From an educational perspective, it is apparent that the covid pandemic has had a significant impact on learning needs. The majority of outstanding learning needs were related to clinical activity that had been reduced or stopped. Positives were identified in relation to educational development out with clinic. At the start of the year the group had outstanding areas of development brought on by the pandemic but were optimistic regarding these being met. However, when the year had progressed nearly half of the group believed they would not be able to meet the targets in their personal development plans.

One key point that has been highlighted from the questionnaires and discussion is the prolonged reduction in clinical experience. A majority of the group had reduced experience in previous posts coinciding with the first wave of the pandemic. It was expected that clinical dentistry would return to full capacity over the course of the 6 months of this study. However, dentistry was faced with a worsening pandemic and recurring lockdowns, thus slowing the transition to full capacity. Overall, there was overall progression in clinical confidence but areas most affected were those that were aerosol generating such as fixed prosthodontics and minor oral surgery. One challenge associated with reduced number of patients was the uncertainty of the role of dental core trainees within a teaching hospital. Trainees felt with an absence of set lists for DCTs trapped between senior trainees and undergraduate students with no specific clinical role.

Individuals’ attitudes to career aspirations were one that interestingly changed over the 6-month period. Initially, the majority of the group wanted to commence speciality training posts, with 11 DCTs highlighting this in the questionnaire which dropped to 6 DCTs in the follow up cycle. This then meant that more DCTs were either undecided or aiming to work in primary care. This shift in attitude appeared to be due to a concern of fewer speciality posts and unwillingness to apply to posts further afield. Additionally, DCTs want to explore alternative options instead of a formalised training pathway. For those who were either in the process of applying to speciality training, or aiming to apply next year, expressed a change in their attitude towards the speciality pathway. As a result of COVID individuals are prioritising posts based upon geographical location and considering applying to different specialities to be closer to family. Travel restrictions that have been in place during COVID have had a direct impact on individuals being less flexible to relocate to places which are a considerable distance from family. Additionally, DCT posts which are of longer fixed term contracts are becoming more desirable as they provide more training and financial security. For those who were intending to specialise, COVID and the change in application process has had no impact on their desire to continue with the pathway. The overall opinion the group had in relation to change in career aspirations, stemmed from the impact COVID has had on individual’s perception of life and wanting to prioritise health and wellbeing over career progression. There was an overarching impression that “life is too short” and DCTs now have a better understanding of what is important in their own lives.

No meaningful trends could be drawn between genders, as both genders were not represented equally in either the questionnaires or focus groups, with the majority of DCTs being female. It was noticed that DCTs who were older and had a background working in primary care had a more realistic expectation of the year and the impact COVID will have on clinical exposure. Additionally, these DCTs felt less stress and pressure compared to working in primary care as responsibilities are shared with consultants and the larger hospital framework. It was felt that this year had been a great year to do DCT as the financial burden felt by associates is not mirrored in hospital roles. DCT1s appeared to be less affected by the prospective of reduced clinical exposure as it was felt they had additional years to remedy this prior to specialty applications. When compared to DCT3 who were largely concerned about the impact the pandemic has had on their portfolios, presentations at both regional and national levels and ability to find cases for reports. There was a sense of urgency to make up for the lost clinical time from March 2020, and a fear that previous DCT3’s would be further ahead clinically. The uncertainty of COVID appeared to have a larger effect on DCT3 as this was their last year before commencing Registrar training.