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Hospital dentistry

BXP56314mSenior House Officer posts (SHO)

Many graduates who have completed Foundation Training (FT) are now looking to salaried positions as a future career pathway. Whereas before most would have gone straight from FT into practice, a shift is slowly occurring and more graduates are seduced by the apparent stability that salaried posts provide. But what are these kinds of roles really like and where do they get you on that all-important career ladder?
It is generally agreed that if you enter into the salaried services straight from FT you will be taking up a Senior House Officer (SHO) position. An SHO job provides training and experience in a relevant speciality, such as restorative dentistry or oral surgery, and is graded as one below a registrar post and two below a consultant. These positions can provide a raft of experience for somebody still relatively fresh out of dental school and even if you don’t decide to go the whole hog and complete specialist training, it can stand you in good stead for your future life in practice. 

Max fax

There are more SHO jobs available in oral and maxillofacial surgery than any other discipline. While max fax can fill some graduates with fear, others are attracted to the diversity and challenges it brings. In this role you will have similar responsibilities to a junior doctor and will therefore be required to clerk in patients, regularly be on-call and assist consultants in theatre. You will also have your own list of patients and be required to attend consultant clinics. A max fax SHO can look forward to seeing a wide variety of conditions and illnesses and will experience a range of eye-opening situations that will either have you signing up for more or running to your nearest comfy practice. Even if you don’t have such a strong reaction to the post, you can be sure that you will leave the hospital with more weapons in your dental arsenal than you had before.


Of course max fax is not the only SHO post you can apply for. Restorative is another popular speciality, which doesn’t usually require on-call work and runs at a much gentler pace than its max fax counterpart. However, just because the work is slower, don’t be fooled into thinking it is any less valuable. Without the time pressures of practice you will be able to work on more complex cases involving endodontics, prosthodontics or periodontics.  The main bulk of your work will be done through specialist clinics where patients have been referred in by GDPs. This kind of work can be very rewarding and useful for your future career, however this means that competition is high for places, so be prepared.


An SHO position in paediatric dentistry can be a good stepping stone for somebody who wants to specialise in orthodontics. Although most posts don’t require an orthodontic element, the experience you get from this kind of SHO post will go a long way towards convincing others that you are ready for specialist training.

Oral surgery 

Oral surgery is another option for those who are interested in this side of dentistry but would prefer not to have the medical responsibilities that so often come with a max fax job. Oral medicine is another favourite and is usually based on patient clinics led by a consultant. 

Special needs

If you like the idea of working with patients who have special needs then community dentistry may be the way forward for you. You can expect to see adults and children with dental anxiety or specific medical needs that require extra attention. You also may be treating elderly patients or those who have a mental illness, all making for a somewhat varied job that is almost certain to keep you on your toes. The communication skills that you learn while in the community service will be invaluable if you then decide to return to practice and there are other techniques such as sedation that you will have learnt, which you can put into practice elsewhere.


While you are an SHO, if you decide you want to become a specialist in any discipline you will have to follow the correct training pathway. That means you will have to complete two years of structured training as an SHO. During this time you will usually be encouraged to take your MFDS or MJDF diploma to become a member of the Royal College of Surgeons. These qualifications are designed for those wishing to qualify for entry to specialist training. It takes, on average, 20 months to complete. Once you successfully complete your diploma you can seek entry onto an approved specialist training programme.

Specialist training

Specialist training will last a minimum of three or five years depending upon the speciality. For example, special rules exist for people wishing to specialise in orthodontic or paediatric dentistry. For these disciplines you are required to complete an additional minimum of two years training on top of the basic requirement of three years. All specialist trainees are issued with a National Training Number (NTN) by their postgraduate dean and are assessed throughout their training to ensure that the necessary support is being given and progress is being made.

Once specialist training has been completed you will be awarded a Certificate of Completion of Specialist Training (CCST). This means you can gain entry to the specialist list in your discipline and that you can call yourself a specialist.

In-depth experience

Whether you decide to spend a couple of years as an SHO to gain more in-depth experience of a particular subject area before returning to practice or go on to complete the full specialist training, there is no doubt that your time as an SHO will have been valuable. Approached in the right way it can be worthwhile and may just put off any decisions about going into practice for a few more years.

Written specifically for dental students, our Career Guide has further details on hospital career options. Our Education Team can also offer help and support with your career choices. 

"You can be sure that you will leave the hospital with more weapons in your dental arsenal than you had before"