Curriculum & Rotations

We’ve put together a comprehensive curriculum covering the following topics in hospital dentistry: 

Restorative Dentistry

Goal: The goal is to increase experience in the use of established and new restorative materials, gain knowledge in the biological aspects of dental materials and increase confidence and competence in the planning and execution of advanced operative dentistry.

Objectives: Upon completion of the program, each resident will be able to:

  • Diagnose dental pathology, using adjunctive diagnostic aids such as radiographs and articulated study casts.
  • Establish a diagnosis, treatment plan and plan of treatment for difficult restorative cases.
  • Select and utilize appropriate restorative materials for a given clinical situation.
  • Perform restorative treatment in an appropriate, logical sequence.
  • Recognize and prioritize appropriately for situations requiring advanced / alternative treatment modalities and modifications (rubber dam, quadrant dentistry, sedation, etc.).

Dental Implants

Goal: The goal is to develop competence in at least one implant system (e.g. Bränemark Nobel Biocare, Zimmer, Straumann, etc.) and increase experience in the use of dental implants, including treatment planning, restoration, and maintenance of the prosthesis.

Objectives: Upon completion of the program, each resident will be able to:

  • Treatment plan single and multiple implant cases.
  • Function as a restorative team member in a multi-disciplinary implant treatment modality.
  • Understand and select an appropriate implant system for a given treatment situation.
  • Understand different surgical modalities for a given treatment situation.
  • Complete the restorative phase of single and multiple implant cases utilizing fixed and removable treatment alternatives.

Fixed Prosthodontics

Goal: The goal is to allow increased proficiency in diagnosis, treatment planning and provision of fixed prosthodontic care, refine skills in dental preparations and understand the use of dental materials and devices specific to this discipline.

Objectives: Upon completion of the program, each resident will be able to:

  • Treatment plan difficult fixed prosthetic cases.
  • Understand and select alternative modalities of care for a given patient case.
  • Understand and implement semi-precision and precision attachments when appropriate.
  • Select appropriate materials and utilize alternate techniques which may be necessary to carry a given case to satisfactory completion.
  • Understand and select appropriate materials for a given clinical situation.
  • Effectively communicate with a commercial dental laboratory for satisfactory case completion.
  • Understand the role of and utilize specialist referrals when appropriate.

Removable Prosthodontics

Goal: The goal is to increase proficiency in diagnosis and treatment planning, in order to refine skills in the fabrication and completion of complete and partial dentures; utilizing new impression techniques, improving working relationships with a dental laboratory and becoming involved in more complicated cases involving pre-prosthetic surgery, ridge augmentation, etc.

Objectives: Upon completion of the program, each resident will be able to:

  • Treatment plan difficult removable prosthetic cases.
  • Accurately diagnose patient difficulties with existing prostheses, and offer improvements in care, when possible.
  • Understand and select alternative modalities of care for a given patient case.
  • Understand and implement semi-precision and precision attachments when appropriate.
  • Select appropriate materials and utilize alternate techniques that may be necessary to carry a given case to satisfactory completion.
  • Understand and select appropriate materials for a given clinical situation.
  • Effectively communicate with a commercial dental laboratory for satisfactory case completion.
  • Understand and implement combination fixed / removable cases when appropriate.
  • Select an appropriate recall interval for prosthetic cases, and schedule surveillance care as required.
  • Understand the role of and utilize specialist referrals when appropriate.

Periodontics

Goal: The goal is to increase development of expertise in nonsurgical periodontics (e.g. scaling, root planning, etc.), understand the indications for periodontal surgery and gain skills in the more routine of these techniques, including an understanding of flap techniques, osseous recontouring, gingivoplasty, etc. In addition, a team management approach, utilizing the services of a dental hygienist, is emphasized. 

Objectives: Upon completion of the program, each resident will be able to:

  • Accurately diagnose periodontal disease, utilizing PSR or full-mouth periodontal charting and radiographs when appropriate.
  • Treatment plan routine and difficult periodontal cases.
  • Properly treat periodontal disease, utilizing appropriate modalities (supragingival and subgingival scaling, antibiotic therapies, ultrasonic scaling and curettage).
  • Perform surgical intervention when appropriate and with follow-up care.
  • Understand indications and uses for guided tissue regeneration, and other advanced alternative care modalities.
  • Effectively motivate patients to improve home care to aid in treatment prognosis.
  • Select an appropriate recall interval for periodontal cases, and schedule follow-up care as required.
  • Understand the role of and utilize specialist referrals when appropriate.

Endodontics

Goal: The goal is to increase proficiency in conventional root canal therapy (especially for multi-rooted teeth), introduce surgical endodontics (including apicoectomy, hemisection, etc.), and refine skills involving the management of traumatized teeth.

