Training (CCST)

On successful completion of the programme and having passed the M Oral Surg, an application
can be made via the Postgraduate Dean to the General Dental Council for the award of a
Certificate of Completion of Specialist Training (CCST) and entry to the General Dental Council’s
list of Specialists in Oral Surgery.

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STANDARD 2: CONTENT OF LEARNING

Methods of assessment

The purpose of training as laid down by the GDC is to promote patient safety by working to
ensure that specialists have achieved the appropriate learning outcomes. The SAC in Oral
Surgery aims to promote excellence in the practice of Oral Surgery and to be responsible for
maintaining standards through training, assessments, examinations and professional
development.

The close relationship between specialists and trainees in Oral Surgery should facilitate frequent
feedback. This is supplemented by regular appraisal by the educational supervisor and annual
evaluation by the Assessment Panel, under the auspices of the Postgraduate Dean. Continuous
appraisal throughout training will be undertaken by the educational supervisor and other senior
members of staff.

Workplace-based assessment tools will include mini-CEX (clinical examination exercise), case-
based discussions (CBD), DOPS (direct observation of procedural skills), procedure based
assessments (PBA) and miniPAT (mini peer assessment tool). The Intercollegiate Surgical
Curriculum Programme (ISCP) has piloted these methods and has demonstrated their validity and
reliability.

The purposes of the assessments:

 indicate suitability of choice at an early stage of the chosen career path

 indicate the capability and potential of a trainee through tests of applied knowledge and
skill relevant to the specialty
 demonstrate readiness to progress to the next stage(s) of training having met the
required standard of the previous stage
 provide feedback to the trainee about progress and learning needs
 support trainees to progress at their own pace by measuring a trainee's capacity to
achieve competencies for their chosen career path
 help to identify trainees who should change direction or leave the
specialty
 drive learning demonstrated through the acquisition of knowledge and
skill
 enable the trainee to collect all necessary evidence for the Annual Review of Competence
Progress
 provide evidence for the award of the CCST
 assure the public that the trainee is ready for unsupervised professional practice.

Trainees will be assessed in a number of different ways during their training. Satisfactory
completion of all assessments and examinations will be monitored as part of the ARCP process
and will be one of the criteria upon which eligibility to progress will be judged.

Assessment of trainees will take two forms:

Examination
Successful completion of the Membership in Oral Surgery (M Oral Surg) examination.

Workplace-based assessments (WBA)(f)

The principal form of continuous assessment of progress and competence will be workplace-
based assessments throughout the entire duration of training.

The principle of workplace-based assessment is that trainees are assessed on work that they are
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 doing on a day-to-day basis and that the assessment is integrated into their daily work.

The assessment process is initiated by the trainee, who should identify opportunities for
assessment throughout their training. The trainee should therefore choose the assessment tool,
the procedure and the assessor. Assessments should be undertaken by a range of assessors and
should cover a broad range of activities and procedures appropriate to the stage of training.

The assessment methods appropriate for use in Oral Surgery are:

 Directly observed practical skills (DOPS). Five satisfactory outcomes will normally be
required per year in eight broad domains: Removal of teeth; Pain and anxiety management;
Soft tissue surgery; Peri-radicular surgery; Implant surgery; Management of cysts;
Orthodontic surgery; Antral surgery. Some procedures could be double counted, for
example using local anaesthesia and sedation for the surgical removal of a tooth could
count as two DOPS.

 Procedural based assessments (PBAs) – Twelve PBAs covering the spectrum of oral
surgery must be completed satisfactorily to level three (see page 10) prior to obtaining a
CCST: Mucocele removal; Sialolithectomy; Surgical removal of lower third molar;
Removal of root from antrum; Implant placement; Autogenous bone graft; Incisional biopsy;
Excisional biopsy; Removal of mandibular cyst; Removal of maxillary cyst; Closure of OAF;
Exposure of tooth.

 Case-based discussion (CbD) (6 satisfactory outcomes will normally be required per

year).

 Mini CEX (6 satisfactory outcomes will normally be required per year). A mandatory
area where a mini-CEX must have occurred in is in taking informed consent for children and
adults, and managing the situation when individuals lack the capability to consent for
themselves.

 MiniPAT (minimum of 2 during training). This will involve formal 3600 feedbacks for an
annual assessment during the ARCP.

 Critical Incident Review (to be used as and when appropriate and recorded in the trainees
log book).

It is also expected that trainees will participate in individual or group tutorials which may also
involve a degree of assessment. These may inform trainers when feeding back to Programme
Directors.

The assessment methods are blueprinted to the curriculum in the tables that follow. It is not
intended that each component of the curriculum is assessed by each method. The assessment
methods indicated have been selected on the basis of their suitability for measuring specific
dimensions of practice. These should be applied as appropriate to the stage of training and
circumstances of the training environment.

Trainees are also expected to keep a portfolio during their training. This should contain as a
minimum:

 Personal details
 Copy of current curriculum
 Details of current clinical activity
o Timetable
o Brief description of activities
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 o On-call duties/Exposure to emergency work
o Study leave
o Teaching activities
 Supporting documentation
o Good clinical practice
 Summary of logbook
 Personal development plan
 Audits in progress/completed
 Case studies – to include those meeting the blueprint in the following tables.
For example including implant cases; medically compromised patients
managed etc.
 Critical incidents
 Completed work based assessments (miniCEX, CBD, DOPS, PBA)
o Maintaining good clinical practice
 Record of courses attended
 CPD logbook
 Clinical governance activities
o Working relationships
 MiniPAT
 Evidence of good relationships with patients e.g. thank-you cards etc
o Record of teaching activities
 Peer review of teaching
 Feedback from students or other trainees
 Commendations
o Record of research activities (if appropriate)
 This could be the review documentation for an academic post

Evidence of competence

There is limited data on the ideal minimum workload figures that will result in a satisfactory level of
competence. It is recognised that this will differ according to the ability and aptitude of individual
trainees and their learning environment. We believe that a diverse range of material seen under
the appropriate supervision and guidance of an educational supervisor is a superior method of
working. Detailed procedures observed by the educational supervisor and judged to be
satisfactory will be recorded in the trainee’s training and learning record. A correctly maintained
and up to date logbook and evidence of satisfactory workplace-based assessments will provide
the framework for graded responsibility and will be used as evidence of satisfactory progress.

The award of CCST will be based on satisfactory completion of the entire series of annual
assessments for Oral Surgery. The major summative assessment will occur by way of the M Oral
Surg examination.

Specialist Membership in Oral Surgery

The Oral Surgery exam would normally be taken near the completion of training and once the
trainee is considered ready by the STC and local Deanery following the relevant ARCP review.

The Membership in Oral Surgery examination will be exploring the candidate’s ability to manage
clinical cases and make appropriate decisions:

i. A written paper
ii. Unseen cases
iii. Communication section
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Curriculum Milestones
These milestones will be used to record how the trainee moves from the “knows/knows how” to
“shows” and “shows how” as training develops. Upon completion of the programme, the trainee
should have the necessary knowledge, skills and attitude shown below in the Content of Learning

Attitudes will be measured by the behaviour demonstrated relevant to that attitude.

Level 1
No or very limited knowledge and experience in subject area
Close supervision/advice required when working in subject area
Attitude/values not well developed.
Level 2
Satisfactory knowledge in subject area, moderate practical experience and skill developing
May occasionally require direct supervision when working in subject area
Attitude/values developing
Level 3 (Ready for completion of training)
Ability to work in area without direct supervision
Knowledge in subject area as expected of a Specialist in Oral Surgery
Performance of tasks and approach to tasks as expected of a Specialist in Oral Surgery.
Attitudes as expected of a Specialist in Oral Surgery.

NB. Generally these levels will correspond with progress through the training period. However,
this will not always be the case as some SpRs will enter the programme with extensive
experience in some areas.

STANDARD 3: MODEL OF LEARNING

Overview of competencies in Oral Surgery

1. Specialty training.
The list of competencies to be achieved in the three years of training is as follows:

Core clinical competencies

1.1 Extraction of teeth & retained roots/pathology and management of associated

complications including oro-antral fistula
1.2 Management of odontogenic and all other oral infections
1.3 Management of impacted teeth; management of complications
1.4 Peri-radicular surgery
1.5 Dentoalveolar surgery in relation to orthodontic treatment
1.6 Intraoral and labial biopsy techniques
1.7 Treatment of intra-oral benign and cystic lesions of hard and soft tissues
1.8 Management of benign salivary gland disease by intra-oral techniques and
familiarity with the diagnosis and treatment of other salivary gland diseases
1.9 Insertion of osseointegrated dental implants including bone augmentation and soft
tissue management
1.10 Appropriate pain and anxiety control including the administration of standard
conscious sedation techniques

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 1.11 Management of adults and children as in-patients, including the medically at-risk
patient
1.12 Management of dento-alveolar trauma and familiarity with the management and
treatment of fractures of the jaws and facial skeleton
1.13 Management of oro-facial pain including temporomandibular joint disorders
1.14 Clinical diagnosis of oral cancer and potentially malignant diseases, familiarity with
their management and appropriate referral
1.15 The diagnosis of dentofacial deformity and familiarity with its management and
treatment
1.16 Diagnosis of oral mucosal diseases and familiarity with their management and
appropriate referral

To successfully achieve the above competencies, trainees must obtain experience of

inpatient management including exposure to emergency work, and be exposed to
appropriate well-focussed general medical and surgical training to develop competence in
ward care.

Basic competencies in the management of health care delivery

2.1 An overview of health services management, administration and use of resources.

2.2 An understanding of evidence-based practice, clinical guidelines and monitoring of
outcomes.
2.3 Awareness of medico-legal responsibilities, jurisprudence and ethics.

STANDARD 4: LEARNING EXPERIENCES

The following teaching/learning methods may be used to identify how individual objectives will be
achieved.

a) Direct clinical care: approximately 60% of training time should be devoted to direct clinical
care. This should largely comprise of direct consultation, review and/or treatment of
patients. In addition a further 20% of training time should be devoted to “other training
activities” which may include indirect patient contact (such as attendance at medical
clinics/ward rounds), attending management related activities etc. The remaining 20%
should be ring-fenced for study, audit and research activity.
b) Independent self-directed learning: This should be encouraged by providing reference
text books.
c) Departmental teaching sessions: These occur on a regular basis in most departments
and may include case reviews, journal clubs and other forms of didactic/seminar based
teaching.
d) Regional training courses: These are valuable learning opportunities. Trainees should be
released from service duties to attend.
e) National training courses: These are particularly helpful in providing specific teaching;
they also allow trainees to identify their position in relation to the curriculum and their peers.
f) Scientific meetings: Research and the understanding of research are essential to the
practice of Oral Surgery. Trainees should be encouraged to attend and present their work at
relevant meetings.
g) Multidisciplinary clinics (MDCs): Attendance at and contribution to MDCs offers the
opportunity for trainees to develop an understanding of multidisciplinary clinical
management in conjunction with related specialties. The MDC is also an important arena for
the development of interprofessional communication skills.

