International dentist Gauri Pradhan talks about the challenges of the overseas registration exam (ORE) and why it has to change.
I came to the UK on 14 September 2007. I had qualified in India with a BDS and then went on to do my master’s in oral and maxillofacial surgery.
The post-graduation degree was an intensive seven-day week, with on calls and night shifts for three years, which included the submission of multiple paper presentations and two dissertations.
After that, I thought nothing could beat the stress. I was wrong.
I quickly realised that my master’s degree will go to waste as will my graduate degree as they aren’t recognised in the UK.
It still hadn’t dawned on me that I would have to jump through multiple hoops – including the overseas registration exam (ORE) – in order to practise in the UK.
If I wanted to go the oral and maxillofacial route, I would have to go through a formal training in medicine which meant another 10 plus years of training after the eight years I had already had back in India.
Big surprise
I was very keen to work, and I decided to apply for senior house officer (SHO) positions in hospitals. This was both to gain UK experience but also to earn money to take courses to prepare for the exam and pay for the exam itself.
I went to London and started dropping copies of my CV in every hospital in the area I had Googled. I was lucky to get a job as an SHO at the Northwick Park Hospital. My SHO experience helped me a lot and I met some helpful people including my consultants, but the hours needed to do the job did limit the opportunities I had to prepare wholly for the ORE.
The ORE exam, I had not realised, was going to be the most expensive examination I was going to take, and I am not just talking about the exam fee. There were courses to take, travelling to do and investments to be made in equipment. I had set up a mini surgery in my house to practice for the exam, like a compressor, suction, mannequin and instruments needed for dentistry. I assure you all people taking this exam have this room set up. This was all while I had a young family.
Difficulties with the overseas registration exam
I got in touch with people from different countries taking or preparing for the exam and started my own preparation using every free minute I had, studying late into the night and working next morning.
I took the first part of the ORE and passed. When I passed part one, I recall thinking to myself that if you prepare well enough you will pass so why do people say it’s tough to get through? But I was in for a big surprise, which lasted three to four years.
I continued working in hospital as an SHO while taking the part two of the exam. I prepared for part two, sat it and failed it. So I prepared again, sat it and failed it the second time. I then prepared again, sat it and failed it again.
By the third failed attempt, I was almost full term pregnant when I took the exam and recall one of the examiners said ‘please don’t give birth here’ in jest to lighten things up.
‘I broke down’
It was a very difficult time. I recall very clearly when I received my ORE results in the afternoon and later that evening I got a call from the hospital asking me to come in for some tests as reports suggested that the baby might have problems in development due to my age and would need to run more tests.
This was the point I broke down. I could not see a light at the end of the tunnel.
I had one more go at the exam – as the rules say that one must pass this exam within five years of sitting part one otherwise you have to retake the first part. And this was when everything was at stake, for I was thinking of going back to India if I were to fail again.
My parents who are renowned in the field of dentistry advised that I should change my career and maybe it was not meant to be. I could not give up – I was top of the class at my university so how was I failing this exam again?
I prepared, retook the exam and thank God I finally passed (hats off to people who have been more successful than me).
All the above was done was done in a full-time job and, later, with a child.
Help for overseas dentists
Time has passed and my son is now 12. It was a tough time for me and my family. I would only prepare for exams or work. There was nothing else I would do during those years. I recall a mortgage advisor who came home to discuss options. While he was asking us our expenditure he asked: ‘How often do you go out to eat?’ My husband and I answered together – never. He was surprised.
I think back and ask myself several times, did it need to be so difficult?
If I hadn’t put so much time and money into funding the exam, could I have had more children? Could I have been a consultant? Where would I be? I have been pushed back a good five to seven years in my career.
After passing the exam, I decided to assist overseas dentists who were unfamiliar with the exam, its preparation, and life in the UK. I founded a charity and, alongside my close friend Shivani Bhandari, who shared my vision, dedicated 10 years to this cause. Unfortunately, political issues arose, prompting us to leave.
We then co-founded the International Dental Organisation – UK (IDO-UK), where I’m pleased to say all trustees share our goals. Our charity focuses on providing guidance, support, and a platform for overseas dentists and dental care professionals (DCPs) to help them settle in the UK, all free of cost.
Final thoughts
1. The exam is not tough but passing it in all areas is the challenge. Apart from the preparation, one’s mental strength, attitude, perseverance and luck are tested
2. There are those lucky few who get through on the first attempt but most of us must go through the painful process of resitting the exam. I have colleagues who have worked at Tesco and McDonald’s etc to take this exam
3. Did it need to be so expensive? All the courses offered are private and frightfully costly. There is no quality assurance for these courses
4. After passing the exam, getting a job is not straightforward in the NHS. I could have become a private dentist the day I got registered but I wanted to work for the NHS. For me, there is a sense of pride about working within the NHS. My dad sings its praises in his short time working at the Morriston Hospital in Wales as a max-fax surgeon. He went back to India to work in a similar format. The world looks up to the NHS and it’s our duty to help in whatever way we can.
If I hadn’t put so much time and money into funding the exam, could I have had more children? Could I have been a consultant? Where would I be? I have been pushed back a good five to seven years in my career.
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