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By Megan McLeod

Starting DFT and overcoming perfectionism

5 min
Megan McLeod smiling in graduation cap and gown

How easy is it to adjust to the pressures of dental foundation training? Megan McLeod, who graduated in July 2023, shares her experience and passes on some tips.

I started my foundation year in September 2023, working in a mixed practice in Redcar. There are seven or eight dentists here, so it’s really big and always busy. However, it’s also very supportive which is nice, and there are always people to help.

Redcar is not an affluent area. It’s very high need. Lots of patients come in needing work doing on every tooth. As the foundation dentist (FD), I quite often treat these high needs patients as the other associates don’t have as much time to take on such cases.

As an FD, I’m not chasing UDA targets as I’m salaried. This is quite different from being an associate. I have a rough target, but it’s not the be all and end all if I don’t hit it. The practice does try to encourage me to reach my target though, as it will help me next year.

Working here and seeing all these high needs patients has definitely been good experience. Now that I’ve worked in the practice for a few months, things are starting to click and I’m getting into the swing of things.

I’m beginning to get a bit quicker and more confident when it comes to decision-making and my appointment times are shorter than when I first started.

Adjusting to real world dentistry

It’s been quite difficult to adjust to being in practice because in dental school you’re protected to a certain extent. You have tutors that will deal with difficult patients.

In the real world, you have to deal with people who may be unhappy with the work you’ve done. You have to navigate those difficult conversations with patients on your own.

Time management is something else I had to learn. I found this difficult at the beginning, especially because at dental school, I would only see one or two patients for the morning. In practice, I definitely felt thrown in at the deep end!

I think a lot of managing your time successfully is about keeping in mind what you want to achieve in that session and being very structured. As mentioned, quite often my patients have very high needs, so they need multiple treatments.

If I’ve completed an ID block, I’ll try to do a few other things at the same time. My advice is to try to prioritise what you’re doing and fit in other things while you’re waiting for it to complete. So, if you need to do a clean, do that while you’re waiting for the ID block to work.

It’s important to be very structured and to work with a nurse as well, as they can be really helpful. My nurse is radiograph trained, which is very useful. If I have children that need an OPT, she’ll take the x-ray and I’ll get on with my notes. Working with the people around you can really help with time management too.

Getting my patient notes finished can be tricky, and usually depends on whether I’m running late or not. If I’m on time, I try to include the unique circumstances for that patient. If there’s something really important, I’ll write at the bottom of the notes ‘needs to be included’.

Quite often I have to go back and fill in the remaining parts of the notes. But I make sure I’ve included the important details. Again, it’s difficult to do it all exactly to a high standard when you have a lot of patients.

Although my supervisors have given me a couple of tips on how to make best use of time, it’s mostly about trying to be more efficient. I’ll admit to being a bit of a perfectionist. For me, it’s been about providing good care rather than striving for perfection. This is important when you’re working in the NHS and seeing a lot of patients in one day.

It has been a bit of a struggle for me to adjust, because I do want to provide the best care that I can. But when you’re working in the NHS, you have that constant time pressure, and you don’t want people to come in and be kept waiting.

If you run half and hour late on one patient, it has a knock-on effect. So, it’s definitely been a challenge to not be too much of a perfectionist.

Focus on improving communication skills

My advice to anyone starting their FD is to be patient at the beginning. Transitioning from dental school to practice is a big jump and a huge change, with the biggest one being having to make more decisions by yourself.

At dental school you have someone holding your hand. You can get advice about all aspects of the time spent with the patient. You can still get advice in practice, but you have to be a lot more decisive.

My biggest piece of advice is to pay particular focus on improving your communication skills. You’ll have a lot more patients to see, so you’ll gain a lot more experience. This means it’s important to have your own way of explaining things to patients and managing situations where someone isn’t happy with your suggested treatment.

I’d also advise taking lots of photos. You can learn so much by looking at photos of your work. You notice all the things you’ve missed while you were doing the work. It’s also great to have photos for getting advice if your supervisor is unable to come in, or they’re busy.

Photos also help you to build a portfolio, which is useful for next year. You’ll be able to show prospective employers what you can do, what you’ve learned and how you have improved.

Want to hear more from Megan? Watch this video on the 'need to knows' for new dentists starting out in practice.

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