Curriculum

Our program is one year long and includes clinical and didactic experiences. It is based at Allegheny General Hospital, a large urban level I trauma facility. The program prepares residents to meet the oral health needs of patients, including those who are medically or mentally compromised.

Program goals

The objectives and goals of our General Practice Residency Program meet the standards required by CODA for advanced education programs. The goals are as follows:

• To plan and provide a broad range of dental and oral healthcare to patients of varying types and needs.
• To instill a commitment toward continuing education for self improvement and for better patient care.
• To competently treat the medically compromised patient in a hospital or other healthcare setting through the interaction of medicine and dentistry.
• To instill a sense of responsibility for underserved populations by providing disease prevention and health promotion services and activities.
• To achieve the clinical judgment for specialty referrals, while continuing to function as the primary care provider.

Clinical experiences

The resident will spend 7 months in the dental treatment area.

The remaining 5 months are spent on clinical rotations, which include:

Oral and Maxillofacial Surgery (2 months)
General Medicine (2 weeks)
Anesthesia (2 weeks)
Emergency Medicine (2 weeks)
Radiation Oncology (1 week)
Medical Oncology (1 week)
Cardiology (1 week)
Nephrology (1 week)
Elective (2 weeks)

These rotations are subject to change each year and may be modified during the academic year to strengthen and enhance the program.

Anesthesiology rotation objectives

The Anesthesiology rotation is 4 weeks long. The number of hours per week is 40 to 50. The intended objectives of this rotation are as follows:

• The resident will be able to perform pre-anesthetic evaluations and physical risk evaluations for conscious sedation and / or general anesthetic patients.
• The resident will be able to select and plan anesthetic agent and techniques.
• The resident will be able to perform venipuncture and endotracheal intubation.
• The resident understands the effect on patients of oral, parenteral and inhalation agents.
• The resident will be able to deliver conscious sedation and/or general anesthesia under controlled conditions under direct supervision in the operating room.
• The resident understands the pharmacology of those agents administered in conjunction with existing patient medication.
• The resident will gain experience in the prevention, recognition and treatment of anesthetic emergencies.
• The resident understands the use of emergency drugs in the management of medical/anesthetic emergencies.
• The resident will be able to assess patient recovery from anesthesia.
  

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Cardiology rotation objectives

The Cardiology rotation is one week (40 hours) long. The intended objectives of this rotation are as follows:

• The resident will become familiar with the various cardiac disease states and their consideration when planning dental treatment for this patient population.
• The resident will become familiar with listening to cardiac sounds.
• The resident will understand the pharmacology and clinical application of cardiac medication.

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Emergency Medicine rotation objectives

The Emergency Medicine rotation is 2 weeks long. The number of hours per week is 40 to 45. The intended objectives of this rotation are as follows:

• The resident will be able to identify and practice his or her role as a member of the Emergency/Trauma team.
• The resident will be able to review a medical history to recognize factors, which may predispose a patient to a systemic emergency.
• The resident will be able to diagnose the primary systemic abnormalities in a patient with a medical/surgical emergency.
• The resident will be able to support a patient’s respiration and/or circulation when required because of systemic collapse.
• The resident will be able evaluate and manage seizures, allergic reactions and sudden loss of consciousness in a patient.
• The resident will have observed the use of emergency drugs in treatment of medical emergencies.
• The resident will be able to function as a consultant in the emergency room for oral disorders as well as in conjunction with the oral maxillofacial surgery (OMFS) resident regarding facial fractures, lacerations, etc.
  

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Internal Medicine rotation objectives

The Internal Medicine rotation is 2 weeks long. The number of hours per week is 40 to 50. The intended objectives of this rotation are as follows:

• The resident will be able to work up specifically assigned patients on the medical service.
• The resident will be able to describe and perform the fundamental elements of history taking, physical examination and the problem-oriented medical record format.
• The resident will be able to develop clinical judgment in relating medical abnormalities to proposed dental treatment.
• The resident will be able perform the mechanics of chart documentation and medical record protocol.
• The resident will have achieved enhanced skills in physical diagnosis/medical risk assessment.
• The resident will understand the relationship between system and oral diseases and correlate the pathophysiological mechanisms.
• The resident will become familiar with a wide range of symptomatic diseases and the drugs used in their treatment and management.

