Here is a profile of an Oral and Maxillofacial Surgery (OMFS) Registrar. He has asked to remain anonymous.
Please tell us a little about your background
I graduated from the University of Melbourne with a Bachelor of Dental Science degree in December 2003. I worked in a rural Hospital in the dental clinic in Shepparton as an “intern” in 2004.
Afterwards, I practiced as a private dental practitioner in suburban Melbourne for 4 years with the aim of obtaining wide varied experiences in all facets of general dentistry.
I returned to the Royal Dental Hospital of Melbourne in 2009 as a “resident dental officer” working in the Oral & Maxillofacial Surgery Unit.
This year I am completing my OMS (Oral Maxillofacial Surgery) BST1 (Basic Surgical Training Year 1) at Royal Hobart Hospital. I am employed as an accredited registrar under the Oral & Maxillofacial Unit.
How did you go about deciding on dentistry and now OMFU?
I’ve always loved working in an hospital environment but what attracted me most was the surgical aspect of Oral & Maxillofacial Surgery. This was a challenge to me rather than the mundane and monotonous work of a general dental practitioner.
My interest increased when I was given the opportunity to assist in a few cases with an Oral & Maxillofacial Surgeon in Melbourne at the Epworth Hospital.
I have keen interest in the management of cleft lip and palate patients and orthognathic surgery (major jaw surgery).
I was offered a second round offer to study dentistry at University of Melbourne and I decided that it was worth looking into … 5 years later I graduated!
Can you give us a brief run down of what you had to go through to get in?
To get into university at the time I finished my VCE exams we had to have a high ENTER (TER?) combined with a reasonably high UMAT score. Some universities also required that you do well in your interview as well. University of Melbourne only reviewed your high school academic record and your UMAT results.
In order to work as a Registrar at RHH in the Oral & Maxillofacial Unit I needed to sit for my Primary Examinations (equivalent to Surgical Primaries?) which was a self-learning exercise whereby you are examined on 6 subjects (Anatomy, Biochemistry, Physiology, Microbiology, Histology and Pathology). For each subject you had a 2 hour written paper and the following week a 10 minute oral viva. Also I needed to apply to the RACDS (Royal Australasian College of Dental Surgeons) as a Trainee. Then once the College accepts you as a trainee you are required to apply for yourself to the various posts available each year in Australia and NZ. I am currently on the Victorian Training Program as a junior registrar and due to the nature of the training program it is now mandatory that I need to complete my medical degree before I can be considered for Advanced Surgical Training.
Research is considered mandatory as well and to be completed in your own time. But you are able to obtain guidance on which topics to look into from the consultants.
What do you enjoy most about Max Facs?
I love the varied and often times challenging nature of OMFS. There is never a time where you will feel that you have mastered any surgical procedure. I believe that the scope of practice is so varied that there are sub-specialities within the specialty itself, e.g. TMJ surgery.
I enjoy the difference that you can make to a young child with Cleft Lip and Palate Deformities and to see the change in their self-esteem as you are able to correct their appearance. This also brings joy to the worried parents as well!
Head and Neck oncology is probably the toughest aspect of OMFS. Unfortunately, there are times when despite surgical intervention both quality of life and prevention of the patient’s death from the advancement of the tumour is futile.
What are the some of the challenges associated with being a registrar in your specialty – how do you go about overcoming them?
By far the biggest challenge to overcome especially here in RHH is rightly so the fact that I am the only registrar covering for OMFU. In most other states there are at least 2 registrars to cover the workload in the hospital.
Being the only registrar means that I am oncall 1:1 every day and all year long except when I’m on leave. This means that I need to review and manage inpatients (both my own and other’s units which have requested OMFU review), outpatients (busy 3.5 day clinic per week), emergency patients in DEM (Dept of Emergency Medicine) and calls from LDO’s/LMO’s outside requesting advice with the management of their patients.
You are to a certain degree reimbursed reasonably well but a cost of time that you otherwise may have been able to spend with your spouse, children, family, friends etc.
What are your interests outside of work? Do you get time to pursue these activities?
Last year when I was not expected to be oncall I had a keen interest in bike riding on dedicated bike trails. Unfortunately I have not been able to continue this but am hoping to restart this when I return to Melbourne next year.
I also enjoy reading e-books which I often use to help me de-stress at the end of a long day at work.
Apart from that spending my available time playing with my son and quality time with my wife occupies what little remains of my free time away from work.
Do you have any advice for budding students wanting to specialise in Max Facs?
Yes … go for it!!! Spend time with registrars … see what kind of work the specialty entails. If you ask nicely the registrar may allow you to assist in theatre with them and if you’re really lucky they may let you have a go. Also link yourself up with a consultant and tell them that you’re interested in finding out more about the specialty. They may let you assist them in private operating sessions and this relationship is crucial if you need their support when it comes time to applying for advanced training positions!
Finally, don’t be fazed by the long time it takes to become a consultant … the reward is the varied and interesting work itself that you will be doing each day! I would rather be poor and do something that I enjoy doing than be rich and do something that you have to drag yourself out of bed to do!!!
PS: Tasmania has a huge shortage of OMFU Specialists!!! You may find that you can choose where you want to practice and find that there is more than enough work for you to do!