Objectives: Upon completion of the program, each resident will be able to:

  • Accurately diagnose pain of dental origin and associated pulpal pathology.
  • Treatment plan routine and difficult endodontic cases.
  • Understand and implement direct and indirect pulp-capping treatments when appropriate.
  • Treat single and multiple rooted teeth utilizing conventional endodontic therapies.
  • Perform limited surgical intervention (apicoectomy, hemisection, etc.) when appropriate.
  • Perform emergency intervention to stabilize and treat traumatized and avulsed teeth.
  • Understand the role of and utilize specialist referrals when appropriate.

Oral and Maxillofacial Surgery

Goal: The goal is to increase competence in routine and surgical exodontia, gain exposure to complicated maxillofacial surgery, gain experience in operating room procedures, and diagnose and treat pre-prosthetic surgical cases. An emphasis will be placed on the management of the patient with medical complexity as well as head and neck cancer.

Objectives: Upon completion of the program, each resident will be able to:

  • Accurately diagnose pain of dental origin and associated pulpal pathology.
  • Select appropriate treatment modalities, including IV sedation and general anesthesia in an operating room setting.
  • Perform routine dental extractions, including selection and utilization of appropriate surgical instrumentation.
  • Perform surgical extraction of root tips and uncomplicated impactions.
  • Perform soft and hard tissue biopsies.
  • Perform pre-prosthetic surgery when indicated.
  • Examine and diagnose facial trauma and fractures of the jaws.
  • Understand the role of and utilize specialist referrals when appropriate. 

Oral Diagnosis and Treatment Planning

Goal: The goal is to improve the ability of each resident to recognize, diagnose and manage pathology present in the oral cavity and surrounding structures, and to adequately manage patients' dental conditions. Residents should be able to formulate, organize and prioritize an appropriate treatment plan and plan of treatment within the context of a patient's particular needs and requirements for treatment modifications.

Objectives: Upon completion of the program, each resident will be able to:

  • Properly perform a head and neck exam.
  • Diagnose and interpret signs of pathology, utilizing radiographs, physical examination, and other diagnostic aids.
  • Diagnose and interpret patient symptomatology.
  • Identify dental problems and formulate multiple treatment plans and options for presentation to the patient.
  • Execute the chosen treatment plan in a logical, orderly and efficient manner.
  • Understand the role of, coordinate and utilize specialist referrals when appropriate.

Preventive Dentistry

Goal: The goal is to increase the refinement of an integrated team approach to dental care, including the coordination of care between the dentist and hygienist, proper referral, examination, and follow-up. In addition, modern techniques of preventive dentistry, home care, and nutritional guidance will be emphasized.

Objectives: Upon completion of the program, each resident will be able to:

  • Function as a member of the oral health team, including hygienists, dental assistants, auxiliary staff and specialists.
  • Diagnose and interpret signs of dental pathology, utilizing radiographs, physical examination, plaque index, biologic sampling, and other diagnostic aids.
  • Consider alterations to treatment plans for a given patient, based on patient oral hygiene status and compliance with home care instructions.
  • Select and utilize appropriate materials for augmentation of a patient’s oral hygiene status, including fluoride, sealants, oral hygiene aids, etc.
  • Coordinate and integrate the examination of hygiene patients within the schedule of non-hygiene dental patients.
  • Select an appropriate recall interval, and schedule follow-up care as required.

Special Care Dentistry

Goal: The goal is to increase the experience and knowledge of techniques and modalities of care as well as alternative strategies for the provision of care. Integration of behavior modification techniques is stressed during treatment planning. Emphasis is placed on active patient follow-up and recall, with the dentist functioning as a part of each patient’s total health care team.

Objectives: Upon completion of the program, each resident will be able to:

  • Understand and function as a member of a special care patient's total health care team.
  • Treatment plan special care cases, recognizing the special needs of the developmentally disabled, and other special care classifications.
  • Diagnose dental pathology, using diagnostic aids such as radiographs and articulated study casts.
  • Select and utilize appropriate restorative materials for a given clinical situation.
  • Perform restorative treatment in an appropriate, logical sequence.
  • Understand and perform customized behavior modification techniques for the special care patient, when appropriate.
  • Understand and counsel special care patients and their caregivers regarding proper nutrition and daily oral hygiene/home care, when appropriate.
  • Recognize situations requiring advanced / alternative treatment modalities (e.g. sedation, OR utilization, etc.) customized to the patient's needs.
  • Understand the role of and utilize specialist referrals when appropriate.

TMD and Orofacial Pain

Goal: The goal of the clinical rotation is to provide the resident the skills required to assess, diagnose and treat routine TMJ system disorders (TMDs) and orofacial pain disorders.

