Hospital dentistry – hot or not?
Considering hospital dentistry? Bethany Rushworth weighs up the pros and cons.
I have worked in what I consider to be the three main settings in dentistry (private practice, NHS general practice and a hospital). I have a fairly well-rounded view on the pros and cons of each.
In this article, I will discuss the advantages and disadvantages of working in an NHS hospital. In particular for those early on in their careers, perhaps considering dental core training (DCT) or specialist training. Notwithstanding the varying size of different hospitals and varied services provided, discussions with colleagues has reassured me that my experience was fairly generalisable! Let’s start with the positives.
Size of the team
Regarding the aforementioned topic of workforce size, it is likely the majority of hospital environments you work in will have more staff members than any general dental practice. I personally loved being part of a big team and seeing so many different people each day.
I am fortunate enough to have a brilliant relationship with the nurse I work with each day.
Everything under one roof
This won’t apply to everywhere, but for me the hospital team I was part of included specialists in OMFS, oral surgery, restorative dentistry, paediatrics, oral medicine, orthodontics and even ENT, plastic surgery and neurosurgery. This meant that an extremely valuable second opinion was never too far away and I was able to learn from some of the very best in their fields.
I felt extremely well supported and being able to work as a big team is something which I really enjoyed.
In general, there are a lot more opportunities to contribute to research when working in a hospital setting than in general practice. Being involved with research is a brilliant opportunity to improve your understanding of scientific papers and increase your awareness of best practice when undertaking your own projects.
This will possibly lead to you contributing to the existing field of research yourself, or at the very least enable you to practice evidence-based dentistry with increased confidence and ability to critically appraise work you see in journals and online. It also looks great on your CV.
On a similar theme, you can get involved with plenty of other existing projects. Although, you must find them and invest the time and effort required. This may include audits, presentations, teaching and local initiatives. Again all of which will strengthen your CV, provide valuable experience and facilitate you meeting new people.
For those doing 1-year positions such as DCT, joining an existing project can sometimes be more effective and beneficial than starting from the beginning. In some cases by the time your idea is up and running, it is time to move on to the next role.
In my opinion, a salary has advantages and disadvantages. I loved having a consistent income each month, regardless of when my annual leave was throughout the year. That being said, I didn’t have as much flexibility as to when I work and what I do.
In general practice I have a lot more control over the treatments I provide. I can also take my annual leave whenever I want (within reason!).
In the hospital I was part of a team which required 24/7 cover. Therefore I would often have to miss family occasions and events due to being on a non-negotiable rota. Now I am in a position to open my clinic to fit around things such as weddings. I don’t do clinical work after 7pm or during the weekend.
Maternity pay and pensions
As mentioned in my previous article about working in NHS general practice, one perk of the job if you have an NHS hospital role is that you get benefits such as the NHS pension and maternity pay. This is something you need to consider if you are planning to work privately.
In some circumstances the amount you might earn as a private associate makes up the difference compared to the majority of salaried hospital posts. However, if you prefer the predictability the regular income might be best for you!
In a salaried NHS position tax is also deducted at source. So, provided you don’t have any other sources of income, you will be able to save money on an accountant. You can relax knowing that your tax bill has already been covered before your pay arrives in your bank account.
Referrals and rapport
Something which I missed in the hospital was building a long-term rapport with my patients. The majority of them were either referred to the department or were there with an acute condition. This means that once the single course of treatment was complete, I wouldn’t see them again.
This is something which I really enjoy about being in general practice. I get to know my patients, often their families and build a long-term relationship and trust with them.
As with any job, in any profession, there will be pros and cons of each. Personally, I loved the fast-paced environment of the hospital. I loved working in a big team, and the complexity of cases which I was involved with.
I didn’t feel this role was as flexible as my current position as an associate. This is because my holiday allowance was very specific. I could only take my annual leave at certain points during the rota. I also couldn’t simply go home if it was quiet. Now, if my last patient were to cancel I can leave. This is a perk of being self-employed.