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h) Audit: trainees should play an active role in departmental audit activity.

The curriculum will be delivered through a variety of learning experiences. Trainees will learn,
from practice, clinical skills that are appropriate to their level of training and to their attachment
within the department. Opportunities for concentrated practice in skills and procedures will be
given throughout training via specialist clinical settings.

Learning from peers will occur at clinical meetings, and in larger departments more senior
trainees may be involved in mentoring less experienced trainees. Formal situations (such as
journal club, above) should be part of every departmental timetable and provide specific learning
experiences. External courses (as above) will be available to trainees. Each rotation/attachment
will allow time during the week for personal study, and the trainee will meet their educational
supervisor regularly for specific input.

Most of the curriculum is suited to delivery by work-based experiential learning and on-the-job
supervision. Where it is clear from trainees’ experience that parts of the curriculum are not being
delivered within their work, appropriate education or rotations to other work places will be
arranged. The key will be regular work-based assessment by educational supervisors who will be
able to assess, with their trainee, their on-going progress and whether parts of the curriculum are
not being delivered within their present work-place.

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STANDARD 5: SUPERVISION AND FEEDBACK

Close supervision of the training programme is essential, not least to ensure safety of the patient
and indeed the trainee. Training programme arrangements should ensure:

 That a Training Programme Director is appointed, who is responsible for the organisation
and day to day management of the training programme. The Training Programme
Director could be a consultant or specialist involved in the training scheme who has
undergone a period of training in a secondary care setting in Oral Surgery, Oral &
Maxillofacial Surgery or Surgical Dentistry.

 The Dental Gold Guide states: “The Postgraduate Dental Dean has responsibility for a
range of managerial and operational issues with respect to postgraduate dental training.
Amongst these is the management of the annual review process, including the provisions
for further review and appeals. The process is carried out by a panel under the aegis of
the deanery Specialty Training Committee (STC). Good practice is for the panel to take
advice from the local College or Faculty Specialty Adviser where appropriate.”

 Supervisors are appointed for the research (if applicable), who have academic training or
proven academic ability.

 A trainer (assigned educational supervisor) is appointed for each trainee, who is responsible
for monitoring the trainee’s progress and ensuring that any difficulties are identified and
resolved as rapidly as possible. They will meet regularly with the trainee; discuss issues
of clinical governance, risk management and the report of any untoward clinical incidents
involving the trainee. They should be a person who works frequently with the trainee and is
closely involved in their training. For rotations involving a district general hospital, the most
suitable person will often be the specialist at the district general hospital most involved in the
particular training programme.

 Formal appraisal meetings between trainers and individual trainees, should be arranged
by mutual consent, and to an agreed agenda to monitor and advise on a trainee’s
progress, training needs, and weekly timetable. The Gold Guide states that ‘As a
minimum, the educational element of appraisal should take place at the beginning, middle,
and end of each section of training’ and ‘The detailed content of the discussion which
takes place within appraisal sessions should normally be confidential and a summary of
the appraisal discussion should be agreed and recorded and any agreed actions
documented.’ These appraisal meetings are distinct, and serve a different function from
the annual ARCP assessments carried out on behalf of the Deanery Specialty Training
Committee.

 Trainees should be exposed to the views of more than one trainer in Oral Surgery and
normally direct supervision should be provided by a Specialist in Oral Surgery. Many
different approaches presented in an unstructured manner may serve only to confuse
trainees; a rigid structured approach technique is equally unsatisfactory. A balance should
be struck in which different approaches are presented so that the trainee has solid core
knowledge against which to make judgements and choices so that a perspective of the
range and effectiveness of contemporary Oral Surgery is gained. Clearly the trainee will also
have to take responsibility for keeping up to date through Continuing Professional Education
(CPE,CME,CPD)

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STANDARD 6: MANAGING CURRICULUM IMPLEMENTATION
The curriculum will be issued to all trainees on appointment. Training Programme Directors and
Assigned Educational Supervisors will ensure that trainers are familiar with the curriculum and
use it as a blueprint for training. Trainers will ensure that trainees have a good appreciation of the
curriculum and this will be explored as part of the ARCP process. The Training Programme
Director will oversee the availability of special interest experience within posts in rotations and will
plan individual placements to ensure that all relevant knowledge and skills can be attained.

The curriculum covers the full range of knowledge and skills required for achievement of a CCST
in Oral Surgery. Regular educational appraisal will identify individual training needs. The ARCP
process will assist in the identification of any deficiency in experience. Assessment will identify
any deficiency in competence relative to the stage of training. The Training Programme Director,
with assistance from the Educational Supervisor, will arrange for deficiencies to be rectified in
other parts of the rotation. The ARCP process will act as an additional process for the
identification and correction of deficiencies. It is expected that trainees will take personal
responsibility for ensuring that deficiencies are identified and reported.

The curriculum outlines the minimum training requirements for delivery in a training programme. It
guides trainers in the teaching methods required to deliver the curriculum and guides trainees in
the learning and assessment methods required for satisfactory completion of training. It is the
responsibility of the Programme Director and Deanery, with the assistance of the Specialty
Training Committee (STC), to ensure that the programme delivers the depth and breadth of Oral
Surgery and subspecialty training outlined in the curriculum. The Programme Director must
ensure that each post or attachment within the programme is approved by the relevant deanery.

Quality management is the responsibility of the local Deaneries. The GDC will quality-assure
specialty training programmes. The SAC will ensure consistency within the specialty and will work
with the JCSTD to develop mechanisms of equity in quality of training.

It is the responsibility of the assigned educational supervisor of a particular post or attachment

within a programme to ensure that the training delivered in their post meets the requirements of
the relevant section(s) of the curriculum. They must undertake regular appraisal with their trainee
to ensure structured and goal-oriented delivery of training.

Trainees must register and enrol with the SAC on appointment to an Oral Surgery training
programme. They must familiarise themselves with the curriculum and with the minimum training
requirements to satisfactorily complete each stage of training and the award of the CCST. They
must also be familiar with the requirements of the relevant Speciality Membership examinations of
the RCS England, RCS Edinburgh, and RCPS Glasgow and must make appropriate use of
clinical logbooks and personal portfolios.

The award of the CCST will be based on satisfactory completion of all areas of the curriculum,
ARCP process and summative assessment occurring by way of the Membership in oral surgery
examination. The Postgraduate Dean/Director will forward to the GDC a recommendation for
award of the CCST. If the GDC accepts the recommendation, it will issue the CCST and place the
trainee’s name on the Specialist List in Oral Surgery once the appropriate application form and
payment has been received from the applicant.

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STANDARD 7: CURRICULUM REVIEW AND UPDATING

The curriculum will be evaluated and monitored by the SAC as part of continuous feedback from
STCs, Programme Directors, trainers and trainees and appropriate lay representation.

Curriculum review will be informed by a number of different processes related to the roles of those
with a vested interest e.g. STCs, TPDs, Postgraduate Dental Deans, Deaneries, trainers and
trainees. This will be coordinated by the SAC. The SAC will also be able to use information
gathered from specialty heads and the National Health Service. Interaction with the NHS will be
particularly important to understand the performance of specialists within the NHS and feedback
will be required as to the continuing need for that specialty as defined by the curriculum.

STANDARD 8: EQUALITY AND DIVERSITY

The Faculties of Dental Surgery of the Royal College of Surgeons of Edinburgh, The Royal
College of Surgeons of England and the Royal College of Physicians and Surgeons of Glasgow
conform to the view that equality of opportunity is fundamental to the selection, training and
assessment of trainees in dental specialties. The Faculties seek to promote a selection process
that does not unfairly discriminate against trainees on the basis of race, religion, ethnic origin,
disability, age, gender or sexual orientation. Patients, trainees and trainers and all others amongst
whom interactions occur in the practice of dental specialties have a right to be treated with
fairness and transparency in all circumstances and at all times.

Equality characterises a society in which everyone has the opportunity to fulfil his or her potential.
Diversity addresses the recognition and valuation of the differences between and amongst
individuals. The concepts of equality and diversity underpin the content and intended delivery of
the curriculum of Oral Surgery, and aim to eliminate discrimination, harassment or victimisation of
any of these groups of people on the basis of: ability, age, bodily appearance and decoration,
class, creed, caste, culture, gender, health status, relationship status, mental health, offending
background, place of origin, political beliefs, race, and responsibility for dependants, religion and
sexual orientation.

The importance of Equality and Diversity in the NHS has been addressed by the Department of
Health in England in ‘The Vital Connection’, in Scotland in ‘Our National Health: A Plan for Action,
‘A Plan for Change’ and in Wales by the establishment of the NHS Wales Equality Unit (g,h,i).
These themes must therefore be considered an integral part of the NHS commitment to patients
and employees alike. The theme was developed in the particular instance of the medical
workforce in ‘Sharing the Challenge, Sharing the Benefits – Equality and Diversity in the Medical
Workforce.’ Furthermore, Equality and Diversity are enshrined in legislation enacted in both the
United Kingdom and the European Union.

Prominent among the relevant items of legislation are:

 Equal Pay Act 1970

 Sex Discriminations Acts 1975 and 1986
 Indirect Discrimination and Burden of Proof Regulations 2001
 Race Relations Act 1976 and Race Relations (Amendment) Act 2000
 Disability Discrimination Act 1995
 Employment Rights Act 1996
 Human Rights Act 1998
 Employment Relations Act 1999
 Maternity and Paternity Leave Regulations 1999
 Part-time Workers Regulations 2000
 Employment Act 2002
 European Union Employment Directive and European Union Race and Ethnic Origin
17
 Directive
 Age Discrimination Act 2006

It is therefore essential that all persons involved in the management of training are trained and
well versed in the tenets of Equality and Diversity and it is expected that all trainers should be
trained in Equality and Diversity.

In addition to the clinical detail of the curriculum, it is expected that trainees will receive
appropriate training in Equality and Diversity as part of their professional development and to
apply those principles to every aspect of all their relationships with patients, carers, colleagues
and trainers (j). The delivery of this training is the responsibility of the Postgraduate Dean. A
record of completion of this training must be held in the trainee’s portfolio. The benefits of this
training are:

 To educate the trainee in the issues in relation to patients, carers and colleagues and
others with whom they may meet in a professional context
 To inform the trainee of his or her reasonable expectations from the training programme
 To advise what redress may be available if the principles of the legislation are breached.

