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4-week Comprehensive Dentistry course (full time) With one-week EXTENSION practice (optional-NEW) One -week REFRESHER COURSE (NEW) 2-week Technical course (full time) Additional experience sessions (all technical and clinical components available) Individual work assessments MOCK exams Dental Therapy course (on request- contact OTC Office for details)
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4-week Comprehensive Dentistry course (full time) One ... › __data › assets › pdf_file › 0020 › 62435 › O… · week 1+2: Demonstrations and practice of all technical

Jun 27, 2020

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Page 1: 4-week Comprehensive Dentistry course (full time) One ... › __data › assets › pdf_file › 0020 › 62435 › O… · week 1+2: Demonstrations and practice of all technical

• 4-week Comprehensive Dentistry course (full time)

With one-week EXTENSION practice (optional-NEW)

• One -week REFRESHER COURSE (NEW)

• 2-week Technical course (full time)

• Additional experience sessions

(all technical and clinical components available)

• Individual work assessments

• MOCK exams

• Dental Therapy course (on request- contact OTC Office for

details)

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All our courses are undertaken at the Royal Dental Hospital of Melbourne.

The technical part of the course takes place in the custom made Simulation Lab. Other sessions will take place in the undergraduate teaching clinic equipped with Adec chairs, suitable X-Ray unit and having access to dental manikins for practice of extractions, local anaesthetic administration, dental radiography, rubber dam, periodontal scaling and others.

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Equipment used (on loan):

• KaVo manikins with Columbia with upper and lower models (for SimLab practice) • High speed and slow speed hand pieces and micro motor • Dental manikins for LA, extractions, radiographs and scaling /perio • Rubber dam kits, punch, and clamps • Radiographic holders (XCP, Kerr, XCP Ora, Kwik-bite, bite tabs) • Gracey curettes set • Surgical instruments, suturing kit, plastic skull • CPR manikin is provided by a certified trainer • Others as required

Diamonds, burs, and polishers: • ADC bur kit

• 3M polishing discs large and small brown/orange series with a mandrel

• Enhance polishing point and cup.

Hand instrument kits:

An Instrument Kit is included in the cost of the 4-week Comprehensive Dentistry course, which students keep (along with teeth) on completion of the course. A standard instrument kit on loan will be available for all candidates enrolled in other courses.

Nordent hand instrument kit with Duralite handle: • Round mirror handle simple

stem with a front surface size #4 mirror

• Single end Explorer #23

• William's periodontal probe

• Non-locking College pliers

• Hatchet #17-18 (10-6-14)

• D/E endodontic explorer DG 16

• Excavator D/E spoon #2

• D/E paddle #1

• D/E ultra-fine IPC

• D/E instrument with paddle-round end condenser

• D/E amalgam condenser Mortenson

• D/E Amalgam condenser #4-10 serrated tip

• D/E amalgam carver Hollenbeck #3

• D/E ball burnisher #45

• Interproximal carver

• Dycal applicator

• Amalgam carrier and silicone cup

• Tofflemire and Siqveland retainers

• Large instrument cassette

NOTE: please read the course information carefully regarding what is provided within the fee for the course.

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Comprehensive Dentistry course

(4 weeks full time)

This course places emphasis on preparation to sit the practical ADC examination and developing confidence in all aspects of dentistry.

This course may be suitable for candidates sitting the New Zealand Dental Registration Examination (NZDREX/NDEB) with a slight modification. Please discuss your requirements and the availability of places with OTC Staff prior sending your application.

Course structure- timetable

Sessions are generally scheduled Monday to Friday 9.30 am – 12.30 pm, 1.30 pm – 4.30 pm and 5.30-8.30 pm and Saturdays from: 9.00-12.00 and 1.00-4.00 The 4-week timetable guide:

week 1+2: Demonstrations and practice of all technical tasks (2-week Technical course) week 3: Clinical OSCE (communication and role plays, skilled OSCE

demonstrations and practice) week 4: Clinical /OSCE (remaining tasks demo and practice) and technical practice

Technical sessions are supervised by experienced demonstrators, with some free practice sessions where the demonstrator will be available for the assessment in the next session.

This course is not designed to re-train the participants in basic dental procedures. Although all tasks will be demonstrated during the course, the candidates are expected to perform the tasks independently supported by self-directed learning and the demonstrators’ feedback. Participants should monitor their own progress by performing self- assessment during each session. Each program will consist of demonstration and practice of the following:

• Practical supervised sessions on dental manikins focusing on teeth preparation and restoration (technical tasks as specified in the ADC Handbook)

• Rubber dam application and fissure sealant on the manikin

• Dental radiography sessions including developing radiographic report.

• Local anaesthetic administration, extractions and suturing on the dental manikin.

• Scaling and root planning on the periodontal manikin

• Partial denture design workshops including surveying

• Examination, diagnosis, and management planning; record keeping and consent session

• Clinical case discussions and role plays including information gathering, diagnosis, risk assessment, prognosis, treatment, management of complications etc.

• CPR/medical emergencies with a qualified trainer

• Infection control protocol is followed as per clinical setting during all technical and skilled OSCE sessions.

• Other tasks as per ADC practical examination requirement

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Course Outcomes:

After completing this course participants are expected to have skills and confidence in:

• following infection control protocol in the clinical dental setting

• concepts of cavity preparations influenced by the extent of caries and choice of restorative material

• restoration of teeth with composite resin and amalgam to original anatomy, including complex amalgams and composite resin restorations

• preparation of teeth and temporization for indirect restorations (particularly metal-ceramic crowns)

• performing of endodontic access cavity on supplied plastic posterior tooth, including application of rubber dam

• taking intraoral radiographs using variety of techniques and holders

• applying fissure sealant

• designing a denture and writing an appropriate prescription

• administrating local anesthetic, removing teeth and suturing

• using hand instruments in periodontal instrumentation

• writing appropriate dental records according to Australian legal requirements

• taking an appropriate dental and medical history, assessing the patient’s risks, formulating a diagnosis, discuss appropriate health promotion and treatment plan and present the skills to provide such a treatment.

