Getting Ahead after Dental School 2023 – IC042

[Jaz]
So we delve deep into the transition from dental school to your first associate position and making an effective portfolio. Now in the same vein, I’m joined today by Dr. Ajay Dhunna. So he’s a little bit more qualified than James, and he has a different perspective to offer. And whilst we do discuss portfolios here as well, and actually Ajay shows an example of his portfolio.

For those watching the video, I highly encourage for you to see this bit if you want to see what an effective modern contemporary portfolio looks like. But Ajay gives his own unique perspective on his top tips to help new grads navigate, because often we feel lost when you’re qualified. We feel overwhelmed. It is a tough gig dentistry and when you lack experience it is way more difficult.

I promise you dentistry becomes easier and easier and easier with more experience. So those first few years are so important to develop resilience and a growth mindset. So we’ll join now Dr. Ajay and I’ll catch you in the outro.

Main Episode:
Dr. Ajay Dhunna, welcome to the Protrusive Dental Podcast. How are you, my friend?

[Ajay]
Yeah, very, very good. Thanks, Jaz. It’s been a bit of a hot one these last couple weeks, isn’t it? But looking forward to this chat today.

[Jaz]
Absolutely. It’s a big, big topic. It’s a huge topic when you feel lost, when you qualify. I remember feeling very lost, doubting career choices. Having those tough days, feeling like you just know nothing. Right. And before we delve into those topics, just give us an introduction, my friend, when did, where did you qualify, what your interests are and what keeps you going?

[Ajay]
Yeah, yeah, sure. So, I qualified in 2018 in Cardiff University. That seems like a lifetime ago now, only four and a half years ago, but that was the best five years of my life. I can’t say that my wife’s listening, but yeah, ever since then kind of went on a journey just to try and be as good as I can clinically. Went on a journey through a couple of courses, but not trying to be one of the course junkies trying to implement it throughout practice.

I had a really, I was very lucky early on. I had very good mentors throughout my FD training and going forward into associateship, it was like kind of not today’s lucky streak, but also you kind of make what you want from it as well. So the FD kind of, I put myself into situations where I wanted to do more difficult cases.

I had the opportunity to do some oral surgery training in my FD as well, because the practice was partnered with a tier two oral surgery contract provider, which was great. And then straight out of FD, I completely restarted the course.

[Jaz]
Let me just probe you on that, Ajay, if you don’t mind, just because that is a really good point, right?

So the oral surgery is, I mean, one of the things that we’re going to discuss is one of the questions I will ask you is what should we be focusing on when we qualify and that I think oral surgery will definitely come up as one of those things, so it’s very apt that you mention that, but is that something that just you fell into by accident, or did you feel as though you had to knock on the right doors, you had to show that you were keen, or you had to grasp the opportunity to make it happen? How did that actually come to fruition?

[Ajay]
It’s like I said, I was a bit lucky in my foundation year, because the practice I was with was partnered with the another practice that had a Tier 2 oral surgery contract, the provider there absolutely incredible surgeon, his name is Tsukiyate (unsure), he actually, he’s a lecturer at Birmingham University, but he helped me a lot through that.

And they kind of scheduled me once a month to go and observe him and shadow him. And that was for the first couple of months. After that, he allowed me to kind of help him out a bit. Initially, it’s that kind of thing where you start off just placing the ID blocks. Then he kind of teaches you how to basically just simple stuff, like assessing X-rays of how you’re going to get an extraction done in the first place, and then going from going on from there to actually do the extractions that are a bit more complex.

And to be honest, I keep that learning with me to now touch wood. I don’t have, I don’t struggle with many extractions these days, but it also helps know your limits as well, but going on from that, like I said, I was scheduled there to be there once a month. I enjoyed it so much. I kind of became proactive myself and I asked to be there like two or three times a month just so I could step up the game there because as dentists generally we are restorative dentists.

There’s the other skills that are involved with it that other skills involved with dentistry that you need to kind of get a stepping stone with and I found this was a really good experience for me that not many of my peers would have had. So I thought I need to make the most of this.

[Jaz]
Well done. And then how do you, obviously you’re really brilliant at restorative dentistry, adhesive, that kind of stuff. What attracted you towards that?

[Ajay]
It’s one of those things where I started getting involved with dentistry, like kind of wider dentistry quite early on. From my final year of uni, I joined the BACD as a student member and then that kind of led me on to meet a lot of other people. I joined Dentinal Tubules in my foundational, foundation year and that was absolutely incredible as well. It’s just getting exposed to a lot of extra, extra dentistry rather than your just foundation year.

I’m a massive advocate of everyone learning their basic skills, but there’s no harm in knowing what’s out there early on. So you can kind of delve deeper into that and know where your interests lie. So that’s what basically sparked my interest in restorative because the idea of taking someone, I think what really sparked the interest was seeing the tooth wear cases, which is what I’m kind of really interested with at the moment.

Your teeth are just so broken down due to a reason. You find out the reason, you deal with it, and then you go on to kind of the massive journey of rebuilding someone’s mouth. It’s almost like dental architecture. And it’s kind of really interesting to me of how we can get from baseline nothing, to rebuilding a whole mouth, not just improving the teeth, improving airway, improving function, improving speech.

It was incredible. So that kind of led me on a journey and which is why yeah, I joined a restorative course with Chris Orr.

[Jaz]
Amazing.

[Ajay]
Yeah.

[Jaz]
I mean, I remember being a final year dental student and I think I accidentally saw this patient who was treated by postgrads and he had these most beautiful gold onlays and just the way that everything just fit together and was rebuilt.