GLOSSARY
ACAT evidence – Acute Care Assessment Tool
ACF – Academic Clinical Fellow
ARCP – Annual Review of Competence Progression
CAT – Critically Appraised Topic
CbD – Case-Based Discussion
CCST – Certificate of Completion of Specialist Training
CCT – Certificate of Completion of Training
CL – Clinical Lecturer
COPDEND – Committee of Postgraduate Dental Deans & Directors
CME- Continuing Medical Education
CPD- Continuing Professional Development
CPE- Continuing Professional Education
DOPS – Directly Observed Procedural Skills
GDC – General Dental Council
HcAT – Healthcare Assessment and Training
IFS – Individual, Family/Friends, Society Model
JCSTD – Joint Committee for Specialist Training in Dentistry
Mini CEX – Mini Clinical Examination Exercise
Mini PAT – Mini Peer Assessment Tool
MOS – Membership in Oral
Surgery examination
MSF – Multi-Source Feedback
NHS – National Health Service
NTN – National Training Number
PBA - Problem Based Assessments (PBA)
PDP – Personal Development Plan
SAC – Specialist Advisory Committee
SDEB- Specialist Dental Education Board (of the GDC)
SpR- Specialist Registrar
StR- Specialty Registrar
STC-Specialty Training Committee
TPD- Training Programme Director
VTN – Visitor Training Number
WBA – Work Based Assessment
WTE – Whole Time Equivalent

18
REFERENCES

a. Oral Surgery Training – A Modern Flexible Programme, March 2008

http://www.rcseng.ac.uk/fds/Documents/oral-
surgery/Guidelines%20For%20Oral%20Surgery%20Training%20Programmes%2007-
2008.pdf

b. Darzi - A High Quality Workforce – NHS Next Stage Review, 2008

c. Annex C in GDC Specialist Lists Review Group Final Report 7th December 2005
http://www.gdc-uk.org/NR/rdonlyres/22EB70C4-C1EA-4002-835B-
A4520DD44FF1/28433/Item14BSpecialistListsReviewfinalreport.doc

d. Career Development Framework for Consultant Appointments in Oral Surgery, January

2010.
http://www.rcseng.ac.uk/fds/docs/oralsurg/Career%20Development%20Framework%20for
%20Consultant%20Appointments%20in%20Oral%20Surgery.pdf

e. The Final Report of the Tooke Inquiry into Modernising Medical Careers, Professor Sir
John Tooke
f. 2008 “Workplace-based Assessment in Clinical Training” John Norcini, Association for the
Study of Medical Education, ISBN 978 0 904473 41 42007
g. “The Vital Connection: An Equalities Framework for the NHS. Department of Health, April
2000

h. “Our National Health: A Plan for Action, A Plan for Change”. Scottish Executive, December
2000

i. “Sharing the Challenge, Sharing the Benefits – Equality and Diversity in the Medical
Workforce”. Department of Health Workforce Directorate, June 2004

j. “Defining and maintaining professional values in medicine” Sir Graham Catto, March 2005,
http://www.rcplondon.ac.uk/wp/medprof/medprof_prog_050318.asp

19
APPENDIX

2.1 General professional content

A GOOD CLINICAL CARE & MAINTAINING GOOD CLINICAL PRACTICE

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning method(s) Assessment
method(s)
…..should be able to: …..should be able to: …..should:
Overall clinical Make a correct Make decisions in the best Attend courses. DOPs, Mini
judgement. interpretation of interest of the patient. Self directed learning e.g. Journal club review; CEX, Mini
An ability to make pathological features in the supervised outpatient clinics; ward-based PAT and
decisions in the best context of available clinical learning, including ward-rounds and
MSF
interest of the patient information. consultations; planned teaching e.g. specialist
using all available registrar training days; clinical and scientific
MOS
clinical/non clinical meetings –departmental, regional, national and
information. international.
The above are relevant to all sections that follow,
choosing the most appropriate and available.
Professional approach. Describe the role of Provide specialist Behave and present oneself in a MiniPAT
Ability to be professional, professionalism in leadership in the provision professional manner at all times. MOS
punctual, and reliable dental care. of oral surgical services.
when dealing with a Organise tasks effectively.
patient. Able to use initiative.
Written records. Describe the principles Produce accurate reports Appreciate the importance of CbD
Ability to respect of diagnostic coding with clear conclusions and timely dictation, cost-effective MiniCEX
confidential nature of the and report archiving. other written use of medical secretaries and MiniPAT
information gathered in a Describe the problems correspondence. the growing use of electronic MOS
clinical setting, to present faced by people for communication.
it legibly and clearly. whom English is not a Recognise the need for prompt
first language. and accurate communication
Explain the relevance of with clinicians.
data protection Show courtesy towards medical
pertaining to patient secretaries and clerical staff.
confidentiality.

18
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning Assessment method(s)
method(s)
…..should be able to: …..should be able to: …..should:
Decision making. Describe clinical priorities Provide specialist leadership Be flexible and willing to MiniCEX
Ability to collate various for investigation and in oral surgical services when change in the light of CBD
strands of information from management. dealing with clinical changing conditions. MiniPAT
different sources (history, problems. Be willing to ask for help. MOS
examination, investigation)
to make decisions in the best
interest of the patient.
Life-long learning. Describe the role of Recognise and use learning Be self-motivated and eager ARCP assessment
Be able to develop an attitude continuing professional opportunities. to learn. Portfolio and PDP review
that constantly seeks to development. Ensure compliance with the Show willingness to learn
update knowledge and skills , GDC requirements for CPD from colleagues and to
to be mindful of ones own and revalidation (when accept feedback.
practice by appropriate implemented).
audit,and be open to new
ways of managing conditions
presenting in oral surgical
practice , based on best
evidence.
Good use of information Describe the principles of Demonstrate competent use Adopt proactive and CbBD
technology. clinical data retrieval and of database, word processing enquiring attitude to new
Ability to utilise electronic utilisation. and statistics programmes. technology.
methods for communicating Undertake searches and Be prepared to use video-
and record keeping. access websites and health- conferencing and
Have cognisance for related databases. telepathology/ telemedicine
safeguards and limitations Apply the principles of systems when appropriate.
when utilising these in the confidentiality in the context
provision of a specialist oral of information technology.
surgical service. Use digital imaging devices
effectively.
Use videoconferencing and
telepathology equipment
when necessary

19
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s)
…..should be able to: …..should be able to: …..should: method(s)
Risk Management. Describe relevant health and safety policies. Apply relevant H&S Be truthful. MiniPAT
Ability to assess and minimise policies in practice. MOS
/remove potential risk to patient,
staff and self.
Evidence. Describe the principles of evidence-based Critically appraise Use evidence appropriately in the CdD
medicine. evidence. Competently support of patient care and own /ISFE
Ability to critically appraise List the drawbacks of commonly used use databases, libraries decisions therein.
evidence for clinical and non guidelines. and the internet.
clinical practice Define the steps of diagnostic reasoning:
Interpret history and clinical signs.
Conceptualise clinical problem.
Generate hypothesis within context of
clinical likelihood.
Test, refine and verify hypothesis.
Develop list and action plan.
Define the concepts of disease natural history
and assessment of risk.
Recall methods and associated problems of
quantifying risk e.g. cohort studies.
Outline the concepts and drawback of
quantitative assessment of risk of benefit e.g.
numbers needed to treat.
Describe commonly used statistical
methodology.

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment method(s)
Learning
…..should be able …..should be able to: …..should: method(s)
to:
Guidelines. Describe advantages Demonstrate the ability to utilise Show regard for individual SIGN, NICE, A blend of assessments referred to in
and disadvantages of guidelines. patient needs when using Internet courses the introduction can be employed
Be aware of national (eg
relevant guidelines. guidelines. Attend courses. according to learning style and local
NICE/SIGN) and local Contribute to the evolution of guidelines. Show willingness to use availability and expertise together with
Independent
guidelines for clinical guidelines. study. thesis e.g. portfolio and the
practice.
MOS. CBD
MiniCEX

20
Patient safety. Outline the hazards Ensure patient safety in Practice. Show regard for patient Attend courses. CBD
Ability to safely manage the of medical / dental Recognise when a patient is not safety. Self directed DOPS
patient in a variety of equipment in responding to treatment, reassess the learning. MiniPAT
settings e.g. under iv common use. situation, and encourage others to do so. Willingness to participate in MOS
sedation, general safety improvement
anaesthesia, waiting room Know how to report Recognise and respond to the strategies.
etc. side effects of drugs manifestations of a patient’s deterioration
prescribed. (symptoms, signs, observations, and Continue to maintain a high
laboratory results) and support other level of safety awareness
members of the team to act similarly. and consciousness at all
times.
Sensitively counsel a colleague following
a significant event, or near incident, to Encourage feedback from
encourage improvement in practice of all members of the team on
individual and unit. safety issues.

Recognise and be able to report side Show willingness to take

effects of drugs prescribed. action when concerns are
raised about performance of
Be able to describe the side effects and members of the healthcare
contraindications of therapeutic team.
intervention.
Recognise own limitations
Ensure the correct and safe use of and operate within them
medical / dental equipment, ensuring competently.
faulty equipment is reported
appropriately. Continue to strive for
improved practice and
patient safety.

21
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s) method(s)
…..should be able to: …..should be able to: …..should:
Structure of the NHS and the Describe the structure of the NHS, Primary Show respect for others,
principles of management (in context Care and Hospital. Demonstrate good time ensuring equal opportunities. ISFE
of the role of the trainee). management and
Describe the role of postgraduate deaneries, prioritisation skills. Recognise the importance of
Ability to describe the NHS and the specialist societies, the Faculties of Dental good time management and the
way it functions. Surgery of the Royal Colleges and the General Develop management skills ability to prioritise tasks.
Dental Council. appropriate to the tasks
To ensure patients are treated
efficiently with awareness of national Describe the central government health required. Take opportunities to become
initiatives such as time frame from agencies (e.g. NICE, HCC, NHS Quality involved in management
referral to appointment. Improvement Scotland, NPSA). Develop a business plan activities.
where appropriate
Describe the importance of a health service for Show willingness to improve
the population. management skills.
Explain principles of appointments procedure.
Listen to patients concerns and
complaints in an empathic and
considered manner.

Describe how a team works effectively. Seek advice if unsure. Show respect for others’ Workplace experience MiniPAT
Clinical teams.
opinions including non-medical with appropriate DOPS
Describe the roles and responsibilities of team Recognise when input from professionals and recognise trainers. PBA
Ability to work in a team, effectively, members, especially within the department another specialty is required good advice. Attendance at MiniCEX
respecting all members in order to and within relevant multidisciplinary teams. for individual patients. didactic teaching MOS
provide the best treatment. Recognise own limitations. sessions within
Work effectively with other department.
Apply initiatives whose absence may health care professionals. Attendance at suitable
impact upon effective team working, courses.
such as dignity at work etc. Attendance at suitable
meetings.
Observe dynamic of
clinic and example set
by trainer.

