Postgraduate Specialist Education
Yrsa Le Bell, Juha Varrela, Risto-Pekka Happonen, Pentti Alanen
Systematic specialist education in dentistry has been given at the Institute of Dentistry, Faculty of Medicine, University of Turku, since 1985. Clinical Dentistry, Orthodontics, Oral and Maxillofacial Surgery and Public Health are the four recognized specialities in Finland.
Two years' experience in general dental practice is required for admission to the programmes. The training posts are full-time, salaried appointments. The total number of hours during the 3 years' programme is about 5000 and in the 6 years' programme about 10 000.
Since year 2000 the clinical treatment services given by the trainees are integrated into the public health care system. The trainees work at university hospital and health care centres. Nine months at health centres is mandatory (with the exception of Oral and Maxillofacial Surgery). The new system will offer the residents a representative range of patients and will allow better utilization of the expertise in dental schools for the benefit of the whole population. However, universities will continue to be responsible for the education. The local health care organization will be reimbursed through a system of special grants by the state for the costs involved in the training.
The speciality in Clinical Dentistry forms a separate entity and covers the disciplines of cariology(including endodontics), prosthodontics(including stomatognathic physiology and geriatric dentistry), periodontology, and pediatric dentistry. The theoretical studies (about 35% of the whole programme) comprise lectures, seminars, demonstrations, literature reviews and self-study. The students are obliged to conduct a research project, which can be clinical, experimental, or based on the literature, and report their findings and conclusions in a thesis or in a written report. In addition, the students have to pass a final written national examination. On completion of the course, the graduate should be able to independently and proficiently master, in practice, the diagnosis, therapy planning and integrated treatment in advanced cases of clinical dentistry. All students follow the same programme during the first two years. The third year is individually designed, permitting the student to acquire a more profound expertise in one of the four main disciplines, i.e. cariology, periodontology, prosthodontics or pediatruc dentistry.
Contact Information: Yrsa Le Bell, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, FIN-20520 Turku, Finland; tel. +358 2 333 8362; fax. +358 2 333 8356; e-mail: yrlebe@utu.fi
Within Clinical Dentistry , the trainee can also select the entity of Oral Diagnosis, Oral Pathology and Oral Radiology as their main field. Specialist training in Oral Diagnosis addresses diagnostic methods in the diseases of the oral cavity and the jaws. The specialist must also be familiar with the diagnosis of the general diseases, which have implications in the oral cavity and the jaws. In the field of Oral Pathology, the graduate should independently and proficiently interpret histological and cytological specimens, and apply various laboratory methods in the diagnosis of diseases of the oral cavity and the jaws. The specialist has to co-operate with various medical specialists. In the field of Oral Radiology, the training aims at providing the student with skills in the interpretation of radiographs, and with knowledge of the physical and technical basics, equipment and imaging techniques of various radiodiagnostic methods.
Contact Information: Stina Syrjänen, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, FIN-20520 Turku, Finland; tel. +358 2 333 8349; fax. +358 2 333 8399; e-mail: stina.syrjanen@utu.fi
The objective of the Orthodontic programme is to provide the students with a solid and broad academic background and give them adequate experience in clinical orthodontics. On completion of the studies, the graduates should master, independently and proficiently, the diagnosis, planning and treatment of malocclusions and anomalies of the facial structures. They should be able to assess treatment need and execute interceptive measures and treatment procedures at appropriate stages of occlusal development. The graduates should be able to train and supervise general practitioners to carry out simple orthodontic procedures, and they should be able to collaborate in multidisciplinary teams responsible for the treatment of orthodontic/surgical and cleft palate patients. In addition, the graduates should be able to critically follow the orthodontic literature and independently develop their knowledge of the field and their clinical skills.
The curriculum has been designed according the recommendations of the European-wide Erasmus/Ortho-project and the directives set by the European Commission on Dental Education. The theoretical courses have included the following topics: craniofacial growth and development; development of the dentition and occlusion; etiology of malocclusions; orthodontic screening and treatment need; diagnostic methods in orthodontics; diagnosis and treatment of malocclusions in the deciduous and mixed dentition; biomechanical aspects of orthodontic treatment; orthognathic treatment; distraction osteogenesis; sleep apnea; long-term effects of orthodontic treatment; occlusal physiology; and diagnosis and treatment of temporomandibular dysfunctions. Through cooperation with the National Cleft Palate Centre at the Central Hospital of the University of Helsinki, the students were given a comprehensive course on the treatment of patients with oral clefts or other craniofacial anomalies. In addition, the students have participated in a series of seminars where the current orthodontic literature has been reviewed and discussed.