• effective communication with patients and staff in the clinical setting

• manage medical emergencies incl. CPR Disclaimer: Please note that the content of the 4- week Comprehensive Dentistry course is continually being reviewed and updated

Course reading materials To maximize the learning experience, it is highly recommended that candidates refresh their general dental knowledge before the start of the course and read relevant literature, textbooks, and articles. It is recommended that the candidates are familiar with the reading material specified by the ADC in the Written and Practical examination handbooks (https://www.adc.org.au/Resource-And-Publications/Assessment-Publications) Please note that all course material, handouts, and notes will be made available to participants electronically on USB on the first day of the course. A small library of common dental textbooks will be available to the course participants.

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After Course support

Attendance in a full 4-week Comprehensive course will award you 20 Scientific CPD points required for your dental registration. We support our candidates after the completion of the 4-week course providing the following:

• Two, FREE of charge, one -hour work assessments within next 3 months after completion of the course

• Free of charge attendance at the next annual OTC conference

• Assistance in CV writing and job application

• Assistance in finding suitable employment after successful completion of ADC practical examination

• CPD programs and up-skilling programs offered to dentists (online and face to face)

Course fees $9,000

The 4-week Comprehensive Dentistry Course fee covers all teaching sessions, hand instrument kit, dental materials and use of equipment necessary for completion of all tasks including access to all manikins, materials and equipment for Skilled OSCE. PPE is also included.

Students will receive two full sets of teeth inserted into models and several additional teeth including,4x simulated caries teeth and 4x teeth for endodontic exercises. Withdrawal Policy

The non-refundable deposit of $500.00 is also considered as a withdrawal fee should students withdraw following notification of acceptance by the OTC into any course, however, if an applicant withdraws within FOUR weeks prior to commencement date an administrative fee of additional $500.00 will be incurred, unless we are able to fill the vacancy. The deposit is not in addition to the course fee.

Course cancellation policy

The course or any part of the course as timetabled may be changed or cancelled at the discretion of DHSV. The DHSV OTC will not accept liability for or be liable of any costs incurred by an applicant including cost of obtaining visa, booking of the flights and accommodation.

One -week EXTENSION Practice (5th week) The candidates who attend 4-week Comprehensive Dentistry course may purchase additional one week of practice immediately after the course. The sessions will be scheduled Monday to Friday 9.30-12.30 and 1.30-4.30. There will be a combination of supervised and unsupervised (free practice) sessions.

Course fee: $1500 or $300 per day.

The fee covers access to SimLab, manikins, hand pieces, dental materials, PPE.

Teeth, burs and instruments must be supplied by the candidate.

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NEW: One-week Refresher Course (full time)

This course will offer one week of practice under close supervision and guidance of our experienced demonstrators who will give a feedback on individual performance of each candidate. This course is suitable for the candidates who already completed one or more courses or may have sat ADC practical examination but were unsuccessful. This course is not suitable for the candidates seeking basic instructions or task demonstrations before attempting to perform every task. During the One-week Refresher course you will be able to practice:

• Technical Tasks in our exclusive SimLab,

• Skilled OSCE (rubber dam application, fissure sealants, scaling with hand instruments, radiography, local anaesthetic and extractions etc.) in our dental chairs experiencing a real clinical environment

• Case Scenarios/Communication discussion sessions

Draft timetable – subjected to change as per individual group requirements (we may increase or decrease number of technical or OSCE session if the group requires more focus and more practice in a particular area)

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Course fees $2,000 Fee includes: all tuition fees, all dental materials for technical tasks, access to and use of all manikins (LA, exodontia, periodontal, radiography) and models, dental films, access to all standard instrument kits including rubber dam kit, Gracey’s curettes kit, hand instruments for technical task, LA and extraction forceps, radiography holders and PPE (except safety glasses and/ or loupes) Candidates must supply own set of plastic teeth, set of burs, safety glasses/loupes

Candidates will be able to purchase though OTC Office own hand instrument kit (same as ADC) and/or ADC bur kits for an additional fee. Withdrawal Policy

The non-refundable deposit of $500.00 is also considered as a withdrawal fee should students withdraw following notification of acceptance by the OTC into any course, however, if an applicant withdraws within FOUR weeks prior to commencement date an administrative fee of additional $500.00 will be incurred, unless we are able to fill the vacancy. The deposit is not in addition to the course fee.

Course cancellation policy

The course or any part of the course as timetabled may be changed or cancelled at the discretion of DHSV. The DHSV OTC will not accept liability for or be liable of any costs incurred by an applicant including cost of obtaining visa, booking of the flights and accommodation.

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Technical course (2-weeks)

This course places emphasis on preparation to sit the practical ADC examination and developing confidence in restorative part of dentistry and focuses on technical aspect of the ADC examination. This course may be suitable for the candidates sitting New Zealand Dental Registration Examination (NZDREX/NDEB) or those who need further practice to master their manual skills.

Course structure- timetable

Sessions are generally scheduled Monday to Friday 9.30 am – 12.30 pm, 1.30 pm – 4.30 pm and 5.30-8.30 pm and Saturdays from: 9.00-12.00 and 1.00-4.00. This course is usually run concurrently with 4- week Comprehensive course. All technical sessions are supervised by experienced demonstrators with some free practice sessions where the demonstrator will be available for the assessment in the next session.

This course is not designed to re-train the participants in basic dental procedures. Although there will be all task demonstrations during the course, the candidates are expected to perform the tasks independently supported by self-directed learning and the demonstrators’ feedback.

To maximize the learning experience, candidates are encouraged to read appropriate textbooks and articles, as well as prepare a few questions before each session. Participants should monitor their own progress by performing self- assessment with the help of the demonstrator, ideally during each session. Due to the limited length of this course there will be no formal assessment.

Course outcome

After completing this course participants are expected to have skills and confidence in:

• following infection control protocol in the clinical dental setting

• concepts of cavity preparations influenced by the extent of caries and choice of restorative material

• restoration of teeth with composite resin and amalgam to original anatomy, including complex amalgams and composite resins

• preparation of teeth and temporization for indirect restorations (particularly metal-ceramic crowns)

• performing of endodontic access cavity on supplied plastic posterior tooth, including application of rubber dam

Course fees $4,000

The 2-week Technical Course fee covers all teaching sessions, use of a manikin with models, use of standard hand instrument kit, access to dental materials, PPE and use of equipment necessary for completion of all tasks.

Students will receive one full sets of teeth inserted into models and several additional teeth including, two simulated caries teeth and two plastic teeth for endodontic exercises.

