OMFS Pathways for the Scottish Applicant

Author: Kai Ewers

Oral and maxillofacial surgery (OMFS) is renowned for its long and arduous pathway. There have historically been various routes into OMFS, with the second-degree often being considered by both dentistry- and medicine-first trainees as the biggest hurdle. With recent changes to specialty training, this guide aims to concisely delineate the pathways available to the Scottish applicant. 

Overview of OMFS Training Pathways

Please note the recent change announced by the OMFS SAC: It has been the case that both ST1 and ST3 were possible entry points for OMFS specialty training. The current intention is that for positions starting from 2027 onwards, recruitment will only be at ST1 level. Although Core Surgical Training (CST) has traditionally been involved in the pathway, allowing dual-qualified trainees to enter ST3, it is likely it will have a less direct role in OMFS training.          

Dentistry-first trainees once completing their primary dental degree and year of Dental Foundation Training (DFT) usually complete 2-3 years of Dental Core Training (DCT) with some OMFS exposure. this is followed by a 3–5-year second degree in medicine. They then complete Foundation Years 1 and 2 (FY1 + FY2) which is followed by entry to ST1 OMFS. This programme runs from ST1-ST7 with the opportunity of skipping ST2 if competencies are achieved (six years total.) 

Medicine-first trainees once completing their primary medical degree then complete FY1 and FY2, during which they may complete an OMFS block. Under the new training pathway, the next direct step would be a 3-5-year second degree in dentistry. This would then be followed by entry to ST1 OMFS. 

Completion of training is often followed by a 6-month or 1-year Fellowship in subspecialty training e.g trauma, oncology, craniofacial.

It is important to note that many trainees take Clinical Development Fellow (CDF) jobs in OMFS in-between training years to get more experience. It is also important to note that ST training is competency-based not time-based, therefore trainees who have already done CDF years and/or CST will be more likely to shorten the ST1-2 portion of training than trainees who have progressed straight through.

Early OMFS Exposure for the Singly-Qualified Dentist in Scotland

The following locations currently offer OMFS DCT rotations:

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The OMFS DCT job description varies by location but may involve ward inpatient work, seeing urgent outpatient referrals, assisting in theatre, holding a trauma bleep and working in the outpatient department.

There is also a dedicated cleft surgery DCT position at The Royal Hospital for Children, Glasgow.

Early OMFS Exposure for the Singly-Qualified Doctor in Scotland

The following locations currently offer dedicated OMFS FY rotations

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FY job roles mainly concern ward inpatient work; however, theatre opportunities and clinic exposure are possible.

The Great Advantage

Students with ‘Scottish’ fee-paying status have a unique advantage in that the fees for second-degree medicine/dentistry in Scotland are significantly less than in the rest of the UK. Second-degree medicine is £1,820 a year, and second-degree dentistry is free. This is opposed to £9,535 for students from the rest of the UK (RUK). As second-degree tuition fees are not fully covered by the Student Loans Company, students typically must provide this money themselves at best over a few instalments over the academic year, if not all at once.

This makes it considerably easier for Scottish fee-paying students to get through a second degree in Scotland. For a 5-year dental course this is the difference of £47,675.

Find out if you qualify for Scottish fee-paying status here: https://commonslibrary.parliament.uk/eligibility-for-home-fee-status-and-student-support-in-scotland/

Second-degree Dentistry for Scottish Doctors

The following table outlines all Scotland-wide, and all shortened UK-wide dental degree options and their respective annual tuition fees. Note that 5-year courses in the rest of the UK have not been included:

*       A four-year option with direct entry into second year is possible if the applicant has MRCS Part A, however this is heavily dependent on whether a place in second year is available or not 

+ This is a 3-year course aimed at OMFS applicants. Places are limited at around 10 per year. Unsuccessful applicants may be offered a place on the 4-year graduate course.

Second-degree Medicine for Scottish Dentists

There are much more shortened second-degree medicine courses in the UK than for second-degree dentistry. These are best seen on this old JTG page link: https://puffy-alpaca-25c.notion.site/Medical-courses-for-dentists-0fccc6b039694e889f6dc04356b586a1

The following table aims to outline all Scotland-wide medical degree options and their respective annual tuition fees. No RUK courses have been included in this table:

*        Dentists have managed before to enter directly into 2nd year for a shortened 4 year programme although this is not specifically advertised.

**       Applicants can apply to the standard MBChB course or the new HCP-Med course for Healthcare Professionals. The latter allows students to study part-time and online while working part-time for the first three years, they then join the rest of the MBChB programme in year 4.

+   There is one dedicated 3-year programme place for OMFS-aspiring dentists, with direct entry into 3rdyear of the MBChB programme. All other entry is into the 5-year programme.

OMFS Work as a Second-degree Student

OMFS work is available as either locum contract or locum ad hoc shifts for second degree students across all the hospitals labelled in the first map of Scotland. Please don’t hesitate for contact me for further details.

OMFS Specialty Training in Scotland

From 2027, successful dual-qualified applicants will enter specialty training at ST1 level. The current ST1-2 portion includes rotations in general and orthopaedic surgery. 

From ST3, trainees work solely in OMFS. This is a pan-Scotland rotation, so trainees can expect to move around a fair bit for various 6-month or 1-year rotations. Upcoming rotations are typically not known until a couple months before. 

As the long distance between Scottish units can be daunting for trainees, personal circumstances are considered when allocating rotations while keeping in mind the needs of the respective populations served by the different OMFS units.

The QE in Glasgow is the main tertiary centre for OMFS in Scotland. Rotations there are therefore usually in one subspecialty as opposed to all other hospitals.

A trainee’s full ST3-7 journey may look something like this:

• ST3: Aberdeen for one year as sole registrar with operating in oncology, trauma and orthognathic surgery.

• ST4: 6 months at the QE, Glasgow doing oncology. Followed by 6 months at the Royal Hospital for Children, Glasgow in cleft and craniofacial surgery. 

• ST5: 6 months in Crosshouse as sole reg doing skins, orthognathic and trauma. Followed by 6 months at the QE, Glasgow doing trauma.

• ST6: 6 months at the QE, Glasgow doing oncology. Followed by 6 months in Dundee as sole registrar. FRCS (OMFS) exam is typically sat at this time

• ST7: 6 months in Livingston, followed by 6 months in trauma at QE, Glasgow.

Post-CCT Fellowships in Scotland

Senior OMFS fellows have come from all over the world to undertaken fellowships in oncology, craniofacial, cleft and trauma in Scotland. Hopefully Scotland will continue this reputation forwards.

Closing Remarks

I hope that this article has helped better inform you about the options available in Scotland for those wishing to pursue OMFS. OMFS is an amazing specialty to pursue, and we are lucky as Scottish applicants that we can access second-degrees in Scotland a lot more affordably. Please don’t hesitate to contact me if you have any more questions about the training pathway, and what Scotland has to offer. 

It is a privilege to be involved in OMFS, and an even greater privilege to advise others after many kind people have themselves advised me