DENTISTRY IN THE ARMED FORCES LOOKING TO TAKE YOUR CAREER IN A NEW DIRECTION? TIRED OF BEING TIED TO THE PRACTICE? CAPTAIN COLIN MCGRATH, DENTAL OFFICER FOR THE ROYAL ARMY DENTAL CORPS, SPEAKS TO THE PDJ ABOUT HIS EXPERIENCE OF WORKING IN THE ARMED FORCES
What was it about dentistry in the armed forces that attracted you?
Can you tell us about a typical day as a dentist in the armed forces?
I signed up to the British Army early in university and so knew little about clinical dentistry. I was attracted at the time by the chance to work in various locations, perhaps abroad. Combining that with fitness and outdoors activities as well as the Army dental cadetship scheme meant I could stop working part-time at university and have more time to study and for leisure activities.
Generally I head into the dental centre for 7.45am to start an emergency clinic at 8.00am. I would normally wear Army uniform to and from work and at lunch time, although we have Defence Dental Service scrubs to wear clinically. Patients are seen throughout the day and the last patient is finished by around 16.30pm. Normally twice a week, time will be allocated for sport or personal training. I may have some admin tasks to do at the end of the day but normally leave at 17.30pm.
How do dental professionals join the armed forces? What are the different roles within this sector? Captain Colin McGrath
The Army currently recruits both dentists and dental assistants through a standard selection process. There are currently also dental hygienists and dental laboratory technicians serving although those trades are no longer being trained or recruited into the Army. As dental care professionals are promoted they can become practice managers and later progress onto other administrative and possibly wider Army roles. Dentists can join up to the age of 55, can have their prior dental employment recognised financially and are offered a higher rank or pay scale. Dentists can apply for full time regular roles or part-time reserve positions in the Army Reserve. Reserve dentists train with the Army between 19 and 27 days a year, during which they are paid an Army salary, but can remain in their civilian employment as well. Entry is through a rigorous selection programme that is specific to each service. It requires the individual to have their leadership skills tested as well as making sure that they would be physically fit, and mentally robust enough to survive the rigours of military service.
How much do different Army settings differ from one another as working environments? In the Army generally you would move locations every two to three years. You could work anywhere from being Officer in Charge (OIC) of a single chair dental centre in Germany (my current role) to a larger eight chair centre in one of the big UK garrisons. The working environments are very similar but may vary depending on how much you integrate with the rest of the Army. There are a few overseas posts which offer a different lifestyle outside working hours such as posts in Brunei and Cyprus.
What is the balance/extent of your clinical work? Currently I’m roughly 80-90% clinical as OIC of my single chair centre. As a newer dentist in a larger centre you would be over 90% clinical. Your role can develop more of an administrative/command role as your career progresses. There are also certain opportunities to become part of a medical regiment where your role can be split equally between clinical and military duties.
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How does working in this sector differ from high street practice? Having only a visiting experience of high street practice and speaking with non military friends, I would say the patient/dentist relationship is different as the military patients don’t pay and dependants pay NHS fees. Military personnel are salaried so it allows you to do the best for each patient within your abilities without any direct financial implications. Clinical activity is monitored but targets are not set. I feel time pressures are definitely less than for those in NHS practice as I can dictate how long I require for each patient.
What are the particular challenges of working in this sector? The nomadic nature of the patient base takes getting used to since patients tend to move locations every three years (as do the dental officers generally). Our role is to ensure that a group of soldiers is dentally healthy to be able to deploy whenever and wherever required in the world. Often the soldiers are away on various courses and training activities making them unavailable for their dental treatment. It means we need to concentrate our time when soldiers are available and may be detached to work elsewhere when they are not. This can lead to working in lots of different centres and requires good time management. Laboratory work for patients used to require careful planning as the lab work was sent to a central Army lab, then sent out to a civilian contract laboratory and it could take a number of weeks to return. However a new civilian laboratory contract has recently been introduced that has dramatically improved quality of work and turnaround times.
Are dental professionals deployed overseas to field hospitals during military operations, and do you ever feel vulnerable or at risk? I personally haven’t deployed yet, as only a small number of dental officers at any one time have been required in
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Afghanistan. Numbers required depends on the number of troops in an operational location. Generally you would be working in centralised hospital location which is within a safe and defended compound. You may occasionally be flown out to the smaller bases if and when there is a requirement.
How does working for the armed forces differ from working in NHS or private dentistry? The major difference in the armed forces is that one is treating a population of patients to get rid of their dental disease so that they are at low risk of having dental problems when they deploy on operations. However at the same time one must still balance the need to treat each soldier as an individual patient to deliver that overall effect. Military patients receive free treatment and all military dentists are salaried. Military dentists can also expect to move every two to three years rather than practising at the same location for the remainder of their career. The Army has a definite chain of command; this must be adhered to and brings with it responsibilities that relatively newly qualified civilian dentists would not normally experience.
What advice would you give to a dental professional considering a career in the armed forces? Be prepared to move regularly and certainly at some point live where you are told rather than where you perhaps wish
to live. Military life can be demanding but also very rewarding. Life skills are learned and friendships made that will last a lifetime. Whether considering a short or long career in the Army, you will have something to give and lots to gain.
What career progression is available to practitioners working in the armed forces? Is this a difficult career path to follow? There is a fairly well trodden career path. However, with the recent reduction in size of the Army things are slightly less predictable. Generally you would join as a Captain, where you are likely to work in a larger centre be OIC of a single chair centre. After five years you are eligible promotion for to Major where your duties can range from two to four chair centres and other wider army opportunities. Later on, on promotion to Lieutenant Colonel, you can remain heavily clinical or move into administration. The rank of Colonel is also possible which can result in management roles of larger centres and regions or work in the headquarters. The Army is a committed training organisation for all its different specialties, so opportunities for paid CPD are plentiful. At certain times in the military there are even opportunities to apply for further higher professional training such as an MSc in a particular area of dentistry. These opportunities are highly competitive but once selected personnel are fully funded and paid their salary while they gain the qualification.
Where can dental professionals go to find out more? For more information, visit the British Army website www.army.mod.uk. If people are even slightly interested, I would urge them to obtain further information. Whether you are a student, newly qualified or several years post-qualified, the Army has something to offer all dentists.
Acknowledgements Thanks to colleagues Captain Simon Donal and Lt.Colonel Palin for their contribution to this article.