Dental Academic Clinical Fellowships - Application Form Part 1

These are the questions used in the Oriel application form for dental Academic Clinical Fellowship (ACF) posts in the 2026-27 recruitment round. See the Dental ACF Supporting Information questions for the post-specific section of the form.

* = mandatory field. (Conditional) = only shown depending on earlier answers.

Public Health Application

  • Please indicate whether you are applying as a medical practitioner or as another practitioner * (Drop-down)
    • Medical Practitioner
    • Another Practitioner

Contact information

  • Surname/Family name (Pre-filled from Oriel profile)
  • First name (Pre-filled from Oriel profile)
  • Middle name(s) (Pre-filled from Oriel profile)
  • Preferred name (Text)
  • Any other name(s) used, where different from the above (Text)
  • Title (Pre-filled from Oriel profile)
  • Date of birth (Pre-filled from Oriel profile)
  • Country of birth (Pre-filled from Oriel profile)
  • Do you have a National Insurance Number? * (Yes/No buttons)
  • National Insurance Number * (Text · Conditional)
  • Address line 1 (Pre-filled from Oriel profile)
  • Address line 2 (Pre-filled from Oriel profile)
  • City/town (Pre-filled from Oriel profile)
  • Post code (Pre-filled from Oriel profile)
  • Country (Pre-filled from Oriel profile)
  • Home telephone (Pre-filled from Oriel profile)
  • Mobile telephone (Pre-filled from Oriel profile)
  • Work telephone (Pre-filled from Oriel profile)
  • May we contact you at work? (Yes/No buttons)
  • Please indicate your preferred telephone number (Pre-filled from Oriel profile)
  • Email address (Pre-filled from Oriel profile)

Please note: Most recruitment communications will be via Oriel message direct to your Oriel account. Any communications will also be sent by email so you must provide an active email address. Please ensure you check your Oriel account regularly for messages throughout the recruitment process. Your contact details can be updated within the “My Profile” section of your portal. To update your profile, click on the pencil icon alongside the fields.

Right to work in the UK

  • Your nationality - country pertaining to nationality * (Drop-down)
  • Are you a United Kingdom (UK)/Irish national? * (Yes/No buttons)
  • Are you a British citizen? * (Yes/No buttons)
  • Are you an Irish citizen who does not require leave to enter or remain in the United Kingdom under the Immigration Act 1971? * (Yes/No buttons)
  • Are you a Commonwealth citizen who has the right of abode in the United Kingdom under section 2 of the Immigration Act 1971? * (Yes/No buttons · Conditional)
  • Are you a European Union (EU) national, European Economic Area (EEA) national or Swiss national? * (Yes/No buttons · Conditional)
  • Do you have EU settled status? * (Yes/No buttons · Conditional)
  • Do you have EU pre-settled status? * (Yes/No buttons · Conditional)
  • Will your pre-settled status change before the advertised post start date? * (Yes/No buttons · Conditional)

Your current immigration status (personal status)

  • Please select your current personal immigration status from the following options. If you are a dependant of a main visa holder, please select the main visa category from the following options. You will then be asked whether you are a dependant on this visa status. You may be asked for more information once you have selected a status. If your visa status is not listed, you should contact the relevant recruitment office. * (Drop-down)
    • British National Overseas
    • Discretionary Leave to Remain
    • Graduate Visa
    • Hong Kong British National (Overseas)
    • I am a fiancé of a UK national
    • Indefinite Leave to Remain
    • My immigration status is not listed as an option
    • No current immigration status in the UK
    • Refugee in the UK
    • Short-term study visa (not over 11 months)
    • Tier 1
    • Tier 2/Skilled worker visa
    • Tier 4/Student visa
    • Tier 5
    • UK ancestry
    • Visitor visa / PLAB visa / Business Visitor visa
    • You are the partner/civil partner/spouse of a UK national

Please contact the relevant recruitment office. (Conditional)

