Sir, I have written the following as my response to the General Dental Council's recent request for views on entry to specialist dental training in the UK but wished also to share them with BDJ readers, as I feel so strongly.

The current entry requirements for dental specialist training in the UK are deeply damaging to patient care and morale in the dental profession. They de-motivate many worthwhile candidates, depress standards of patient care in the UK National Health Service and deprive specialist practices of essential manpower. They are heavily biased against the practical intelligent individual and select mainly those who are fit only for the protected environments of hospital or academia having fled there after at most six months of unhappy general dental practice. They also discriminate against the mature entrant and exclude at least 90% of the profession through their inability to pass the intellectual mountain of the Membership of Faculty of Dental Surgery (formerly Fellowship in Dental Surgery) or afford years out from NHS care. They force individuals to receive 10 or more years 'training'. The current system delivers poor financial value; candidates are forced to fund three duplicate qualifications from universities and Royal Colleges of Surgeons where one would suffice.

Specialist practice in the UK needs individuals who actually want to treat patients as people and who are equipped to do so. It is over-supplied with researchers, academics and others who are essentially refugees from the tough realities of professional practice under self-employment. The successful specialist understands not only their discipline but the needs and difficulties of those who refer patients to them. They need superlative communication skills and first-class people-management skills.

The entry requirement should be that someone can demonstrate, through a simple log book of pictures, how their patients have benefited from the practitioner serving at least three years within a worthwhile general dental practice (not hospital or community). There they will have demonstrably coped with patient care, especially the provision of molar endodontics, crown and bridgework together with denture work ie the treatments that currently attract the highest level of negligence or indemnity settlement. This period allows them to handle the outcome of their decisions. During that period they will have had attachment(s) to specialist practices of say a day each week. This would allow them to test the waters without fear. It also avoids the 'watching Nellie' phenomenon because they experience real learning from people properly trained to enthuse and encourage rather than nit pick. The Royal Colleges of Surgeons should have no role in the entry requirements.

The current minimum lengths of training programmes need to be at most three years with a year of that droppable for those whose project demonstrates achievement. Remember that the individuals completing them have already had at least five years of undergraduate training and are prone to 'burn-out'. Using recognition of previous training towards the specialist training programme, in all specialties previous projects from general dental practice should attract at least a one year reduction in the overall training programme.