Publications

Here are a selection of articles written by Dr M K Vasant, which were published in professional dental journals.

Face to Face with Manny Vasant
FACE TO FACE WITH MANNY VASANT Independent Dentistry March 1999

Kathryn Thomas RDN, Dip DHE, is currently combining running a dental practice management consultancy with working as practice manager in a wholly private single dentist practice in Limpsfield Chart, Oxted, Surrey. She also lectures throughout the UK and abroad to postgraduate dentists and memebers of support teams on all aspects of achieving success in practice.

Manny Vasant, one of the first holders of the new fellowship in general dental practice, explains to Kathryn Thomas why he was motivated to take the new diploma offered by the faculty of general dental practitioners.

In February 1998, 11 dentists were the first in the UK to be successful in gaining the Faculty of General Dental Practitioners' brand new diploma - the Fellowship in General Dental Practice or FFGDP (UK), as it is to be known.

Another success as Manny Vasant reaches Gilmans Point on Mount Kilimanjaro

In this article, we learn from one of the brave 11 precisely what motivated him to take this examination, what it has done for his practice and patients, and exactly why the Faculty felt there was a place for one more diploma.

Manjul (Manny) Vasant is the principal of a practice with four dentists and one hygienist in Norbury, South London. He graduated in 1972 and went on to obtain the US Board Examination and the New York State Licence Examination in 1976. He is an ex-board member of the Faculty of General Dental Practitioners. His current positions include serving as a regional adviser in General Dental Practice for the University of London, and as a vocational training organiser. He is also an examiner for MGDS and DGDP (Emeritus), and he works as a staff dentist at the Mayday University Hospital. In addition to these duties, he finds time to sit on numerous committees.

Why, then, does someone as busy as this, with an abundance of commitments, and with double MGDS (England and Edinburgh) choose to spend hundreds of hours in pursuit of more letters after his name?

I was lucky enough to find a window in Manny's hectic schedule to pose some questions.

Kathryn: Manny, you already have a successful, busy practice and your existing qualifications reflect your commitment to continued learning. Why put yourself through what has been described as a 'baptism of fire' and take yet another examination?

Manny: This is a familiar question! Interestingly, I went to climb Mount Kilimanjaro a few weeks ago and the African guide posed a similar question when he asked what people - mostly Europeans, Americans, and Japanese - get from this self-torture. In my case, I wanted to prove to myself, if not my wife, that, at nearly 50 years of age, I can still do it!

I suppose, in terms of the Fellowship, yes, it could be considered an ego trip, but, after MGDS, I felt lowed it to my patients to continue to maintain the standards that I was able to attain then. In other words, the MGDS confirms that you can do it, and the Fellowship, on the other hand, assures that you do do it. Also, having been actively involved in the Faculty and in the machinery of standard setting, I felt it was appropriate to offer myself for the test.

The official certificate point at Gillmans Point

Just to digress for a moment were you successful in your attempt to climb Mount Kilimanjaro?

Yes, I'm pleased to say I also got that certificate this year too. I made it to Gilmans Point - the officially recognised summit point. I hasten to add that doing the

So, tell me, around what stage in a dentist's career would you suggest taking this examination?

Well, let's assume the current Vocational Training will progress to General Professional Training in the very near future. It would be very nice to summate this with a Diploma in General Dental Practice - renamed Membership in General Dental Practice (MFGDP). Membership in General Dental Surgery (MGDS) is an established gold standard in clinical practice and, quite appropriately, is not available until five years after qualification to allow enough time for polishing one's skills. This will give certain exemptions from the clinical components of the FFGDP. As I said earlier, the latter will confirm that you have not only attained the gold standard, but you also have the fabric and structure to enable you to deliver

Manny, a large part of the examination seems to revolve around something called 'Manual of Care' - can you explain what this is?

This is now called the 'Portfolio of Evidence'. It is, in fact, a living workbook that explains the structure, process and outcome of everything that affects patient care in practice on a day-to-day basis. There are some 20 sections that fundamentally encompass the Donabedian concept of structure, process and outcome, each of which measures quality of care. Each section has clearly laid down criteria and evidence required to satisfy these criteria. This makes it very user friendly and the bottom line is that really you can't fail as such you or your mentor(s) have as much time as you like to get it right before you take the plunge - and you know exactly what is required to get it right. This Portfolio of Evidence is obviously a dynamic document that is updated on a regular basis

Let's take one of the areas of the Portfolio of Evidence - the section on staff training, for example - can you give me an example of how you satisfied the criteria for this section?