This was like, wow, how do you even begin to do this kind of dentistry? That really made me think just like you did, you see them tooth wear cases being treated and the question becomes, I want to do this. How can I do this? And if you don’t go to outside your comfort zone, if you don’t go to the BACD, if you don’t go to AACD, wherever you are in the world and you start to see what is possible out there.

You don’t get that spark. You don’t get that sort of inspiration, that dose of inspiration. You need a, ‘Hey, I can do this. Can I do this? How can I do this?’

[Ajay]
Yeah, that’s the question, isn’t it? It’s always, how can I get there? It’s not like I want to do it or, oh, it’s impossible. It’s too, how do I get to that stage?

And that’s kind of, that’s a real big question for a lot of the young dentists like these days, because mainly because of social media, but I think that’s, they’re seeing a lot more. And they want to do a lot more, but I think they need to understand how to do it.

[Jaz]
And how did you evolve from your sounds like a very positive first year out of dental school for you. To going into practice and how soon did you go into, I’m only assuming, practice or mixed practice. Tell us about your sort of working environment.

[Ajay]
Yeah, sure. So I was lucky my first year at my foundation. Yeah. I keep saying lucky. It’s like you are what you make it, but I was lucky because I had great mentors.

My foundation trainer was great. He supported me really well. He let me carry on with what I wanted to, as long as I had justification and showed him that I knew what I was doing, basically not as it was that standard thing in foundation dentistry, you’re a safe beginner. But you have to be so, that was kind of the stepping stone through foundation dentist, the dental year, and I just kind of incorporated all the knowledge that I’ve learned from BACD short courses, the internal tubules webinars and their online learning as well as just going to also the foundation kind of scheme.

Talks were great. I mean, I was lucky to have, at that point, Lewis McKenzie was still doing the foundation teaching. So we had Lewis McKenzie teaching our composites. So that was incredible to see that. And he did the adhesive onlays. So I had great inspiration early on.

Going on from that, I stayed in my foundation practice for another two years, actually, which is great for me. It’s that thing that a lot of dentists kind of, young dentists, they kind of skip from practice to practice to practice. Sometimes circumstances don’t allow anything else. But I was lucky to be able to see my work from foundation.

You come back maybe a year later. This tooth chipped there. That cusp has broken off. This is just not comfortable for patient. This tooth devitalized even because it was a deep feeling that this kind of thing. And I was lucky enough to see this progression of my patients and then my own patients that I’ve done the work on.

So then I can reflect back and that’s always a word that I love using. I love using reflection because you probably see in Jaz, me and Ferdie, my business partner, we take loads of photos and it’s the biggest thing for reflection. So I used to take loads of photos and that was a massive stepping stone.

That was really the key factor for my progression in an early stage is taking photos, didn’t have a great setup at the start. I took the photos that I needed to take, look back at them in a few months. If a patient came back, I was like, what could I have changed? And it’s that question again, how could I have got better?

I look back at what I did, I know I’ve got better knowledge now, incorporate it into the next patient, and there we go. Kind of improved for the next patient. It’s that self awareness of where you’re going wrong so that you can reflect on that and get better in the future. That was one of the biggest things for me, kind of, as part of my progression.

That was through my, kind of, next two years in, that was in Telford in my foundation practice, and then that was in conjunction with me doing a year long restorative course with Chris Orr. And I say this to everyone who has asked me, that kind of, that I even tell him when I see him at BACD I was like, that literally changed my career from a very early age.

It’s probably because I did it straight out of foundation training. I didn’t have time to get bad habits. So I was learning in quite comfortable environment with Chris teaching me being around other dentists that are in a very similar circumstances Some of them had been qualified for 20, 30 years even some of them are just in my a couple years ahead of me. So we’re all in the same boat, but we’re learning-

[Jaz]
And I bet those guys were 20, 30 years qualified They probably said to you Ajay. Hey, AJ you actually It’s really good you’re doing this now, because some people think that, hey, you don’t even know how to do the basics yet, but you’re different, Ajay, you’re very, very switched on you’re very keen, and I know your experience is very, very positive, and there is an element of luck involved with getting the right supportive mentor and trainer, so yes, I agree, there is always an element of luck, but it’s good often to, especially something like Chris Orr’s course, so restorative focus the whole thing about aesthetic dentistry, all dentistry should be aesthetic anyway, right?

We’re not doing Class IV composites that are ugly anyway, so I think a foundational course like his, I haven’t done it, but I’ve got all my, so many friends, obviously, that have done it, have always said wonderful things about it, and so it’s good to hear this perspective that actually you weren’t disadvantaged for anything, it propelled you by doing it early on, and you didn’t get those bad habits, so that’s an important reflection point.

[Ajay]
Yeah, so literally it was that. I didn’t get into bad habits early on. I managed to pick up kind of techniques that he did himself. But I say this to a lot of people that, especially young dentists, kind of classed as course junkies. They go from course to course to course. You need to go on courses, but you can never really copy exactly what the course provider does.

You need to pick up your own technique because some, what’s comfortable in someone else’s hands is not going to be comfortable in your hands. So obviously Chris taught us the techniques and taught us the protocols of things. I took that and I was like, okay, this is what I can do with my hands and this is how my brain thinks.

I’m a bit more, I’m not more, my brain works quite logically. Probably similar to Chris’s, but it’s the fact that he’s got so much more experience and stuff that he does, I can’t do. He’s just a wizard. But so I needed to kind of adapt the teaching to what I could do. And I do this, I did this with quite a few courses.