Candidates will be able to purchase own hand instrument kit and ADC bur kits for a fee.

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Withdrawal Policy

The non-refundable deposit of $500.00 is also considered as a withdrawal fee should students withdraw following notification of acceptance by the OTC into any course, however, if an applicant withdraws within FOUR weeks prior to commencement date an administrative fee of additional $500.00 will be incurred, unless we are able to fill the vacancy. The deposit is not in addition to the course fee.

Course cancellation policy

The course or any part of the course as timetabled may be changed or cancelled at the discretion of DHSV. The DHSV OTC will not accept liability for or be liable of any costs incurred by an applicant including cost of obtaining visa, booking of the flights and accommodation.

.

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Application and Payment Forms

Orientation Training Courses (OTC) 2020 Semester 2

COMPREHENSIVE DENTISTRY COURSE (4 Weeks full time) Fee: $9,000 NEW: One-week EXTENSION Practice Fee: $1,500 TECHNICAL COURSE (2 Weeks full time) Fee: $4,000 NEW: ONE WEEK REFRESHER COURSE (full time) Fee: $2,000 OTC MOCK EXAM Fee: $1,000 -$1,200 ADDITONAL EXPERIENCE SESSIONS Fee: variable

• SKILLED OSCE (per 3hrs.session with demo+practice) Fee: $500

• Radiography demo and practice (3hours) Fee: $500

• Radiography practice (per hour) Fee: $100

• OSCE tutorials incl. CPR (per session) Fee: $200

• Technical SimLab session (per day with materials) Fee: $300

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Application Please fully read all sections of information package prior to completing this application form

1. Registration will not be considered/ reserved until a complete application form, including

deposit, and required attachments, is received by the office. IN POST- PANDEMIC TIME WE PREFER TO RECEIVE SCANNED APPLICATIONS AND SCANNED DOCUMENTS. Original form must be provided in person on the first day of the course or mailed prior the course if time permits.

2. Applications for any course will not be accepted without a current Australian Dental Council number.

3. The deposit in the amount of $500.00 for the Comprehensive Dentistry and

Technical course, Refresher Course is also considered as a withdrawal fee, if a student withdraws following acceptance into any course. However, if an applicant withdraws within four weeks prior to commencement date and the vacancy is not able to be filled, an administrative fee of additional $500.00 will be incurred. The deposit is not in addition to the course fee. If the candidate’s name is placed on a waiting list, no payment will be processed until a course becomes available.

4. Payment of Fees:

• Fees for all courses must be paid in full FOUR weeks prior to the commencement

date. The actual date for payment will be included in your Acceptance Letter. Students who do not pay in full by the due date may have their place cancelled and offered to another applicant.

• No cash payment will be accepted. American Express transactions cannot be processed.

• Payment may be made by credit card (Visa, MasterCard), cheque/money order, direct

into the DHSV/RDHM Operating Account, i.e. internet banking or cash payment made at

your local bank. Contact the OTC office and DHSV/RDHM banking details will be

provided. Once the payment is made, the OTC must be notified of the transaction date

and your receipt number, so that our Finance Department is able to credit the transaction

against your invoice.

• If someone other than yourself is paying for the course on your behalf, they must

complete the authorization form and return with your paperwork – this form must be

completed each time a payment is made. If the authorization form is completed with

just the deposit of $ 500.00 entered, it must be completed again for the balance owed.

• If you are living overseas, it is preferable that you undertake a direct payment to The

Royal Dental Hospital Melbourne, i.e. internet banking or provide credit card details.

Note that when making transfers from overseas, bank transfer fees may be charged, it

is usually in the range of less than A$25.00 (Australian). If this occurs and a balance is

outstanding, this can be paid on the first day of your course. Should you decide to send

a cheque, please make out to “The Royal Dental Hospital of Melbourne” and the money

must be in Australian Dollars.

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• Note that due to postal issues from overseas, it is recommended that cheques are not

sent.

• The deposit/withdrawal fee will only be deducted as a separate payment from a

credit card if an applicant withdraws from any course following acceptance of an

offer, otherwise full payment will be processed as per the date listed in your OTC

“Acceptance of Offer” letter.

• Additional Experience Sessions- Full fee is required upon acceptance to any Additional

Experience Session. No refunds of fees will apply if the applicant withdraws at any time

after confirmation of session(s) unless sessions are cancelled and/or rescheduled to the

time inconvenient to the applicant.

Submitting your application Street Address: (preferred)

Melbourne Orientation Training Courses (OTC), The Royal Dental Hospital of Melbourne 2nd Floor, 720 Swanston Street, Carlton, Vic. 3053, Australia

Our contact details:

OTC Orientation Training Course:

Phone: +61 3 94341 1177 (Merala) or +61 3.9341 1178 (Magda)

E-mail: Ms. Julie McCormack, Manager: [email protected] Dr Magda Schwarz, OTC Coordinator: [email protected] Ms. Merala Lesevic, Administrative and DA Support: [email protected]

Website: https://www.dhsv.org.au/careers/otc Facebook: https://www.facebook.com/otcdhsv/

Street address:

OTC Office, 2nd floor The Royal Dental Hospital of Melbourne 720 Swanston Street Carlton, Vic.3053, Australia

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Application form 2020 semester 2

Comprehensive Dentistry course

(4 weeks) with or without Extension Practice (5th week)

Personal details & educational background: NAME: Mr. / Mrs. / Ms. / Dr … . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .

(Family name) (Given names)

GENDER: M / F DATE OF BIRTH: . . . . . . . . . . . . . . . . . . . . . . . .

ADDRESS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . POSTCODE . . . . . . . . . . . . . . ..

EMAIL: ………………………………………………

TEL NO: ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . MOBILE NO: ………………………………………

AUSTRALIAN DENTAL COUNCIL REF NO: . . . . . . . . . /. . . . . . . . . .

AUSTRALIAN RESIDENCY AND VISA STATUS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..

DENTAL DEGREE/S: Please note the University / Country and level of Qualification / Year of completion

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General Information:

(a) When will you sit the Australian Dental Council Examinations?

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Date of ADC examination)

(b) How did you become aware of the OTC courses?

You are a past OTC student Referred by an OTC student

Referred by outside organization, e.g. ADC Other Source, please list details

Attach THREE

Passport size

photos (approx.