22
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning Assessment method(s)
method(s)
…..should be able to: …..should be able to: …..should:
Describe the roles of relevant Recognise the importance of Recognise and respect the As above As above
Clinical teams (cont.)
clinical specialties and their prompt and accurate request for a second opinion.
limitations. information sharing with Recognise the importance of
primary care team following induction for new members
hospital attendance. of a team.
Delegate, show leadership Respect skills and
and supervise safely. contribution of colleagues.
Practice with attention to the Recognise own limitations.
important steps of providing
good continuity of care.
Keep accurate attributable
notes.
Demonstrate leadership and
management in the following
areas:
Education and
training
Performance of
colleagues
High quality care
Effective handover
of care
interdisciplinary
team meetings.
Provide appropriate
supervision to less
experienced colleagues.
Describe the role of effective Communicate effectively. Be prompt and respond Discussion with trainers and CBD
Communication with communication in relation to courteously and fairly. staff. MOS
colleagues other members of the clinical
team and other departments
and clinical teams.

23
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Teaching and Assessment
Behaviours Learning method(s) method(s)
…..should be able to: …..should be able to:
…..should:
Complaints Describe local Anticipate potential Act with honesty, Discussion with MOS
Ability to be receptive to complaints, to handle them with sensitivity, complaints procedures. problems. sensitivity and promptly. whole dental team. CBD
outlining how the patient can make an official complaint. Be aware of
strategies to minimise complaints Describe systems of Manage dissatisfied Be prepared to accept Attend courses.
independent review. colleagues and patients. responsibility.
Independent study

B HEALTH

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s) method(s)
…..should be able to: …..should be …..should:
able to:
Describe the role of Act accordingly. Recognise personal health Attend courses. MiniPAT
Personal health
occupational health services. as an important issue. ARCP
Ability to recognise when ones health may adversely affect the Independent study.
treatment of a patient. To take steps to ensure patient safety at all Describe professional
times responsibilities to the public.

24
 C PROBITY

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s)
…..should be able to: …..should be able to: …..should: method(s)
Describe the legal Appropriately involved in Recognise absolute importance of accuracy NHS Performance
Service information the development of training. and impartiality. management. review
framework for
advertisements. ARCP
Describe the legal Produce a report that is Honesty and integrity. NHS Performance
Writing reports and giving evidence Timeliness. management; review
framework in relation to accurate, honest, and within
evidence and report writing. limits of professional relevant courses. ARCP
experience.
Describe the Research Obtain ethical and Put safety and care of patients first. Research Performance
Research Governance Framework and institutional approval. supervisor. review
Ability to undertake research such as a ‘Good Clinical Practice’. Conduct research with honesty and integrity. ARCP
clinical trial mindful of the legislation that Attend courses
needs to be followed in order to protect Recognise the value of critical appraisal of
patients e.g. Ethics, Caldicott Guardians, ICH evidence and importance of de novo research
GCP. in progressing and developing an evidence
base for current clinical practice.

Describe financial rules of Apply institution’s financial Not induce patients to accept private dental Relevant courses Performance
Financial dealings employing institution. rules. care if this is not in their best interest. review
ARCP
Manage funds appropriately. Be trustworthy.

Declare conflicts of interest.

25
 D CLINICAL GOVERNANCE, QUALITY ASSURANCE AND AUDIT

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning Assessment
method(s) method(s)
…..should be able to: …..should be able to: …..should:
Describe the application of - Design and direct audit Recognise the importance of Relevant courses and guidance of Audit project.
Audit and Quality Assurance projects trainer.
audit principles to Oral audit in maintaining and
Ability to audit one’s own practice to Surgery practice. - Organise and undertake a improving quality of treatment
ensure satisfactory outcomes Describe current audit clinical audit project including interventions and service
following treatment of patients with a activity within the specialty. implementation of outcomes provision.
wide range of oral surgical Describe the audit cycle data and re-audit.
conditions. service and data
confidentiality.
Describe the legal issues Perform appropriate history Recognise importance of Speak with trainers. Mock
Expert Witness Reports assessments.
relating to patient and examination in medico- accuracy in medico- legal
Ability to understand the legal examination on behalf of the legal setting. system.
framework in which an expert court. Prepare appropriate written
opinion is required. report.
Clinical Governance Describe: - Utilise appropriate Recognise: Workplace (administrative) ARCP
- evidence-based clinical communication / presentation - Importance of maintaining experience with appropriate feedback.
- Be able to describe the principles practice including cost skills. professional and personal trainers including attendance at
of clinical effectiveness and clinical effectiveness. - Demonstrate skills of self- standards. suitable governance sessions.
audit both locally and nationally and - the development and reflection and self-appraisal. - The need to constantly appraise - Appropriate range of
contribute where possible. application of clinical - Utilise critical appraisal skills and evaluate clinical practice and opportunities for observational and
- Demonstrate awareness of guidelines and standards. and be able to apply to research procedures. personal involvement in
systematic reviews of research - relevant risk assessment. evidence. governance within the
evidence. - multi-disciplinary clinical - Produce and update patient organisation.
- Contribute to peer review and the care pathways and information material. - Attend trainee didactic teaching
appraisal process. appropriate integration of sessions within department.
oral surgery. Independent study.
- the differences between
clinical audit and research
and how to apply ethics to
clinical audit.

26
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning Assessment method(s)
method(s)
…..should be able to: …..should be able to: …..should:
Describe: - Construct, analyse and use Make the care of your patient As above
Clinical governance (cont.)
- the process of revalidation patient surveys. your first concern.
- Carry out critical/adverse (when implemented) and the - Use procedures to ensure Respect patients’ privacy,
incident reports and assessment of individual consumer involvement and dignity and confidentiality.
demonstrate an awareness of clinical performance consultation. Be prepared to learn from
the ways in which this - the role of GDC/GMC, Practice evidence-based mistakes, errors and
process can be used to Royal Colleges, Specialist medicine. complaints.
improve clinical care. Societies and Universities in Aim for clinical effectiveness Recognise the importance of
the process of professional (best-practice) at all times. teamwork.
- Consider disciplinary self-regulation. Report critical incidents. Share best practice with
procedures in place for all - the levels of responsibility Take appropriate actions if others.
professional staff. and accountability within the you suspect you or a
- Show in-depth awareness of NHS (or other environment colleague may not be fit-to-
clinician’s medico-legal in which the trainee may we practice.
responsibilities particularly working).
those related to Oral Surgery. - procedures for reporting
concerns over the level of
- Be able to describe quality competency and fitness to
assurance in the delivery of practice of professional
clinical care. colleagues.
- Show knowledge of human
resource strategies to
promote staff welfare.
- Show knowledge of
equality of access issues for
minority groups requiring
clinical care.
- Show an understanding of
medical records
administration.
Appraisal and assessment Describe the concepts and Maintain an appraisal Demonstrate a positive Discussion with trainers ARCP
practice of appraisal and portfolio. attitude to appraisal.
assessment. Undertake an effective Be aware of equality and
appraisal or assessment. diversity issues as they relate
to appraisal.

27
 E RESEARCH

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment method(s)
Learning
…..should be able to: …..should be able to: …..should: method(s)
Describe the principles of Undertake a systematic critical Demonstrate curiosity and a Undertake research Submit postgraduate degree
To be able to plan and analyse a performing a research study. review of scientific literature. critical spirit of enquiry. project. or: show signs of scholarship
research project. Describe how to use Demonstrate effective written Ensure patient confidentiality. such as publishing papers or
Understand research methodology, appropriate statistical methods. and verbal presentation skills. Demonstrate knowledge of the acquiring grants.
including development and Describe the principles of Initiate, complete and importance of ethical approval Present papers at meetings.
production of protocols, preparation research ethics and the publish/present at least 1 and patient consent for clinical ISFE
of manuscripts and be aware of how structure and function of local research project or 2 case reports research. ARCP
to write a research grant application. research ethics committees. by the end of training. Enthusiastic to be involved with
Produce sufficient published or Describe relevant data Understand how to write a research.
publishable material to satisfy the collection and data research grant application.
requirements of the ARCP. analysis techniques and
methods of statistical analysis.
Describe the principles of
research funding.
Describe the design and Design a project and write a Understanding and willingness Undertake project;
Research Methodology to seek appropriate advice on Supervision Postgraduate
conduct of appropriate protocol for simple research meet local ethics
research in the field of Oral projects. design and conduct of research. committee. degrees if appropriate
Surgery. Seek ethical approval for Willingness to adhere to the Research Project or
projects. principles of Good Clinical programme management if
Practice. appropriate
Describe the role of statistics Recognise appropriate use of Recognise the importance of Spend time with
Biostatistics statistics in dental research. ISFE
ISFE
in dental research and key accurate application of statistics statistician.
types of statistical tests in biomedical research Attend courses.
commonly used. Independent study.

28
 F TEACHING & COMMUNICATION

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning method(s) Assessment method(s)

…..should be …..should be able to: …..should:

able to:
Describe adult Able to: Demonstrate a willingness - Workplace experience (teaching and ARCP feedback
To have the skills, attitudes and learning - Utilise appropriate and enthusiasm to teach communication) with appropriate trainers Appropriate
practices of a competent principles and communication / presentation trainees and other health including attendance at suitable learning accreditation/training for
teacher needs. skills. workers in a variety of clinical and teaching sessions at a relevant stage teaching if appropriate eg
Teaching and Communication Describe a range - Use different instruction settings. in training eg dental hospital. FHEA
- Communicate effectively both of teaching materials ensuring experience in - Appropriate range of opportunities for Peer review of teaching
orally and in writing with peers, strategies. teaching, lecturing, small group Demonstrate a professional observational and personal teaching and
practitioners, staff, patients and Describe the facilitation, chair-side and attitude towards teaching. communication within the organisation.
the public. principles of practical instruction.
- Develop and present teaching - Demonstrate awareness of Show willingness to
instructional sessions. evaluation. learning and learning needs of participate in workplace-based
- To undertake formative students (or recipients) of assessments.
assessments for students. instructions. Maintain honesty and
- Differentiate between Demonstrate effective teaching objectivity during appraisal
appraisal and assessment and Facilitate learning process. and assessment.
have a working knowledge of
the advantages and Recognise:
disadvantages of each. - Personal effectiveness in
delivering lectures, tutorials,
- Manage groups with different
seminars and clinical
learning needs effectively in
demonstrations.
same session of teaching.
- The value of course
evaluations and reflective
practice.

29
 G MANAGEMENT & ADMINISTRATION

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning method(s) Assessment
method(s)
…..should be able to: …..should be able to: …..should:
Describe: - Utilise appropriate Recognise: - Workplace (administrative) experience ARCP
Management and - local and national NHS and MiniPAT
communication / presentation / - How to work effectively as part with appropriate trainers including
Administration corporate organisational and negotiating / counselling / of a team and manage and attendance at suitable committees and
- Demonstrate relevant skills administrative structures appraisal / mentoring skills. delegate appropriately. management sessions at a relevant stage
for working in an relevant to one’s sphere of - Handle complaints - Methods of communication / in training.
organisational setting. practice. sympathetically and administration used by others and - Appropriate range of opportunities for
- Deal effectively with staff, - appropriate Health and Safety efficiently. adapt to these in order to achieve observational and personal
managers and administrators. (including cross-infection - Manage time and delegate as an appropriate outcome. administration within the organisation.
- Plan and discuss management control) and employment / appropriate. Self directed study.
of a dental clinic/practice. equality and diversity - Develop business case /
- Deal with complaints / legislation. strategies with appropriate
grievances especially from input from administrative
patients. Have IT knowledge equivalent colleagues.
- Manage time effectively and to the ECDL (European - Use appropriate ICT to
adopt strategies for coping with Computer Driving License). facilitate administration and
stress. clinical practice.
- Demonstrate a working
knowledge of the employment
and health and safety
regulations.
- Discuss best practices in
management and
administration and contrast
these with those in the training
institution.