Oh, yes! This is my pet subject and was by far the easiest task for me. As it happens, we have in place a very practical staff training system. Allow me to show you the various

Our staff manual is very comprehensive, as is our manual on system operating procedures. Essentially, these manuals tell us how to do things. I'm sure most practices have similar manuals, but the question is how to get the staff to read them - and this is where we scored. Together with my associates and senior nurses, I produced a 'Practice Development Portfolio'. Each member of staff is given a copy to keep. The manual is divided into five modules, with each module consisting of about 20 questions. Every new member of staff is required to answer the questions at home in their own time, using the manuals when necessary. The emphasis is on learning a task rather than just regurgitating an answer. Staff are required to submit their answers to two people drawn from senior nurses, associates or hygienists in the practice, at which time they may also be asked to perform some practical tasks such as generating a recall on the computer or mixing a dental material.

The modules for new staff must be taken at intervals of one, three, six, 12, and 18 months and each module earns a practice certificate that has pay rises and certain other benefits attached to it - these are the incentives! Involving staff at different levels gives them control of their own progress. When they have completed the five modules successfully, they are encouraged to sit the National Examination for Dental Nurse!

It sounds like quite a lot of work! Your practice has a large NHS component. Is it really possible to attain these standards under the present fee structure?

I think it would be misleading I were to say it isn't a lot of work. I would also not be telling the truth if I said the NHS fee scale would keep a practice afloat. However, of the two new cases that I had to present for the assessment, one was, in fact, an NHS case. Also, if you have all the systems set in place, you will make the

I think the current climate shows practices are changing patients are beginning to appreciate quality and are opting to have certain treatments done privately. This is very encouraging and attaining the Fellowship is a positive step towards reassuring patients of the quality of care they can expect. - it's akin to the ISO 9002 in industry. We need to aim for the highest levels of quality care and never budge from this - let the patients or the politicians find the money to pay for the high standards.

How do patients know that you have this diploma?

In an ideal world, it would be nice if the national press listed the names of dentists who have not undertaken any peer review, but this is not feasible! More seriously, though, this is where the FGDP needs to do some work. I am hoping that in due course, Which? and other magazines would pick up on the meanings of these diplomas. Perhaps the FGDP may be able to suggest a press release for those awarded the diploma and the recipients can then use the publicity to promote their practice.

What was the most challenging aspect of the assessment? And what advice would you give to anyone thinking of taking this step?

I have to say that the clinical module was probably the most challenging part. In theory, it is possible to approach this examination without having attained the MGDS first. To my mind, this would be foolhardy and frustrating, except for a select few who may be exempt from some of the clinical modules by virtue of their other postgraduate qualifications approved by an appropriate committee. But, for the vast majority of people, it would be sensible to attain the MGDS first, get exemption from these and then undertake the Portfolio of Evidence, clinical audits and interpersonal skills components which form part of the FFGDP assessment.

You were a kind of guinea pig, as well as one of the architects of the assessment. How different is the subsequent exam going to be?

I think it is fair to say that, as assessors, we were required not simply to design a suitable assessment for later use, but we were required actually to live it. We tried many different things and some assessments proved too time consuming. However, every stage was monitored closely by the Faculty Board and an independent chairperson so, in fact, we ended up doing more than is required by

I understand that people who have been awarded the diploma will now act as mentors for future candidates. How does this work?

It's a sort of buddy system, where a candidate is teamed up with an assessor who provides support, advice, and a degree of hand-holding. A reasonable amount of encouragement

The aim is for the mentor to be with the candidate every step of the way. They will usually meet at the candidate's practice where the mentor will offer practical recommendations on how the candidate can best achieve the goal.

Would you say that it has been a positive experience for you and your patients?

Yes, definitely. Apart from my own huge sense of achievement, I think it has really improved the way in which the practice is run and I hope it is reflected in improved patient care. So much time is saved by having a properly structured system of management within the practice, where each member of staff is quite clear about his or her role. We were reasonably well organised before, but the Portfolio of

So, what's next?

Very shortly we'll be moving premises. This will enable me to put in place many of the things that I think are important in terms of the fabric of a practice. And I'll still be involved in assessment, albeit on the other side of the table this time! My son is going into dentistry so no doubt there will be some mentoring to be done on that front too.

Manny, thank you for your time.

You're welcome - I just hope that some people reading this will be encouraged to do what did and take the plunge.

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