Faculty of Dental Surgery Royal College of Surgeons of Edinburgh

Faculty of Dental Surgery Faculty of General Dental Practitioners (UK) Royal College of Surgeons of England Registered Charity no: 212808

Dental Faculty Royal College of Physicians and Surgeons of Glasgow

Faculty of Dentistry Royal College of Surgeons in Ireland

MFDS/MFD EXAMINATION
Guidance for Candidates INTRODUCTION
The MFDS/MFD Examination is an assessment for candidates who are close to or have completed a two-year period of general professional training. Individuals who aspire to enter programmes of specialist training will be expected to have passed this assessment. The examination is designed to test candidates knowledge and understanding of all aspects of the syllabus in a structured manner. The examination is Intercollegiate in the first two parts (Parts A and B) and will be held in four centres in UK and Ireland twice a year in April and September. The papers in both centres will be held at the same time and using the same question papers. The third part (Part C) will follow a common format but will be Collegiate and success in this part will identify the Royal College of Surgeons/Physicians and Surgeons (College) in which the membership will be awarded and so affiliation established. This examination is also held twice a year 4-6 weeks after Part B. These notes are to be read in conjunction with the MFDS/MFD Syllabus and Regulations and are provided to help potential candidates in their preparation for the examination. Details of the structure of Part C of the examination should be sought from each College.

APPLICATIONS
Application forms are available on request from all four Colleges. Completed forms should be submitted to only one of the Colleges. Application should be made for Part C to the chosen College of affiliation. Evidence will be required of appropriate training (see regulations) and the appropriate examination fee should be submitted with the application.

EXAMINATION STRUCTURE
The examination is in three parts: Part A will consist of two subsections: 1. A two-hour Multiple Choice Question (MCQ) paper consisting of 60 questions. All the questions will have the same format. Each question will have a single initial statement followed by five possible responses. Any of the five responses may be correct or incorrect and the candidates will be expected to indicate whether each response is true or false. Each MCQ question will count for an equal number of marks. Marks will not be deducted for wrong answers. This paper will concentrate on Sections 1-6 of the Syllabus. This part of the paper will be answered on a printed answer sheet which will be marked electronically.

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2.

A one and a half-hour Multiple Short Answer (MSA) paper consisting of 15 questions. Each question will have a similar format. The questions are expected to be answered in about six minutes. Each MSA question will concentrate on a particular area of the syllabus and ask a series of related questions designed to test application of knowledge and understanding. All question parts will require short precise written responses of no more than a few lines. Diagrams may be included as part of the overall question. This paper will concentrate on Sections 1,2,3,4,5 and 6 of the syllabus. Candidates who overflow the allocated space on the paper for each response will waste time and gain no extra marks. The number of marks awarded for a correct response will be shown beside each part of each question. Each MSA question will be awarded the same number of marks overall. When the papers are marked examiners will use a precise marking scheme to award marks. Five questions on systemic disease in relation to dentistry will be included in the paper. These questions will simulate a clinical scenario and concentrate on Section 3 of the syllabus. Colour photographs, radiographs, laboratory reports, medical and dental histories may all be included to set the scene. A sequence of questions will then be asked relating to this clinical situation. Cross-compensation between the two subsections of Part A will be possible. A pass or fail grade will be awarded for the whole of Part A. Candidates must achieve a pass grade in Part A before proceeding to Part B.

Part B will consist of two subsections 1. An MCQ paper with 75 questions which will last two and a half hours. Questions will have the same format as those in Part A MCQ. Questions in this paper will have an emphasis on the later half of the syllabus (Section 7-11) but some questions will be asked on the rest of the syllabus. Marks will not be deducted for wrong answers. This subsection will be answered on a printed answer sheet, which will be computer marked. An MSA paper which will last one and a half hours. There will be 15 questions in this paper. Each question will indicate the area of knowledge being tested. Questions may be asked from all sections of the syllabus. Cross compensation will be possible between the subsections in Part B. A pass or fail grade will be awarded for the whole of Part B. A pass grade in Part B will be required before a candidate can proceed to Part C. Part C will consist of two subsections 1. 2. An OSCE examination with a minimum of 16 stations.

2.

Two oral examinations lasting 15 minutes each, questions will be asked on any part of the syllabus and may include both basic science and clinical subjects. This Part of the examination will be Collegiate, that is each College will design its own examination. All four Colleges will however adhere to the Intercollegiate Syllabus.