Like I said, with Lewis McKenzie’s, I can’t do composites like he can. So I adapted my way of doing things to make sure that it’s comfortable for me. And it’s worked out in a way that it’s kind of, it’s done well. Like, I’ve got the right protocols. Patients are coming back happy. There’s no sensitivity.

Yeah. It’s all going well like that. And doing one of these courses really early on has really, really helped. And I do recommend that for young dentists quite early on, not just to kind of do it because your mate’s doing it. Your mate’s uncle’s dog is doing it or whatever, but it’s one of those ones where you just need to get good habits early on.

And because when you come out of dental school, essentially the phrase is you don’t know what you don’t know. So just try and learn what you need to know.

[Jaz]
One of my favorite quotes, man. You don’t know what you don’t know. Well, you mentioned a really good point about photography, but it’s one of those things.

It’s kind of like We sound like broken records on this podcast, like, if you count all the podcast episodes and anything on the theme of career development and mentorship, always photography will come up, but it cannot be emphasized enough about how many of our colleagues do not take enough photos, and so I’m going to be a little bit savage now, and I might upset some of my Protruserati, and I apologize if you’re affected by this comment, but it’s for your own good if you need to hear this.

I hate it when on our Telegram group, or on the Protrusive group, or any dental Facebook group, or any WhatsApp message I get, or any email I get, I get an essay describing the clinical scenario.

[Ajay]
Could I just take a photo?

[Jaz]
Where one photo, just one photo, literally all it took was one photo to describe everything. The exact scenario. I think what I found is that these colleagues are just not in the rhythm of taking photos. They don’t have their camera nearby. There’s too much out of their comfort zone. And I see this is why there is a stumbling factor. And it’s just about when you’re, it’s very noble and good to ask for help.

And I’m always happy to help everyone. But the advice you get out is so dependent on the input. So good input, i. e. good quality records and photos, even just photos, good quality photos, you will get good advice. If no one wants to read an essay. Right, saying this happened and that happened and this and this and can you give me some advice?

And you see those posts get the lowest engagement in terms of help. When you’ve got photos, you get the best opinions. Obviously, you’ve experienced this as well because you’re in education, you’re teaching young dentists and what not, you’re helping out with the lovely things that you do. Is this something that you’ve found as well?

[Ajay]
Oh yeah, a hundred percent. We get questions like this, they, oh, how do I do this? What should I do for this cavity? What or which matrix should I use for this kind of thing? And we get a massive-

[Jaz]
I was using, I was, yes, I was drilling a cavity. It was an MOD it had a two millimeter crack, and it just completely vividly described. It just needs one photo.

[Ajay]
It literally just need a photo of the single tooth there. Just quickly, just bang, shoot there, done send it over. And it sorted. It’s one of those things where you can’t tell people enough times. They just won’t listen. Some people are, I wouldn’t say they’re stubborn, it’s just they haven’t got into habits.

They haven’t got into good habits going back to my kind of early career. I literally, as soon as I got into the practice, I set my camera up by the side of me. So it was always there. It was a back then it was a really light set up actually, it was just, it was a very simple setup. It was a Nikon camera with a ring flash.

The workhorse camera basically just grab it, point, shoot, taken, photos taken, add it to the clinical records, ask for advice from my mentors, ask maybe even for case report, even for my foundation, yeah, but it was there quickly, I could just quickly take it and I got in habits of doing it. My nurse got annoyed with me because I started practicing taking photos on her, so, but it got me in it, it got me faster at doing it.

[Jaz]
That’s a hallmark of a good dentist, practicing a lot on your family. So I did it on my mum, my wife, then fiancé, and then yeah, loads of patients. Running a little bit late at the beginning because you’re just trying to perfect your photos and trying to get more photos and stuff. And some patients will say to you that you’ve taken more photos.

Literally, the other day a patient said to me, you’ve taken more photos in my mouth than anyone’s ever taken me outside my mouth, actually. So, you get comments like that. But patients notice that you’re into it, you’re dedicated, you’re interested in what they’re doing. And patients always have responded positively to that, I find. So if anyone out there is still not made the plunge yet, just please, it’s the most basic thing you could do, most fundamental thing you could do for growth is get into photography. How soon did you get your access to a camera after qualifying?

[Ajay]
So I was actually into a bit of photography before I finished dental school. So I had a camera just for holiday photos. So I had the camera body, but I actually got into dental photography two months before I started foundation training, just because I met Ferdi who is now my business partner. So we were just chatting because we met on a course when I was in final year, he was in foundation dentist, and we just started chatting about photography.

And I was like, I’ve got this camera. I need to start taking photos. We bounced ideas off each other, came up with a setup for ourselves. He was taking photos for his case reports and everything. And I was here. I didn’t have any teeth to take photos of. I was taking photos of a Kung Fu Panda model. Just to try and practice the zoning and everything and taking photos of my sister’s teeth, my mom’s teeth.

I’m just getting in the habit. So yeah, I bought a secondhand lens. I’ve still got this set up today and it’s actually used for our course now, the photography course that we teach. It’s actually used for that course now, but it’s still fully working. The setup I got was a secondhand, I had the body already, it was a Nikon D50300.

That’s really old now. They don’t even sell that. I had a secondhand lens, secondhand flash actually from someone at the practice. Still got that, still got the lens. It still works really well. Still takes great photos. I just upgraded it to different camera, different lens, different things, different setup.

But that still works. And this is one of the things, it’s maybe a stepping stone for not stepping stone. It’s maybe a learning point for dentist is, young dentists is they say everything’s so expensive and it is expensive, but you need to see the kind of the value of the investment. It’s not kind of a cost to me.