30
H HEALTH EDUCATION AND PROMOTION AND EPIDEMIOLOGY

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning Assessment method(s)
method(s)
…..should be able to: …..should be able to: …..should:
Describe: Recognise: Workplace (clinical) CBD
Health Education and - Contribute appropriately to
- the role of Health Education - the role of the Oral Surgery experience with appropriate MiniCEX
Promotion: and Promotion in improving the development and specialist in Health trainers. MOS
An ability to: dental health. implementation of Health Education and Promotion the
• Advise each patient on - key DH and specialist body Education and Promotion impact of the patient’s oral Attendance at didactic
appropriate preventive guidance and policy programmes. and general health status and teaching sessions within
methods especially in regarding Health Education - Communicate at an the proposed advice on their department.
relation to oral hygiene, and Promotion. appropriate level with quality of life.
smoking cessation, sensible patients. - the need for supportive Attendance at suitable
alcohol intake. Describe cross infection - Explain to patients the care, prevention and courses.
• Be able to use and deploy control measures in dentistry. impact of alcohol and maintenance.
methods to prevent tobacco on disease - the need to work with other Attendance at suitable
occurrence and recurrence of progression and quality of clinicians and DCPs in meetings.
dental and oral mucosal life. provision of treatment,
diseases in individual - Advise on the issues of within their skill base and Independent study.
patients. non-compliance. designated role, to achieve
• Develop a care strategy in - Use a range of methods appropriate outcomes.
conjunction with the patient, and technologies to prevent
producing a plan according infection during treatment
to their needs and procedures, between patients
preferences. and staff and during transport
• Advise other health care of materials between the
professionals on methods and laboratory and the clinic.
technologies to prevent
infection during dental
treatment procedures,
between patients and staff
and during transport of
materials between the
laboratory and clinic e.g.
impressions.
Describe the design and Assess and apply the results Recognise the value and Independent study. Research project if
Epidemiology, Survey design conduct of oral of local and national dental limitations of Advice from supervisor. appropriate
epidemiological studies and epidemiological studies and epidemiological studies.
surveys. surveys.

31
 I DELIVERY OF CARE

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning Assessment
method(s) method(s)
…..should be able to: …..should be able to: …..should:
Describe the relevance to Recognise situations when Be open to constructive Independent study
Relevance of outside bodies professional life of: criticism. ARCP
appropriate to involve these
Be aware of the organisations that are bodies and individuals. Accept professional
- the royal medical colleges regulation.
responsible for governing the practice of oral - GDC
surgery and ensuring the safety of the - Postgraduate Dean
patient. - defence unions
- BDA
- specialist societies.
Describe the process for gaining Demonstrate appropriate use of Recognise importance of Workplace (clinical) DOPs
Informed consent informed consent. written material and verbal patient’s autonomy. experience with PBAs
Ability to prepare a patient for a procedure so communication. appropriate trainers MOS
that they fully understand the implications Describe the principles of consent Be open and willing to including attendance at
and effects of that treatment. issues as relating to oral surgery Able to describe the benefits and describe the benefits and appropriate clinics and
clinical practice and research. risks of procedure risks of procedure. ward rounds.
Be able to outline various treatment options Appropriate range of
and the risks (as well as the option of doing clinical cases for
nothing). observational and
personal treatment.
Attendance at didactic
teaching sessions within
department.
Attendance at suitable
courses.
Attendance at suitable
meetings.
Independent study.
Describe extent of one’s experience Be willing to consult and to Recognise own limitations Workplace Clinical DOPS; MOS
Recognise own limitations admit mistakes. experience
and ability to undertake that Know when to ask for MiniPAT
procedure or operation. advice. PBAs

MOS

32
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Teaching and Learning Assessment
Behaviours method(s) method(s)
…..should be able to: …..should be able to:
…..should:
Describe the legal issues relating to managing Demonstrate awareness of legal issues. Act with Workplace (Clinical) ARCP
Legal issues
and treating adults and children. compassion and experience.
understanding at all Independent study.
times.
Describe relevant strategies to ensure Use and share all information appropriately. Respect the right to Workplace (clinical) MiniPAT
Confidentiality confidentiality. Demonstrate appropriate use of written confidentiality. experience with
Ability to respect the Describe responsibilities under data protection material. Respect for appropriate trainers.
confidential nature of the legislation. patient/carers points Attend trainee didactic
information gleaned in the of view and wishes. teaching sessions within
management of the patient. department.
Attendance at suitable
Understand the legislation courses.
that governs such and ensure Attendance at suitable
information is not disclosed meetings.
to a third party without the Independent study.
patients consent.
Describe the principles of delivery of When appropriate, seek further advice about Willingness to seek Speak to NHS
Delivery of Care and effective Oral Surgery practice. management.
specialist Oral Surgery care in the hospital, appropriate advice
Practice Management
community and practice settings and support when
establishing future
career.

33
 Pre-operative Care: Pre-operative care: Willingness to seek Workplace (clinical) CBD
Peri-operative care Describe: - Synthesis of history and examination into appropriate advice experience with MiniPAT
Ability to provide treatment - Indications for surgery operative and to put patient appropriate trainers DOPS
in a safe environment. - In patient management including the management plan including management of welfare first. including attendance at PBA
influence of the patient’s medical health on medical health issues on choice of anaesthetic, Know when to seek appropriate clinics and MOS
clinical practice surgical procedure advice from other ward rounds, Accident &
- Required preparation for surgery -how to monitor vital functions including fluid specialists on Emergency settings and
- Outcomes and complications of surgery input and output, homeostasis, BP, electrolytes management or in theatre.
- The admission process, pre operative -how to request appropriate special when to refer Attendance at medical
assessment (including special investigations) investigations and where appropriate and/or surgical ward
Intra-operative care: undertake them e.g. ECG, venepuncture, IV rounds
Describe: access Appropriate range of
- Steps involved in operative procedure - explain procedure and outcomes to patient clinical cases for
- alternative procedures in case of and parents at an appropriate level observational and
encountering difficulties - obtain informed consent personal treatment.
Post-operative care: - construct an appropriate theatre list Attendance at didactic
Describe: - communicate appropriately with other teaching sessions within
- Potential complications of procedure relevant department.
-surgical and non surgical shock members of the theatre team Attendance at suitable
- Outcomes of procedure Intra-operative care: courses.
- Likely post-operative progress from disease - Undertake treatment under local anaesthesia, Attendance at suitable
process to intervention and resolution. sedation or general anaesthesia meetings.
- Use assistance as appropriate Independent study.
- Communicate appropriately with other
members of theatre team
- Recognise and manage surgical and non
surgical causes of shock

34
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning Assessment
method(s) method(s)
…..should be able to: …..should be able to: …..should:
Describe the relevance Provide effective explanation for Make decisions about operative Workplace (clinical) DOPS
Operative Interventions PBA
of basic sciences to the role of operative management. interventions in partnership with experience with appropriate
– the trainee will be able to undertake operative techniques. Undertake accurate evaluation of patient and/or patient/guardian. trainers including attendance at
safely and effectively, operative Describe a range of operative interventions. Evaluate Recognise own limitations and appropriate operating lists.
techniques. different operative options for different oral tissue choose appropriately when to seek Appropriate range of clinical
techniques. lesions. advice from surgical or other cases for observational and
Undertake procedures safely. colleagues. personal treatment.
Post-operative Care: Assess outcomes. Attendance at didactic teaching
- Assess patient and physiological sessions within department.
parameters Attendance at suitable courses.
- Make appropriate intervention to Attendance at suitable
deal with changing meetings.
parameters Independent study.
- Communicate appropriately with Involvement in training dental
other team members, students or working in
patients and carers specialist practice.
- prioritise interventions
- Recognise complications of
procedure.
Describe the relevance Provide specialist leadership in the Recognise the importance of As above As above
Continuity of care of continuity of care. provision of oral surgical services. punctuality and attention to detail.
Ability to organise appropriate cover in
your absence for the care of a patient
you may have operated on.
Ability to recognise those patients that
require to be seen again by yourself and
those who can be reviewed by their
practitioner.

35
 J EQUALITY & DIVERSITY

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning method(s) Assessment
method(s)
…..should be able to: …..should be able to: …..should:
Describe the relevant Treat patients/parents/carers fairly and in line Demonstrate a non-discriminatory - Workplace experience (teaching and CBD, ARCP;
Equality and
law pertaining to with the law to promote equal opportunities approach to patients/parents/carers communication) with appropriate trainers
Diversity equality and diversity. for all patients or groups of patients. and colleagues. including attendance at suitable learning and
teaching sessions at a relevant stage in training.
Treat all team members and other colleagues
fairly and in line with the law.

36
 2.2 Specialty-specific content

A BASIC BIOLOGICAL SCIENCE RELEVANT TO ORAL SURGERY

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Teaching and Learning method(s) Assessment
Behaviours method(s)
…..should be able to: …..should be able to:
…..should:
Explain the general growth and Assess normality and Recognise importance Attend courses. MOral Surg; CBD;
Normal and abnormal Self directed learning e.g. Journal club review; MiniCEX
development of the child and the detect abnormality in of basic sciences for
growth and development limits of normality. general, facial or dento- understanding health MOS
supervised outpatient clinics; ward-based learning,
(including anatomy and and disease.
Describe facial growth and those alveolar development. including ward-rounds and consultations; planned
physiology) of the conditions which may affect Apply knowledge of (This is assumed to be teaching e.g. specialist registrar training days; Also able to apply
stomatognathic system. facial growth. basic sciences when the case for all clinical and scientific meetings–departmental, theoretical
Describe normal development assessing patients and sections that follow). regional, national and international. knowledge when
and potential abnormalities in formulation of treatment The above are relevant to all sections that follow, appropriate in DOPS
growth of the teeth and dento- plans. choosing the most appropriate and available. and PBAs
alveolar complex, including Select appropriate (The above are relevant to all sections that follow (This is assumed to
abnormalities of tooth eruption. interventions on the choosing the most appropriate available). be the case for all
Describe the anatomy of relevant basis of basic sciences of sections that follow).
hard and soft tissue structures in relevance to oral soft
the head and neck region. tissues.
Explain alterations in
homeostasis in disease states.
Describe the repertoire of
responses of oral soft and hard
tissues to trauma of pathology.
Describe the different options for
intervention with consideration of
their potential advantages and
disadvantages.

