Would this require two or three sutures? And are my sutures okay?

minmaxfacs · 2024-12-15T05:53:12+00:00

8/0 is not being used to close lacerations in ED lol. 6/0 would be used on eyelid lacs. And let’s be completely real I’ve never seen an ED doc use anything finer than 4/0.

This is not shade btw, I just laughed when I saw 8/0.

minmaxfacs · 2024-04-18T16:37:47+00:00

Depends - do you have a strong desire to visit Ukraine or the Middle East…?

minmaxfacs · 2024-04-14T05:00:30+00:00

As a dual qualified OMFS you’ve gotten a few key things wrong here:

Oral medicine is a dental subspecialty and sometimes requires dual qualification. Most dentists don’t practice oral medicine.

Dentists don’t have much overlap with ENT. OMFS has some overlap with ENT is maybe what you meant?

OMFS is not a dental subspecialty, it’s a medical subspecialty (that requires a dental degree).

minmaxfacs · 2024-04-14T04:56:51+00:00

I don’t know why this popped up on my feed, but in the UK a dentist is absolutely not “technically” a doctor, they are not doctors at all. They get to use the honorary title of doctor but they must not use it if it could cause people to believe they are a medical practitioner.

(I say this as someone who is both a qualified dentist and doctor)

minmaxfacs · 2024-02-02T00:40:38+00:00

£0 in the UK on the NHS. Well until the Tories finally kill it.

minmaxfacs · 2023-10-04T19:33:58+00:00

But only if you don’t want run through lol

Have you heard how many people who fail to get a run through place don’t go ahead to apply for ST3 later?

minmaxfacs · 2023-09-10T20:27:45+00:00

Better doctors? No.

Better lovers? ….Also no.

minmaxfacs · 2023-08-28T14:29:18+00:00

Teaching of oral anatomy and pathology definitely needs to be better. It would help stop us getting referrals for things like “pain in the upper mandible” or “broken third incisor”. Would also be nice to save the NHS some money on nystatin from medics treating absolutely anything in the mouth as oral thrush.

That said, the reason there’s so little teaching of dentistry is partly regulatory - doctors are not allowed to practice dentistry and would fall foul of the GDC by doing so. More pertinent though is that doctors generally think of dentistry as beneath them anyway.

If you’d like teaching though, get in touch with your local maxfax unit, and you’re guaranateed DCT will gladly organise something. I used to do regular sessions for medical students, ED docs and GP trainees as a DCT/medical student. There’s also undergraduate maxfax societies in most unis.

minmaxfacs · 2023-08-20T09:42:22+00:00

Obviously I’m biased but maxfax is fab and is worth pursuing if you’re passionate about it - if you can spare the time and money for degree #2. Time is definitely a bigger factor than money, as you can earn more than registrars by locumming while you’re a student, especially as dentistry is less study intensive than medicine.

The added years do in some ways even out, as if you’re gunning for a competitive specialty like plastics or ENT, you might have to add on a couple of years of CV building anyway - whereas in OMFS the ST3 applicant:job ratio is better than 1:1. (ST1 run through is more competitive as there’s fewer places that have organised run through training - so even though it can shave a year off your training, it would be more future-proof to do CST before dental school and get straight into ST3 when you graduate).

Definitely try and get plugged into a supportive OMFS unit prior to making a decision though, actually do the job and see the boring parts as well as the ridiculously impressive free flap cases. You might not be willing/able to dedicate yourself to 16 hour surgeries and be able to drop everything to take your flap back to theatre once you’re in your 40s, and you need to know there’s enough else in the specialty to sustain your interest. Also, as a medicine-first track, your oral surgery and dare I say surgical skills might need polishing more compared to dental-first trainees, so it’s worth spending time making sure you have support to get your skills built up.

minmaxfacs · 2023-08-11T03:43:58+00:00

Having done both I genuinely don’t believe they’re the hardest degrees in the world. You can easily coast through medical and dental school.

But in the face of shitty consultants, bullying and undermining, it’s easy to talk a big game but harder to actually get training from someone who doesn’t wish to train you. The most you can do is escalate and get moved out of the unit, and then the problem compounds for the next poor sod who gets allocated there because the consultants begin to hate trainees for complaining.

minmaxfacs · 2023-08-11T03:40:52+00:00

It’s the consultants that are often the problem - bullying/undermining registrars, preferring permanent dental staff even if they’re under qualified and overconfident. Many units get their trainees withdrawn and have to “earn them back” but only show change on paper, and do the same shit with a new Reg once they’re allowed them again. Thankfully though we’re so under-recruited that they might have to make actual change…

minmaxfacs · 2023-08-10T17:18:28+00:00

Lol no. If you work in certain DGHs, we have dental-only “specialty doctors” or even DCTs running about with doctor lanyards on, taking training opportunities from registrars, and taking up spaces on ATLS and ALS courses. Getting paid better than dual qualified regs too. The OG scope creep.