It was more of an investment. And so the value of the investment has turned over a lot more kind of in terms of that, because taking the photos is patient education. You’re not selling treatment, it’s co diagnosis. And then you’ve got your clinical records, you’re protected, things like that. There’s mountains of benefits of taking photos, but that was my setup back then.

Still got it now. And for anyone listening, I would just say that you need to get a camera straight away, as soon as you can, as soon as you can in foundation training. The foundation dentists that I know in Birmingham that we’ve chatted to, I’ve drummed this into them so much that they’ve actually started asking it for presents for birthdays and Christmases because it is essentially, yeah, it’s a camera to me is a toy.

To someone else it might not be but it’s because I enjoy photography so that’s it’s a good present to be honest because they can be expensive but the earlier you get it the better your habits you’re going to get in early and just quickly on that if you are looking to find some kind of tips of photography Ferdi’s actually written an article for the BACD which outlines a basic setup so anyone can check that out really.

[Jaz]
Amazing just pass that over I’ll put in the show notes for everyone to check out below that’d be good.

Occlusion is just so confusing. Does occlusion even matter? Wait, don’t you just grind away all the blue marks, right? You mean like plant it low, let it grow or leave it high and let them cry? Listen, what are these interferences even interfering with?

Is it safe to lengthen teeth? How much can I raise my patient’s bite? How can you stop your composite restorations from chipping? Can you raise the OVD on a patient with clicking TMJs? Is canine guidance always better than group function? Why can’t I just use the dial technique on all my wear case? Can I stop my patients from grinding?

What the bloody hell is crossover? What should the occlusion look like after orthodontics? How and why do you check for fremitus? What on earth is a custom incisal guide table? How do you use a leaf gauge? Do you always need to use a facebow? Does everyone really need perfect occlusion? What is the difference between edge wear and pathway wear?

Is it naughty to adjust the opposing tooth? What the f*** is centric relation? Occlusion is coming. One does not simply just open the bite. May the force of mitigation be with you.

If you want to do a deep dive 30 plus hours into occlusion online, just like in this format, but actually individual videos, lessons that are five minutes long, 20 minutes long, a few odd half an hour lessons, and lots of clinical videos and case walkthroughs, then check out occlusion.online. It’s Occlusion Basics and Beyond online course with me and Mahmoud.

If you are looking to take the next step in learning occlusion, that’s going to make your restorative dentistry predictable. Yeah. My first paycheck as a foundation dentist went pretty much towards a camera set up all on gumtree, secondhand, pretty much used, purchased from photographers who look after their equipment so I didn’t have to break the bank.

Although, yeah, it cost me a lot, but I was living with my parents at the time so that I could then buy this camera and start taking photos, thousands of photos in my first year.

[Ajay]
Oh, yeah.

[Jaz]
And I think this is when you speak to dentists who are really showing their work and they’re taking really good quality photos, okay, and showing good quality work.

I speak to them and the trend is the same. They started very early on and it was a relentless pursuit of trying to improve their photography and reflect on their work. So that, I know we’ve banged on about this but it can’t be emphasized enough. So you qualify for dental school, you have to now manage emotions.

You have to learn how to consent. You have to learn how to talk about money to patients. You have to learn without, yes, I know you have your trainer if you’re in the UK and you’re having the scheme or wherever you are in the world, your first year dentist, you’re not in that protected, as protected environment as you are in dental school.

You are your own person, you are your own man, your own woman. It can get very stressful, failed extractions.

[Ajay]
Yeah.

[Jaz]
Perforations, separated files, all these things basically. You end up feeling quite dejected, you end up feeling like you’re rubbish, you end up blaming yourself. How does one navigate this? What kind of ideas have you had for this?

[Ajay]
Dentistry is stressful. It’s a very stressful thing, but the thing about dentistry is that it’s not a single person’s sport. It’s a team sport. If you’ve got a problem in practice, if you’ve got a problem with anything you’re doing, or if you don’t even feel confident in yourself, you need to communicate to that to someone and whether that be your trainer, like you said, be that your trainer, even your nurse, even your kind of your family, you need to be able to communicate. I think the first stage of getting through the stress of dentistry at an early age is talking to people about it. And it’s not even talking to people about saying, Oh, this feeling didn’t go so well.

Cause people aren’t going to want to hear about certain feelings, especially if they’re not dentists, just talking to them about your day, just talking to them about, this patient talked to me like this, or I didn’t know what to say to this patient when this happened. And it’s just talking to them because even if you’re not, even if you’re talking to a non dentist, they will still give you, have invaluable advice about communication, about how to deal with situations.

And this is how I think in my perspective from my early career, I actually improved a bit because just talking to a lot, not many of my kind of immediate family are dentists. There’s a couple of dentists, but all the same age. So the older lot, they’re all in business, they’re doing other things, IT, things like that.

So they’re customer facing as well. Talking to them about how they interact with other people was really helpful at an early age because you can really see how, like you said, emotions are portrayed, how situations are dealt with, and that was very helpful. I think what one mistake a lot of young dentists make is not talking to enough people.

And that sounds really stupid, but just talking to enough people, not in a dental environment, and also in a dental environment outside of the practice, because one of the early things that helped my communication, just side note is that I, I’m naturally kind of from back in the day, naturally I’m an introvert.

So, but that kind of came, I came out my shell in the, my final year of foundation, final year of university and my foundation training year, because I started attending more conferences, more networking events. And I started chatting to people, talking to people and I realized that I’m not alone in this situation.