37
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s)
…..should be able to: …..should be able to: …..should: method(s)
Describe the principles of genetically Apply knowledge of genetics in the Recognise the impact of genetically determined MOS
Principles of determined conditions. diagnosis of oro-dental conditions. conditions on patients and their families.
Genetics
Recognise the features and genetic Accurately recognise and classify Recognise the role of the Oral Surgeon as part of
basis of common syndromes with genetically determined defects of dental multidisciplinary team in the management of
significant oro-facial features. hard tissues and of tooth form, size and patients with genetically determined conditions.
number.
Describe the genetically determined
defects of dental hard tissues and of
tooth form, size and number.

Explain/describe the role of cell biology Apply knowledge of the role of cell biology Appreciate contribution of cell biology to patient MOS
Cell Biology in health and disease. to management of the patient. care.

38
 B HISTORY & EXAMINATION

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning Assessment
method(s) method(s)
…..should be able to: …..should be able to: …..should:
Carry out a Describe normal and abnormal Be able to use structured questionnaires Fully address concerns, ideas and expectations Workplace (clinical) Portfolio
thorough and anatomy and physiology of and related documents as adjuncts to of the patient and /or their parent/guardian. experience with MiniCEX
appropriate intra- and extra-oral history-taking in selected instances. appropriate trainers MOS
assessment and structures and tissues. Respect patient confidentiality. including attendance at
examination of the Complete a thorough examination of the appropriate clinics
patient, their Describe dental, medical and patient and their hard and soft tissues and Maintain cultural awareness and identity. wards, Accident &
dental, oral and social history factors likely to make appropriate diagnoses. Emergency settings and in
peri-oral tissues be relevant to the presenting Ascertain a thorough history with Value patient comprehension and views. theatre.
in relation to the condition and its previous consideration of possible local or Appropriate range of
presenting management. systemic triggers including iatrogenic Recognise importance of a collateral history in clinical cases for
complaints of the causes. certain situations e.g. related to capacity of observational and
patient, Describe the spectrum of illness patient to engage fully in history taking, or personal treatment.
Identify and record risk factors for
arriving at an behaviour and relate this to where the history is unreliable. Attendance at didactic
conditions relevant to mode of
appropriate diseases relevant to Oral teaching sessions within
presentation.
diagnosis of the Surgery practice. Recognise own limits and choose appropriately department.
condition from Use and interpret correctly all when to ask for help. Attendance at suitable
the information Describe assessment in an appropriate investigations (e.g. courses.
provided and emergency setting Act in the best interest of the patient Attendance at suitable
examination and radiographic, vitality tests, . meetings.
investigations haematological and microbiological tests Independent study.
undertaken. etc) to diagnose. Involvement in training
Communicate effectively to derive a dental students or in
diagnosis. specialist practice.

Develop a hierarchy of action to

safeguard the patient in an emergency
situation
Make an assessment of the likelihood of a
significant underlying diagnosis and
differentiate patients with urgent and non-
urgent care needs.

39
 C CORE CLINICAL COMPETENCIES

1.1 EXTRACTION OF TEETH & RETAINED ROOTS/PATHOLOGY AND MANAGEMENT OF ASSOCIATED COMPLICATIONS
INCLUDING ORO-ANTRAL FISTULA

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning Assessment
method(s) method(s)
…..should be able to: …..should be able to: …..should:
Describe the Formulate a treatment plan Recognise importance of basic science Workplace (clinical) DOPS; PBA
Dental extractions - Signs and symptoms experience with Portfolio
- Liaise with restorative and understanding of health and disease.
Ability to assess those teeth - Differential diagnosis dentist and other relevant Maintain disposition to do good to appropriate trainers MOS
that require extraction and - Investigations and radiographic specialist(s). patients and always act in patients’ best including attendance at
those that can be restored. interpretation associated with teeth that - treat/drain infection and/or interests. appropriate clinics and
require extracting. remove tooth. Resist pressure from patient or carer to theatre lists.
Ability to safely extract a Describe common indications for tooth - use instruments safely and provide inappropriate treatment e.g. Appropriate range of
tooth and deal with repair and tooth extraction. appropriately. extraction of tooth that does not warrant clinical cases for
complications that may arise. Describe methods of medical Carry out technique under such. observational and
management including treatment of local anaesthesia, sedation or Be willing to offer care. personal treatment.
inflammation/infection. general anaesthesia. Behave appropriately when dealing with Attendance at didactic
Describe/explain the pharmacology and Carry out steps of procedure a difficult patient. teaching sessions within
therapeutics of analgesia. safely and correctly. department.
Describe the anatomy of mouth, jaws, Surgically remove a fractured Attendance at suitable
teeth and supporting structures relevant tooth: courses.
to the operation. - use techniques of bone Attendance at suitable
removal and tooth division meetings.
- know when to submit tissue Independent study.
for pathological examination Involvement in training
- use intra-oral suturing dental students or in
techniques. specialist practice
Explain potential (or see Section A).
complications to the patient.
Institute aftercare and know
when to review.

40
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Teaching and Assessment
Behaviours Learning method(s)
…..should be able to: …..should be able to: method(s)
…..should:
Oro-antral communication/root/tooth in maxillary Explain relevant: Formulate a treatment plan for See section C As Section A DOPS; PBA;
antrum - Signs and symptoms disorders affecting the maxillary 1.1. above Portfolio
- Differential diagnosis antrum following tooth extraction.
Ability to assess and safely repair an OAF (or - Investigations and radiographic
remove tooth/root from antrum) and deal with MOS
interpretation. Perform an endoscopic examination
complications that may arise. of maxillary antrum.
Explain methods of medical management
including treatment of Use techniques of antral exploration /
inflammation/infection. lavage.

Explain the relevance of endoscopic Use antrostomy and know when to

examination of maxillary antrum. use appropriate anaesthesia.

Explain indications and techniques. Remove root, retained root or dental

fragment.from maxillary antrum:
Explain potential complications to the - Carry out procedure safely and
patient. correctly.

Use techniques of local flap closure.

Use intra-oral suturing techniques.

41
 1.2 MANAGEMENT OF ODONTOGENIC AND ALL OTHER ORAL INFECTIONS

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s)
…..should be able to: …..should be able to: …..should: method(s)
Describe: Clinical Skills See section C 1.1. (As Section A DOPS;
Abscess/infection - Signs and symptoms above) Portfolio
- formulate treatment plan
Ability to identify dental/oral surgical - Differential diagnosis - recognise the relevance of early MOS
cause for infection (local and/or spreading) - Investigations and involvement of microbiologist.
and manage it in a safe manner. radiographic interpretation Treat/drain infection.
- Methods of medical and Manage compromised airway (surgical
surgical management airway).
- Potential complications Carry out technique under local anaesthesia,
including management of sedation or general anaesthesia.
compromised airway. Recognise difference between local and
spreading infection.
Recognise systemic sepsis (sepsis
syndrome).
Recognise infection as an early indicator of
immunosuppression, e.g. diabetes,
immunocompromised states.
Institute aftercare and review.
- Describe the causes of Technical Skills Recognise importance of basic DOPS
Ability to recognise and deal with MOS
swelling of head and neck Drain tissue space infection using: science and understanding of
complications that may arise - Appropriate aseptic preparation
- Describe the anatomy of health and disease.
oro-facial spaces. - Exposure and exploration of tissue
- Explain the microbiology of space(s). Maintain disposition to do good
head and neck infection. to patients and always act in
- Describe the anatomy and Recognise when the airway is at risk.. patients’ best interests.
physiology of the upper aero-
digestive airway. Relieve airway or know when to refer.
- Describe the anatomy of
lymphatic drainage and vital Know when and how to collect samples.
structures.
- Recognise risks associated Secure appropriate drains and dressings.
with blood borne infections.
- Explain techniques of non-
surgical and surgical airway
management.

42
 1.3 MANAGEMENT OF IMPACTED AND UNERUPTED TEETH; MANAGEMENT OF COMPLICATIONS
& 1.5 DENTOALVEOLAR SURGERY IN RELATION TO ORTHODONTIC TREATMENT

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Teaching and Assessment
Behaviours Learning method(s)
…..should be able to: …..should be able to: method(s)
…..should:
Explain signs and symptoms - Formulate treatment plan including See Section C As section A DOPS; PBA;
Impacted teeth aftercare. 1.1. above. Portfolio
associated with the need to remove
Ability to identify when an impacted tooth requires removal impacted teeth. - Be able to treat/drain infection and/or MOS
and manage it in a safe manner. Describe complications associated remove tooth.
with removal (and retention) of Carry out technique under local
Ability to recognise and deal with complications that may impacted teeth (supernumeraries). anaesthesia, sedation or general
arise. Describe investigations and anaesthesia:
Ability to identify whether an unerupted tooth requires radiographic interpretation relevant - carry out steps of procedure safely
removal, exposure, reimplantation/transplantation, or to impacted wisdom teeth. and correctly.
retention in conjunction with other relevant specialists. Describe: - undertake Surgical exposure or
- indications for removal of transplantation of unerupted tooth,
impacted wisdom teeth including including various techniques of
NICE/SIGN guidelines. exposure and bone removal.
- potential complications and how - packing and/or bonding of tooth
to manage them. - techniques of tooth splintage
- relevant pharmacology and - intra-oral suturing techniques
therapeutics of postoperative - institute aftercare and review
analgesia prescribed.
Explain why and when to leave a
retained root.

43
 1.4 PERI-RADICULAR SURGERY

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Teaching and Learning method(s) Assessment
Behaviours method(s) )
…..should be able to: …..should be able to:
…..should:
In relation to peri-radicular Clinical Skills See section C Workplace (clinical) DOPS; PBA;
Peri-radicular surgery surgery, explain: 1.1. Portfolio
Formulate treatment plan experience with appropriate trainers
Ability to identify whether periradicular - Signs and symptoms. - Recognise the relevance of early including attendance at appropriate MOS
surgery is appropriate or other forms of - Differential diagnosis. involvement of microbiologist. clinics eg restorative clinic.
management required. - Investigations and Technical Skills Appropriate range of.clinical cases for
radiographic interpretation. Apical surgery and enucleation of observational and personal treatment.
Know differential diagnosis and treatment - Pathogenesis of chronic cyst where present: Attendance at didactic teaching sessions
options. infection and cystic - Carry out surgical technique under within department.
Ability to undertake this surgery in a safe lesions. local anaesthesia, sedation or general Attendance at suitable courses.
manner. - Potential complications. anaesthesia. Attendance at suitable meetings.
- Carry out steps of procedure safely Independent study.
Ability to recognise and deal with Describe most appropriate and correctly. Involvement in specialist dental practice.
complications that may arise. surgical method. - Demonstrate techniques of exposure,
bone removal and enucleation of
Explain when to refer to pathology.
restorative dentist. Use various ways of sealing dentinal
tubules.
Describe relevant - Demonstrate intra-oral suturing
pharmacology of drugs techniques.
prescribed.

