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We live in an age when we endlessly talk about evidence-based practice, but are constantly being bombarded by new, untested techniques supported by charismatic KOLs. So, how do we guard against being seduced by all this ‘fool's gold’?
In the UK, we are fortunate because our orthodontic postgraduate programme incorporates a masters thesis that includes a research component. By completing this, our trainees will learn the fundamentals of research methodology and critical appraisal. This will go some way in preparing them for a world in which innovation and treatment is primarily being driven by finance and marketing. They will certainly be better placed to sort out the ‘wheat from the chaff’ when it comes to the claims made about the latest and best techniques. This will not only keep them grounded and healthily cynical, but will also protect our patients in a world of DIY orthodontics
Why then, when everything is sorted out, and we have an orthodontic training programme that has taken decades to refine, and is now the envy of many European countries as well as the USA, and is considered to be as good as any and better than most, are we doing our damndest to wreck it?
The added value of undertaking a postgraduate research degree as part of orthodontic training has been long established. Professors Mills and Houston both wrote at length on this subject,1,2 and it has been highly regarded as the ‘gold standard’ method of training for the past 40 years. And never has it been more pertinent than today.
It is irrelevant that some medical training does not aspire to these high standards, and why does it matter that other specialties are willing to reduce their training levels to the ‘lowest common denominator’ in the endless quest for fairness, equality and reduced training times? We, in orthodontics, have been lucky over decades to attract many of the brightest and best trainees to what is considered by some to be the best profession in the world.3
I have, over the last 40 years, travelled to many countries and met hundreds of overseas orthodontists, all of whom have undertaken a masters degree or equivalent. They are among the happiest group of dentists I have ever encountered. The fact that it costs them a few thousand pounds more to obtain qualifications that are the envy of the world, and that put them in a position to not only compete for the highest jobs, but also to identify the charlatans and snake-oil salesmen who unfortunately lurk in the corridors of our chosen specialty, does not even cross their minds. It is worth the money ten times over, bearing in mind they have had the best training possible.
It will be an enormous mistake if the General Dental Council take it upon themselves to remove the masters degree from orthodontic training, just because all the other specialties, and medicine in general, do not include a research component. Why not use orthodontics as a model for training and raise the standards in all the other specialties to this incredibly high level? We in orthodontics have great hopes for all our trainees and we want them to continue to get the very best training possible, which will allow them to work in Europe and beyond, providing the same high levels of patient care as their overseas-trained colleagues.
The regulator and the profession must accept that there is a big world out there and that future trainees may want to seek employment overseas. We must provide all our trainees with the tools and the potential to compete for jobs on the international stage and to continue to provide the highest possible standards of clinical service, unless we want our specialty to revert to the status of barber surgeons.