School of dentistry advanced education program in general practice residency



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MEHARRY MEDICAL COLLEGE

SCHOOL OF DENTISTRY

ADVANCED EDUCATION PROGRAM IN

GENERAL PRACTICE RESIDENCY
PROGRAM GOAL:
Our Advanced Education Program in General Practice Residency is an educational program designed to provide training beyond the level of pre-doctoral oral healthcare education by using applied basic and behavioral sciences. Education received in this program is based on the concept that oral health is an integral and interactive part of total health. The goal of this program is to expand the scope and depth of the graduates’ knowledge and skills to enable them to provide comprehensive oral health care to a wide range of population groups.
PROGRAM OBJECTIVES, COMPETENCIES AND ASSESSMENTS:
Objective 1:

To train each resident to provide general dentistry and emergency dental care to the general public beyond the level of the pre-doctoral education.


Objective 1 Competencies:

  1. Interact with patients in a manner that is professional, builds rapport and confidence, respects patient’s rights and dignity, puts the patient’s interest first and maximizes patient’s satisfaction with dental care and abide by the HIPPA guidelines.

  2. Obtain consultation from professional specialty colleagues and refer patients (as needed) for the treatment of complex dental procedures (beyond the scope of a general dentist), medical consult and psychological consult.

  3. Develop skills in the treatment planning of complex cases as it relates to the replacement of missing teeth, partially and complete edentulous cases, with fixed, removable and /or implants.

  4. Diagnose and treat mild to moderate periodontal disease with non-surgical and surgical methods. Understand the indications for periodontal surgery and gain skills in the techniques of gingivoplasty, crown lengthening, and flap design.

  5. Perform uncomplicated and surgical exodontia procedures for all erupted teeth, extraction of soft tissue third molar extractions, utilize intravenous and inhalation sedation under the supervision of the OMFS faculty.

  6. Understand the pharmacological techniques for allaying apprehension and pain.

  7. Appropriately diagnose, treatment plan and manage pulpal and periapical disease by treatment of restorable and uncomplicated cases as well as being exposed to the current concepts in pulpal therapy.

  8. Understand properties, indications and placement of contemporary restorative materials.

  9. Treat uncomplicated disease and abnormalities of the pediatric patient and understand the non-pharmacologic behavior management skills needed to treat the pediatric patient.

  10. Appropriately assess and triage incoming emergent needs.

  11. Manage minor and moderate infections and be able to properly incise and drain as well as medicate properly.

  12. Develop skills in utilizing the E4D cerac equipment and soft tissue laser.

  13. Understand and interpret findings from the 3D digital radiograph

  14. Develop skills in treatment planning for implants (single placement, bridges and implant supported removable prosthesis), placement and restoration.

Assessment Mechanism for Objective 1:



  1. The American Board of General Dentistry pre- and post-tests

  2. Faculty and residents evaluation forms ( rotation – specific)

  3. Weekly Seminars

  4. Literature Search

  5. CE classes

  6. SImLab exercises

  7. Quarterly evaluations

  8. Quality assurance review of clinical and lab procedures as well as chart reviews

  9. Audits of clinical experiences from the Oral and Maxillofacial Surgery rotation.

Objective 2:

To train each resident in an intellectually challenging and sensitive environment which assures academic excellence, professional competency and ethical standards.
Objective 2 Competencies:


  1. Practice and apply the principles of professional ethics and jurisprudence in the practice of dentistry, acts professionally towards colleagues, patients and their families.

  2. Research, evaluate and utilize peer reviewed scientific literature as a basis for treatment planning and decision- making during the course of treatment.

  3. Complete all paperwork, chart entries, and other requested documents in a timely and appropriate manner.

  4. Present complex dental cases in an interactive setting of attendees and peers

  5. Develop a portfolio of completed complex dental cases to include at least one implant case and one OR surgical case at the end of the academic year.

Assessment Mechanism for Objective 2:



  1. Faculty and residents evaluations (rotation-specific)

  2. VA Journal Club

  3. Mortality and Morbidity Lecture series.

  4. The Professionalism evaluation

  5. Quarterly evaluations

  6. Chart audits

Objective 3:

To provide each resident with activities that broaden resident interest and experience in teaching, research, continuing education and community service.
Objective 3 Competencies:


  1. Utilize the values of patient centered care, lifelong learning, adaptability, acceptance of cultural diversity and professional ethics in professional practice.