3.5cm x 3.5cm) -

use paperclip

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Application form 2020 sem.2

One -week REFRESHER course

Personal details & educational background: NAME: Mr. / Mrs. / Ms. / Dr … . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .

(Family name) (Given names)

GENDER: M / F DATE OF BIRTH: . . . . . . . . . . . . . . . . . . . . . . . .

ADDRESS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . POSTCODE . . . . . . . . . . . . . . ..

EMAIL: ………………………………………………

TEL NO: ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . MOBILE NO: ………………………………………

AUSTRALIAN DENTAL COUNCIL REF NO: . . . . . . . . . /. . . . . . . . . .

AUSTRALIAN RESIDENCY AND VISA STATUS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..

DENTAL DEGREE/S: Please note the University / Country and level of Qualification / Year of completion

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General Information:

(c) When will you sit the Australian Dental Council Examinations?

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Date of ADC examination)

(d) How did you become aware of the OTC courses?

You are a past OTC student Referred by an OTC student

Referred by outside organization, e.g. ADC Other Source, please list details

Attach THREE

Passport size

photos (approx.

3.5cm x 3.5cm) -

use paperclip

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Application form 2020 sem. 2

Technical course (2 weeks)

Personal details & educational background: NAME: Mr. / Mrs. / Ms. / Dr … . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .

(Family name) (Given names)

GENDER: M / F DATE OF BIRTH: . . . . . . . . . . . . . . . . . . . . . . . .

ADDRESS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . POSTCODE . . . . . . . . . . . . . . ..

EMAIL: ………………………………………………

TEL NO: ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . MOBILE NO: ………………………………………

AUSTRALIAN DENTAL COUNCIL REF NO: . . . . . . . . . /. . . . . . . . . .

AUSTRALIAN RESIDENCY AND VISA STATUS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..

DENTAL DEGREE/S: Please note the University / Country and level of Qualification / Year of completion

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General Information:

(e) When will you sit the Australian Dental Council Examinations?

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Date of ADC examination)

(f) How did you become aware of the OTC courses?

You are past OTC student Referred by an OTC student

Referred by outside organization, e.g. ADC Other Source, please list details

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Documents to be attached:

A letter from the ADC noting your eligibility to proceed with the ADC examination process.

Attach THREE

Passport size

photos (approx.

3.5cm x 3.5cm) -

use paperclip

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A copy of a letter giving date when you are sitting the ADC examination - if you have

already been allocated an examination date.

Copy of your WRITTEN EXAMINATION results (only if you have already sat this examination).

A certified copy of your Dental Degree, with English translation (if applicable)

Copy of the page in your passport showing your eligibility to remain in Australia or visa

notification from the Department of Immigration.

Three Passport size photos, with your surname printed on the back – paper clip to top of

application form. (E.g. 3.5 cm x 3.5 cm photos) – do not staple.

Course Dates

(check dates on the OTC website https://www.dhsv.org.au/careers/otc )

Please indicate which course(s) you plan to attend by ticking the box.

COMPREHENSIVE DENTISTRY course (4-week)

Commencing on:

ONE WEEK EXTENSION PRACTICE – 5th week (new)

Commencing on:

ONE-WEEK REFERSHER COURSE (new)

Commencing on:

TECHNICAL COURSE (2 WEEKS)

Commencing on:

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4-week Comprehensive Dentistry course

One-week Extension practice (5th week)

One-week REFRESHER Course

2-week Technical course Acceptance of offer Part 1

I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(print name)

accept the offer of entry to the Melbourne Orientation Training Course conducted by Dental Health Services Victoria (The Royal Dental Hospital of Melbourne) to attend:

Comprehensive Dentistry Course (4 weeks)

One-week Extension practice course (5th week)

One-week REFRESHER course

Technical course (2 weeks)

Commencing on: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

I understand that the following clauses will apply: (please tick boxes)

The deposit will only be refunded if the course the applicant has applied for is cancelled and/or no place is available on the course applied for.

The deposit will become a cancellation fee if the applicant withdraws from any course following notification of acceptance of an available place.

If I choose not to attend the course as timetabled, there will be no refund of fees once the course has commenced.

A claim for a refund of the course fees will not be considered after the course has commenced.

The course or any part of the course as timetabled may be changed or cancelled at the discretion of DHSV, which will accept NO liability for any costs incurred by the applicants regarding visa, travel, and accommodation.

...................................................................... (Signature of candidate)

Date:

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DHSV INVOICE NO ……………….

OTC Office will complete this

Comprehensive Dentistry Course (4 weeks) with or without Extension course (5th week)

Acceptance of offer Part 2

Applicant’s Personal Details: NAME: Mr. / Mrs. / Ms. / Dr … . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .

(Family name) (Given names)

GENDER: M / F DATE OF BIRTH: . . . . . . . . . . . . . . . . . . . . . . . .

ADDRESS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . POSTCODE . . . . . . . . . . . . . . ..

EMAIL: ………………………………………………

TEL NO: ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . MOBILE NO: ……………………………………… Payment Details:

TOTAL COURSE FEE: $9,000.00 AUD (for 4 weeks) OR $10,500 (for 5 weeks) **circle

Deposit of $500.00 will be charged at the time of application. Payment in full for this course is due approximately FOUR weeks prior to commencement of each course and must be received by the OTC Unit, (The Royal Dental Hospital of Melbourne, 720 Swanston St, Carlton VIC 3053) by the due date as noted in your acceptance letter. Payments by cheque for the deposit are to be made out to The Royal Dental Hospital of Melbourne. Your deposit is not in addition to the full course fee. Full details for the payment method for course fee will be sent with Acceptance

of Offer Letter.

Payment can be made by: (please circle method you are using)

VISA / MASTERCARD CHEQUE / MONEY ORDER (please attach) INTERNET BANKING

CARD NO:

CARDHOLDERS NAME: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Expiry Date: / CVV:

CARDHOLDER’S SIGNATURE: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Deposit/withdrawal fee:

• I ……………………………………………………………………… authorize DHSV/RDHM to deduct the sum of $500.00 from my credit card as per the above details. This fee will only be deducted at the time of acceptance into the program applied for and will be considered as a withdrawal fee should an applicant withdraw.

