Proposal: To remove the entry restriction on only Dental Technology undergraduates applying to the programme.
Update For Membership
Dear Members,
I hope you all had a good Christmas and Happy New Year to you all.
This letter is an update on the progress the IMPT Education Committee, Trainers Groups and the IMPT Council have made on broadening the entry requirements for the STP in Reconstructive Science (MFP/RS).
History – STP Launch
Firstly, a brief history of why we are at this point. At the inception of the STP programmes we were the only group stipulating one course (BSc Dental Technology), one route as an entry requirement. Because of the nature of our course we (IMPT & Universities) required knowledge of head and neck anatomy, dental materials science and the manufacture of dental devices as a necessity. With the dental device manufacture we also stipulated General Dental Council registration (GDC) as a Dental Care Professional (DCP/DT). This stipulation (DT + GDC) was always seen as problematic by the National School of Healthcare Science and Chief Scientific Officer. We were told this restriction was only to be in place for a limited period (not specified) before this would be reviewed. The concerns were that we would face challenges in applicant quality, recruitment numbers and selection with restricted entry.
In 10 training intake years (2013-2022), 2013 was the only year we filled the minimum required number of training posts. This number of ‘10’ trainees each year was designated by the profession (IMPT STP Working Group) the Universities (Kings/MMU) and the Department of Health/NHS Employers (Author- Paul Newell DoH; MFP workforce review 2006). 10 each year was the number needed to maintain our workforce numbers. The DoH agreed to fund all 10 through the funding Health Education England process. MMU and Kings based all their predications and funding on 10 students in each of the 3 years.
Challenges of Recruitment and Training Numbers in MFP/RS
Having only one course (Dental Technology), one route into MFP/RS has meant we can only have those graduates from a University offering Dental Technology. Currently 1 UK University (Cardiff). Of the graduates each year only those with a 2.1 or above can apply. With ‘top up’ BSc programmes included the estimate is around 20 DT’s each year (info from Cardiff University 2021) could apply. From that group some will choose commercial work, other hospital routes, a ‘steppingstone’ to other courses such as Dentistry and some may choose MFP/RS. Since 2013 (first intake) we have only had 10-15 applicants who meet our entry criteria for on average 7 posts. Of those 10-15 who make the shortlist, not all will pass the interview process. We have had instances at recruitment where we have the same number of successful applicants as training posts. This is not a competitive environment.
Every year since the centrally funded Health Education England (HEE) national training pathway (STP) began, we have faced the challenge of filling the course minimum requirement of 7 in terms of units training and numbers applying. There has been great work from Education/Training leaders and IMPT members to promote the course and encourage applicants and training centres. We have seen the development of new training units in the last two entries in 2020 & 2022 thanks to the hard work of the current training Leads (SW rotation). You will note from my last sentence a ‘gap’ in 2021. In fact, we have had three years of not being able to run the course – 2016, 2017, and 2021. We have termed this a ’fallow year’. In 2021 we had enough training centres but not enough successful applicants to fill the required minimum trainees on the course (Kings MMU minimum 7). Successful students were turned away from the profession.
We have a high rate of drop out from the course when compared to other STP courses (source NSHCS). The course is challenging, the work-based competency and the academic components are difficult to complete.
IMPT Members Work to Improve Recruitment
As a Council and as a profession we have had meetings each year on how we might improve applicant numbers and the training unit numbers offering places. Each year we face the same challenges. One of the ideas to improve this situation has been to remove the two restrictions on applications. Dental Technology + GDC registration. To be very clear, DT is still the preferred route into MFP/RS. The removal of the restriction would allow other Science based, practical focused, undergraduates to apply for STP in RS. These would be from a list approved by the IMPT Education Committee in conjunction with the Universities (MMU & Kings).