Examination Results The results will not be announced until four weeks after the end of Parts A and B examinations.

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Examiners Examiners have been appointed by all four Royal Surgical Colleges. The cohort of examiners contains both basic scientists and clinicians who cover all aspects of dental science and clinical practice. These examiners will work as an Intercollegiate team for Parts A and B and each individual Royal Surgical College will conduct their own Part C examinations according to the model described in the regulations. Candidates will not meet examiners in Part A or Part B of the examination. Specimen Questions Specimen questions are included with this document. They are not to be considered indicative of syllabus coverage in a typical paper. The questions in each paper will be chosen to sample representatively the area of the syllabus concerned. Over a series of diets/sittings candidates will be liable to questioning on any part of the syllabus. Specimen q uestions are included only to indicate the style and format of the questions that a candidate will be expected to answer in Part A and B of the examination. The questions shown will not be used in the examination. Feedback to Candidates Following adjudication of the examination results, these will be issued to the candidates as a pass or fail for the whole of Part A or Part B. If candidates wish further information regarding the examination, this can only be provided on request to the Examinations Department following announcement of the results. This information will consist of a statement of a candidates performance in the MCQ paper and MSA paper of either Part A or Part B. The performance will be recorded, as a number of standard deviations a candidate was, above or below the pass mark in these two Parts of the Examination. No further information will be made available to candidates.

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MFDS/MFD PART A SPECIMEN QUESTIONS

1. The roots of the following permanent teeth are normally completely formed by ten years: (a) (b) (c) (d) (e) 2. maxillary lateral inciser maxillary canine maxillary first molar mandibular central inciser mandibular first premolar

The healthy junctional epithelium: (a) (b) (c) (d) (e) shows no rete-pegs contains keratinising cells is a source of antibody production attaches by hemidesmosomes to enamel arises only from reduced enamel epithelium

3.

The head of the condyle of the mandible: (a) (b) (c) (d) (e) has collagenous tissue on its articular surface is the site of insertion of the medial pterygoid dislocates more commonly anteriorly than posteriorly contains on its articular surface a layer of dense fibrous tissue is limited in its lateral movement by the stylomandibular ligament

4.

Myocardial infarction: (a) (b) (c) (d) (e) is commonly caused by coronary artery occlusion may produce clinical appearances of shock because of reduced cardiac output most frequently affects the right ventricle is associated with chronic periodontal disease is more prevalent in soft water than in hard water areas

5.

Staging of carcinomas is based on: (a) (b) (c) (d) (e) size of the primary tumour presence of blood borne metastases cellular differentiation of the tumour presence of lymphatic spread length of time the tumour has been present

6.

Persistent bleeding following tooth extractions can occur in patients who are: (a) (b) (c) (d) (e) polycythaemic taking phenytoin taking aspirin found to have an International Normalised Ratio (INR) <1.0 chronic alcohol abusers

7.

The following are visible on radiographs: (a) (b) (c) (d) (e) the developing second permanent molars at 6 years the fully formed crowns of the canine teeth at 9 years the completed roots of the lower premolars at 10 years calcification in the crowns of the permanent central incisors at 1 year the root tips of lower third molars are near the inferior alvolar canal at 15 years.

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SAMPLE MSA QUESTION, SECTION 2: ORAL BIOLOGY TEMPOROMANDIBULAR JOINT

(a) Select the most appropriate words listed below to fill in the blank spaces in the following paragraph: [5 marks] The temporomandibular joint is an atypical ................................................. joint. articular attachment includes the ......................................... condyle The

surfaces consist of ............................................................. . The retrodiscal lamina which contains elastic predominantly occurs in the

fibres. Subluxation of the head of the

........................................... direction. Fracture dislocation of the neck of the condyle can damage the ................................................................ nerve. primary cartilaginous secondary cartilaginous synovial elastic cartilage fibrocartilage hyaline cartilage superior inferior anterior posterior lateral medial auriculotemporal chorda tympani nervus spinosus

(b)

Name the muscle of mastication commonly described as being attached to the disc of the temporomandibular joint. [1 mark]

(c)

Circle the correct location of the attachment of the sphenomandibular ligament to the mandible: [1 mark] posterior border of ramus neck of condylar process lingula coronoid process

(d)

Complete the diagram showing the movement in the HORIZONTAL PLANE of a point between the incisal edges of the lower central incisors when the following exercise is performed: [3 marks] Commencing with the teeth in centric occlusion, indicated by A, the mandible is in turn (i) moved to the maximally retruded occlusal position, B, (ii) moved fully to the left hand side, C,

(iii) moved to the fully protruded occlusal position, D, and (iv) moved to the incisal edge contact

position, E.

