Collaborative New Graduate Dental Officer Program

Developed by Sydney Local Health District Oral Health Services, Southern New South Wales and Murrumbidgee Local Health District Oral Health Services

Background

The new graduate rotation has been an initiative of Sydney Dental Hospital (SDH) for over 18 years. It has provided graduating dentists throughout Australasia with an opportunity to work in a well reputed dental hospital and gain excellent clinical experience in various fields of dentistry, with a primary focus on general dentistry.

The primary aim of this program was to recruit 6 final year dentistry students anticipating graduation at the end of the calendar year with a keen interest in the principles of public sector dentistry and demonstrated ability to deliver high quality dental services to the eligible population. The new graduate dentists recruited through this process are mentored and guided by senior clinicians and specialists throughout a structured 24 months of experience. This program advances their clinical knowledge, skills and experience in general dentistry and provides exposure to specialties like Oral Surgery, Special Care Dentistry and Paediatric Dentistry.

An audit of productivity within COHC found that new graduate dentists are clinically slower than their more experienced colleagues. This impacts on the ability to efficiently reduce the very long waiting lists in COHC. Interestingly, the same audit found that clinicians with a minimum of 4 to 6-months experience were significantly more efficient and were able to see patients at a similar pace to those with a few years of experience. The type and complexity of treatment completed by the new graduate dentists also increased after working in COHC for 4 months.

Despite the concerns with new graduate dentists, the rotations have been extremely successful in other facets. Entry into this position has proven to be very competitive with over 150 applications for the 6 positions every year. Being such a sought-after position increases the prestige of our institution and forms a very high benchmark for other hospitals and organisations who are trying to establish new graduate programs around Australia. Furthermore, it has provided an avenue for fresh ideas and enthusiasm to be brought into every department in the hospital as well as provide an opportunity for senior clinicians to teach and mentor younger dentists. Lastly, as one of the largest tertiary teaching hospitals in New South Wales, this program provides the ability for SDH to be the leader in supporting and mentoring young dental graduates entering the profession.

In 2019 Sydney Dental Hospital and Oral Health Services revised the New Graduate Dental Officer program. It involves a 24-month contract during which the new graduate dentists work and are mentored in COHC and Specialist departments at SDH.

In 2021 SDH and OHS established and implemented an Aboriginal New Graduate Oral Health Therapist (OHT) program to support employment initiative for Aboriginal students receiving scholarships for studying dentistry or oral health therapy at the University of Sydney.

Southern NSW and Murrumbidgee Local Health Districts oral health services (SNSW&MLHD OHS) currently has 3 FTE vacancies for Level 1 /2 Dental Officers. Repeated recruitment attempts have been unsuccessful.

SLHD, SNSW & MLHD OHS have collaborated to develop a New Graduate Dental Officer rotation program that will incorporate rotations at the Community Oral Health Clinic (COHC) and Specialist clinics at Sydney Dental Hospital (SDH) in Sydney Local Health District (SLHD) and regional/rural rotations in Murrumbidgee Local Health District (MLHD) or Southern NSW Local Health District (SNSWLHD) for each of the 9 program participants over a 24-month period.

The New Graduate Program at Sydney Dental Hospital and Oral Health Services (SDH & OHS), SNSW&MLHD OHS is an opportunity for development of practical skills and to gain experience as a Dental Officer in one of New South Wales's public tertiary dental facilities, community, and rural oral health clinics. New graduates are recruited through an interview process and clinical assessment to commence the first year of the program. An opportunity to continue for a second year of rotations exists depending on performance and the fulfilment of the competency requirements in the first year of the program.

The aim has been to eventually incentivise these new graduate dentists to take up full-time roles in the Community Oral Health Clinics (COHC) or rural/ regional public dental clinics, if available.

This proposal is intended to provide recommendation on a recruitment model that will introduce regional and rural rotations and help build a strong team of hard-working dentists who are interested in public health dentistry. This proposal will also provide insight into the many benefits of the Collaborative new graduate rotation program.

Proposed Collaborative New Graduate Rotation Program

It is proposed that a New Graduate Rotation Program is developed and implemented in collaboration with SNSWLHD and MLHDs to enhance service provision for patients living rurally.
9 New Graduate DOs will be recruited by SLHD as DO level 1, year 1 at 4.0 FTE and DO level 1 year 2 at 5.0 FTE as per the NSW Health Dental Officers award for a 24-month period as participants in this program.
All participants will be employed by SLHD and seconded to MLHD for their regional and rural rotations.
A collaborative recruitment process initiated by SDH and OHS with SNSWLHD and MLHD will be undertaken to hire the 9 new graduate DOs to commence the first year of the program.
The new graduates will be recruited via an interview process and a clinical assessment.
The Program will incorporate rotations at the Community Oral Health Clinic (COHC) and Specialist clinics at Sydney Dental Hospital (SDH) in Sydney Local Health District (SLHD) and rural rotations in SNSWLHD and MLHD for each of the 9 program participants over a 24-month period.
Rotations will be facilitated in the following settings (attached Appendix A):

SLHD

COHC SDH for 9 months in total
Specialist Clinics at SDH for 6 months in total
Oral Surgery 2 months
Special Care Dentistry 2 months
Paediatric Dentistry 2 months

SNSWLHD or MLHD

locations where vacant FTE is identified, and appropriate clinical support is available. This is likely to be in larger centers such as Wagga Wagga, Albury, Griffith, Queanbeyan, or Bega Oral Health Clinics for 9 months in total

There will be a structure to each rotation (as per the attached Appendix B: COHC, Oral Surgery, Special Care, Paediatric Dentistry and SNSWLHD and MLHD Rotation Handbooks).
Year 1 and Year 2 new graduates are required to maintain a handbook of their procedures and are encouraged to self-reflect.
Year 1 and Year 2 new graduates will demonstrate learning outcomes through a case study presentation at the end of year one and year two.
Year 1 graduates will need to fulfill the performance and competency requirements of year one to an expected standard to continue to Year 2.
Leave and performance will be managed by the LHD where the new graduates are located during each rotation.
Pending satisfactory performance and fulfilling the expected competency standard for year one as per the program, there will be an opportunity to continue for a second year of rotations.
New Graduate Dental Officers will be seconded for 9 months in the 24-month period to SNSWLHD and MLHD.
When the New Graduate dental Officers are seconded and on rotation in SNSWLHD and MLHD, SNSWLHD MLHD will pay the staff member through normal payroll processes for wages.

