The UK Mentoring and Support Programme (MSP) for those considering a career in Oral and Maxillofacial Surgery (OMFS). A review of a 'Register Interest in OMFS' website and the MSP as two key resources created by the British Association of Oral and Maxillofacial Surgeons to promote recruitment and retention (2008-2020).

In 2008, to create a rapid route for information transfer in relation training and recruitment for OMFS trainees, the British Association of Oral and Maxillofacial Surgeons (BAOMS) created a website to "Register Your Interest in OMFS" (RYIO). From 2011 a Mentoring and Support Programme (MSP) was created to provide focussed guidance for trainees aiming for specialty training. This paper reviews the effectiveness and cost of these programmes. Between 2008 and 2020, 1744 individuals used RYIO on 2715 occasions. Of these registrations, 1772 were by dentists, 193 dental students, 589 doctors and 161 medical students. 2354 were from UK and Ireland and 351 from the rest of the world. 188 registrants subsequently became UK OMFS trainees or specialists. All registrants valued the information provided. In response to RYIO trainee feedback the new 'Taste of OMFS 2020' programme was created. The MSP was originally called the Junior Trainee Programme (JTP). The MSP scheme provides a layer of mentorship/support which runs parallel to the medical/dental training post or period of study. Of 180 members of MSP, 72 have obtained specialty training posts in OMFS. There are 88 current members. Full information is available on the BAOMS website www.baoms.org.uk. Reviewing both programmes, participant feedback is excellent with tangible results whilst cost effectiveness is high.

Systematic review of lingual nerve retraction during surgical mandibular third molar extractions.

The lingual nerve is at risk of damage during mandibular third molar (M3M) surgery. Current trends to avoid lingual retraction and prevent injury to the nerve run counter to the surgical principles of locating and protecting important structures. To our knowledge, the last review of this subject only considered repurposed lingual retractors such as the Howarth. Other studies have reported the use of purpose-built retractors with improved outcomes for lingual nerve injuries. This systematic review aims to assess the current view regarding lingual nerve retraction in M3M surgery. A search of PubMed and Web of Science using the key words "lingual", "nerve", "retractor", and "retraction" returned 118 results, 10 of which were selected for inclusion (nine original research papers and one systematic review). The data comprised 16,133 M3M extractions using no lingual retractor, repurposed, and purpose-built retractors. No lingual retraction showed a 0.60% risk of temporary and a 0.08% risk of permanent injury to the nerve. Repurposed retractors showed a 7.9% risk of temporary and 0.41% risk of permanent injury, and purpose-built retractors a 0.56% risk of temporary injury. No reported cases of permanent injury were associated with the use of purpose-built instruments. The evidence suggests that whilst the use of repurposed retractors increases the risk of injury to the nerve, there is no such risk with purpose-built retractors. Current data sets are confounded by the limitations of non-randomised, non-blinded studies, but trends show that lingual nerve retraction with purpose-built retractors may help to prevent permanent injury to the lingual nerve.

Training in oral and maxillofacial surgery: a medicine-first perspective.

Specialist registration in oral and maxillofacial surgery (OMFS) requires dual medical and dental qualification involving at least eight years of undergraduate study. Training has continued to evolve since dual qualification was introduced and has often resulted in unwarranted repetition. If a time-based curriculum is necessary, second degree trainees should be allowed to pursue research and audit, and gain relevant clinical experience in lieu of repeating previously covered material. Junior surgical training could be integrated into the second degree. A programme that records competencies during the second degree may demonstrate equivalent to other aspects of junior training. One barrier is timetabling, which often restricts the integration of second degree trainees with OMFS units. Junior training in OMFS could be streamlined if the content was agreed nationally. This would also offer the opportunity for those key institutions that implement these changes to take on a prominent role in OMFS training.

Role of live animals in the training of microvascular surgery: a systematic review.

As training in microvascular surgery often involves the use of live animals, it is important that such a practice is regularly revisited and justified, particularly in the context of emerging training strategies such as virtual simulation. This systematic review was therefore designed to assess the ongoing need for their use over other methods. A search of PubMed and MEDLINE using the major MeSH terms: anastomosis, surgical vascular procedures, microsurgery, and training, yielded 1386 titles from which 153 abstracts were read, 70 papers analysed, and 17 included. Nine of these papers were randomised studies that compared different methods of training. Other publications were included if the use of live animals was assessed or commented upon, or both (8 publications). Only one study randomised trainees to a non-living animal model or a living model, with detailed assessment that included clinical transfer to live surgery. It showed no significant difference in the quality of training, and excellent techniques of assessment. There was much discussion on the advantage of regular training and opportunities to practise without tuition, but there was no clear advantage for the use of live animals. Our review emphasises the lack of evidence regarding the need for live animals in the training of microsurgical or microvascular skills. Although the assumption remains that the use of live rats is essential, there is a clear need for a high-quality, comparative study to justify the continued use of such models given the quality of the alternatives now available.