With a distinct shortage of Oral Medicine specialists in WA, it’s an excellent time to consider specialising in this varied and rewarding field.
Each year, the Doctor of Clinical Dentistry (Oral Medicine) course at UWA Dental School accepts two to three new students.
Currently, there’s a shortage of Oral Medicine specialists across Australia, as Oral Medicine was not recognised as a speciality until 2009 in Western Australia, after Program Convenor, Associate Professor Ramesh Balasubramaniam OAM, advocated for the speciality to be recognised in WA.
“Associate Professor Agnieszka Frydrych, myself, and Dr David Booth visited Nicola Roxon, the Minister for Health at the time, to get Oral Medicine a speciality recognition in the State,” Ramesh recalls. “In 2010, it was nationally recognised.”
More Oral Medicine specialists are required to improve access to care. “Even in Western Australia, where we have nine registered Oral Medicine specialists in the State, my personal waiting list in private practice is seven months,” Ramesh says.
“Even the first-year graduates in Oral Medicine are booked up a few weeks ahead. If patients have delayed access to care, it could mean a delay in diagnosis, which means delayed treatment, and ultimately an increase in morbidity and mortality. That’s why access to care is so critical.”
The three-year program is led by Ramesh and other academic staff, including Associate Professor Agnieszka Frydrych and Research Supervisor Dr Omar Kujan. The program is supported by adjunct staff and clinical supervisors, Oral Medicine specialists Drs Alissa Jacobs, Amanda Phoon Nguyen and Lalima Tiwari. Oral and Maxillofacial Surgeon Dr Frank Chang assists students with the surgical procedures.
The course curriculum includes oral and maxillofacial diseases, oral oncology, salivary gland disorders, orofacial pain, temporomandibular disorders, and dental sleep medicine.
“The best thing about our program at UWA is we have a very strong didactic component, with seminars in orofacial pain, oral disease, oral biology and histopathology,” Ramesh says. “We also have histopathology sessions, and five to six clinical sessions a week of patient care in the first and second years. As part of the program, you are also expected to publish two papers – one review paper and one experimental paper on a study that you have conducted.
“In your third year you will be seconded to various medical rotations, as well as required to spend time in other Oral Medicine centres, such as The University of Sydney, The University of Melbourne and The University of Queensland, and the medical rotations include pathology, rheumatology, psychiatry, sleep medicine, pain medicine, neurology, radiology, paediatrics, dermatology and oncology.”
Associate Professor Agnieszka Frydrych says the course has a strong presence in the head and neck cancer space, with the students having the opportunity to participate in the diagnosis, treatment planning and management of patients with head and neck cancers.
“The students have the opportunity to attend multi-disciplinary clinics and interact with specialists involved in the care of head and neck cancer patients,” she says. “This includes medical and radiation oncologists, head and neck surgeons, speech pathologists, dietitians – a large group of people that participate in very complex management of these patients.
“From the oral medicine point of view, we see these patients with the aim of initially preparing them for cancer treatment, particularly the radiation therapy. Cancer treatments are associated with all sorts of short- and long-term adverse effects, which we help to manage.
“We have two dedicated clinics per week to look after the head and neck cancer patients, as well as the weekly multi-disciplinary meetings, so there is extensive exposure during the course of the program to these patients.
“Management of head and neck cancer patients is extremely complex, and our students are able to interact with highly specialised clinicians. They find this rewarding and interesting,” she adds. “The students are able to see complex cases through our association with Sir Charles Gairdner Hospital.”
Dr Jeremy Lau is a first-year Oral Medicine student, who was drawn to the puzzle-solving aspect of the speciality.
“A lot of patients present with signs and symptoms that can be unexpected. When you can solve the puzzle and see the patient’s conditions can be treated or managed, it is very fulfilling,” he says.
“Oral Medicine is a holistic speciality where we are not just dealing with a condition,” he adds. “Instead, a lot of patients have complex medical and psychosocial histories, which will also need to be considered.
Often, we are part of a larger multi-disciplinary
team that involves general dentists, GPs, medical
and dental specialists.
“It is a very rewarding speciality; no doubt it is challenging in terms of the knowledge you need to have, and you appreciate the importance of oral medicine and the difference it can make to patients,” he adds. “The course has been very enjoyable so far and I can see it is a very comprehensive course, covering all aspects of oral medicine very thoroughly.”
Ramesh says specialising in Oral Medicine offers a great range of career opportunities, including in private practice, hospitals and academia, and offers economic comfort.
The difference the speciality can make to patients is also greatly rewarding. “I think there are not many areas of dentistry where you truly can save someone’s life; for example by picking up a cancer early,” Ramesh says.
“If you are considering applying, you need to ask yourself if you enjoy the process of thinking, as this speciality is very much a thinking sport,” Ramesh says.
“To enhance your chances of getting into a program it is important that you express your interest early, get to know the local oral medicine specialists, spend some time rotating through the oral medicine clinics, and perhaps even in private practice or a local hospital. You could also consider writing a paper with one of the Oral Medicine specialists.”
For more details visit uwa.edu.au/study/d/clinical-dentistry or contact Ramesh directly at ramesh.balasubramaniam@uwa.edu.au
The course accepts between two to three students each year. Interested applicants for the 2023 intake can apply before 30 June 2022, to start in January 2023. Apply at uwa.edu.au/apply
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