44
 1.6 INTRAORAL & LABIAL BIOPSY TECHNIQUES

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Teaching and Assessment
Behaviours Learning method(s) method(s)
…..should be able to: …..should be able to:
…..should:
Biopsy techniques In relation to biopsy techniques, Clinical Skills See Section C 1.1. As Section A above. DOPS; PBA
Assessment of lip swelling and explain: - formulate treatment plan. MOS
other problems. - Signs and symptoms. - carry out appropriate surgical technique under local
- Differential diagnosis. anaesthesia, sedation or general anaesthesia safely.
Ability to identify causes of such - Investigations relevant to the - institute aftercare and review.
soft tissue changes. management of lip swelling. - demonstrate ability to discriminate between those who
Know differential diagnosis and - Causes of such swelling. need surgery and those who don't, and communicate
treatment options. - Potential complications. this.

Know when to refer or confer with

other specialists.
Ability to undertake therapy in a
safe manner.
Ability to recognise and deal with
complications that may arise.

45
 1.7 TREATMENT OF INTRA-ORAL BENIGN AND CYSTIC LESIONS OF HARD AND SOFT TISSUES

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Teaching and Assessment
Behaviours Learning method(s)
…..should be able to: …..should be able to: method(s)
…..should:
See Section C See Section A DOPS; PBA;
Benign and cystic lesions In relation to benign and cystic lesions, 1.1. Portfolio
Clinical Skills
Ability to identify cysts and benign explain: - formulate treatment plan MOS
lesions in hard and soft tissue in the - Signs and symptoms - institute aftercare and review
oral cavity and jaws. - Differential diagnosis of benign and - be able to decide correct management (biopsy or
cystic lesions of the jaw. excise) of jaw cyst/oral hard tissue/soft tissue under
Know differential diagnosis and - Investigations and radiographic local anaesthetic, general anaesthetic or sedation
treatment options. interpretation relevant to the techniques.
Know when to refer to or confer management of benign lesions and - carry out all steps of procedure safely and correctly.
with other specialists. cysts.
- Pathogenesis of benign and cystic
Ability to undertake therapy in a lesions.
safe manner. - Potential complications.
- Methods of treatment.
Ability to recognise and deal with
complications that may arise.

46
 1.8 MANAGEMENT OF BENIGN SALIVARY GLAND DISEASE BY INTRA-ORAL TECHNIQUES AND FAMILIARITY WITH THE
DIAGNOSIS AND TREATMENT OF OTHER SALIVARY GLAND DISEASES

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s)
…..should be able to: …..should be able to: …..should: method(s)
Stone retrieval Explain the causes of intermittent/persistent Clinical Skills See Section C 1.1. See Section A. DOPS; PBA;
swelling of major salivary glands. - Take accurate relevant history. Portfolio
Ability to identify when a MOS
- Perform a clinical examination of the neck
salivary duct is blocked and In relation to salivary gland disease, explain: and salivary glands.
why it is blocked. - differential diagnosis - Follow all steps to safely remove a stone
Know when to refer to or - investigations from the submandibular duct under local
confer with other specialists - methods of medical and surgical anaesthesia, sedation or general anaesthesia.
eg radiologist. management.

Ability to undertake therapy

in a safe manner.
Ability to recognise and deal
with complications that may
arise.
Explain the causes of intermittent/persistent - Perform excision/biopsy and repair Recognise importance of basic As above DOPS
Ability to identify a mucous swelling of salivary glands. techniques. science and understanding of MOS
cyst/swelling - Describe differential diagnosis of salivary – know when and how to do so safely and be health and disease.
gland swellings including relevant able to deal with any complications arising, Maintain disposition to do good
investigations. including appropriate referral. to patients and always act in
- Explain methods of medical and surgical patients’ best interests.
management and explain potential
complications.
- Describe clinical features and differential - Perform excision/biopsy and repair MOS
Ability to identify a benign techniques.
diagnosis of salivary gland swellings
lesion from a malignant
including relevant investigations. – know when and how to do so safely and be
lesion able to deal with any complications arising,
including appropriate referral.

47
 1.9 INSERTION OF OSSEOINTEGRATED DENTAL IMPLANTS INCLUDING BONE AUGMENTATION AND SOFT TISSUE
MANAGEMENT

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Learning Assessment
method(s) method(s) )
…..should be able to: …..should be able to: …..should:
Oral and Dental Describe:- Aetiological factors Workplace (clinical) ARCP Case
Implantology The knowledge affecting dental loss and alveolar Clinical Skills Maintain disposition to do good to experience with reports; CBD;
and skills to use dental resorption. - Take history and examination of the patients and always act in patients’ appropriate trainers DOPs; Mini-
implants to replace missing - Specialised investigations and patient with dental loss and/or best interests. including attendance at CEX; PBA
dentition and oral tissues. classification of alveolar resorption. alveolar resorption and formulate Work within a team structure to appropriate MOS
Ability to identify which - The principles of osseointegration treatment plan. ensure appropriate restoration of the multidisciplinary clinics.
treatment option is best for and implant borne/retained dental dentition. Appropriate range of
the patient. prostheses. Technical Skills… clinical cases for
Know when to refer to or - All treatment options for the case, - Insert implants and any necessary Recognise: observational and
confer with other specialists both implant and non implant bone harvest and augmentation, - importance of basic science and personal treatment.
e.g. restorative specialist. rehabilitation. and/or soft tissue procedures or understanding of health and disease. Attendance at didactic
Ability to undertake surgical - Relevant biology, anatomy, guided bone regeneration, under local - the relevance and inter- teaching sessions within
treatment in a safe manner. physiology, pathology, anaesthesia, sedation or general relationship of dental implant department.
Ability to recognise and deal microbiology and technical anaesthesia treatment on overall patient care and Attendance at suitable
with complications that may requirements in provision of dental - Provide post-operative care and long-term maintenance and courses.
arise. implants with a range of implant follow-up function, and on patient well-being Attendance at suitable
systems. - Show a high degree of skills in the and self-esteem. meetings.
- Current and seminal literature on choice and execution of appropriate - the cost implications of treatments Independent study.
indications for, success / failure techniques for all stages of the involving implants and guidelines
criteria and biological implications surgical implant placement. applicable to provision of such
of provision of dental implants. - Construct surgical and radiographic treatment.
- Surgical techniques for implant guides to aid planning of number,
placement, bone harvest and position and angulation of fixtures.
augmentation, and exposure
- Biological benefits of and
indications for their use.
- Principles and practice of
prevention of diseases relating to
implant structures.

48
 1.10 APPROPRIATE PAIN AND ANXIETY CONTROL INCLUDING THE ADMINISTRATION OF STANDARD CONSCIOUS SEDATION
TECHNIQUES

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Teaching and Assessment
Behaviours Learning method(s) )
…..should be able to: …..should be able to: method(s)
…..should:
Describe the principles of cognitive Recognise the impact of normal and abnormal Recognise the ethical and See Section DOPs
General Behavioural Concepts: legal aspects of A above. MOS
development and behavioural psychology. behaviour patterns in children and adults in the
Explain non-pharmacological behaviour clinical setting. managing adult and child
management techniques used in dentistry. Apply knowledge of behavioural psychology to behaviour in the dental
manage anxiety and anxiety related behaviour in setting.
the dental setting.
Pain control, Analgesia, Sedation Describe: - Show a high degree of skill in the choice and - The need for empathy As above ARCP Case
and Anaesthesia - Relevant biology, anatomy, physiology, execution of appropriate anaesthetic or sedation and patient counselling reports; CBD;
An ability to: pathology, microbiology and technical techniques for all stages of the planned skills. DOPs/Mini-CEX
- Provide appropriate analgesics for requirements in provision of such care. treatment in conjunction with other specialists / MOS
control of pain, pre- and post- - Current and seminal literature on dental care professionals managing the patient.
operatively. indications for, success/failure criteria - Carry out appropriate procedures for safe and
- Provide profound and sufficient and biological implications of provision effective administration of local anaesthesia or
local analgesia during all treatment of local or general anaesthesia or conscious sedation and work closely with
procedures taking account of the conscious sedation techniques. colleagues providing general anaesthesia.
patient’s medical status and - Anaesthetic agents, equipment,
treatment needs. medicaments and techniques to provide
- Practice administration of local relevant treatment and the response of the
analgesia in complete safety and be patient to treatment regimes.
able to manage any associated
complications.
- Plan provision of appropriate
Oral Surgery for patients who can
be treated only by the use of
general anaesthesia.
- Monitor and evaluate the
effectiveness of treatment provided
under any of these pain
management modalities.

49
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s) )
…..should be able to: …..should be able to: …..should: method(s)
DOPs
Sedation Identify those suitable for Recognise and apply appropriately MOS
Describe the principles and delivery of conscious
Ability to identify when sedation for adults and children receiving dental care. sedation and to construct the ethical and legal requirements of
sedation is helpful and the form appropriate treatment plans. practitioners delivering conscious
of sedation eg oral, IV etc. Describe the design and safe operation of equipment Recognise those conditions sedation.
used to deliver inhalation and IV sedation and which may make patients
Know when to refer to or monitor patients during sedation procedures. unsuitable for sedation. Construct and lead an appropriate
confer with other specialists. Safely and effectively dental team for conscious sedation
Ability to use sedation in a safe NB: The above complies with guidance set out deliver sedation as an delivery.
manner. under the Standing Committee for Conscious adjunct to dental care.
Sedation Show clinical IV sedation
Ability to recognise and deal skills.
with complications that may Deal with complications or
arise. emergencies which may
arise during sedation.
As above DOPs;
General Anaesthesia (GA) Portfolio
Describe, at a basic level, the principles of general Deliver oral surgical care for Recognise and apply appropriately
Ability to identify when anaesthesia in children and adults. children and adults under the ethical and legal requirements of MOS
general anaesthesia is general anaesthesia. practitioners delivering dental
appropriate. Describe the risks and advantages of various methods . treatment under GA.
of airway management from both the dental and
Be able to inform patient of anaesthetic point of view. Construct and lead an appropriate
other options and risks dental team for care under GA
associated with this form of Explain the dentist’s role in the management of delivery.
anaesthesia. complications/emergencies which may occur during
Know when to refer to or delivery of GA.
confer with other specialists.
Describe the facilities, equipment and staffing
requirements for safe and effective delivery of care
under GA.