STP Applicants Status- Statutory Registration
Most healthcare training pathways do not require statutory registration prior to application. Generally, in the Scientist, Nursing, AHP groups, training leads to registration. In our case registration with the Health & Care Professions Council (HCPC) as a Clinical Scientist. We do not require GDC registered applicants for reasons of patient safety. All trainees are supervised. The requirement was placed as our trainees and qualified staff may be required to make medical devices that are deemed part of dentistry. To be clear the registration is as a Dental Technician (DT). The scope of practice of a DT. Any device manufactured that is not the work of a DT does not require the individual to be registered with the GDC as a DT. We have to review the changes in our practice over the last 10 years. Can you see a change in the work we undertake? What will the trainee exiting the programme in 2027 be undertaking?
Non-Dental Technology Qualified Staff
The IMPT have been very clear. Any Member (MIMPT) must be on a statutory register. The GDC or the HCPC or both dependent on job role and competence. If the trainee has no DT qualification, is not on the GDC register as a Dental Care Professional (DT) then they will not be able to ‘practice dentistry’ after qualification. In our context that is the work of a DT. Laboratory staff can work under the supervision of a GDC registrant but clearly any tasks/devices we deem DT would need the competence of a DT. Our previous Chairman has given the profession updates on the discussions with the GDC in 2021-22 (AGM 2022/Liverpool Congress 2022). The outcome of which will be a statement on ‘dual statutory registration’ for GDC registrants (IMPT Members & BAOMS Fellows). Clearly stating that your own registrant status depends on your own practice and the job you undertake. In short, if you are making a maxillary obturator and a lower denture for a patient you would be expected to be on the GDC register as a DT (clearly identifiable as a dental device). If you are taking an intra oral impression, that is in the extended scope of practice of a DT, you will need to be on the GDC register with the correct extended training and competency assessed. If you are making a surgical dressing plate, a keloid splint or a facial prosthesis that is not the regular work of a DT (not in DT Scope Of Practice) you would not need to be registered with the GDC as this is not dentistry. The GDC were clear that as an MFP/RS you would have to be on a statutory register, to protect vulnerable patients.
IMPT Members & Council Position
The IMPT Council have discussed the potential for non-Dental Technology entrants for the past 2-3 years. The proposal was put to the membership by the Education Lead Prof Trevor Coward at the BAOMS joint meeting in Sheffield in 2020 and those members present voted in support of the proposed changes pending discussions with the NSHCS, GDC and CSO. IMPT Council took a further vote in support of the proposal.
Discussions with the GDC & Chief Scientific Officer (CSO)
Prof Trevor Coward as Education Lead and Jason Watson as Chair had the discussion with the GDC (2021-2022). There are no regulatory barriers to this proposal.
Considerations for Feedback
The focus of the Education Committee and Lead Trainers has been what if we do need some basic ‘core’ DT skills and/or a Reconstructive Scientist that is registered with the GDC when they qualify? What are the options?
There were discussions at the last Trainers meeting about how best to support training units and prepare the new trainees if they do not have a dental Technology background. One idea was to have pre-STP training workshops, another would be short courses in the first year of STP study. Under the new curricula the trainees are mostly observing MFP tasks in the first 6 months. So alongside this we could work on their core DT skills. These would not lead to a GDC registrable qualification but would assist in the delivery.
Another proposal is a pre STP or post STP study DT qualification with an FE college such as Bolton. The current minimum is level 3 for the GDC.
In the future job descriptions would have to be revised to reflect the needs of the service. Not just automatically including GDC registration. Specific services will still require a DT bias to the job role. Other services may require only HCPC registration with an MFP/RS bias to the role. This is an evolution of training.
A questionnaire is going to be sent via the Lead Trainers/IMPT Education Committee to MFP/RS members to gather views on a wider basis. We want your views as members and your ideas on how we can improve the current training and education challenges. Please engage in the questionnaire, this is the future of our profession from 2027 onwards. How has your service changed in the last 10 years? What will it be like in the next 10? When we qualified, we were entering the best job in the world. The profession has a national funded training programme, providing research, innovation, structured development and in the context of the NHS, a well-paid training opportunity. How do we continue to protect the profession for the future?
Thank you for your consideration of the above points. Please feel free to contact me or the Education Committee Lead Karen Boyd so your thoughts are included in the review process.
Kind regards,
Mr Hitesh Koria
Chair IMPT