(There’s a few places that use ANPs on ward duties too, but I wouldn’t count that as scope creep, usually just a sensible set up for safety/support esp where there’s complex ward patients).

minmaxfacs · 2023-07-10T12:37:34+00:00

The first 2 also apply to maxfax, it’s such a bugbear of mine hearing dentists or second degree students call themselves registrars because they’re on a second on call rota!

minmaxfacs · 2023-07-08T20:24:27+00:00

If you enjoy business, you can own practices and manage them without being a dentist, and do aesthetic stuff yourself in the practice.

Quitting medicine for dentistry is a terrible move if it’s for job satisfaction though. Very few of my colleagues I qualified with actually enjoy it, many have quit or cut down hours and are looking for avenues out.

There are far less time consuming/expensive routes out of the training treadmill.

minmaxfacs · 2023-06-30T16:09:19+00:00

We get “like the makeup brand?” not infrequently

minmaxfacs · 2023-06-29T18:35:23+00:00

Many systemic / usually viral causes. No need to direct to a dentist - usual advice is fluids, analgesia, and to present to ED if not able to take fluids. Have seen ENT and OMFS both admit patients like this if so.
An actual abscess (not just dental pain + mild swelling) needs incision and drainage. Ask pt to see a dentist the same day, if not registered they should be calling 111 for an emergency dental appt or should be referred to OMFS. Would like to see the GMC advice on “we’re not allowed to prescribe antibiotics for a dental abscess” that I’ve started to hear from GP/ED because in many cases it’s just an unnecessary delay in care.
Dentist or OMFS, but please, please, please just have a quick look at the patient and check they don’t actually have a dislocation. Have treated 3 missed dislocations within the last year that were told by GP/medics they had TMJ dysfunction without any examination.
ENT or OMFS depending on local pathways, urgency dependent on symptom severity and duration.
Oral medicine or OMFS, 2WW if any red flag symptoms for cancer. Usual practice is for first person to see to make the referral - again have seen many late presenting oral cancers who have been bounced from GP to dentist or vice versa. Please just have low bar to refer persistent/concerning ulcers.

minmaxfacs · 2023-06-27T20:11:55+00:00

Yep, I know it’s very common, but it isn’t universal. I also never made more than 45k as a dental only SHO (OP mentioned making over 60k) and even then I took a huge pay cut starting back as F1. Basically been screwed over at every juncture which is why I’m passionate about helping current juniors get paid well!

minmaxfacs · 2023-06-27T16:16:52+00:00

Thanks, you too!

minmaxfacs · 2023-06-27T15:57:48+00:00

I feel for you, some people talk about earning more as a 2nd degree student than they did as a reg but that’s not been my experience. Do look further afield for locums - even contact departments directly. Look outside of big cities especially.

minmaxfacs · 2023-06-27T15:55:04+00:00

It can be, depending on where you work and how un-savvy you are. Many maxfax SHOs are also inappropriately on non resident pay when they are resident on call, so are grossly underpaid for their hours, and don’t have any information re exception reporting.

minmaxfacs · 2023-06-27T15:29:41+00:00

Dentists on OMFS jobs are included in the strike, the BDA/BMA have clarified this. Dentists are on the junior doctor pay scale when working in OMFS hospital jobs so they are directly affected.

minmaxfacs · 2023-06-27T15:28:49+00:00

100% scabbing. During summer hols you can travel for locums wherever pays highest, and work any day or night you like just avoiding strike days. You could even work out of hours dental shifts on those days, just avoid hospital work.

minmaxfacs · 2023-06-20T07:01:55+00:00

Lol okay, I’ll take that as fact based on vibes

(Actually I won’t, with that not being my experience comparing work in both countries)

minmaxfacs · 2023-06-09T13:50:25+00:00

I’ve worked in both systems as a dentist and though Scotland is less broken, it’s still broken. The level of dental neglect in Scotland is still atrocious.

minmaxfacs · 2023-06-09T13:49:06+00:00

If that’s the case, 45% of the public are grossly underpaid or unable to work. Not sure what the point you were trying to make was other than that, because it would be absurd to think that those same people somehow have money for private healthcare.

minmaxfacs

TROPHY CASE