Life as an Oral & Maxillofacial SHO |
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As I approached my final week as an Oral & Maxillofacial Senior House Officer (SHO), I was confronted by mixed feelings of sadness and absolute relief. Relief as I was longing to catch up on my sleep and to finally call my weekends my own again; but sadness as I knew I was unlikely to have another job as exciting as this one.
Practice or Hospital?You may be wondering why young, energetic individuals would trade a financially rewarding, comfortable life working from 9-5 in practice for working double the hours and for half the pay in a hospital. So did I. I was working harder than ever before and my pay was a fraction of that earned by my friends in practice. However, it soon dawned on me that I was gaining far more than I had at first realised. I was learning at the same rate as I was at school and university, and for the first time in my life I was getting paid for the privilege.
DutiesObviously every maxillofacial unit is different, but the duties in each of them are generally similar. The day usually starts with a ward round, updating the team on all of the maxillofacial inpatients and any new admissions from the night. We would see each patient and write an update in the notes with a plan of action for the day. It would then be the job of the SHO in charge of the wards to ensure that all these jobs are carried out.
If I was not on call, my day involved minor oral surgery clinics, consultant clinics and clerking patients for theatre. The latter was a whole new concept that I only really mastered a year into my job. This involved summarising the patient’s maxillofacial history, medical history and management plan into one entry in the notes. The idea was to highlight any medical conditions that may affect the general anaesthetic, to check that all preoperative tests have been done and to ensure that the patient fully understands the operation they are due to have.
One of my jobs that I enjoyed the most was my time in theatre. This was what maxillofacial surgery was all about. It was away from the pressures of the rest of the hospital and the consultants and registrars seemed more relaxed in this environment as well. It was a great time just to learn and to see all the procedures I had only ever read about.
On call duties are the ones that most people talk about. Depending on the unit, you see all patients referred to you with facial and mandibular fractures, facial lacerations, severe dental infections and more. It is the SHO’s job to assess the patient, carry out any special tests including blood tests and X-rays, and then relay this information to the senior members of the team. As you get more experienced, you learn to make some clinical decisions yourself and to decide which patients require inpatient treatment.
On call requires you to function when your body really doesn’t want to. It is physically and mentally demanding and at 4am it can bring out the monster in you! Perhaps with the new shift patterns the SHOs will not be so chronically tired, and they should be able to enjoy the work more. When I first started, I found myself drowning in the unknown. However, at some point I began to develop confidence in my skills. It may have been after seeing the suturing skills of my medical colleagues, or after I found myself giving advice to a dental practitioner with far more experience than me. All of a sudden I seemed to know what I was talking about!
What they look for…During my Vocational Training, I met a Maxillofacial Consultant who told me that the two most important qualities that a maxillofacial SHO should have were reliability and honesty. I would have to agree, although I would also add enthusiasm. An SHO’s ability to complete a task directly affects the other members of the team. Likewise, if you’ve made a mistake, forgotten to do a job or are just unsure what to so, it is infinitely better to say something than to keep quiet. Finally if you’re keen and you love to learn then you should definitely give maxillofacial surgery a go. Not only does your day to day work prepare you well for the MFDS examinations, but it also provides you with opportunities that you would not find anywhere else. As an SHO you can learn as much or as little as you want.
District Generals versus Teaching Hospitals When you apply for a job, consider the type of experience that you want. District General Hospitals (DGHs) have smaller maxillofacial units and tend to give the SHOs more hands on experience. The trauma tends to be less severe, but in terms of everyday skills that you can take away with you to all other fields of dentistry, the experience is far better at a junior level. On the other hand, if you want a career in maxillofacial surgery or you want to gain experience in handling more complex (and at times more traumatic) cases, then the larger teaching hospitals may be up your street. The teaching hospitals have more to see and arguably more specialists from all fields to learn from; but as a junior there is less hands on experience as the teams are much larger.
As with any job you apply for, you must go and visit the unit beforehand. Not least to meet the team and have your face seen, but also to see if it is an environment that you think you will enjoy and excel in. If you find the right unit with people who love to teach, then they will feed your enthusiasm and inspire you to achieve things that you never thought were possible… |
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Paroo Mistry graduated from Bristol in 2002. She completed VT on the Leicester scheme and then worked in the Restorative department at Sydney Dental Hospital, Australia. On her return she spent 12 months as a Maxillofacial SHO and is currently working as a Community Dental Officer in London.
Paroo looks back at 6 months in a District General Hospital and 6 months in a Central London teaching hospital. With the benefit of hindsight she examines the pros and cons of hospital jobs and tips on applying.
This article was published by ‘The Probe’ in February 2006. |
