RCSEd Dental Ambassador Wins the William Houston Gold Medal in Orthodontics
RCSEd Communications Team
Last week the College held it's first Diploma Ceremony of 2023, where RCSEd Dental Specialty Ambassador for Yorkshire and Humberside, Tom Frawley, was awarded the William Houston Gold Medal for the best candidate at the Membership in Orthodontics examination (MOrth) taken through the Royal College of Surgeons of Edinburgh. 
Tom Frawley is a Consultant Orthodontist at the Charles Clifford Dental Hospital in Sheffield. He is also an Honorary Senior Clinical Lecturer at the University of Sheffield and the departmental audit lead. He obtained his MFDS examination with the College in 2015, before embarking on 'run-through' specialty training in Orthodontics in Sheffield and Barnsley. During this time, he completed his MClinDent (with Distinction), before gaining Membership and Fellowship with the College in 2019 and 2021 respectively. In 2022, Tom was awarded an RCSEd educational grant, and is currently completing a Postgraduate Certificate in Dental Education.
We had the pleasure to welcome Tom at the Diploma Ceremony on Friday 3 February, where he was handed in his medal by Dean of the Faculty of Dental Surgery, Professor Philip Taylor.
We are incredibly proud of Tom and his achievements and honored to have him part of our network of Dental Ambassadors. We spoke to him and learned more about his dental career path and what the William Houston medal means to him and his future endeavors.
You have received the William Houston Gold Medal for achieving the highest mark at MOrth, can you tell us more about this accomplishment?
"I feel very humbled to have been awarded the Gold Medal as many excellent orthodontists have won it in the past. I feel like it is very much in the past now but it is nice to reflect on occasionally. My success is a reflection of how excellent my clinical training was in Sheffield and Barnsley, so I have my trainers to thank for their part in that."
What motivated you to choose Orthodontics as your specialty?
"When I was younger, I used to attend my brother’s orthodontic appointments with him. I remember my curiosity being peaked by how much his orthodontist had to think about what they were doing at each visit. In retrospect, I now understand their dilemma as he had quite a difficult malocclusion to treat! I was always interested in the specialty, but found that there were fairly limited opportunities to get relevant orthodontic experience after completing my undergraduate degree, aside from the more 'short-term' orthodontic options. I therefore struggled to grasp exactly what being an orthodontist would involve on a daily basis, which was fairly important for me to understand before committing to specialty training. In 2015, I had the opportunity to go to Belfast for a DCT2 post, which was split between Orthodontics and Paediatric Dentistry. This turned out to be a fantastic learning experience and cemented my desire to specialise in Orthodontics.
I particularly enjoy the creative side to Orthodontics, such as planning and executing treatment mechanics to deal with a particular clinical problem. We generally see patients more frequently than other specialties, which gives us the opportunity to get to know our patients really well over a period of time. Most importantly, it is genuinely rewarding to see how our treatment translates into improving the quality of our patients’ lives."
Tell us about your experience with the MOrth examination and what tips would you give to those preparing for the exam?
"I sat my MOrth with RCSEd in 2019. The examinations were run over three days; I remember it being difficult to remain focused in between individual examinations as the weather was particularly good in Edinburgh! On reflection, it was a robust test of everything I had learnt over the preceding three years of training.
The best thing about the examination was that it felt like an accurate reflection of what an orthodontist does clinically on a day-to-day basis; from being examined on how I had treated my own patients to my communication skills in presurised situations. The nature of the exam made it a test of stamina as much as anything else. There have been a few changes since I sat the examination, including the omission of the “treated cases” section. Whilst there are undoubtedly some drawbacks associated this, it has been replaced with a new section focusing on candidates’ ability to apply their understanding of orthodontic treatment mechanics to novel clinical scenarios. This is one of the most important aspects of Orthodontics so I am confident that the new examination remains just as valid and robust.
Over the past few years, there have been some excellent orthodontic webinars from the RCSEd series aimed at MOrth level trainees. I would encourage readers to investigate the archived versions of these in preparation for their examination.
My advice for all new orthodontic trainees is to be proactive in maximising the clinical aspects of your training. Personally, I found that taking regular clinical photographs was a great way of focusing my learning experiences for each and every patient. For those in the run-up to the exam, it is a much better use of time to be tested by supervisors on new patient clinics than to be sat with your head in a textbook. During the exam itself, you need to be resilient in dealing with setbacks. If you feel like something hasn’t gone to plan then you need to hit the “reset” button, move on and not dwell on it. If you have a difficult unseen case that catches you off guard, then it is a good idea to outline the rationale for your preferred treatment approach by initially explaining to your examiners why that particular case is challenging. This should bring your examiners on board immediately as they will be able to see that you have noticed the key issues; it’s a bit like showing your “working out” in a maths exam.
Fundamentally, MOrth is a clinical exam which requires candidates to communicate their thought processes effectively."
Tell us about your work as a Consultant Orthodontist at Charles Clifford Dental Hospital, what challenges do you and your dental team currently face and what brings a smile to your face in your practice?
"From a clinical perspective, I treat patients with a range of complex malocclusions; the bulk of which for me personally consists of orthognathic, cleft lip and palate and complex orthodontic-paediatric patients. To manage these patients holistically I have multidisciplinary clinics with a number of different specialities, which is one of my favourite parts of being a Consultant. I’m also quite heavily involved in research and teaching; both of which add another dimension to the role and ensures that no day is the same.
Our main challenge as a team has been dealing with the impact that the Covid-19 pandemic has had on waiting times, particularly for our patients who require some form of surgical input. The best thing about my job is when a patient has their braces off at the end of a complex multidisciplinary treatment. It is extremely rewarding to have such a big impact on these patients, which often comes at a key point in their lives."
What advice would you give dental undergraduates and postgraduate dentists looking to pursue specialty training?
"Specialty training can be challenging and isn’t for the faint hearted; it’s important to do your homework and get an idea for what the specialty is like before committing to it.
Many specialist societies run courses aimed at providing undergraduate and postgraduate dentists with additional information about the specialty and the application process itself from current trainees and Consultants. For example, the British Orthodontic Society run a “So You Want To Be An Orthodontist?” course for this very purpose. I was invited to present at one of these events recently; they can be very popular so it is worth booking well in advance. These courses also give prospective applicants the chance to connect with trainees who have been through the process of applying for specialty training before. Once you’ve made up your mind, then get involved with people from your speciality of interest. Senior colleagues will be more than happy to help if you show an interest in their specialty. I’m currently mentoring some undergraduate and postgraduate students in Sheffield who are interested in applying and know several colleagues who are doing the same.
Finally, specialty training is often quite competitive. Always be prepared to come back stronger the following year with another application if you’re unsuccessful on the first occasion. Stay positive; it is definitely worth it in the end."
To learn more about our Dental Ambassadors and their mission visit our Ambassadors page. For more details about the MOrth examination, go to MOrth part A and MOrth part B.
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