• PLEASE NOTE:

If you wish to pay by internet banking or make the payment at your local bank, contact the OTC office and banking

details and instruction will be provided. If your fees are being paid by someone other than yourself, i.e.

husband/wife/friend, refer to formation attached - “Authorization to Pay on Behalf of Candidate”.

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DHSV INVOICE NO ……………….

OTC Office will complete this

One-week REFRESHER course

Acceptance of offer Part 2

Applicant’s Personal Details: NAME: Mr. / Mrs. / Ms. / Dr … . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .

(Family name) (Given names)

GENDER: M / F DATE OF BIRTH: . . . . . . . . . . . . . . . . . . . . . . . .

ADDRESS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . POSTCODE . . . . . . . . . . . . . . ..

EMAIL: ………………………………………………

TEL NO: ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . MOBILE NO: ……………………………………… Payment Details:

TOTAL COURSE FEE: $2,000 AUD

Deposit of $500.00 will be charged at the time of application. Payment in full for this course is due approximately FOUR weeks prior to commencement of each course and must be received by the OTC Unit, (The Royal Dental Hospital of Melbourne, 720 Swanston St, Carlton VIC 3053) by the due date as noted in your acceptance letter. Payments by cheque for the deposit are to be made out to The Royal Dental Hospital of Melbourne. Your deposit is not in addition to the full course fee. Full details for the payment method for course fee will be sent with Acceptance

of Offer Letter.

Payment can be made by: (please circle method you are using)

VISA / MASTERCARD CHEQUE / MONEY ORDER (please attach) INTERNET BANKING

CARD NO:

CARDHOLDERS NAME: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Expiry Date: / CVV:

CARDHOLDER’S SIGNATURE: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Deposit/withdrawal fee:

• I ……………………………………………………………………… authorize DHSV/RDHM to deduct the sum of $500.00 from my credit card as per the above details. This fee will only be deducted at the time of acceptance into the program applied for and will be considered as a withdrawal fee should an applicant withdraw.

• PLEASE NOTE:

If you wish to pay by internet banking or make the payment at your local bank, contact the OTC office and banking

details and instruction will be provided. If your fees are being paid by someone other than yourself, i.e.

husband/wife/friend, refer to formation attached - “Authorization to Pay on Behalf of Candidate”.

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DHSV INVOICE NO ……………….

OTC Office will complete this

Technical course (2 weeks)

Acceptance of offer Part 2

Applicant’s Personal Details: NAME: Mr. / Mrs. / Ms. / Dr … . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .

(Family name) (Given names)

GENDER: M / F DATE OF BIRTH: . . . . . . . . . . . . . . . . . . . . . . . .

ADDRESS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . POSTCODE . . . . . . . . . . . . . . ..

EMAIL: ………………………………………………

TEL NO: ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . MOBILE NO: ……………………………………… Payment Details:

TOTAL COURSE FEE: $4,000 AUD

Deposit of $500.00 will be charged at the time of application. Payment in full for this course is due approximately FOUR weeks prior to commencement of each course and must be received by the OTC Unit, (The Royal Dental Hospital of Melbourne, 720 Swanston St, Carlton VIC 3053) by the due date as noted in your acceptance letter. Payments by cheque for the deposit are to be made out to The Royal Dental Hospital of Melbourne. Your deposit is not in addition to the full course fee. Full details for the payment method for course fee will be sent with Acceptance

of Offer Letter.

Payment can be made by: (please circle method you are using)

VISA / MASTERCARD CHEQUE / MONEY ORDER (please attach) INTERNET BANKING

CARD NO:

CARDHOLDERS NAME: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Expiry Date: / CVV:

CARDHOLDER’S SIGNATURE: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Deposit/withdrawal fee:

• I ……………………………………………………………………… authorize DHSV/RDHM to deduct the sum of $500.00 from my credit card as per the above details. This fee will only be deducted at the time of acceptance into the program applied for and will be considered as a withdrawal fee should an applicant withdraw.

• PLEASE NOTE:

If you wish to pay by internet banking or make the payment at your local bank, contact the OTC office and banking

details and instruction will be provided. If your fees are being paid by someone other than yourself, i.e.

husband/wife/friend, refer to formation attached - “Authorization to Pay on Behalf of Candidate”.

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Authorization to pay on behalf of candidate:

(a) I, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . (name of person paying fees)

agree to pay the sum of $....................................(AUD)

on behalf of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (name of candidate)

(b) I authorize Dental Health Services Victoria, The Royal Dental Hospital of Melbourne to

debit my credit card on their behalf of the above candidate - details as listed on Part 2

Acceptance Form.

CARDHOLDERS NAME: (please print) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CARDHOLDER’S SIGNATURE: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CARDHOLDER’S HOME ADDRESS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CARDHOLDER’S PHONE NUMBER:

CARDHOLDER’S EMAIL ADDRESS:

Signature. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date: . . . . . . . . . . . . . . .

(c) This form must be completed each time a transaction is

undertaken. If two card holders are paying, i.e. one for

the deposit and one for the course fee. (two forms are

required)

If payment is being made by someone other than the candidate, the form below

must be completed for each payment transaction.

Please ensure that the credit card details are entered on the Part 2 Form, including the Expiry

Date and that the person whose credit card is being used, signs the Part 2 Form in the

appropriate place.

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MOCK Exams

Additional experience:

Skilled OSCE

Dental Radiography

OSCE Theory

Technical SimLab

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OTC Mock Exam

OTC is able to offer a two- day MOCK EXAM for all candidates who wish to test their skills and abilities before sitting ADC practical examination. The offer is open to all past OTC participants as well as those who have not attended any of our programs.

This MOCK exam is designed to give you a feedback on overall performance. It is not an exact replica of the current new format of the ADC Practical examination. Overall content, timetable, questions, assessment sheets are designed and used by OTC, based on the information released by ADC in relation to the new format of the Practical examination. Over two days the candidates will be tested on several different tasks. Marking will be done by two or more experienced assessors/demonstrators. Detailed written feedback on each task will be given at the conclusion of the examination to each of the candidates.

TECHNICAL DAY: All candidates will have a full set of appropriate teeth mounted in the model. Standard hospital hand instrument kits and hand pieces will be provided. Personal protective equipment (gowns, masks, and nitrile gloves) will be provided.

Candidate must bring own safety glasses and, if required, magnification loupes. Note: most of the prescription glasses are not considered as protective glasses unless they have side shields fitted.