Accommodation expenses for MLHD rotations

SNSWLHD and MLHD Oral Health Services will provide temporary accommodation expenses as negotiated and dependent on locally supported and approved procedures. Based on an average weekly rent in Wagga Wagga, Albury, and Griffith of $330, the total accommodation for 3 participants annually is estimated at $52,000.

Dental Officer Rural Incentive Scheme (DORIS)

Program participants would be eligible for the DORIS allowance for the period of their rural rotation (up to an additional $20,000 per annum over the award salary) for the positions being advertised. The extended package will be on a pro-rata basis for part-time employees.
If any participant withdraws prior to completion of Year 1, external advertisement for a 12-month contract to fill this Year 2 position will be undertaken by SLHD and MLHD.
New Graduates will need to commit and will be unable to withdraw in the middle of the year.
The positions will be 24-month contracts and will not be extended after the 24 months under the same conditions.
Given these positions will always remain as year one and year two contracts, there is a clear understanding that these clinicians will have to find other employment at the end of year 2 and at the end of Year 1 if unsuccessful in securing a year 2 position.
If a permanent vacancy becomes available, participants can apply for this to be recruited as permanent staff members.

Benefits of the Collaborative New Graduate Program

Ensures each year cohorts of enthusiastic and motivated clinicians are being hired (all of which are amongst the top of their dental schools). Without this position, there is no direct way to hire young talent
COHC, Specialist and regional/rural rotations in Year 1 and Year 2 incentivises new graduates to stay on and increase their learning, experience, and become confident clinicians.
Increases opportunity to attract and retain experienced dentists both in SLHD and SNSWLHD and MLHD

Improved outcomes for Consumers

Provision of patient and family centred care as clinicians have added understanding of principles of public health dentistry
Improved clinical outcomes
Reducing waiting times for patient care

Improved Outcome for SDH and OHS Staff

Improves the name and reputation of SDH amongst the greater dental community and makes SDH a prestigious institution
Brings energy and enthusiasm to existing staff, builds on department morale, and improves team bonding.
Senior clinicians are given the opportunity to mentor and pass on their experience and in turn work with new graduate clinicians with up-to-date evidence-based practice. This ensures our patients receive the best and most current clinical treatment.
Opportunity to involve them to undertake quality initiatives/ oral health promotion activities/ research.
Possibility of publishing an article on the benefits of a structured rotation.
Improves the profession by providing excellent learning opportunities.
Competes with Westmead Centre for Oral Health, who have a long-running and successful new graduate program.
May help bring more post-graduate students to SDH for their specialty training by showing our ability to have a strong new graduate rotation.
Gives SDH an opportunity to employ young clinicians who may become the future of the hospital (take up higher roles) and without these positions, there is no easy way to evaluate, recognise and hire young talent with keen interest in public health dentistry.

Improved outcomes for MLHD Oral health service

Improved reputation of SNSW and MLHD's oral health service as a supportive workplace that is committed to excellence, enabling new graduate dental officers to feel confident in their current roles and supported in their professional development.
An increased opportunity for SNSW and MLHD's to attract and retain new graduate clinicians who may choose to continue to practice in rural locations, minimising the impacts of long-term vacancies on clinical activity and consumer outcomes.
Senior clinicians are given the opportunity to mentor and pass on their experience and in turn work with new graduate clinicians with up-to-date evidence-based practice.
Opportunity to involve them to undertake quality initiatives/ oral health promotion activities/ research and possibility of publishing an article on the benefits of a structured rotation.
Improves the profession by providing excellent learning opportunities.

Feedback from current and recent new graduate dentists at SDH and OHS

Excellent rotations. All felt their level of clinical experience was far beyond that of their colleagues in other jobs.
Benefitted greatly from the rotations in Specialist Clinics.
Benefitted greatly from the mentorship and treatment planning sessions.
Many were willing to stay on at SDH, but all wanted an opportunity to continue rotations in Year 2 (they preferred to not be in COHC full-time for the whole year)

Expectations from New Graduate Dentists during this program

Provide each patient with good quality patient-centred care.
Be a good team player and respect all patients and staff.
Work alongside senior staff and follow their instructions when given.
See extra patients when asked to by senior staff /reception.
Be prepared for each day. This includes:
Reading files at the beginning of the day and discussing patients with clinical mentors and specialist for that day as required
Go to each rotation with enthusiasm and a motivation to learn.
Commitment to completing all rotations.
Attendance at all rotations will be strongly monitored.
Always demonstrate NSW Health CORE Values:

Collaboration
Openness
Respect
Empowerment

The program is a steep learning curve. However, with the right attitude, the rotations will be a very enriching experience. If you believe that you are suited to the program, we encourage you to apply. For more information, contact:

Dr Trupta Desai Head of Department, Community Oral Health Clinic, SDH and OHS,

via email: trupta.desai@health.nsw.gov.au and

Angela Rankin, Manager Oral Health Clinical Network covering Southern & Murrumbidgee Local Health Districts
via email: angela.rankin1@health.nsw.gov.au