  • Please specify * (Drop-down · Conditional)
    • Tier 1 (Entrepreneur)
    • Tier 1 (Exceptional Talent)
    • Tier 1 (General)
    • Tier 1 (Graduate Entrepreneur)
    • Tier 1 (Investor)
    • Tier 1 (Post Study Worker)
  • Please specify * (Drop-down · Conditional)
    • Tier 2 (General)
    • Tier 2 (Intra-company Transfer)
    • Tier 2 (Minister of Religion)
    • Tier 2 (Sportsperson)
    • Tier 2 (Skilled Worker)
  • Please specify * (Drop-down · Conditional)
    • Tier 5 (Temporary Worker - Charity Worker)
    • Tier 5 (Temporary Worker - Creative and Sporting)
    • Tier 5 (Temporary Worker - Government Authorised Exchange)
    • Tier 5 (Temporary Worker - International Agreement)
    • Tier 5 (Temporary Worker - Religious Worker)
    • Tier 5 (Youth Mobility Scheme)
    • Tier 5 (Temporary Worker - Seasonal Worker)
  • Is your current post in training? * (Yes/No buttons · Conditional)
  • If yes, what is your current training programme? * (Text · Limit: 150 characters · Conditional)
  • Is this your own visa or are you on a dependant visa? * (Drop-down · Conditional)
    • I am a dependant
    • Yes, this is my own visa
  • What are you currently undertaking on your Tier 4/Student visa? * (Drop-down · Conditional)
    • Tier 4 Doctorate Extension Scheme
    • Graduate of UK medical/dental school - currently in Foundation Programme
    • Graduate of UK medical school - successfully completed foundation
    • Currently studying for a Masters/PhD
    • Other
  • When did your course start? * (Date · Conditional)
  • When did/does your course finish? * (Date · Conditional)
  • Please state your sponsoring organisation * (Text · Limit: 150 characters · Conditional)
  • Does your visa state the following restrictions? ‘No employment as a doctor or dentist in training’ * (Drop-down · Conditional)
    • No, it does not state those restrictions
    • Yes, it does have those restrictions stated
  • Do you have a right of abode? * (Yes/No buttons · Conditional)
  • Visa start date * (Date · Conditional)
  • Visa expiry date * (Date · Conditional)
  • Will you be granted indefinite leave to remain by the advertised post start date? * (Yes/No buttons · Conditional)
  • If so, please provide the date you expect to be granted indefinite leave to remain * (Date · Conditional)

Equality and diversity information

The information you enter on this Equality and Diversity monitoring form will be used for monitoring purposes only and will not be used in assessing and/or scoring your application or at interview stage. This information is kept confidential and accessibility is strictly limited to individuals on a relevant basis.

Monitoring information

  • Date of birth (Date)
  • Gender (Drop-down)
    • Male (including trans man)
    • Female (including trans woman)
    • Non-Binary
    • Other (not listed)
    • Not Stated
  • Is the gender you identify with the same as your sex registered at birth? (Drop-down)
    • Yes
    • No
    • Prefer not to say
  • Do you live and work permanently in a gender other than that assigned at birth? (Drop-down)
    • Yes
    • No
    • Prefer not to say
  • Please select the option which best describes your sexuality (Drop-down)
    • Heterosexual or Straight
    • Gay or Lesbian
    • Bisexual
    • Other sexual orientation not listed
    • Not Stated
  • I would describe my ethnic origin as: (Drop-down)
    • White - British
    • White - Irish
    • White - Any other White background
    • Mixed - White and Black Caribbean
    • Mixed - White and Black African
    • Mixed - White and Asian
    • Mixed - Any other mixed background
    • Asian or Asian British - Indian
    • Asian or Asian British - Pakistani
    • Asian or Asian British - Bangladeshi
    • Asian or Asian British - Any other Asian background
    • Black or Black British - Caribbean
    • Black or Black British - African
    • Black or Black British - Any other Black background
    • Other Ethnic Groups - Chinese
    • Other Ethnic Groups - Any other ethnic group
    • Not Stated
  • Please indicate your religion or belief: (Drop-down)
  • If other please state * (Text · Limit: 100 characters)
  • If other please state (Text · Limit: 150 characters · Conditional)
  • Are your day to day activities limited because of a health problem or disability which has lasted, or is expected to last at least 12 months? (please include problems related to old age) (Yes/No buttons)
  • Please indicate if your day to day activities are affected by the following: (Checkbox · Conditional)
    • Physical impairment
    • Sensory impairment
    • Mental health condition
    • Learning disability/difficulty
    • Long-standing illness
    • Other
  • If you selected ‘other’ please specify (Text · Limit: 50 words · Conditional)
  • Please indicate your marital status (Drop-down)
    • Single
    • Married/Civil Partner
    • Divorced/Person whose Civil Partnership has been dissolved
    • Widowed/Surviving Civil Partner
    • Separated
    • Not Stated
  • Are you pregnant, on maternity leave or returning from maternity leave? (Drop-down)
    • Yes
    • No
    • Prefer not to say

FOR APPLICANTS APPLYING TO NORTHERN IRELAND POSTS ONLY

  • Please select your community background (Drop-down)
    • Not Specified
    • I am a member of the Protestant community
    • I am a member of the Roman Catholic community
    • I am a member of neither the Protestant nor the Roman Catholic community
  • Please indicate your marital status (Drop-down)
    • Not Specified
    • Single
    • Married / Civil Partnership
    • Other
    • Unknown
    • Divorced
    • Widow / Widower
    • Separated

Full employment history (UK/Overseas)

  • Are you able to provide any employment history? * (Yes/No buttons)

Where experience is required for a post, selecting ’no’ will make you ineligible and it will not be possible to submit your application.