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SAMPLE MSA QUESTION, SECTION 2: ORAL BIOLOGY TEMPOROMANDIBULAR JOINT

(a) Select the most appropriate words listed below to fill in the blank spaces in the following paragraph: [5 marks] The temporomandibular joint is an atypical ................................................. joint. articular attachment includes the ......................................... condyle The

surfaces consist of ............................................................. . The retrodiscal lamina which contains elastic predominantly occurs in the the neck of the condyle

fibres. Subluxation of the head of the

........................................... direction. Fracture dislocation of can damage the ................................................................ nerve. primary cartilaginous secondary cartilaginous synovial elastic cartilage fibrous tissue hyaline cartilage superior inferior

anterior posterior lateral medial

auriculotemporal chorda tympani nervus spinosus

(b)

Name the muscle of mastication commonly described as being attached to the disc of the temporomandibular joint. [1 mark] lateral pterygoid

(c)

Circle the correct location of the attachment of the sphenomandibular ligament to the mandible: [1 mark] posterior border of ramus neck of condylar process lingula coronoid process

(d)

Complete the diagram showing the movement in the HORIZONTAL PLANE of a point between the incisal edges of the lower central incisors when the following exercise is performed: [3 marks] Commencing with the teeth in centric occlusion, indicated by A, the mandible is in turn (i) moved to the maximally retruded occlusal position, B, (ii) moved fully to the left hand side, C, (iii) moved to the fully protruded occlusal position, D, and (iv) moved to the incisal edge contact position, E.

one mark for connecting each of BC, CD, DE in a way that is essentially correct

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SAMPLE MSA QUESTION, SECTION 3: SYSTEMIC DISEASES IN RELATION TO DENTISTRY

WRITE YOUR NUMBER HERE ................

A HAEMATOLOGICAL PROBLEM
A 55-year-old female patient has the following haematological parameters: Patient Haemoglobin Haematocrit (PCV) Red cell count (RCC) Mean red cell volume (MCV) Mean corpuscular haemoglobin concentration (MCHC) (a) 7 g/dl 32 % 3.5 x 1012 /l 105 fl 30 g/dl Normal range 11.5 - 15.5 g/dl 37 - 50 % 3.8 -5.8 x 10 12 /l 76 -96 fl 32 - 36 g/dl

Give the two most probable nutritional deficiencies responsible for these haematological changes. [2 marks]

(b)

Name four medical conditions which are associated with these haematological changes. [4 marks]

(c)

Name three oral conditions which are associated with these haematological changes. [3 marks]

(d)

How might the haematologist describe the appearance of this patients erythrocytes in a stained blood film? [1 mark]

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A HAEMATOLOGICAL PROBLEM
A 55-year-old female patient has the following haematological parameters: Patient Haemoglobin 7 g/dl Haematocrit (PCV) 32 % Red cell count (RCC) 3.5 x 1012 /l Mean red cell volume (MCV) 105 fl Mean corpuscular haemoglobin concentration (MCHC) 30 g/dl Normal range 11.5 - 15.5 g/dl 37 - 50 % 3.8 -5.8 x 1012 /l 76 -96 fl 32 - 36 g/dl

(a)

Give the two most probable nutritional deficiencies responsible for these haematological changes. [2 marks] vitamin B12 folate

(b)

Name four medical conditions which are associated with these haematological changes. [4 marks] acceptable answers would include any four of the following: coeliac disease Crohns disease deficit in intrinsic factor production malabsorption syndrome previous abdominal surgery (or gastrectomy, intestinal resection) (Addisons) pernicious anaemia folate deficiency tropical sprue B12 deficiency drug induced - folate antagonists or named drugs including methotrexate, phenytoin and sodium valproate

(c)

Name three oral conditions which are associated with these haematological changes. [3 marks] acceptable answers would include any four of the following: angular cheilitis burning mouth or oral dysaesthesia or sore tongue candidiasis or candidosis recurrent aphthae or ROU or intraoral ulcer smooth tongue (atrophic) glossitis beefy red tongue

(d)

How might the haematologist describe the appearance of this patients erythrocytes in a stained blood film? [1 mark] macrocytic 8

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