Oral and maxillofacial surgery (OMFS) continues to face a recruitment crisis. Despite increasing competition ratios across most surgical specialties, OMFS training posts remain unfilled, with more vacancies than applicants in several recent years. This is concerning given the NHS backlog and the fact that OMFS already accounts for 13% of unfilled consultant posts in the UK, and that 23% of the current consultant workforce are above retirement age. Without decisive action, the specialty’s workforce and scope of practice are at risk.
Traditionally, OMFS recruitment has been dominated by dental graduates progressing through dental core training (DCT). However, the pool of dental graduates is small, with only around 1100 completing training each year, compared with more than 9000 medical graduates. Medical graduates represent a larger, under-utilised pool of applicants, yet medical students are rarely exposed to OMFS during their training.
The lack of visibility begins at undergraduate level. Medical schools often lack OMFS societies and structured teaching, unlike orthopaedics and plastics, which maintain strong student groups. Goodson et al reported that only 27% of medical students were aware of the essential requirements for OMFS training. This problem is compounded by the limited number of OMFS foundation training rotations: out of more than 9000 annual foundation posts, only around 75 include OMFS. By comparison, other specialties routinely feature in the foundation programme, ensuring early exposure and recruitment interest.
This represents a major missed opportunity. Increasing the number of OMFS rotations for medical foundation doctors would not only provide much-needed service support, working alongside DCTs, but would also expose medical graduates to the breadth of OMFS practice. Amid workforce shortages medical graduates could sustain clinical delivery while strengthening recruitment.
Several strategies could help unlock this potential. Expanding OMFS rotations within the foundation programme is an achievable first step, but this must be supported by greater undergraduate engagement. Medical schools should be encouraged to establish OMFS societies and integrate teaching on the specialty’s scope and career pathways. National bodies such as BAOMS could play a coordinating role by supporting student-led initiatives and offering mentorship opportunities, building on the success of the Mentoring and Support Programme.
Importantly, widening recruitment to include more medical graduates would not dilute the specialty’s standards. UK OMFS training, which requires dual qualification in both medicine and dentistry, is internationally respected. Medical graduates could complement dental colleagues, strengthen the workforce, and enhance the specialty’s visibility. A medicine-first entry pathway has already been explored and may represent a valuable adjunct to existing structures.
The OMFS recruitment crisis cannot be solved by focusing solely on dental graduates. To safeguard the future workforce, the specialty must look beyond its traditional applicant base. Medical graduates are a large, motivated and untapped resource, currently excluded by lack of exposure and opportunity. By expanding OMFS rotations in the foundation programme and increasing undergraduate engagement, the specialty can attract more medical graduates, strengthen its workforce, and secure its future role within UK surgery.
