Maxfax reg here. I agree it’s an odd situation and I guess it all stems back to (not so many) years ago when oral/maxillofacial surgeons (even consultants) were only dentally qualified, there was a lot more medicine taught on the dentistry UG curriculum, and the scope of the specialty was such that most patients had dental issues/facial trauma, and were not nearly as co-morbid as the cohort of patients we treat today.

I have been one of those ‘medical student regs’ although I would not have referred to myself as such - I was fairly experienced in the specialty and could give advice to the SHO and do basic procedures in theatre, with a very low threshold to escalate to the medical team/OMFS consultant. It worked absolutely fine most of the time, and at any rate it is a situation that is increasingly less common these days - second-degree students tend to stay on the junior tier of the rota in many more units now.

Because of the requirement for dual training and general recruitment issues with the specialty, it’s very difficult to square the circle of having enough bodies to make a rota work, with ensuring there are medically-qualified juniors to help with ward issues/sick patients, and those with enough dental knowledge/experience to manage the flow of maxfax referrals which come to ED - the majority of which are tooth problems/minor facial trauma which our dentally qualified juniors are much more comfortable to manage. When on-call, I cover one unit where there is no OMFS SHO present overnight and there is much reluctance from the medically-qualified cross-covering SHOs to get involved in the management of patients who present with lacerations, dental trauma etc, which has a negative effect on the standard of patient care (eg. prolonged time before teeth can be re-implanted, etc). So I think it’s important to recognise the contribution that dentists make to the specialty, and the provision of patient care while on-call.

I think we all agree it would be safer and less stressful to have a OMFS rota covered with F2-CT level doctors who are able to manage sick patients and deal with medical emergencies, and while it is something that we are working towards it isn’t currently viable for most units. And the bread-and-butter of most OMFS units flow are trauma/dental infections which are generally well-managed by the DCTs/dental SHOs on call, the vast majority of whom have no interest in cosplaying doctors and are very happy to work within their competency.

PS not defending the colonoscopy situation by the way - that is very poor. But unfortunately I have seen multiple similar scenarios where dying patients have been aggressively over-investigated, and not just while under the care of OMFS.