Each student has conducted a research project analysing outcome of treatment in selected groups of patients. The planning and preliminary findings of these projects have been discussed in seminars. All students participated in the meeting of the Scandinavian Orthodontic Specialist Students (SCOUP) in Helsinki, June 1999.
A specialist education program for foreign students, equivalent to the requirements for orthodontic specialists in Finland, is being developed at our institute. This forthcoming programme will be open to foreign applicants who want to practise orthodontics in their own country.
Contact Information: Juha Varrela, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, FIN-20520 Turku, Finland; tel. +358 2 333 8350; fax. +358 2 333 8450; e-mail: juha.varrela@utu.fi
In Finland, Oral and Maxillofacial Surgery (OMS) is a specialty of dentistry and medicine. The training programme is open to dentists and physicians. Either a D.D.S. or M.D. degree is required for enrolment in the training programme. After completing the programme, the trainee will be a dental or medical specialist in oral and maxillofacial surgery, depending on his/her basic training.
The six-year curriculum comprises theoretical and clinical training. The residents work at the Department of Oral Diseases, Turku University Central Hospital. Part of the clinical training is done in other Central Hospitals in the Province of Western Finland. The treatment the graduates deliver to ambulatory and hospitalised patients covers the full scope of oral and maxillofacial surgery: pre- and postoperative patient management, orofacial pain, oral mucosal diseases, diseases of the temporomandibular joint, diseases of the salivary glands, diseases of maxillary sinuses, complications of oral surgery, dentoalveolar surgery, infectious diseases, traumatology, cysts and benign tumours, orthognatic surgery, preprosthetic and implant surgery, and reconstructive surgery. In addition, the trainees will be exposed to craniofacial surgery, aesthetic surgery, and treatment of malignant tumours. Furthermore, the residents obtain clinical experience in adjacent medical specialities with specialists in other areas of medicine and dentistry. The goal is that the oral and maxillofacial specialists will be able to take full responsibility for the diagnosis and treatment of diseases of oral soft tissues and jaw bones.
Contact Information: Risto-Pekka Happonen, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, FIN-20520 Turku, Finland; tel. +358 2 333 8240; fax. +358 2 333 8248; e-mail: risto-pekka.happonen@utu.fi
The training for the speciality in Public Health is focused on three aspects, administration, legislation and planning in health care, monitoring, evaluation and epidemiology, and health services research and health care economics. Many large education modules are selected from other faculties or universities; for instance, social policy at the University of Turku. For practical training, collaboration with the National Research and Development Centre for Welfare and Health in Finland, and other local and national health care organizations is intensive.
On completion of the programme, the graduate should be able, for example, to master the ethical and juridical basis of health care, know how to measure and estimate the oral and dental status of the population, the trends appearing in it and the factors affecting them, and the possibilities of the health care organization to influence health status. The graduate should also know the structure of public administration and the role of health care in the organization, as well as municipal planning and decision-making protocol and should master practical leadership within the organization. The degree consists of general studies, subject studies, a thesis, a national examination and service in the public health care organization. Theoretical studies are mainly completed within the first and second years, the practical service being done mainly during the third year, preferably in the public health care unit of the city of Turku.
Contact Information: Pentti Alanen, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, FIN-20520 Turku, Finland; tel. +358 2 333 8383; fax. +358 2 333 8356; e-mail: pentti.alanen@utu.fi
Foreign students from EU- or non EU-countries wishing to apply to the specialist education program in Clinical Dentistry are recommended to consult the websites of the Finnish Dental Association www.hammasll.fi (- Practising dentistry in Finland) and the website of the National Authority for Medicolegal Affairs www.teo.fi . Basically the requiremants are as follows:
Applicants from nonEU countries have to apply for a work permit to practise dentistry in Finland from the National Authority for Medicolegal Affairs, TEO Lintulahdenkatu 10, 00500 HELSINKI, Finland, Telephone: int. +358 9 772 920, Telefax: int. +358 9 7729 2138. NB. Applicants from EU-countries do not need a work permit. All applicants will require a certificate of the Finnish (and/or Swedish?) language. A 2 years' experience in general dental practice in Finland is required from all applicants wishing to apply for the specialist education program in Clinical Dentistry.
Twenty Years of Systematic Graduate Education in the Speciality of Clinical Dentistry