  2. Demonstrate self-motivation by researching current evidence-based literature.

  3. Attend all scheduled clinical and didactic sessions and report on time.

  4. Prepare and present patient cases in a formal and informal setting

  5. Present a poster or table clinic at a local, state or national meeting

  6. Participate in outreach community activities such as the Remote Area Medical (RAM) activities

  7. Mentor D3 and D4 students during their GPR rotation and engage them in case presentations

  8. Attend local dental societies’ meetings and learn how to network with colleagues.

  9. Present special lectures (case studies) at the quarterly Mortality and Morbidity Series.

Assessment Mechanism for Objective 3:



  1. Required CEs with topics based on outcomes of the American Board of General Dentistry pretest

  2. The Professionalism evaluation

  3. Required attendance to the school of dentistry’s Heritage Lectures

  4. Survey outcomes for lectures presented by the residents

  5. Quarterly evaluations

  6. Attendance sheets at didactic lectures

Objective 4:

To provide each resident with a broad experience which would enable them to function effectively in the dental management and treatment of a diverse patient spectrum to include medically compromised patients under general anesthesia, HIV+/AIDS patients, mentally compromised patients and other special needs patients in a hospital setting.


Objective 4 Competencies:

  1. Manage patients admitted to the hospital for dental treatment.

  2. Develop treatment plans and provide appropriate dental treatment for special needs patients including cardiac and renal transplant candidates, HIV+/AIDS patients, radiation and chemotherapy patients, orthopedic implant candidates and persons with intellectual and developmental disabilities.

  3. Identify need for medical consult

  4. Understand pharmacologic techniques for allaying apprehension and pain.

Assessment Mechanism for Objective 4:



  1. Faculty evaluations from Internal Medicine, Anesthesia, Oral and Maxillofacial Surgery and the VA Clinics.

  2. Audit of residents clinical experiences in the Oral and Maxillofacial Surgery rotations

  3. Quarterly evaluations

Objective 5:

To recruit residents who are likely to practice general dentistry in an underserved area utilizing the hospital for dental patient care.
Objective 5 Competencies:


  1. Potential applicants interviews

  2. Alumni surveys

  3. Actively engage the residents in a private practice model to include, but not limited to, understanding scheduling, communicating with staff, understanding production, understanding the overhead of a practice and their profit margin.

Assessment Mechanism for Objective 5:



  1. Data collected from alumni yearly surveys

  2. Monthly production assessment for each resident ( to include the types of dental procedures)

  3. Monthly assessment of number of patients treated.

  4. Assessment of QA cases

  5. Monthly OR cases per resident

  6. Monthly sedation cases per resident

Objective 6:



To train each resident in health care in a hospital setting.
Objective 6 Competencies:

  1. Manage patients admitted to the hospital for dental treatment

  2. Actively participate as a member of the multispecialty team in the treatment of a medical emergency with a dental related problem.

  3. Identify need for medical consultation

  4. Make informed judgment on the risk of dental procedures to ambulatory and in-patients.

  5. Recognize significant deviations from normal health status that may affect dental treatment.

  6. To be able to perform medical histories and physical examinations on patients

  7. Management of orofacial infections and knowing when to consult the services of a specialist

  8. To understand the importance of the “team approach” to health care

  9. To understand the common medical/surgical entities that the physician encounters on the inpatient service, further to provide formal instruction and clinical experience in medical risk assessment.

Assessment Mechanism for Objective 6:

  1. Audit of clinical experiences from the Oral and Maxillofacial Surgery rotation.

  2. Faculty and resident evaluation from Internal Medicine, Anesthesia, Oral and Maxillofacial Surgery

  3. Quarterly evaluations

  4. Pre and posttest’s results

  5. Quality Assurance reports

  6. Charts audit

  7. Tests result from the medical simlab experience


Remediation Plan: Failure to achieve a competency level in any of the competency statements will result in an individualized clinical/educational enhancement plan with benchmarks. The resident will be monitored weekly, and evaluated monthly and at the next quarter.


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