If you’re preparing for Dental Foundation Training (DFT) and getting ready to step into the working world, you may be wondering what life will be like if you decide to become an associate dentist. What options will be open to you, and how will it all feel?
Tilly Houston, who graduated from Bristol Dental School in 2020, currently splits her time working as an associate between two different practices. Here, she shares her experience of what life was like as a new associate.
Following foundation training, I worked as an associate dentist in two different practices. One practice was private, the other was a mix of NHS and private, and I was working five days a week.
Recently, I was offered the opportunity to work in a newly opened private cosmetic practice. The practice was beautiful, and the sort of work I wanted to do, so I couldn’t turn it down.
I decided to drop a day at one of my other practices to pick up a day in the new practice. This meant I was working at three different practices for a short time, which was never my plan, but it’s just how it worked out.
Keeping my options open
When I started this new job, I didn’t want to drop one of my other jobs completely as that felt a bit risky.
I’d had no chance to test the water to see what the new practice was like. So, during that transitional period, I felt the safest thing to do was to drop a day at one of my current practices and pick up a day in the new one.
In doing so, I could see how it went and experience a little craziness for a few months. Worst case scenario, I could always go back to the old practice as I still had my foot in the door.
I decided to cut down to two practices in the end, as working across three was a bit much. I loved the practice I decided to leave, but it was further to travel to than the other two. It was a head versus heart decision, and my head won.
NHS felt safer
Looking back, when I first came out foundation training, I felt more comfortable with the NHS side of things. Possibly because that’s what I’d been used to.
I felt that because I was so fresh out of training, I wasn’t sure I was good enough to suddenly be charging private fees. I thought patients would expect everything to be perfect – not that it wouldn’t be, but I felt the pressure.
I started at one private practice straight after foundation training for one day a week. It was a really supportive environment, but I found that for around the first six months of working there, I was a little nervous going in.
It seems silly in a way, but I felt like I was wearing two different hats. For NHS and private you should be carrying out the same quality of dentistry, but I felt there was a bit more pressure to perform in private dentistry.
The pressure wasn’t coming from patients, as they were all lovely. I thought they were going to have super high expectations, and be really demanding and unreasonable. However, they’ve all been the loveliest people who, I found, value their teeth. As such, they cared about and were interested in what I was doing.
If you’re coming out of foundation training, I’d recommend working within NHS dentistry for a couple of years if you can. The great thing about the NHS is that you’re exposed to everything.
With one patient you’re doing dentures, with the next you’re removing a tooth. After that, you might be doing a root canal. And when your skills feel quite fragile from coming straight out of training, working within the NHS is a great way to build experience.
You can start to do things a little more on autopilot, without thinking: “Where’s my mirror?”, or “Where’s the suction?”. Also, as patients weren’t paying as much towards treatments, I felt I had a little less pressure on me.
The most difficult part of the process for me was talking about money. I felt uncomfortable with some of the prices of some treatments. I was thinking: “£800 for a crown? I would find that expensive.”
Having the conversation about the difference between the price of NHS and private treatments was also quite tricky. You don’t really discuss money at all during foundation training. So, I felt a little more comfortable with NHS treatments as I didn’t have to worry about the financial side of things.
Imposter syndrome
It’s easy to forget that you’ve been in training for five years, as well as a year of DFT on top. You’ve made it through dental school, you’ve been assessed rigorously and you’ve been deemed as safe, competent and able to pursue a career in dentistry.
But you forget all of that and think: “I’m the worst dentist out there because I don’t have years of experience.” This is all while trying to come across to patients as if you know what you’re doing and talking about.
I remember having a moment where I was sat with a patient and I realised that I didn’t have to get anyone to check the work I’d done. I could just say: “Okay, your filling is done”. It was a little bit like when you pass your driving test and go for your first drive alone. It was surreal.
There’s a bit of imposter syndrome that I think most young dentists feel to some degree. I was lucky that there were quite a few younger dentists at one of the practices I went into. It was helpful to have people in the same boat as me. Otherwise, it could have felt quite isolating.
Some surprises in store
Something that took me by surprise was the amount of patients who were scared of the dentist. I’ve always had good dental experiences, so I assumed everyone was the same. I remember being really shocked by how terrified and anxious a lot of the population is about dentistry.
I’ve been to the same dentist my whole life. I would go every six months and have a chitchat, and a clean, and that was that. It was always a pleasant experience and it wasn’t until I became a dentist that I realised how many people are terrified.
I then had to learn how to manage those emotions, because I didn’t know what it felt like to be scared or what was going on in their head. Now I get it, and I think I’m a better dentist for it.
Although I was prepared for the transition from foundation training to associate to be tough, I still found the pace of everything (both NHS and private) much faster than I anticipated.
I started off quite slowly and kept control of my diary. I could book treatments in for a little bit longer, as well as time for breaks. But there are still targets to meet, so you do need to get quicker.
During foundation training I would book in three hours to do a filling, and there was no pressure to be time efficient. When in practice, I didn’t know how long I needed to take out a tooth or to do a crown prep.
The reception team would book in the amount of time that the other dentists would require, and I really couldn’t do it in that time. So, I was taken aback by how difficult it was to get into the flow of how long things take because you’re thrown in at the deep end, seeing lots of patients.
That first six months is probably the steepest learning curve I’ve experienced. I remember looking back after that time and being shocked at how much I’d developed as a clinician in such a short space of time. You do feel really proud of yourself.
When I left dental school, I never thought I would have been doing so much so quickly. It was really nice to look back and reflect on that. You think you’ll never get there, but you do.