All candidates will be required to bring their own sets of burs, diamonds, and discs for tooth preparation and restoration finishing/polishing.

An enamel hatchet is the only instrument that may be brought and used in the clinic as we are not able to supply at the time of the OTC MOCK EXAM

Amalgam capsules (SDI Permite1, 2, 3 spills, 3 spill ECT), composite resin (Tetric, Gradia, Wave flow), temporary crown material (Protemp Garant), impression material (Optosil), rubber dam (IsoDam), sectional matrices Triodent V3 and radiographic films will be provided. Candidates are permitted to bring their own materials if they wish. Fender wedges are not provided but permitted if you would like to use them.

Own hand pieces, hand instruments (except enamel hatchet), matrices (sectional matrices), and preformed crowns, rubber dam kits including clamps and a hole punch, radiographic holders are not permitted.

Please note that we will provide materials and equipment available in the clinics at the Royal Dental Hospital of Melbourne and it may or may not be same or similar to the materials and equipment available at the ADC Centre.

Tasks: OTC MOCK EXAM may include any task, not limited to the following list:

• Class IV composite resin restorations on pre- prepared teeth

• Class III composite resin cavity preparation

• Class II amalgam or composite resin preparation or restoration

• Complex amalgam or composite restoration/preparation

• Tooth preparation for indirect restoration

• Porcelain fused to metal crown preparations

• Provisional restoration of the prepared tooth/teeth

• Endodontic access cavity on a molar

• Infection control will be observed through ALL exercises.

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All tasks for the Technical Day will be allocated in morning during the Introduction and set up time. You may plan your day accordingly.

CLINICAL DAY (OSCE) Tasks:

You will be briefed just before the examination and the thorough instruction will be given to you. There will be several stations. The tasks may include MCQ/SAQ, discussions with examiners or “patients”, taking radiographs, extract teeth, apply rubber dam, perform periodontal instrumentation etc. Several stations will include one-to-one tasks with discussion/communication or direct observation by the examiners, other tasks will be based on rotations of 10-15 minutes intervals and may include a written component.

Results: Most of the results in the form of written feedback will be available at the end of the exam and any remaining feedback forms will be e-mailed within 5 days and/or posted to the candidates.

Facilities: The technical component will be in the SimLab and Clinical component will be in the clinic.

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Fee: $1,200 or $1,000 (a discount of $200 is offered to the candidates who previously attended OTC

Comprehensive or Restorative Dentistry courses or previous MOCK exams)

The Mock exam fee covers all equipment, materials and teeth used during the exam and written feedback.

Students will receive one full set of teeth inserted into models and other pre-prepared teeth as required.

Withdrawal Policy

The non-refundable deposit of $500.00 is also considered as a withdrawal fee should students withdraw following notification of acceptance by the OTC into OTC Mock Exam, however, if an applicant withdraws within TWO weeks prior to commencement date there will be no refund of fees. The deposit is not in addition to the total fee.

Course cancellation policy

The course or any part of the course as timetabled may be changed or cancelled at the discretion of DHSV. The DHSV, OTC will not accept liability for be liable of any costs incurred by an applicant including cost of obtaining visa, booking of the flights and accommodation.

DATES:

Please check our website or contact OTC office about current dates.

Our contact details:

OTC Orientation Training Course:

Phone: +61 3 94341 1177 (Merala) or +61 3.9341 1178 (Magda)

E-mail: Ms. Julie McCormack, Manager: [email protected] Dr Magda Schwarz, OTC Coordinator: [email protected] Ms. Merala Lesevic, Administrative and DA Support: [email protected]

Website: https://www.dhsv.org.au/careers/otc Facebook: https://www.facebook.com/otcdhsv/

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OTC Additional Experience Dental Radiography

Dental Radiography sessions may be offered to the past and current OTC participants and

candidates not enrolled in any of the OTC courses. The following sessions may be offered:

• Radiography practice on manikin with demonstration - fee $500 per 3- hour session • Radiography practice without demonstration - only for past OTC candidates who

attended a session with demonstration previously or any clinical based program (5- week)

- fee$100 per hour.

Two candidates may attend same session. Every attempt is made to pair up applicants to

minimize the cost for the candidates, but it cannot be guaranteed. Full payment is required at the

time of application as it can be reduced if another candidate is found to share the same session.

If you prefer to have one-to-one session, please make a note in your application. All sessions may be available depending on timetable of the scheduled programs. Full fee is

payable before the session. Note that the confirmed sessions can be cancelled or rescheduled due

to unforeseen circumstances. The applicant will be notified of the change, alternative dates may be

offered, or fee reimbursed, if the applicant is unable to attend on alternative day.

Dates: All applicants first must contact OTC office and confirm the dates of the sessions before sending

the application. A completed application and payment must be received by the OTC office within 7

days after the dates are confirmed, otherwise the session may be offered to another applicant.

Venue:

The Royal Dental Hospital of Melbourne,

Second floor Teaching Clinic

720 Swanston Street, Carlton, Vic.3053

Report to OTC Office 5-10 minutes before your scheduled session. You may ask the

second-floor receptionist for directions to the OTC Office.

All materials and equipment (films and variety of holders), PPE (gown, masks, and gloves)

will be provided.

Ensure appropriate dress code: no denim jeans, no open toe shoes or runners are allowed in

the clinical area.

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OTC Additional Experience:

• Skilled OSCE /communication

• Technical (SimLab) sessions

• Individual work assessments

Additional Experience session cover many different areas of interest tailored to the candidate’s needs. Maximum two candidates can attend any session however one-to-one offers better learning experience. Dates: to be arranged per request. OTC can offer the following sessions:

SKILLED OSCE / communication session. This session provided demonstration, discussion, practice, and feedback on candidate’s performance in one or more skilled OSCE tasks: LA administration, extractions, rubber dam application, fissure sealant, periodontal scaling. It is up to the candidate which tasks are to be included in the session. All tasks are performed on the dental manikins mounted in the clinical chair. All materials, manikins, models and instruments relevant to the task and PPE are provided. Fee: 3-hour session demonstration and practice $500 1-hour practice (only ex-OTC or who had demo sessions) $100

OSCE communication /Case discussions Special attention is paid to communication with staff and patient and the ability to discuss relevant topics effectively. The candidates may choose to attend:

