MGDS - Joining the Dental Elite

The idea of doing the MGDS, the Diploma of Membership in General Dental Surgery of the Royal College of Surgeons of England occurred to me on maternity leave. I thought it would ‘keep me busy’ while I waited for my daughter’s arrival. I knew several colleagues who had started MGDS, but none who had successfully passed the rigorous exam. In fact, only about 300 dentists in the UK, less than 2% of the profession, held the post-graduate qualification.

I already held my dental degree, honours science degree (in oral microbiology), and the Diploma in General Dental Practice. I was experienced in learning and taking exams. How hard could it be?

I soon found out. I recall the post-natal period as a haze of sleep deprivation. Memories of night feeds mingle with journal reading. My maternity locum at Gentle Dental Harrow accepted a hospital training post. I returned to work four weeks after Amy’s birth. In between working, expressing milk, mothering, breastfeeding and sleeping, I studied for the first part of the exam, the theoretical paper. One year later, I passed.

The final clinical part of the Diploma beckoned. I read constantly. I was on a first name basis with the staff at the British Dental Association Information Centre. The practice administration systems were overhauled. Every treatment protocol was scrutinized for best practice, evidence base, conformity to currently accepted guidelines, techniques and materials used and laboratory specifications. Only the highest standards were acceptable.

Four patients (‘clients’, my preferred terminology, was not an industry standard, I realized) were invited for treatment to demonstrate my clinical skills. One was a housebound gentleman with schizophrenia who required new false teeth. Another was my dental technician who did his own laboratory work, beautiful gold crowns, inlays and onlays, if I do say so myself. Two others were my daughter’s nannies. Both had grown up in Eastern Europe and had multiple dental needs. I remember them holding Amy while I provided hygiene, fillings, root fillings, porcelain veneers, crowns and partial dentures. At regular intervals Amy would wriggle and scream. We would pause while I fed her, then return to work.

A telephone support network sprang up in the study group I attended. One colleague remarked his wife and staff had threatened to leave him if he did not pass the exam. Another asked me if I thought we would pass.

"Of course we will. We wouldn’t be sitting this exam if we didn’t think we would", I replied.

We hauled ourselves to the finish line.

Gentle Dental Harrow was inspected. My loyal and longstanding staff were inspected. Two of my patients were inspected. I was inspected. I was quizzed on every aspect of my practice, patient care, treatment planning and general dentistry. The clinical exam process took place over two weeks.

Finally, at the Royal College itself, envelopes bearing results were distributed. As I read the words, "We have much pleasure in informing you…" I cried, laughed, and hugged my colleagues. All in my study support network passed, but only half the candidates overall.

I went on to co-author a series of papers on how to pass the exam, which was published in journal and book form by the Faculty of General Dental Practice (UK). I keep up to date in my profession with research, writing, reading, lectures and tutorials. Memories of the exam faded, but the ethic of excellence has thrived. Alongside my daily focus on the care of people with dental fears and phobias, I never forget my desire to provide the best quality work I can offer. I enjoy the confidence I feel and the results and trust I gain. Was my MGDS experience a worthwhile investment? Most definitely.

15 Minutes of Fame (By Proxy)

My mother decided that all four of her children would be doctors, and this was the message I received from an early age. My father was a psychiatrist and my mother worked as a nurse before parenting took over. Medicine was the only career path mentioned.

When I missed out on entry to medical school, my father said if I studied hard I could reapply in a year. There were no congratulations for getting into dental school, which felt like second prize, if it were a prize at all.

I failed my first year of dentistry. Undiagnosed ADHD? Poorly developed study skills? A distracting boyfriend (as my mother believed)? Or an unconscious wish not to follow in the family footsteps? Whatever the case, I repeated the part of the subject I failed (chemistry) and passed very creditably the second time around, particularly since I then went to all the lectures.

My parental ambitions for me lay in tatters, but by this time the miracle had occurred. I had fallen in love with dentistry, both the job and the profession. I loved the way my own previously aloof dentist treated me as a colleague from the moment I shared I was in dental school.  I thrived on tales of oral hygiene transformed and delighted in working with my hands. I spent the time I had aside from study to do voluntary assistance in the oral biology department, beginning a life long passion for research. And I took classes in karate and bicycle maintenance, ideal for improving my fitness, confidence and coordination.

By the time I graduated, I was one of the top students, winning scholarships and research prizes. I did an honours science degree in oral microbiology. In my first paid job, I was able to offer free dental care for my parents, who by now had started proudly telling friends and colleagues that their daughter was a dentist.

I settled in London and worked as an associate for some years before setting up my own practice in Harrow. I acquired both the diploma and memberships in general dental surgery from the esteemed Royal College of Surgeons in between gestating, lactating and rearing my daughter. I thanked God I wasn’t a doctor. I didn’t see how I could have worked and parented if I’d had the life of a busy GP or hospital doctor instead of the manageability of dental practice.

My dental school days carry distant memories of despairing tutors chastising me for spending too long talking to patients and not enough time doing ‘real work’ (drilling and filling). I’m grateful that today my real work involves a lot of chatting, or ‘quality conversations’ as the psychiatric profession calls it. I love getting to know my clients, and helping transform their lives for the better, not just their teeth. So maybe I have integrated my medical/psychiatric/nursing family culture after all.

And my siblings? My older brother became a doctor and a medical researcher. My twin sister became a doctor and later a psychiatrist. Both, like my father, became professors. My younger sister, a renegade, became a film producer with her own production company. My parents, in their own ways, loved us and were proud of us all.

Her offspring were not the only children exhorted to achieve by my mother. One of my dear school friends shared her wish to become a teacher with my mother, who then decried her lack of ambition and told her she must do law. Today Julia Gillard is the Prime Minister of Australia, my claim to 15 minutes of vicarious fame, and the living proof that my mother wasn’t always wrong.