50
 1.11 MANAGEMENT OF ADULTS AND CHILDREN AS IN-PATIENTS, INCLUDING THE MEDICALLY AT-RISK PATIENT

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s)
…..should be able to: …..should be able to: …..should: method(s)
Hospital in-patient care Describe the process for admission of a Take, record and interpret an accurate Fully address concerns, ideas and As Section A Portfolio
patient to hospital. history from patients of any age expectations of the patient and /or their above. .
Ability to explain to a within the scope of Oral Surgery parent/guardian. MiniPAT
patient the hospital process. Describe risk factors for the patient’s practice MOS
Describe differential condition, and understand relevance to in- Respect patient confidentiality.
diagnosis when appropriate, patient management. Communicate effectively. Know Maintain cultural awareness and identity.
and treatment options. where to refer. Seek advice if unsure. Value patient comprehension and views.
Describe how a hospital surgical team
Know when to refer to or works. Recognise when input from another Demonstrate willingness and ability to
confer with other specialty is required for individual teach students and healthcare colleagues
specialists. Describe the roles and responsibilities of patients. sound history skills where appropriate.
Ability to undertake team members, especially within the
therapy in a safe manner. department and within multidisciplinary Work effectively with other health Show respect for others’ opinions.
teams. care professionals.
Ability to recognise and Be conscientious and work co-
deal with complications that Explain the process for gaining informed Describe the nature, benefits and risks operatively.
may arise. consent. of planned procedure.
Respect colleagues, including non-
Describe the principles of consent issues as medical professionals and recognise
relating to oral surgery clinical practice and good advice.
research.

51
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s)
…..should be able to: …..should be able to: …..should: method(s)
Hospital prescribing Explain:- - Provide appropriate analgesics for control CBD;
- Pharmacology and therapeutics of of pain, pre- and post-operatively. Demonstrate willingness to seek MiniPAT
Ability to prescribe safely. analgesia. appropriate advice and support from
- Pharmacology and therapeutics of - Provide appropriate antibiotics or other colleagues when needed. Portfolio
Understand the relevance of antibiotic therapy and drugs to reduce drugs where indicated. MOS
the patients medical history to swelling. Appreciate when to discuss patient
prescription of drugs. - Pharmacology and therapeutics of management with colleagues from
emergency drugs. other hospital clinical specialties.
Understand the legislation
surrounding the safe Describe indications for provision of Demonstrate an appreciation of
prescription of drugs for local or general anaesthesia or conscious when to discuss patient management
dental/oral surgical use. sedation techniques. with colleagues from other hospital
clinical specialties.
Know when to refer to or Describe anaesthetic agents, equipment,
confer with other specialists. medicaments and techniques to provide
relevant treatment.

Management of the medically Describe: Recognise importance of a collateral history An appreciation of when to discuss As above Portfolio
at-risk patient - the spectrum of general illness in certain situations e.g. related to capacity patient management with colleagues MOS
behaviour and relate this to diseases of patient to engage fully in history taking, from other hospital clinical
relevant to Oral Surgery practice and in- or where the history is unreliable. specialties.
patient management.
- the appropriate investigations needed Assess the likelihood of a significant
for management of patients with underlying diagnosis and differentiate
complex medical histories and/or how to patients with urgent and non-urgent care
obtain relevant advice. needs.
Hospital discharge and Describe the process for patient - Institute aftercare and review Willingness to seek appropriate As above. Portfolio
follow-up discharge, appropriate prescribing and advice and support from colleagues
arrangements for follow-up if required. when needed.

52
 1.12 MANAGEMENT OF DENTO-ALVEOLAR TRAUMA AND FAMILIARITY WITH THE MANAGEMENT AND TREATMENT OF
FRACTURES OF THE JAWS AND FACIAL SKELETON

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Teaching and Assessment
Behaviours Learning method(s) method(s)
…..should be able to: …..should be able to:
…..should:
Dental trauma and dento-alveolar Describe: Clinical Skills See Section C 1.1. See Section A above. DOPS; MiniPAT
fractures. - Aetiology of facial trauma. - Assess and examine a patient with CBD; MiniCEX
- Priorities of management. facial trauma. MOS
Ability to identify extent of trauma, facial
- Assessment of airway and level - Manage airway and treat emergency
fractures and treatment options.
of consciousness dento-facial trauma.
Know when to refer to or confer with other (Glasgow coma scale). - Formulate treatment plan and
specialists. - Signs and symptoms of fractures prioritise management.
of facial skeleton. - Perform clinical exam of orofacial
Ability to undertake surgery in a safe - Classification of dental trauma region including cranial nerves.
manner. and dento-alveolar
Ability to recognise and deal with fractures.
complications that may arise. - Classification of facial fractures.
- Assessment of head injury and
cranial nerve function.
- Aetiology.
- Interpretation of radiographs.
- Potential complications.

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 1.13 MANAGEMENT OF ORO-FACIAL PAIN INCLUDING TEMPOROMANDIBULAR JOINT DISORDERS

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s)
…..should be able to: …..should be able to: …..should: method(s)
CBD;
Orofacial pain Describe/explain: Clinical Skills Recognise orofacial pain with potentially high morbidity See Section A MiniPAT;
- History of presenting - Elicit and interpret an accurate including suicide risk or malignancy, or where associated above. DOPs;
Ability to identify a differential conditions. pain history. with a significant underlying systemic illness. MiniCEX
diagnosis for facial pain based - Signs and symptoms of - Examine the patient, to MOS
upon history and relevant common causes of oro- identify/exclude causes of pain. Recognise own limitations and choose appropriately when
investigations. facial pain. - Formulate a treatment plan. to seek timely advice and input in to patient care from
Know treatment options. - Differential diagnosis. other healthcare colleagues, for example a Pain Team,
- Investigations. Technical Skills Neurology, Neurosurgery, Liaison Psychiatry or Clinical
Know when to refer to or confer - Methods of medical and - Use local anaesthetic techniques Psychology.
with other specialists. surgical management. including nerve blocks.
Ability to undertake therapy in a - Relevant pharmacology - Define the indications for
safe manner and to recognise and therapeutics. imaging and other investigations
and deal with complications that - Techniques of nerve in the context of orofacial pain.
may arise. blockade - Describe the different therapeutic
- Relevant neurosurgical options with considerations of
interventions. their potential advantages and
disadvantages.

54
Upon completion of the programme, the trainee –
Objective Knowledge Skills Attitudes and Behaviours Teaching and Assessment
Learning method(s)
…..should be able to: …..should be able to: …..should: method(s)
CBD;
Temporomandibular joint Describe/explain: Clinical Skills Maintain disposition to do good to See Section A MiniPAT;
disorders - Relevant biology, anatomy, - Take a comprehensive history. patients and always act in patients’ as above. DOPs ;
Diagnose oral parafunction and physiology, pathology, pharmacology - Examine the TMJ and muscles of best interests. MiniCEX
other factors in the and therapeutics and radiology in mastication. Recognise: MOS
development of dysfunction of provision of care and advice for - Formulate and instigate a treatment plan. - importance of basic science and
mandibular movements and the temporomandibular disorders. - Describe the potential role of the occlusion. understanding of health and disease.
TMJs. - Current and seminal - Communicate effectively and - the need for empathy and patient
literature on diagnosis (eg signs & empathetically with patients to identify counselling skills.
Provide behavioural advice for symptoms) and management of these potential aetiological factors and signs and - the relevance of treatment of
the management of these disorders. symptoms of temporomandibular disorders. temporomandibular disorders on
problems. - Different treatments available - Show a high degree of skill in the choice overall patient care and long-term
(medical and surgical) for TMJ and execution of appropriate techniques for functions and on patient wellbeing.
Construct appropriate occlusal disorders and their limitations (eg jaw treatment in conjunction with other
appliances for the diagnosis exercises, interocclusal appliances, specialists/dental care professionals
and treatment of these occlusal adjustment, psychological managing the patient.
problems. approaches, biofeedback). - Exclude other serious causes of pain in
- Differential diagnosis and exclusion that region.
Communicate and work with of other conditions e.g. Giant cell
colleagues on the arteritis,
multidisciplinary management
of these problems.

Monitor and evaluate the

effectiveness of treatment
regimes.

55
 1.14 CLINICAL DIAGNOSIS OF ORAL CANCER AND POTENTIALLY MALIGNANT DISEASES, FAMILIARITY WITH THEIR
MANAGEMENT AND APPROPIATE REFERRAL

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Teaching and Assessment
Behaviours Learning method(s) method(s)
…..should be able to: …..should be able to:
…..should:
Identification of clinically suspicious In relation to oral cancer and potentially Clinical Skills See Section C 1.1. See Section A above. DOPs; CBD;
lesions malignant diseases, explain/describe: - Examine the oral mucosa. MiniCEX
- Aetiological factors and differential diagnosis. - Undertake biopsy techniques. MOS
Ability to identify a benign lesion from - Investigations. - Interpret results and formulate
a malignant lesion. - Possible relationship to systemic disease. a treatment plan.
Know differential diagnosis and - Relevant pharmacology and therapeutics. - Refer appropriately.
treatment options. - Signs of malignant disease.
- Diagnostic tests and know when to refer.
Know when to refer to or confer with
other specialists.
Ability to undertake biopsy in a safe
manner.
Ability to recognise and deal with
complications that may arise.

56
 1.15 THE DIAGNOSIS OF DENTOFACIAL DEFORMITY AND FAMILIARITY WITH ITS MANAGEMENT AND TREATMENT

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Teaching and Assessment
Behaviours Learning method(s) method(s) )
…..should be able to: …..should be able to:
…..should:
Describe: Clinical Skills See Section C 1.1. See Section A above. CBD; MiniCEX
Dentofacial deformity MOS
- Developmental anatomy of facial - Take a history and examine the
Ability to obtain a history. skeleton and facial musculature. patient with facial deformity.
- Classification and assessment of - Formulate a treatment plan.
Know a differential diagnosis for the facial deformity. - Refer appropriately.
development of such conditions, and treatment - Psychology of facial deformity. -Provide post-operative care and
options. - Norms of facial proportions. follow-up.
Know when to refer to or confer with other - Techniques of cephalometric
specialists. analysis.
- Potential complications of surgery.

1.16 DIAGNOSIS OF ORAL MUCOSAL DISEASES AND FAMILIARITY WITH THEIR MANAGEMENT AND APPROPIATE REFERRAL

Upon completion of the programme, the trainee –

Objective Knowledge Skills Attitudes and Teaching and Learning Assessment
Behaviours method(s) method(s)
…..should be able to: …..should be able to:
…..should:
Oral mucosal diseases including leukoplakia, Describe: Clinical Skills See Section C 1.1. See Section A above. CBD; MiniCEX;
erythroplakia/oral ulceration. - Aetiological factors and - Examine the oral mucosa. Portfolio
differential diagnosis. - Know when it is appropriate MOS
Ability to identify a benign lesion from a malignant - Investigations. to biopsy.
lesion. - Possible relationship to - Carry out steps of biopsy
Know differential diagnosis and treatment options. systemic disease. safely and correctly.
- Relevant pharmacology and
Know when to refer to or confer with other therapeutics.
specialists. - Signs of malignant disease
Ability to undertake biopsy.
Ability to recognise complications and deal with
them.

57