Training in surgery of the temporomandibular joint: perceptions of trainees in oral and maxillofacial surgery in the United Kingdom.

Surgery of the temporomandibular joint (TMJ) is emerging as a subspecialty in its own right within Oral and Maxillofacial Surgery (OMFS). Recent guidelines on training and practice within this area have laid down standards of competence in certain procedures, and asked for evidence of "exposure" to others at the point of completion of higher training in OMFS. Provision of surgery of the TMJ is becoming more centralised within tertiary referral centres, with resulting disparity in opportunities for clinical experience in different training regions. We sought to gain a national perspective about this, and establish whether all trainees are truly equal when it comes to exposure to surgery of the TMJ during higher surgical training. An electronic survey was distributed to all members of an online Yahoo! group forum reserved for specialty trainees in OMFS. From those surveyed, 25 (48%) stated they had no experience of arthroscopy, while 19 (37%) and 38 (75%) reported no exposure to operations for alloplastic and autogenous replacement of the TMJ, respectively. A mode score of 1 out of 5 (44%, n=22) was returned when they were asked to rate the likelihood of considering TMJ surgery as a subspecialty. The current survey highlights variable exposure to operating on the TMJ across geographical divides within the UK, and little interest among trainees in pursuing the subspecialty as a career.