Special Care Dentistry:

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Irish Society for Disability and Oral Health
June 2009

• Special Care Dentistry
• The Way Forward for the Specialty

Dr Janice Fiske, Chairperson of the SAC and
Specialist in Special Care Dentistry
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Special Care Dentistry

• SCD is concerned with the improvement in oral
• health for adults and adolescents who have a
• physical, sensory, intellectual, mental, medical,
  
• motional or social impairment or disability, but
• more often a combination of
• a number of these factors

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Outline

• History to specialty recognition
• Key bodies involved in specialist
• training
• Mediated entry
• Specialty training

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A short history

• The Birmingham Study Group 1968-1974
• 1976, British Society of Dentistry for the
  Handicapped formed (renamed
  British Society for Disability and Oral
  Health, 1999)
• 1990, British Society of Gerodontology formed
• 1990, GDC and DoH sought to formalise specialist
  care in the UK

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A short history

• 1995 Development Group for Community Dental
  Practice established under the
  aegis of RCS England
• Report Moving Forward Establishing the
  Specialty of Special Care Dentistry
• 1999, Dean of RCS England established a working
  group in SCD which recommended the establishment
  of a Joint Advisory Committee in Special Care
  Dentistry (JACSCD) as a free standing committee
  to oversee
• the introduction of training programmes
• the development of curricula, training standards
  and formative assessments

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A short history

• JACSCD established in 2000 (2000-2007) produced 2
  documents
• A Case of Need Proposal for a Specialty in
  Special Care Dentistry
• Training in Special Care Dentistry
• Standing Dental Advisory Committee specialty
  review
• GDC specialty review

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Specialty recognition

• 7th December 2005 GDC announcement to
  support, in principle, the
  development of a
  Specialty in SCD
• 2007, SDEB approved the specialist training
  curriculum
• 2007/8 - consultant appointments made in
  anticipation of specialist recognition,
  increasing from 2 to circa 14

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Specialty recognition

• 2008, SAC in SCD set up
• September 2008 GDC formal recognition of
  specialty in SCD and SAC officially formed
• October 2008 - specialist list opened for
  transition

To date there are 53 listed Specialists in SCD
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• Key bodies involved in specialist training

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Role of the GDC and SDEB

• Quality assures specialist training and
  specialist listing
• Sets principles for entry to specialist training
• Develops flexibility in the recognition of
  previous training, experience and qualifications
  towards specialist training
• Development of a generic curriculum framework for
  all specialty curricula
• Approves curricula for each specialty

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Role of the Deaneries

• Approve and quality manage postgraduate training
  programs in the dental specialties
• Quality manage specialist training programmes
• Appointment of trainers, trainees and
  training programme directors
• Conduct assessment
• Recommend award of CCT to the GDC

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Role of the SAC

• The focus and location for the work of the Dental
  Faculties
• Available to the GDC to advise on matters
  pertaining to prior training and learning and
  equivalence for the purpose of mediated entry or
  accredited prior learning
• SAC as a body should provide advice on
• approval of new programmes
• recognition of prior learning/experience towards
  specialist training

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• Membership of SAC in SCD

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Mediated entry to the specialist list

• Based on equivalence of 3 years specialist
  training based on experience and training in a
  number of areas
• Guidance is on the GDC website www.gdc-uk.org
• Mediation period runs from
• 1st October 2008 to
• 30th September 2010

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• The Mediation Process

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The Mediation Process

• Portfolio assembled
• Application sent to the GDC
• GDC couriers it to FDS RCS England
• SAC monthly meetings to assess applications

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The Mediation Process contd

• Application assessed against mediation criteria
• Two independent reviewers
• Consensus opinion formed
• Letter of recommendation to the GDC
• GDC informs applicant

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Compiling your portfolio

• Provide a CV that covers all the mediation
  criteria
• 2. Provide evidence for each criteria
• 3. Compile it in a neat, tidy and organised
  manner which is easy to follow

Put in sufficient to provide the evidence not
everything you have ever done!
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FAQs about mediation

• Q. I dont have a postgraduate qualification,
  should I even bother to apply?

• Yes, as assessment for mediation is on the basis
  of experience as well as training

Each case is reviewed on its own merits
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• I am working in paediatric special care and
• have been told I shouldnt apply although my
  caseload is mainly special care is this
  correct?

• A. Special Care Dentistry relates to adults and
  adolescents. Agreement with the SAC in paediatric
  dentistry that children with disability sit in
  the domain of paediatric dentistry

If you have a mixed case load, you could put
forward your evidence for the adolescents and
adults for consideration  
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• Q. How current does the special care dentistry
  experience need to be?

A. Recognition of specialists is usually on the
basis that they are in a position where they have
the necessary skills to do the role at the time
of application for mediated entry to the list
For example, someone who has done no SCD for
10years might be deemed unsuitable, whereas
someone who has taken a career break of a year
or so might be deemed suitable
Each case is reviewed on its own merits
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• Q. Is the assessment of the portfolio done on the
  breadth of relevant cases i.e. lots of different
  conditions?

A. You are expected to show a variety of patient
groups, modalities of treatment and treatment in
a variety of settings, over a period of years in
SCD
You can do this through your log book, referrals
and a small number of in-depth case studies
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Q. How do we get evidence of patients treated
while working for a different PCT, some of which
may have been treated many years ago?

• A. A testimonial from that PCT stating that you
  worked there full/part time for xx years and the
  client group you treated comprised of
  .............

You would still need to provide current evidence
of SCD experience, as you would be unlikely to
gain entry to the list based on only information
from years ago
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Q. Will it count against us if we have not taught
SCD? People working in/linked to teaching
hospitals will have an unfair advantage.

• A. The SAC appreciates not everyone has the same
  opportunities to do everything and this is taken
  into consideration
• Not working in a teaching hospital does not
  preclude you from being involved in teaching
  altogether for example with patients, carers,
  peer groups and team members

It is unlikely that the SAC would not recommend
someone for entry to the list on the basis of no
or minimum activity in teaching and/or research
alone
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Q. How many are they the GDC going to allow
onto the list?

• A. There is no specific number
• It depends on how many people with appropriate
  experience and/or training equivalent to that
  expected to be achieved by a 3 year specialist
  training apply for entry to the list during the 2
  year transition period

Transition ends on 30th September 2010
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Specialty training

• Approved 3 year training programme that covers
  the specialist training curriculum
• Current curriculum being revised to SDEB standard
  format
• Specialist Training Committees set up by
  Deaneries
• Training programmes approved by Deanery
• Appointment of programme director(s) and
  trainer(s)
• Appointment of trainee(s)
• Regular assessments throughout training
• Membership or Intercollegiate Fellowship
  examination
• CST gained
• Entry onto the specialist list

Entry on to the Specialist List via mediation
process until 30/09/2010
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Other considerations

• The Gold Guide a guide to postgraduate
  dental specialty training in the UK
• National advisor
• Vanita Brookes / Karen Gordon
• SCD panel
• Funding for training posts

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Akin to climbing mountains
Requires preparation, organisation and endurance
The achievement makes it all worthwhile
Thank you for your time and attention