• one or more group case discussion sessions together with the candidates attending a Comprehensive Dentistry course (usually it is a 3-hour session allowing discussion of multiple cases)

• one-to-one discussion of clinical cases or questions and answers with one of our demonstrators (one-hour session)

It is recommended that the candidates refresh the textbook knowledge and read relevant literature, journals, and articles to have maximum benefit of learning. The expectation is that all candidates have basic dental knowledge and will be able to discuss signs and symptoms, examination and tests, diagnoses, and management for common dental problems. Fee: group session $200 (for 3-hours) one to one session $200 per hour

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Additional Technical (SimLab) sessions

The fee covers access to the facility, manikin with appropriate models (screw type) and standard instrument kit (not Norden), high and slow speed hand pieces materials and PPE. The candidates must bring plastic teeth and burs. Own materials and hand instruments may be used; however, there will be no discount of fees Fee: $300 per day (2x 3-hour sessions AM and PM)

Individual work assessment

Technical task assessment with one of our Demonstrators with immediate feedback. Fee: $200 per hour

Note: candidates who attended one of our long courses will be able to book two FREE assessments within 3 months after the completion of the course.

Please contact OTC office by e-mail for current offers and available timeslots.

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Application Please fully read all sections of information package prior to completing this application form

1. Registration will not be considered/ reserved until a complete application form, including deposit of $500 (or full fee if total payable I sless ) and required attachments, is received by the office.

IN POST- PANDEMIC TIME WE PREFER TO RECEIVE SCANNED APPLICATIONS AND SCANNED DOCUMENTS. Original forms must be provided in person on the first day of the course or posted prior the course if time permits.

2. Applications for any course will not be accepted without a current Australian Dental Council number.

3. Full fee is required at the time of the application .The deposit in the amount of $500.00 or full fee (if total fee of the course is less than $500) for any of the courses is also considered as a withdrawal fee, in the event that a student withdraws following acceptance into any course. The deposit is not in addition to the course fee.

4. If the candidate’s name is placed on a waiting list, no payment will be processed until a course becomes

available.

5. Payment of Fees:

A. Fees for all courses (except MOCK exam) must be paid in full at the time of application.

Students who do not pay in full by the due date may have their place cancelled and offered to another applicant. We do not process any payments (except deposits) more than four weeks before the course.

B. No cash payment will be accepted. American Express transactions cannot be processed.

C. Payment may be made by credit card (Visa, MasterCard), cheese/money order, direct into the

DHSV/RDHM Operating Account, i.e. internet banking or cash payment made at your local bank.

Contact the OTC office and DHSV/RDHM banking details will be provided. Once the payment is

made, the OTC must be notified of the transaction date and your receipt number, so that our Finance

Department is able to credit the transaction against your invoice.

D. If someone other than yourself is paying for the course on your behalf, they must complete the

authorization form and return with your paperwork – this form must be completed each time a

payment is made. If the authorization form is completed with just the deposit of $ 500.00 entered,

it must be completed again for the balance owed.

E. If you are living overseas, it is preferable that you undertake a direct payment to the Hospital, i.e.

internet banking or provide credit card details. Note that when making transfers from overseas,

bank transfer fees may be charged, it is usually in the range of less than A$25.00 (Australian). If

this occurs and a balance is outstanding, this can be paid on the first day of your course. Should

you decide to send a cheque, please make out to “The Royal Dental Hospital of Melbourne” and

the money must be in Australian Dollars. Note that due to postal issues from overseas, it is

recommended that cheques are not sent.

F. The deposit/withdrawal fee will only be deducted as a separate payment from a credit card if an

applicant withdraws from any course following acceptance of an offer, otherwise full payment

will be processed as per the date listed in your OTC “Acceptance of Offer” letter.

G. Additional Experience Sessions- Full fee is required upon acceptance to any Additional Experience

Session. No refunds of fees will apply if the applicant withdraws at any time after confirmation of

session(s) unless sessions are cancelled and/or rescheduled to the time inconvenient to the

applicant.

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Submitting your application

Street Address: (preferred)

Melbourne Orientation Training Courses (OTC), The Royal Dental Hospital of Melbourne 2nd Floor, 720 Swanston Street, Carlton, Vic. 3053

Our contact details:

OTC Orientation Training Course: Phone: +61 3 94341 1177 (Merala) or +61 3.9341 1178 (Magda) E-mail: Ms. Julie McCormack, Manager: [email protected] Dr Magda Schwarz, OTC Coordinator: [email protected] Ms. Merala Lesevic, Administrative and DA Support: [email protected]

Website: https://www.dhsv.org.au/careers/otc Facebook: https://www.facebook.com/otcdhsv/

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Application form 2020 sem.2

Additional Experience:

Radiography, OSCE, Technical sessions

OTC MOCK Exam, Assessments

Personal details & educational background: NAME: Mr. / Mrs. / Ms. / Dr … . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .

(Family name) (Given names)

GENDER: M / F DATE OF BIRTH: . . . . . . . . . . . . . . . . . . . . . . . .

ADDRESS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . POSTCODE . . . . . . . . . . . . . . ..

EMAIL: ………………………………………………

TEL NO: ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . MOBILE NO: ………………………………………

AUSTRALIAN DENTAL COUNCIL REF NO: . . . . . . . . . /. . . . . . . . . .

AUSTRALIAN RESIDENCY AND VISA STATUS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...

DENTAL DEGREE/S: Please note the University / Country and level of Qualification / Year of completion

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General Information:

(g) When will you sit the Australian Dental Council Examinations?

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Date of ADC examination)

(h) How did you become aware of the OTC courses?

You are past OTC student Referred by an OTC student

Referred by outside organization, e.g. ADC Other Source, please list details

Attach THREE

Passport size

photos (approx.

3.5cm x 3.5cm) -

use paperclip

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Documents to be attached:

A letter from the ADC noting your eligibility to proceed with the ADC examination process.

Copy of a letter giving date / venue of when you are sitting the ADC examination - if you

have already been allocated an examination date.

Copy of your WRITTEN EXAMINATION results (only if you have already sat this examination).

A certified copy of your Dental Degree, with English translation (if applicable)

Copy of the page in your passport showing your eligibility to remain in Australia or visa

notification from Department of Immigration.

Three Passport size photos, with your surname printed on the back – paper clip to top of

application form. (E.g. 3.5 cm x 3.5 cm photos) – do not staple.