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Medical Oncology rotation objectives

The Medical Oncology rotation is conducted on the Internal Medicine service and is 4 weeks long. The number of hours per week is 40 to 50. The intended objectives of this rotation are as follows:

• The resident will be able to work up specifically assigned patients on the medical service.
• The resident will be able to describe and perform the fundamental elements of history taking, physical examination and the problem-oriented medical record format.
• The resident will be able to develop clinical judgment in relating medical abnormalities to proposed dental treatment.
• The resident will be able perform the mechanics of chart documentation and medical record protocol.
• The resident will have achieved enhanced skills in physical diagnosis/medical risk assessment.
• The resident will understand the relationship between system and oral diseases and correlate the pathophysiological mechanisms.
• The resident will become familiar with a wide range of symptomatic diseases and the drugs used in their treatment and management.

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Nephrology and Hypertension rotation objectives

The Nephrology and Hypertension rotation is 1 week (40 hours) long. The intended objectives of this rotation are as follows:

• The resident will have been exposed to clinical manifestations and treatment of renal failure.
• The resident will have become familiar with treatment modalities and pharmacology and equipment.
• The resident will become familiar with the various stages of renal failure and their consideration when planning dental treatment for this patient population.

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OMFS rotation objectives

The Oral Maxillofacial Surgery (OMFS) rotation is 8 weeks long. The number of hours per week is 45 to 50. The intended objectives of this rotation are as follows:

• The resident will have demonstrated sufficient knowledge pertaining to hospital protocols for admitting and discharging patients, including obtaining a medical history, physical examination, orders and operative notes, and consultations.
• The resident will have demonstrated sufficient knowledge pertaining to the recognition and treatment of various diseases and trauma associated with the oral cavity.
• The resident will have demonstrated sufficient knowledge to integrate protocols for physical diagnosis, pharmacology, surgery and medicine.
• The resident will have demonstrated sufficient knowledge to assist and perform selected surgical procedures including:
  • Routine extractions
  • Impaction removal
  • Biopsies
  • Soft and hard tissue procedures
  • Pre-prosthetic surgeries
• The resident will have demonstrated sufficient knowledge relating to patient work-up, scheduling and providing dental care in the operating room according to hospital protocols and procedures.
• The resident will have demonstrated sufficient knowledge to describe the management of major head trauma, including ordering, interpreting appropriate lab tests and treating complications.
• The resident will have demonstrated sufficient knowledge to function effectively with medical colleagues and support staff while providing in-house coverage.
• The resident, in conjunction with an OMFS resident, will take in-house trauma call during their rotation.
• The resident will have demonstrated competence in the indications for and the obtainment of informed consent prior to the provision of dental care.
• The resident will have demonstrated sufficient knowledge pertaining to sedation, pain and anxiety control and will have clinically demonstrated competence using dialogue, inhalation, oral, parenteral (IM or IV) agents to an appropriate level.
• The resident will have demonstrated sufficient knowledge pertaining to identifying medical conditions that require consultation or physician referral for medical management and/or clearance relating to the patient’s proposed dental treatment.

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Radiation Oncology rotation objectives

The Radiation Oncology rotation is 1 week (40 hours) long. The intended objectives of this rotation are as follows:

• The resident will have exposure to clinical manifestations and treatment of head and neck cancer.
• The resident will become familiar with treatment modalities and equipment.
• The resident will understand the relationship between tumoricidal doses of radiation and oral/dental affects and complications when planning dental treatment for the head and neck cancer patient.
• The resident will have observed and performed laryngeal exams.

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Didactic learning experiences

A robust lecture schedule is presented to the residents throughout the year. Our teaching faculty consists of dentists from each dental specialty as well as general dentists. Each month the lecture schedule is developed to cover the standard set forth by the Commission on Dental Accreditation as well as tailored to the interests of our residents.

In addition to the lecture schedule, two reoccurring didactic learning experiences are held monthly, Journal Club and Treatment Planning Session.

Journal club

Journal Club is held monthly. At the Journal Club session, the resident presents a peer-reviewed artile to the other residents and faculty. It is then discussed and critiqued.

Treatment planning session

A treatment planning session is held monthly. At this session, the resident presents a case that he or she diagnosed and for which he or she planned treatment. The cases are discussed and alternate treatment options are considered.

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