Education and Training Registration Commitee Dental (ETRCD)

Dental education and training oversight have been streamlined through the merger of the under- and post-graduate functions into one committee.

Previously, dental matters at the Medical and Dental Professions Board (MDB) were dealt with by three Subcommittees of the Board:

  • the Examinations Subcommittee which had oversight over the examinations for foreign-trained dentists
  • the Undergraduate Education and Training Subcommittee (UET) which looked at all undergraduate matters related to dentistry in South Africa (including accreditation of undergraduate training programmes at the four dental schools/faculties in the country)
  • and lastly the Post-graduate Education and Training Subcommittee Dental (PETD) which was responsible for all post-graduate Specialist programmes in South Africa (including accreditation of the post-graduate programmes and facilities) and the evaluation of foreign-trained specialists that wanted to register in South Africa.

All three Subcommittees had a support and administrative structure and reported to the Education and Registration Committee (ERC) of the Medical and Dental Board. Earlier this year the Board looked at the mandates and functioning of all its committees and one of the recommendations was to merge the activities related to dentistry (under- and post-graduate) into one committee resulting in the Education, Training and Registration Committee Dental (ETRCD) reporting to the Education and Registration Committee and onto the Medical and Dental Board (MDB).

Activities

  1. Currently the ETRCD is looking at a new structured examination for foreign-trained dentists. The challenge is dental training programmes are different in different schools/Universities and countries all over the world. For instance, in a country like India there are over 350 dental training institutions (public and private) and it is impossible to know the level of competence and the level of training the students are exposed to in their programmes. In order to protect the public, the HPCSA as a regularory body, has to evaluate all these foreign-qualifications for equivalence to the South African degree. In addition, the HPCSA has to subject the foreign-trained dentists to an assessment that will reasonably establish their level of knowledge and clinical competence. This is in line with International best practice and applies to South African qualified dentists wanting to practice in most countries outside South Africa.
  2. The other activity that the ETRCD is currently occupied with is the establishment of a Unitary National Professional Exit Examination for Specialist training in South Africa. This is a reality for Medical Specialists and will hopefully materialise for Dentistry after broad consultation with all stakeholders. All Heads of Departments /Specialties will be involved in this process as they are the custodians of the Specialist programmes.

Scope of Practice

Somewhat linked to the last point, is the question of the scope of practice. In some of the dental specialties, there has been debate concerning the possible overlap of some of the procedures carried out. The committee believed that it was necessary to produce a principled statement as set out below, but also to impress upon the specialties on the importance of defining their scope to obviate any confusion. The statement is as follows:

Principles with respect to the scope of practice of the dental specialities

Chambers dictionary states that to specialise is to “narrow and intensify”, and that a speciality is “something special or distinctive”.

The principle governing a specialty is that any person registering as a specialist does so on the principle that they voluntarily limit their practice to that specialty in order to seek to gain absolute expertise in the practise of that specialty. To practice outside that specialty is to render it no longer “special or distinctive”.

Each of the dental specialities requires intensive training over a four or five-year period, and it is the scope of this training that should define the scope of the practice of that speciality. This requires that all dental schools should have a common core curriculum which defines this scope, and that this common curriculum be applied in each school and be accredited by the Health Professions Council of South Africa. Furthermore, it requires that there be a national examination to ensure quality control over the standards of those registering in the speciality.

Where new technology requires a different approach to the practice of each speciality, it is incumbent upon the clinicians to ensure that they receive appropriate training in that technology as well as the dental schools to provide that training, both to existing specialists and also within the common core curriculum, hence ensuring accreditation of this additional training.

The limits of the scope of each of the dental specialties as so defined must be respected by each specialist and verified by Council as part of their accreditation processes. In this way, the best interests of the patient will become paramount.

It is incumbent upon the specialist groups and associations, the dental schools, and the HPCSA to respect the scope of practice of each of the specialties and to ensure that appropriate action is taken against those individuals who practice outside that scope.

If a specialist wishes to practice on a routine basis, procedures which fall under the scope of practice of another speciality, that person must de-register as a specialist and cease to refer to themselves as a specialist.

At the workshop, the four schools agreed to work with their respective specialist societies to define their scopes of practice and that work is ongoing.

The ETRCD will consolidate issues related to Dentistry and hopefully reduce duplication of activities at the Medical and Dental Board.