Objectives: Upon completion of the program, each resident will be able to:

  • Diagnose orofacial pain emanating from the TMJ, masticatory muscle and associated structures.
  • Diagnose and treat certain TMJ and masticatory muscle disorders.
  • Provide conservative therapy for TMDs.
  • Understand the role of the specialist in treating TMDs and be able to refer as needed.
  • Understand different therapies that are available in the treatment of various TMDs and be able to integrate these into a comprehensive treatment plan.
  • Understand categories of certain neuropathic pain.
  • Understand characteristics of neuropathic disorders.
  • Understand management of neuropathic disorders.
  • Understand categories of certain headache disorders.
  • Understand characteristics of headache disorders.
  • Understand management of headache disorders.

Pain Control

Goal: The goal is to increase familiarity with modern pain management techniques during an anesthesia rotation at the University of Michigan Hospitals. Residents will be expected to develop skills in venipuncture, and oral/nasal intubation, as well as pharmacological management of patients.

Objectives: Upon completion of the program, each resident will be able to:

  • Understand and select an appropriate modality of pain control for each specific patient and treatment.
  • Determine the need for parenteral medication, oral medication, inhalation sedation, or general anesthesia as each case and procedure may require.
  • Effectively administer a chosen local anesthetic, including standard dental blocks, as well as alternative techniques, when appropriate.
  • Understand and determine possible drug interactions, take proper precautions to prevent such occurrences, and be knowledgeable in emergency measures should such interactions occur.
  • Evaluate and assess the medical risk of a patient before being recommended for general anesthesia.
  • Successfully intubate a patient for general anesthesia.
  • Successfully complete a venipuncture procedure for a patient.

Radiology

Goal: The goal is to increase the development of advanced radiological techniques, including cephalometric analysis, as well as improvement in routine chairside radiographic techniques and diagnostic skills.

Objectives: Upon completion of the program, each resident will be able to:

  • Understand, determine the need for, and select an appropriate radiograph and utilize an appropriate radiographic technique to aid in diagnosis or visualization of structures necessary for the completion of patient care.
  • Interpret and evaluate radiographs for quality and diagnostic ability.
  • Identify normal structures, and deviations from normal on a diagnostic quality radiograph.
  • Understand and discuss alternative imaging techniques, including MRI, CT scan, digital radiographs, etc. 

Laboratory Skills

Goal: The goal is to develop communication skills with the dental laboratory technician and effectively utilize of off-site services.

Objectives: Upon completion of the program, each resident will be able to:

  • Effectively communicate treatment needs to a dental laboratory technician.
  • Coordinate patient care with a dental laboratory.
  • Utilize a dental laboratory as part of the oral health care team, as a source of alternative treatments and procedures as appropriate.

Asepsis

Goal: Principles of asepsis are covered as part of the hospital's program in infection control. Each resident is responsible for proper implementation of infection control and asepsis during all patient care sessions.

Objectives: Upon completion of the program, each resident will be able to:

  • Understand and be aware of all current regulations affecting the practice of dentistry.
  • Effectively comply with all existing rules and regulations at the institution, state, and federal levels.

Infection and Hazard Control

Goal: Principles of infection and hazard control are integrated with the hospital's program of infection control. Each resident is responsible for proper implementation of infection control and asepsis during all patient care sessions.

Objectives: Upon completion of the program, each resident will be able to:

  • Understand and be aware of all current regulations affecting the practice of dentistry.
  • Effectively comply with all existing rules and regulations at the institution, state, and federal levels.
  • Understand and utilize Universal Precautions during all phases of patient care.
  • Effectively communicate information to patients about current infection control practices, and alleviate any patient concerns about dental care and the transmission of disease. 

Physical Evaluation

Goal: The goal is to develop of the ability to evaluate a patient's general health status and interpret physical signs and symptoms of systemic disease. Utilization of laboratory data to assess the presence of abnormal systemic diseases and recognition of those medical conditions that may affect the provision of routine dental care is stressed. Residents will increase their ability to perform a physical evaluation, read and understand medical charts, understand basic physiology, interpret basic laboratory values and commonly prescribed medications.

Objectives: Upon completion of the program, each resident will be able to:

  • Complete an assessment of a patient's general health status.
  • Utilize medical laboratory tests and data as an aid in assessment and diagnosis of a patient's health status.
  • Understand and interpret medical records, abbreviations, and conventions.
  • Understand and assess commonly prescribed medications and their potential impact on dental treatment.
  • Understand the impact of a patient's medical status on dental treatment, and to adjust a patient's treatment plan as appropriate, given predisposing medical conditions.
  • Understand, recognize and manage common medical emergencies that may occur in the course of dental treatment.
  • Utilize Basic Life Support techniques on a patient, as appropriate.
  • Understand the role of and utilize specialist referrals when appropriate.

