The world of dental practice was turned upside down by the coronavirus pandemic, but spare a thought for fifth-year dental students like Ann Varghese who had been looking forward to her last few weeks at Sheffield Dental School. Rather than sitting her final exams and celebrating her achievements with the friends she had made during the course, Ann found herself back at home in Liverpool after the pandemic struck.
Although disappointed at missing out (hopefully temporarily) on her graduation ceremony, Ann used the time to reflect on the valuable experience, knowledge and skills she gained as a student and prepare for the challenges that lie ahead in dental practice. And despite the setback, she is still brimming with enthusiasm for her chosen career.
"I decided that I wanted to be a dentist in about year 12," Ann remembers. "I did a lot of work experience in hospitals, practices and labs and saw how much flexibility and variety there is from day to day." After visiting a number of university dental schools, Sheffield emerged as her top choice, thanks in part to the clinical experience on offer.
It took time for Ann to settle in, but she was grateful for the support of teaching staff and senior students in helping her adapt to student life. "I had lots of inductions from members of staff and Sheffield's pastoral team really get involved, especially in that first year, to make sure we were getting on okay. There were also socials where we had the chance to talk to people in the years above about their experience. It took time but by my second year I loved being at dental school!"
Taking a look around
She advises students who follow in her footsteps to ensure they have a realistic picture of life at their chosen dental school and to embrace the experience. "There are a lot of blogs and videos online about dental students' experiences," she says, "and I think they are quite honest about what to expect and the various challenges there can be. Don't expect an easy life, but once you find your niche you'll really enjoy it."
She adds that it's important to do extra-curricular activities too, "because that helps you to become more well-rounded and to enjoy the course a lot more. If you volunteered or played sport before, keep doing that because being able to talk with different people and relate to them is really important in dentistry. And you need a chance to relieve stress."
"Sheffield being close to the Peak District, I used to go on long walks and I had a group of friends outside of the course because it can be quite a tight bubble. I think it's really important to have people in your life from different backgrounds and perspectives. For example, I volunteered at a homeless charity and that helped when I was having a hard day. It was heart-warming to go somewhere else and make a difference for people who were really struggling."
Reflecting on the course itself, Ann was pleased that it met her expectations by providing plenty of opportunities to gain clinical experience. She credits the school for managing the smooth transition from lecture theatre, to developing clinical skills on phantom heads, to her first encounters with patients in clinic. "It was still quite daunting to treat someone who was much older than me," she confides, "but it was so rewarding to get to the point where I could interact with patients, as that's where my strengths lie."
She is also grateful to teaching staff for their encouragement and enthusiasm. "When we were in clinic, the tutors wanted to hear about my interests and it was nice to have that investment. When they saw someone was passionate about an area of practice, the staff really welcomed questions and were willing to arrange extra sessions or cover more difficult procedures which I really enjoyed.
"My interest in oral surgery meant I had the opportunity to spend a few weeks in the maxillofacial department at Lincoln Hospital, which was an amazing experience as I saw some really interesting reconstructive surgery. There were also three outreach placements of six to eight weeks in a general practice setting where we saw about six patients each day, and I really felt a rapid improvement during that year."
Don't expect an easy life, but once you find your niche you'll really enjoy it.
Challenges and changes
While Ann thoroughly enjoyed her experience at Sheffield, it wasn't without challenges. However, she believes these have been beneficial for her development as a dental professional. As she points out, "There are a lot of things you have to learn that aren't on the formal curriculum."
"One thing I found was that it was a really competitive environment. Obviously you want to excel as a dental student, but equally you need to be a team player and that was a difficult balance sometimes, which could be a source of tension. Of course, that will happen within a normal workplace as well and learning how to deal with other people is part of the job."
A particularly big challenge for Ann was failing a clinical exam. "It really hit me hard as I'd always performed really well in exams at school," she recalls. "Looking back, I wish I'd picked myself up quicker because while it closed some doors, it ultimately gave me more drive and determination to invest in other areas." Ann credits the teaching staff for helping her bounce back. "One of the things I really appreciated is that Sheffield has quite a small cohort and the tutors get to know you quite quickly. Their message was: 'Ann, you are actually really hard working, and we see that. Don't let this failure affect you. Just keep working hard.' It was heartening to have their reassurance."
That hard-won resilience proved essential when the pandemic struck. "Coronavirus was on the horizon from about February," she remembers. "At first, the school said that as far as they could see, we would sit our final exams as normal." But the situation changed dramatically a few weeks later." I had been at a morning clinic when we first heard that the facility was being shut down and that patients would be contacted when it reopened. Then we were told that the whole dental hospital was actually being closed and we needed to get our patients' details. After that, we were sent home and I returned to Liverpool with a quarter of my belongings.
"It was a struggle because I didn't get to say goodbye to my colleagues or my tutors and I didn't know what was going to happen with exams. I was also stuck at home during lockdown because I have underlying health conditions and my mum and brother work in the healthcare sector which meant we were already at a high risk of getting COVID-19."
Throughout this time, Ann kept in touch with news and other members of her year through social media. "Staff reassured us that they were working really hard to find the best outcome, but they wanted to give us definite information rather than continually move the goalposts."
Students' clinical targets were eventually tallied up by including the procedures they had completed on Outreach placements, which as Ann explains was not the usual approach. "Those who had not met their clinical targets, even with this revised inclusion criteria, would then have to write a reflective log about why they had fallen short, measures they had taken to try and rectify the situation and what they would do to improve in the future.
"In terms of summative assessment, we completed two online assessments, which were in a completely different format to what our final exams would have been. So we were stressed (even about exams), but it was more the fear of the unknown at that point, as no one knew what to expect from these new online assessments."
"As much as I'm delighted that I have graduated, it all feels anticlimactic," she continues. "We were supposed to have our graduation ceremony on 21 July but it's been postponed and I'm unsure when it will be rearranged. The dentists usually have a graduation ball too but that's been rescheduled for January. It would be a real shame if we didn't have a chance to celebrate together."
At the same time, being at home has given Ann a chance to reflect on her time in Sheffield and to focus on the contribution she hopes to make in her career. She has already been giving something back by taking part in some peer-learning sessions with third-year students and by volunteering for the NHS Responder scheme and as an online mentor for the charity Brightside, which helps students prepare for further education.
There are a lot of things that you have to learn that aren't on the formal curriculum.
"Having the time off has enabled me to become more knowledgeable about life outside Sheffield and reflect on my strengths and the areas I can work on. Another positive is that it has improved communication between staff and students in many ways. For example, we've had the chance to discuss important issues that aren't directly related to the course, like mental health, equality and diversity. I'm not sure that would have happened without the pandemic."
Now that routine dental appointments have resumed, Ann is looking forward to getting her dental career back on track with her Foundation Training post. "I'm looking forward to meeting new people who are going to invest in me. I'm hoping that my educational supervisor will be really friendly and I just want to get stuck in. To be honest, it would be amazing just to pick up a drill and work on my technique because I haven't been able to do that since March and it seems very alien."
"My placement will be in Southport, within the Liverpool scheme, which will be nice because I'll be living at home. It will be interesting to catch up with others on my course at the end of the year to compare our different experiences."
Ann recognises that she will be starting her new career at a precarious moment for the dental profession, but she remains optimistic. "I have seen articles that question whether dental practice is viable if we're only able to see five patients a day. But at the same time, I think the pandemic has allowed dentists to really invest in their careers a lot more and reflect on what being a dentist means to them. It's been amazing to see how passionate people have been about getting back to work and being able to help our patients."
Interview by Susan Field.