There’s hundreds of thousands of other people in the same situation with me. They didn’t know how to deal with a certain patient. They’ve also had someone complain about maybe a fractured file, maybe the tooth didn’t come out as easy as you wanted to, things like that. And at the end of the day, it’s fine.

I don’t know if I should be saying this, but there’s that saying in dentistry, but you never killed anyone. It’s a tooth at the end of the day, but you always want to treat them as best as you need to do. But you need to understand there’s a patient at the end of that, and if you talk to them like a person, then great, you’re going to be getting along with your patient well. And the only way to talk to, kind of, people in general is by talking to people in general.

[Jaz]
Very true, and you said that you went on lots of conferences, networking events. Did you follow this up with any non clinical courses? Communication type courses.

[Ajay]
I did a one communicate, I did a communication course, not in my foundation training.

Well, the foundation training had the communication courses inside. The non clinical communication courses came after my foundation training because I felt that my foundation training didn’t kind of cover everything that I wanted to, such as like the standard thing of ethical selling. Because you’re an associate now, you need to be able to kind of convert or just basically, I don’t like using the word convert or upsell.

You basically want to be educating the patient on the best thing that they need. And the patient needs to have, needs to kind of understand that at the same point as well. And that is a quite a difficult thing to get through your head early on because at the start, when you’re young, you’re just thinking, ‘Oh, it’s a private versus NHS crown’.

It’s this much money versus this much money. You’re not thinking about the benefit for the patient of using say, adhesive lithium disilicate rather than metal crown on band three NHS. So it’s things like that where the benefits need to be explained properly, but so the patient sees the value in it as well.

And I think that’s really important as well, for sure, non clinical communication courses are without shadow of doubt, kind of very, very underrated. Because I think that the point is when you go on that course, you don’t see an immediate result after the course. You have to put it into practice.

It’s that same thing with patients with perio. They don’t see the benefit of perio until six to twelve months down the line, but it’s the same with communication. You won’t see the benefit of your communication courses unless you put it into practice and then go down the line of talking to the patients in a certain way and then six months down the line you’ll see your books are full of what you want to be treating because you’ve told the patients the value of what you’re treating them for.

[Jaz]
Very true, and you already mentioned about visiting this oral surgeon as part of when you’re in DF1 and learning so much from them clinically, but I bet you, you learned so much about the communication and consenting and patient mannerism, right?

So there’s a dual benefit. So even though yours was like, you got lucky in a way that this was, they had this like a link and you had like this once a month thing, but there’s nothing stopping anyone right now, okay, to contact a local specialist or a local colleague that you respect and going in and shadowing.

And yes, you think you go in there who’s, oh, I’m going to learn how to do these composites and stuff by watching them. But I bet you you’ll come away thinking, wow, I like how he explained this to this patient.

[Ajay]
Oh yeah, a hundred percent. Like I said, it was a tier two or surgery referral practice that I got to shadow once a month.

And because it was a referral practice there, the oral surgeon, Dr. Atif he got referred all the nervous patients, the difficult teeth and things like that. All he got, he also got referred teeth that are actually easy to do. But dentists didn’t want to do them just because, I mean, we’ve all been through that where we’ve seen referrals of teeth that should have been taken out in practice, but they’ve been referred because I don’t know, X, Y, Z, but then that kind of, that leads on to kind of patient’s emotions just because in their head, they’re thinking, oh, this, this is too difficult to be done in practice. So they walk into that situation thinking, oh, this is going to be a really difficult situation. I’m going to be coming out of here in loads of pain.

My face is going to be out here. Just hearing how Tsuki (unsure) talked to the patients just to put them at ease. I mean, to be honest, he would have been talking to them the same way he would be talking to mates. It was a very good rapport he built up within probably about two minutes of them walking through the door.

He would have commented on something saying something nice, just, ah, you’ve got a nice scarf on today. It’s a bit cold outside. I’m glad you’re keeping warm and things like that. Just relating to them, taking their mind off the actual treatment, taking their mind off why they’re actually there. And that’s all about communication.

Just making the patient feel at ease. And by the end of it, the patients are saying, like, it’s a strange one, isn’t it? They’re saying thank you for taking my tooth out, even if they’re not coming in in pain, they just need the tooth out. They’re saying thank you for making my experience feel good. Having a tooth out was never a comfortable experience, but if you can make the patient feel good about it, then yeah, that’s a win win situation for you.

And yeah, he was a wizard with his hands. It was like a magician with his tongue goes, oh, he could literally just, that’s a very weird phrase. But, no, he could literally talk through anything, but it was a great way to learn for myself because when I see a tooth kind of that’s on the books to extract now I can put a patient ease in one of the practices.

I literally get all the anxious patients referred to me now just because I’m nice. I’m nice, apparently, but in reality, I’m just listening to patients.

[Jaz]
You make them feel listened to and respected. And so the lesson here, guys, is, sometimes you’re not in the best environment. Sometimes you may get in a place where you don’t have enough mentorship, but what you need to do is be proactive and seek that. And one of the great ways to seek that is by shadowing, because you will learn not only clinical, but the non clinical. Now, I’m just going to switch gears, Ajay, and talk about the desires of the dentist when they’re in DF1 and moving away and gearing up for the next level from there.

Yes, let’s say they’ve been, they’ve got a camera taking photos, let’s say they’ve been shadowing and stuff. Quite commonly nowadays, trajectory seems to be, I want to specialize and therefore they do these hospital posts, or going into private. Now, we’ve talked a little bit about this previously on the podcast, in those countries where they have a public system and a private system and a bit of a mixed system.