If you completed clinical training equivalent to Foundation Year 1, before graduation from medical school, you must include this in your employment history.Remember to include any F1 / F2 posts here if applicable. (Conditional)

Please list all relevant employment from current/most recent employment history. Please give details for the last ten years only or as far back as necessary to evidence the minimum 48 months work experience required for eligibility. For applicants who work (or have worked) outside of the NHS details of the Agenda for Change bandings can be obtained from NHS Employers. (Conditional)

If your posts are concurrent, please ensure you list each post separately stating the exact whole time equivalent for each, ensuring posts are listed in chronological order including exact start and finish dates. For consecutive posts, please ensure the end date of a post is not also the start date of the next. (Conditional)

Employment history - data entry section

  • Employer name * (Text · Limit: 150 characters)
  • Address * (Text box (long answer))
  • Country * (Drop-down)
  • Postcode (Text)
  • Type of organisation * (Drop-down)
    • Primary Care
    • Secondary Care
    • Community Services
    • Hospice
    • Military
    • Prison
    • School
    • Social Care
    • Other
  • Other (please specify) * (Text · Limit: 50 characters)
  • If other, please specify * (Text · Conditional)
  • Is this post paid employment in an NHS organisation? * (Drop-down · Conditional)
    • Yes
    • No
  • Less than full time (LTFT) * (Drop-down)
    • Yes
    • No
  • If LTFT what amount (whole time equivalent) * (Text · Conditional)
  • Start date * (Date)
  • End date * (Date)
  • Is this your current post? (Tick box)
  • Duration of post (in months) (Text)
  • Observer/clinical attachment/unpaid post * (Drop-down)
    • Yes
    • No
  • Post title * (Text · Limit: 150 characters)
  • Post type * (Drop-down)
  • Please specify * (Text · Limit: 50 characters)
  • Please specify * (Text · Conditional)
  • Specialty * (Drop-down)

This section has been designed to enable applicants to capture the experience worked in different specialties within a single post accurately. Please see the following example of how this could be populated: Post type: DCT (selected previously)Dental specialty one: Oral Pathology Percentage of overall training programme: 50Dental specialty two: Oral MedicinePercentage of overall training programme: 50You may add up to a maximum of TWO specialties; combined these specialties must add up to 100 (Conditional)

  • Dental specialty one * (Drop-down · Conditional)
  • % of overall training programme * (Text · Limit: 5 characters · Conditional)
  • Dental specialty two * (Drop-down · Conditional)
  • % of overall training programme * (Text · Limit: 5 characters · Conditional)
  • Level of post (Drop-down)
    • CCST
    • CL
    • CT1
    • CT2
    • CT3
    • DCT1
    • DCT2
    • DCT3
    • DFT
    • F1
    • F2
    • N/A
    • ST1
    • ST2
    • ST3
    • ST4
    • ST5
    • ST6
    • ST7
    • ST8
    • StR
    • DFT + DCT1
  • Employer name * (Text · Limit: 150 characters)
  • Address * (Text box (long answer))
  • Postcode (Text)
  • Less than full time (LTFT) * (Drop-down)
    • Yes
    • No
  • If LTFT what amount (whole time equivalent) * (Text · Conditional)
  • Start date * (Date)
  • End date * (Date)
  • Post title * (Text · Limit: 150 characters)
  • NHS employer (Drop-down)
    • Yes
    • No
  • Grade of post * (Text · Limit: 50 characters)
  • Is this your current post? (Tick box)
  • Duration of post (in months) (Text)
  • Observer/clinical attachment/unpaid post (Drop-down)
    • Yes
    • No

Employment gaps

  • Do you have any gaps in your employment of more than 4 weeks duration? Please include career breaks for maternity leave, health etc — The answer to this question has been auto-generated based on the employment history entered above. Therefore this appears as a read-only field, you are not required to answer it. If you think that this is incorrect, please review the employment records entered previously. (Yes/No buttons · Conditional)
  • Do you have any gaps in your employment of more than 4 weeks duration? Please include career breaks for maternity leave, health etc — The answer to this question has been auto-generated based on the employment history entered above. Therefore this appears as a read-only field, you are not required to answer it. If you think that this is incorrect, please review the employment records entered previously. (Yes/No buttons · Conditional)
  • Do you have any gaps in your employment history, of more than 4 weeks duration, prior to three years before the advertised programme start date for this post? * (Yes/No buttons)

Additional employment gaps

  • Start date * (Date)
  • End date * (Date)
  • Explanation * (Text box (long answer) · Limit: 100 words)

NHS experience

  • In total, how many months of paid employment as a doctor in the NHS do you have? * (Text)

View Application Forms