Course Dates (check dates on the OTC website https://www.dhsv.org.au/careers/otc

Please indicate which session(s) you plan to attend by ticking the box.

Radiography session with Demonstration

Date:

Radiography session without Demonstration

Date:

OTC MOCK EXAM Date:

OSCE /Skilled OSCE Dates: Individual assessment Date:

Other Dates:

Signature of the applicant: …………………………………….

Date:…………………………

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Additional Experience: Radiography, OSCE, Technical sessions

OTC MOCK Exam, Assessments

Acceptance of offer Part 1

I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(print name)

accept the offer of entry to the Melbourne Orientation Training Course conducted by Dental Health Services Victoria (The Royal Dental Hospital of Melbourne) to attend:

Radiography session with Demonstration (fee $500) date:

Radiography session without Demonstration (fee $100 per hour) date:

OTC MOCK Exam (fee $1,200 or $1,000 for ex-OTC) date:

OSCE communication/case discussion date

Skilled OSCE date:

Individual assessment date:

Others (specify:

I understand that the following clauses will apply: (please tick boxes)

The deposit will only be refunded if the course the applicant has applied for is cancelled and/or no place is available on the course applied for.

The deposit will become a cancellation fee if the applicant withdraws from any course following notification of acceptance of an available place.

If I choose not to attend the course as timetabled, there will be no refund of fees once the course has commenced.

A claim for a refund of the course fees will not be considered after the course has commenced.

The course or any part of the course as timetabled may be changed or cancelled at the discretion of DHSV, which will accept NO liability for any costs incurred by the applicants regarding visa, travel and accommodation.

Signature: ............................................ Date:...............................

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DHSV INVOICE NO . . . . . . . . . . . . OTC Office will complete this

Additional Experience Radiography, OSCE, Technical sessions

OTC MOCK Exam, Assessments

Acceptance of offer Part 2

Applicant’s Personal Details: NAME: Mr. / Mrs. / Ms. / Dr … . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .

(Family name) (Given names)

GENDER: M / F DATE OF BIRTH: . . . . . . . . . . . . . . . . . . . . . . . .

ADDRESS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . POSTCODE . . . . . . . . . . . . . . ..

EMAIL: ………………………………………………

TEL NO: ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . MOBILE NO: ……………………………………… Payment Details:

TOTAL COURSE FEE: $ ……………………AUD (MUST be written by the candidate)

Deposit of $500.00 will be charged at the time of application for the MOCK exam and the balance is due FOUR weeks before MOCK. Payment in full for other Additional experience sessions is due at the time of application and must be received by the OTC Unit, (The Royal Dental Hospital of Melbourne, 720 Swanston St, Carlton VIC 3053). Payments by cheque for the deposit are to be made out to The Royal Dental Hospital of Melbourne. Your deposit is not in addition to the full course fee.

Payment can be made by: (please circle method you are using)

VISA / MASTERCARD CHEQUE / MONEY ORDER (please attach) INTERNET BANKING

CARD NO:

CARDHOLDERS NAME: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Expiry Date: / CVV:

CARDHOLDER’S SIGNATURE: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Deposit/withdrawal fee:

• I ……………………………………………………………………… authorize DHSV/RDHM to deduct the sum of $500.00 from my credit card as per the above details as a withdrawal fee from the MOCK exam. The total fee for other Additional Experience session will be charged as a withdrawal fee.

• PLEASE NOTE:

If you wish to pay by internet banking or make the payment at your local bank, contact the OTC office and banking

details and instruction will be provided. If your fees are being paid by someone other than yourself, i.e.

husband/wife/friend, refer to formation attached - “Authorization to Pay on Behalf of Candidate”.

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Authorization to pay on behalf of candidate:

(b) I, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . (name of person paying fees)

agree to pay the sum of $....................................(AUD)

on behalf of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (name of candidate)

(d) I authorize Dental Health Services Victoria, The Royal Dental Hospital of Melbourne to

debit my credit card on their behalf of the above candidate - details as listed on Part 2

Acceptance Form.

CARDHOLDERS NAME: (please print) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CARDHOLDER’S SIGNATURE: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CARDHOLDER’S HOME ADDRESS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CARDHOLDER’S PHONE NUMBER

CARDHOLDER’S EMAIL ADDRESS:

Signature. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date: . . . . . . . . . . . . . . .

This form must be completed each time a transaction is undertaken. If two card holders are paying, i.e. one for the deposit and one for the course fee. (two forms are required.

If payment is being made by someone other than the candidate, the form below must be

completed for each payment transaction.

Please ensure that the credit card details are entered on the Part 2 Form, including the Expiry

Date and that the person whose credit card is being used, signs the Part 2 Form in the

appropriate place.

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Important contact details:

1. OTC Orientation Training Course: Phone: +61 3 94341 1177/+61 3.9341 1178 E-mail:

Ms. Julie McCormack, Manager: [email protected] Dr Magda Schwarz, OTC Coordinator: [email protected] Ms. Merala Lesevic, Administrative and DA Support: [email protected]

Website: https://www.dhsv.org.au/careers/otc Street address: OTC, 2nd floor The Royal Dental Hospital of Melbourne 720 Swanston Street Carlton, Vic.30153, Australia.

Postal address: Orientation Training Course (OTC) Business Development and Commercial

Services Dental Health Services Victoria Corporate Office, Level 1 720 Swanston Street, Carlton, Vic. 3053

2. Australian Dental Council (ADC) Phone: +61 3 9657 1777 E-mail: [email protected] Website: www.adc.org.au Street address: Australian Dental Council, Level 6, 469 La Trobe Street, Melbourne, Vic.3000

Postal address: ADC PO Box 13278 Law Courts, Melbourne, Vic.8010

3. Australian Health Practitioner Regulation Agency (AHPRA) Phone: 1300 419 495 (from Australia) +61 3 9275 9009 (From outside Australia) Website: https://www.ahpra.gov.au/About-AHPRA/Contact-Us.aspx National Office street address: Level 7, 111 Bourke Street, Melbourne, Vic.3000

National office postal Address: AHPRA GPO Box 9958 Melbourne, Vic.3001

4. Australian Dental Association Website: https://www.ada.org.au (federal)

Australian Dental Association – Victorian branch Website: www.adavb.net