It’s not a given that just because you’re going to go into the fancy private system, that’s your ticket to happiness. I know plenty of dentists who’ve not had that experience and they are very, very happy in mixed practice. What advice would you give to the young dentists listening very early on about planning their next career move and the whole debate of specializing and what kind of practice they need to go into?

[Ajay]
Sure. Well, I think from the young dentist I’ve spoken to kind of recently, it’s changed from what it was a couple years ago during the COVID years. Okay. And that’s, I think a couple of years ago during the COVID years, a lot more people were looking towards specialism, staying in hospital and going through that.

However, saying that, obviously during COVID, the COVID years, the private practice boomed and there was a lot of kind of a social media boom on that as well. So a lot more dentists are seeing what can be done in private practice, which is dangerous, in my opinion. Because they’re seeing things like people, they’re seeing people do these cases that have been in practice for literally 10, 15 years and they think, oh, I can do that when I finish next year.

And I was like, no, okay. And it goes back to that saying, you don’t know what you don’t know. And that’s a really important thing. And Jaz, have you heard of the Miller’s Triangle, the Miller’s Pyramid? The competence pyramid.

[Jaz]
Ah, yes. Unconsciously incompetent.

[Ajay]
Yeah, yeah. So that’s kind of very relevant to dentistry, in my opinion. When you finish dental school, you might be unconsciously incompetent at that point very early on, but you don’t want to be consciously incompetent because that’s a bad phrase, that’s a bad position to be in. You don’t want to be bad and know you’re bad and not do anything about it.

So in my instance there, kind of following on from your question is, I know it’s a long-winded answer, but I think at this stage they need to get focused on foundation training, straight outta uni, out after foundation training. They need to pick up from on foundation training what they’re not good at first.

And if they’re not good at it, find out why they’re not good at it. And it goes back to that kind of thing on reflection. And you might not be completely good at it, you might be mediocre at it, you might be great at something, you might be bad at something else, just try and be, in my opinion, you need to try and learn the basics of what you’re not good at first, so that you can go on to be good at what you want to be good at, and this is a kind of convoluting topic there, but it’s because you want to be, in my opinion, dentistry from an early stage is single tooth dentistry.

Like, in the NHS, in foundation training, you’re treating a problem. You’re dealing with this problem, you’re dealing with that problem. Essentially, you want to get to doing multi teeth. You want to be doing whole mouth holistic dentistry. That should be the end goal. Kind of general, if you’re going to go down the restorative route, dentistry route, things like that.

And if you need to, if you’re going to go down that route, you need to know what you need to improve on. And like I said, it goes back to your reflection. So there’s not one answer for saying specialism versus going into private practice. But I do think, however, that there should be no rush in doing any of those things.

If you are going to go down the specialism route and then great, you do that, but you need to, it’s a very strange one because you need to decide what you want to specialize in quite early in that sense, don’t you? From what I know of the specialism route, you’re going to be staying, you’re going to basically dedicate the next few years to being in hospital to go in the DCT post and then get into your specialism training.

So that’s kind of a big task, really. It’s quite daunting when you think about this is what you’ve dedicated your life to now. From that stage early on, where you might not have even given something else a chance.

[Jaz]
I mean, that’s the hospital route. There are obviously the paid routes of playing for the MClinDents and stuff. Those options do exist, obviously. And sometimes people are 10, 15 years in practice, then they go into it. So the ship has never sailed.

[Ajay]
No, definitely not. But I think that point of view, from 10, 15 years from then, you’ve kind of gone through the motions of finding out what you’re interested in and finding, and you’ve done your single tooth dentistry on every single tooth in the mouth multiple times.

You’re going into multi tooth dentistry, holistic whole mouth dentistry, and you want to get better at it and formalize your education in that, which is great. I think that’s a great scenario to be in. And then kind of looking back to the other route is, and this is a kind of a double edged sword, in my opinion, it’s like you said, the grass is that isn’t always green on the other side.

I’m lucky kind of going from my mixed practice. I still work in the NHS kind of mixed practice at the moment, just because I’m a foundation trainer now at that practice as well. I still do a lot of quite a bit of private work because of that communication thing of patients, but in my private practices.

I’m very lucky, again, because I’ve put myself in a situation where I’m surrounded by people that are like minded people that want to get the best for their patients. Whereas I know for sure a lot of my friends have not been in that situation. They’ve been advertised jobs. Which kind of promise things that aren’t actually in their practice and everyone’s heard this we all seen on kind of the dentistry forums on Facebook. People in kind of contractual issues because they want to get out of the practice because they thought I was promised this I was promised all these patients I was promised all this equipment I was promised this XYZ kind of pay or whatever, but I’m not getting it so in terms of private practice, the grass is not always greener on the other side. I do however feel that if you get in the right private practice then a hundred percent, you’re going to have a better experience for yourself.

That’s a bit of a kind of double edged sword statement in itself as well, because you can’t get that in a mixed practice, but just focusing on the private practice. If you get in the right one, you’re going to be much less stressed, in my opinion, from my own experience, you’d be less stressed in terms of you don’t have targets to reach of a certain kind of UDA target.

Okay, you’re going to have other targets to reach from the practice point of view, but that will be doing the treatments that you want to do. If you don’t want to do something or you find out firstly why you don’t want to do it, and then you might have to refer it. But it’s great if you refer it in house to a practice like that, then great, you can go and observe the person.

I mean, the private practice I work at, I don’t do any endo at that practice, but I found out why it’s because I don’t feel like an offer endo to the best of the ability that’s available at that practice. So there’s been times where I’ve gone to shadow the endodontist. And I’ve learned loads, like I said, just shadowing even now.

