The ‘Flawed’ ORE And Dentist Shortages

The ‘Flawed’ ORE And Dentist Shortages

The looming prospect of dentist shortages in the UK has been highlighted after a General Dental Council executive described the Overseas Registration Examination (ORE) as ‘flawed.’

The GDC’s  Executive Director of Strategy, Stefan Czerniawski, has said on the regulator’s website that the ORE is “A flawed system made worse by the pandemic.”

Until now, the ORE has only had to be passed by dentists who gained their qualifications outside the European Union.

Currently, dentists with a European qualification from an EU member state  do not have to take the ORE, but from the end of next year (2022), the UK Government will no longer automatically recognise such qualifications, following the end of an agreed ‘transitional period.’

This means that from 2023, the ORE will become the primary international route for any dentist from outside the UK who wishes to register with the General Dental Council. 

In September 2021, a report commissioned by the GDC and led by the University of Plymouth “Identified variations in dental education standards across the European Union.”

The GDC said the findings in the study  “Indicate continued variation between and, within countries of the EU, in the provision of dental education, and little evidence that ambitions for harmonisation between Member States have been achieved.”

Mr Czerniawski starkly laid out the contribution to the dental  workforce made by overseas dentists. 

The GDC executive said  on the regulator’s website “Over recent years, about a third of dentists registering with the GDC have done so on the basis of qualifications from outside the UK, and they now make up nearly a quarter of all dentists on the register.”

“They provide a vital part of the overall dental workforce, ensuring that there is more capacity for dental treatment than UK graduates can provide alone.” 

There has been much discussion among dentists, particularly on social media, about the difficulties encountered in recruiting dental associated, and keeping them long-term.

In May 2021, the British Dental Association  said a survey of dentists in England showed that nearly half (47%) indicated they were likely to change career or seek early retirement in the event that restrictions related to COVID remained in place. ​

Although there appear to be no official statistics available currently as to the numbers of practitioners who have ‘gone private,’ many practice principals have indicated that they have either already increased their private patient numbers significantly or intend doing so in the near future.

Following the recent announcement of the revised General Dental Service targets imposed on NHS dentists working in  England, many said on social media that they fully intended ‘handing back’ their NHS contracts.

Some have reported difficulty in recruiting associates to work under NHS contract, thus potentially exacerbating the NHS dental access crisis.

The UK produces an approximate 1300 dentists per year, from 17 universities, according to the Dental Talent Blog. The website pointed out that the pandemic has “Disrupted final year students and their decision making around careers.”

Early in December, the GDC announced the resumption of Part 2 of the Overseas Registration Examination after it had to be suspended in early 2020 due to the pandemic.

Part 2 of the examination, which includes practical examination of a candidate’s skill, will take place in January 2022.

Mr Czerniawski outlined the necessity for the ORE. He said “We need dentists from other countries who want to practise in the UK to meet the same rigorous standards which we expect of dentists who trained in the UK.” 

“It’s in everybody’s interest that applicants from other countries have a process to follow which they can be confident is a fair test of their professional competence and provides them with a clear route to registration.” 

Mr Czerniawski said that candidates have to complete parts 1 and 2 of the ORE within strict legal time limits. He said candidates have to follow a process “Set out in inflexible legislation which only the government can change.” He said the pandemic had only exacerbated the problem.

He said the GDC had been calling for changes to the legislation for a long time, so that the regulator had the ‘flexibility to address these issues.”

Under rules which govern the ORE examinations, Part 2 of the exam must be passed within five years of first attempting Part 1.

As a result of the delays caused by the suspension of the exam, Mr Czerniawski said “The more candidates have reached the five-year limit without an opportunity to take Part 2.”

He said legislation give the GDC no discretion to relax the five-year limit for candidates who have neared the limit due to COVID, although the GDC has been discussing changes to the law with the Department of Health and Social Care.

Mr Czerniawski said “We are optimistic that that will lead to a solution, but until the necessary legal changes are made, candidates will not be able to sit the Part 2 exam if they have reached the five-year limit.” 

He continued “The sooner the ORE can resume, the sooner we can start to make inroads into the problem, and it’s a big step forward that we have been able to arrange a Part 2 session for January next year.”

Mr Czerniawski’s full blog can be read here.

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