Oral and Maxillofacial Surgery (2016)

Entry into ST3 will usually involve a competitive selection process. The current person specifications for entry into ST3 in Oral and Maxillofacial Surgery are shown on the Modernising Medical Careers website. The essential components here are completion of the common component of the core surgical training programme (as evidenced by successful ARCP, WPBA and completion of the MRCS examination) and completion of the Oral and Maxillofacial Surgery specific components of the early years training as evidenced by a successful ARCP and completion of the appropriate WPBA.

Intermediate Stage Overview

The intermediate stage of training comprises three indicative years (ST3 to ST5). The purpose of the intermediate stage is to allow a trainee to acquire and develop the specialist skills, knowledge and attitude that will allow further progress towards a CCT in the specialty.

The intermediate stage of specialist training will provide increasing exposure to the core aspects of oral and maxillofacial surgery. The aim is to acquire the competencies and specialist surgical skills that will form the basis for safe clinical practice in the generality of the specialty. The logbook should record development of operative skills and any deficiency in experience or competency during ST3 and ST5 must be corrected during this period.

Instructional courses in various aspects of the specialty will probably be attended during this time. This will include a microsurgical skills course if not already attended. Attendances at regional study days, national and international conferences will be encouraged. Trainees should seek to develop their experience in audit, teaching, presentations and contributing to the specialty literature.

On completion of ST5 of specialist training the trainee will have acquired the following:

Increasing competence in the peri-operative care of the maxillofacial surgical patient
Competence in diagnosis and clinical management of most oral and maxillofacial conditions
Competence in the operative care of a greater range of oral and maxillofacial conditions (i.e. in addition to those listed for ST3 and ST4).

This section gives examples of some other areas of the curriculum that it is

The following problems are commonly encountered and should be managed competently by the end of ST4, up to and including operative intervention if appropriate.

In addition to the conditions identified in the initial phase, trainees in the intermediate stage would be expected to be able to deal with, whether encountered as a result of being ‘on-call’ or working in an out-patient clinic setting the following:

Diagnosis and management of patient with developmental deformity of the facial skeleton
Diagnosis and management of patient presenting with oro-facial malignancy

During this stage the trainee will gain competence to the level defined in the syllabus in a number of technical skills and procedures. A trainee would be expected to be able to perform all of the procedures listed below without the direct scrubbed assistance or supervision of a trainer in addition to those identified in the initial stage. The list is not exhaustive, although it covers most of the common procedures expected at this stage.

Maxillofacial trauma

Open reduction and fixation of symphysis/body/angle of fractured mandible
Elevation of fractured zygoma
Open reduction and fixation of fractured zygoma
Reduction and fixation fractured maxilla (Le Fort I)

Salivary gland surgery

Removal of stone from submandibular duct
Excision of neoplasm of minor salivary gland
Sublingual gland excision
Submandibular gland excision
Partial/superficial parotidectomy
Total conservative parotidectomy
Radical parotidectomy

Orthognathic surgery

Genioplasty
Mandibular ramus osteotomy
Le Fort I maxillary osteotomy

Temporomandibular joint surgery

Arthrocentesis

Neck surgery

Tracheostomy/cricothroidotomy
Exploration/ligation of external carotid artery
Cervical node biopsy

Reconstructive surgery

Harvest of non-vascularised extra-oral bone graft

Aesthetic surgery

Scar revision/Z-plasty etc.

Neural surgery

Trigeminal nerve cryotherapy/neurectomy/chemolysis (peripheral)

Click on Workplace Based Assessments to view the assessment forms including DOPS and PBAs