And I say even now, it’s only four and a half years since I qualified, but it’s great. And because I can learn, I can pick up tips and ideas from learning something that I’m not confident in to give to the best of my ability. So I think private practice itself is going to be the goal of most dentists, but getting into the right private practice, there’s a way to do it.

I think. And I don’t think dentists should go just straight for the first thing they see on a Facebook forum. They shouldn’t go for the first thing they see come through the door. The way I got into the private practice I work in where it was a kind of non traditional way is I actually saw this practice down the road that I really like the look at and they weren’t advertising a job.

I essentially posted well, I sent them my CV and portfolio. And I said, I really like the work that you do at this practice, and I would love to be part of the team. Here’s the work that I do at the moment. I’m really happy to talk about kind of anything else that you, anything, any questions that you have about the work or kind of, even if there’s any opportunities coming up in the future, I would love to be considered.

[Jaz]
And this is a letter that you posted addressed to the principal? Yeah?

[Ajay]
Yeah. So that was led, that was sent to the practice and say, and then this wasn’t an advertised job. There was a job going at another one of his practices. But not this one, but I wanted to work here because it’s, I mean, me being lazy, it was down the road, but it was an amazing practice.

Like the work coming out of the practice was great. I know for a fact the principals had great ethoses and they had the right frame of mind and it was great. It was what I wanted to achieve from, it was a practice that I wanted to be in and that’s how I got that job. And it wasn’t even advertised.

[Jaz]
So be proactive. It’s that lesson right there. It’s like a few times we’ve had a guest on. They talk about how they got their first job. And it’s a very common theme. To put yourself out there. So you put yourself out there. There was no job advertised. But you created that job. You created that position for yourself.

Yeah, going out of your comfort zone and showing someone your portfolio, which is a topic we can talk about, how long should it be? What should be in your portfolio? We had an episode about this recently, actually. They’re going to come on these trips and come about the same time. So we won’t talk too much about portfolio, but anything that you want to add regarding portfolio?

[Ajay]
But I think your portfolio as a young dentist should have absolutely everything in there. It should even have the things that haven’t gone so well. And by console, I don’t think you should say like, ah, this has completely just gone wrong. I mean, like you should have in there kind of reflections of what you could have improved on.

I mean, I’ve got my portfolio on my computer. I don’t know if I can share the screen or whatever, but am I able to?

[Jaz]
Yeah. Do you want to share it? Yeah, you should be able to.

[Ajay]
I’ll just quickly share just quickly. So yeah, essentially I printed this out and I sent it to the practice, but essentially it’s just a portfolio of work that I did early on.

This hasn’t been updated since 2020. So 2021 or something like that. But yeah, this is just an example of my early portfolio. So contents page, just everything there. About me page. I mean, it’s very word heavy at that point. I would change things now, but this is just early cases go through author cases.

My just basically case reports of my cases and the best thing I think that was the best thing is this bit, the learning points and reflection of what I could improve on because I know that I’m then reflecting back on work. And if I have a similar case come through, Then great. I know exactly how to plan it out.

I mean, you can see here the kind of smart design thing that was left from Chris Orr but this was all kind of my thought process. This is how I plan cases at that point. Things have changed differently. Now this is some also rest of stuff at that point, me showing rubber dam skills, photography skills, just going through all these and literally just going through this. It’s showing exactly what I did at that point.

[Jaz]
Very good. I mean, that was really, really great. If you show the example for those audio listeners, I would encourage you to check out the video to see Ajay’s example of a portfolio, which is a little bit dated now, but it looks stunning and brilliant. And I can see why it was so effective in getting the job. You did get the job, right?

[Ajay]
Yeah.

[Jaz]
Definitely. Yeah, no surprises there. The main question I want to cover, obviously, about how lost you feel, and how you need to like I said, go to gain that network, identify your weaknesses. I also think you should identify your strengths and play to your strengths as well to try and develop into your niche.

That’s important. The importance of photography, which we emphasize, look, if you don’t have photography, you don’t have a camera, you don’t have a portfolio, right? So one leads to the other. It goes out saying, and we talked about your example of you being very proactive with the CV. Are there any other points you want to mention to dentists in terms of helping them navigate the first year or first two years?

[Ajay]
You need to make sure that you have a personal life. You can’t do dentistry just like I said, dentistry is a stressful thing. Not something you can just focus on yourself. You need to have a team behind you, where that team is your family, where that team is your practice, your nurse, your friends, your peers.

You might not have, you might be the only friend in your friend group that is a dentist. That is actually a very, like, hard position to be in because firstly, you don’t really have anyone not to compare but to kind of grow with. At that point. So you need to make friends within a dental circle as well.

That’s why networking so good, but on a personal level, you need to make sure you’re making time for your personal time. Dentistry is a very hard thing and it can be a very dark kind of career if you make it that way. You need to deal with your stress levels. You need to deal with your kind of physical restraints, your mental restraints, physical restraints, treat yourself, go for your massages, just loosen up your body, join a gym, join that class you always wanted to join.

Just literally make sure you’re enjoying yourself as well. And then mentally wise, like I said, just talk to people, talk to your friends, get out there, do something different. Dentistry isn’t the be all end all. You need to enjoy your career. You need to enjoy your life. You need to enjoy your career.

So you can enjoy your life. It’s kind of kind of goes to hand in hand, but I think this is something that a lot of young dentists, they don’t keep in the head very well. And I know that for a fact because I teach them and I talk to them and I hear their their qualms. The same with you Jaz, you do the same thing you hear all their qualms, you hear all their problems and even from the foundation dentists coming through their main stress right now is worrying about oh, have I done, have I done this feeling too high?

Is the GDC going to sue me for having a feeling too high? Am I going to get sued? Is the GDC going to strike me off or missing caries here I call the patient. Yeah, you might miss caries people miss caries early on. You call the patient up, you get them back in, you tell ’em, oh sorry, this just missed that.

Then shouldn’t be missing caries. But yeah, this is one of those things. But you should be stressing about things where you’re not able to sleep, where it affects your daily life. And I think that’s a really important topic, really important point to get across. It’s not an easy career, unless you’re proactive, like we said, that word proactive, unless you’re proactive to make it an easier career for yourself.

And you need to look after yourself as an individual, mentally, physically, and just to have fun. And I actually put this in my lectures when I teach, when I talk to fifth year dentists, I actually say to them, go on holidays, literally, you feel better, save some money every month, even if it’s just 50, 50 quid, a hundred quid every month.

If you’re able to save some money, you just get away for a couple of days. De stress. Decompress, sit by the beach. Vitamin D is healthy for everyone and everyone knows that. Just get some, just enjoy yourself, have some fun.

[Jaz]
Well said and I’m a big believer and an advocate and I say this to my colleagues that try and book out your year of holidays in advance so you know where you’re going in March.

Where you’re going in September, you’re going to Cornwall in December, wherever you’re going, whenever. It’s nice to know, even if you’re not going anywhere, you have this week and a half booked off in October, okay, to be filled. It’s just nice to know and to try and strategically place your breaks to that, evenly, so you don’t burn out.

I’m a huge believer. I love the fact that I know exactly what I’m doing in the next 12 months and I exactly, I know when my time off is, this is how I can stay focused and I can stay energized. Ajay, tell us about the teaching you mentioned about the photography course. I know you do some adhesive stuff as well. Is it online? Is it in person? Give us a flavor of that.

[Ajay]
So, the course, me and my business partner, Ferdi Chum, he’s based up in Newcastle, we teach a course called Trinity Dental Courses. It’s basically aimed at dentists trying to improve kind of basic skills. So it’s photography, rubber dam, and posterior resin.

The reason we call it Posterior Resin and not just a composite course is because we’re trying to build the foundations of what you need to do to say, build up a core, to build up a strong foundation for a tooth for the future, so, those are kind of three basics that we’ve kind of dealt with on that, just because those, and I always start the course by saying.

And adhesive dentistry isn’t the future anymore, it is the now. Like five, ten years ago, it was the future. Now, it’s happening now. We need to know how to do these things as best as we can. You’ve got rubber dam teaching how to isolate properly, and this is because people take ages putting rubber dam on.

I mean, the nurses always get fed up with it, taking 15 minutes, half the appointment to put rubber dam on. The protocol that we teach for rubber dam actually. It has worked pretty much 90% of the time for delegates just to get them really fast. And the great thing is it’s a safe way you never, there’s no risk of aspirating the clamp or anything like that.

That’s a really good way. Then the photography course is basically teaching, going to masterclass of photography for you to understand, not just giving you settings and go away, take some photos. It’s really teaching you how to use a camera. The teachings that we give on that course will actually be able to help you take photos in kind of holiday nature landscape photos because you understand how to take a photo and kind of taking the photo isn’t about click and shooting with settings. It’s about controlling light at the end of the day and after the kind of the session that we give you, you’re going to know how to control the light.

Just like that really quickly you’re going to know how exactly how to change the settings and we’ve had really good feedback from that because again going back to foundation training. It’s these days it’s only half a day of foundation of your foundation training study days It’s not enough for you to learn and practice.

So we give hands on training for the photography for that. And like I said, the third day is posterior composite, posterior resin restorations We go into different types of matricing so to cover basically I think it’s five different scenarios. You’re placing a rubber dam, we show you kind of how to build up deep margins, et cetera, but basically basic, simple principles that every young dentist is now seeing on Instagram, trying to copy, but not knowing how to do.

And we want to basically give you that knowledge. So you’ve got that in your head of house, how to do things properly, which is the best thing. It’s one of those courses. I think it’s kind of that stuff that you’re meant to know that people never actually learn. And it sounds so stupid and simple, but you’d be surprised how many delegates come on our course that don’t even know which bonds they’re using, which generation of bond they’re using, how to even use that bond.

And it’s a big common factor. So it is mainly aimed at kind of younger dentists coming through who just want to up their game. And this is a great way to kind of build your portfolio, your CV. And to be honest, we always talk about courses being an investment, but the investment for this is actually a lot cheaper than most other courses because we wanted to make it accessible for young dentists.

And plus me and Ferdi both really enjoy the teaching. So it’s not about the money. Check it out. It’s called Trinity Dental Courses.

[Jaz]
It sounds, yeah, it sounds foundational. And just tell the website and I’ll also put in the show notes as well.

[Ajay]
It’s called trinitydentalcourses.co.uk.

[Jaz]
Great. I’ll put down the short show notes and your next dates and stuff. You and Ferdi met you guys at the BACD together as well. Very switched on guys. Very, very fun to speak with and big time dental geeks. So, please do show your support Protruserati. If you’re looking for rubber dam photography, the foundational stuff, then do check these guys out.

Well, there we have it guys. Thanks so much for making it all the way to the end of this episode. As usual, there will be some links for you to click on in the show notes. If you found this useful or you know someone who will like this episode, please send it to them. This one and of course the one we did earlier this week with James Murray on portfolio building.

If you know a new grad or someone at the end of dental school who will benefit from this, then please don’t hesitate to share this with them and I’ll catch you back on the more clinical episodes next week.