Practice Management

Goal: The goal is to provide the resident with insight into techniques of managing a dental practice.

Objectives: Upon completion of the program, each resident will be able to:

  • Understand financial principles, the time value of money, debt management, etc.
  • Understand dental insurance, claims, and managed care principles.
  • Evaluate a managed care third party contract offer.
  • Understand different career alternatives available to the dental professional.
  • Evaluate an associateship agreement and be able to locate and secure an acceptable position if desired.
  • Evaluate a practice purchase agreement and be able to locate and secure a professional practice if desired.
  • Understand and be aware of his or her legal and ethical responsibilities associated with dentistry and dental practice.
  • Select, implement, and manage an effective patient recall system.
  • Effectively manage and participate in the business management of a private dental office.

Dental Ethics

Goal: The goal of this instruction is to heighten ethical and professional responsibility and to promote ethical and moral conduct and professionalism in dentistry.

Objectives: When completed the resident will have a more broad knowledge of:

  • How to make ethical decisions
  • How to assess small and large ethical situations
  • The link between dental ethics and law
  • Understanding healthcare ethics in association with moral, ethics and law
  • Understanding the importance of ethics in the professional and business arenas
  • The importance of informed consent in dentistry
  • How to analysis moral choices and how to make them
  • How to identify conflicts of interest

Rotations

General Practice residents rotate on-service and off-service. Here’s what you can expect:

On-Service Rotations

During this program, residents are exposed to providing dental care in multiple settings to a variety of underserved patient populations, including those with medical complexity and special health care needs. The hospital setting allows for unique dental care environments, including operating rooms, inpatient, outpatient and emergency settings.

Residents are exposed to diagnosis and management of unique oral and maxillofacial problems in these settings and provide essential and timely care for patients who otherwise have limited access to care. Together with multiple rotations in dentistry while on-service, residents are expected to engage in the essential elements of lifelong learning to prepare them for continued professional growth after completion of the program.

On-service rotations include:

Comprehensive Dental Care in an Operating Room Setting Under General Anesthesia 

The resident is assigned to provide comprehensive dental care in an operating room setting under general anesthesia for approximately 12 days per year in both the University and Mott Hospitals. The patients treated in this setting are those patients who have obtained a dental screening in the outpatient Hospital Dentistry Clinic, and it has been deemed the operating room setting is the most appropriate setting for their comprehensive care. This may be due to an inability to cooperate in a routine clinic setting or due to medical complexity or both.

Goals: The purpose of the rotation is to provide experience in the care and management of patients undergoing comprehensive dental care under general anesthesia surgery. This includes a pre-operative history and physical examination; prescription and administration of medication for control of pain and infections pre-, peri- and post-operatively (with emphasis on the actions, interactions, indications, contraindications, and toxic reactions of those drugs), diagnosis and treatment planning as well as decision-making for longevity of care rendered, methods of handling tissue to minimize trauma; and the initiation, development and completion of the patient's record.

Objectives: Upon completion of this rotation, the resident should be able to:

  • Demonstrate proficiency in skills and techniques for standard operating room protocol including:
    • Scrubbing
    • Gowning
    • Surgical draping
    • Pre-operative preparation of patients
    • Instrument preparation and handling
  • Describe the duties of various personnel working in the suite, including dental assistants, scrub nurses and circulating nurses.
  • Explain the scheduling protocol used in the operating room, including pre-operative dental screening and decision-making in recommending patients for comprehensive treatment in an operating room setting under general anesthesia.
  • Actively participate in the following procedures:
    • Screening and medical history
    • Observing and recording a physical examination
    • Prescribing pre-operative, peri-operative and post-operative medications
    • Completion of comprehensive dental care procedures
    • Writing progress notes, operative reports, and discharge summaries
    • Post-operative care and evaluation of patients, including:
      • Changing dressings
      • Prescribing appropriate medication for pain control
      • Prescribing appropriate medication for infection control

Emergency Dentistry - After Hours On-Call Rotation

Goals: The purpose of this rotation is to provide the resident with experience in diagnosing and treating emergency problems related to the oral cavity. Emergency problems may include acute infection of dentoalveolar origin, acute disorders of the oral mucosa, hemorrhage of the oral cavity, and traumatic injuries to the dental and maxillofacial structures.

Objectives:

  • To provide the resident training and experience in the oral-facial emergencies.
  • To provide experience in wound debridement and suturing.
  • To provide experience in treatment of dentoalveolar fractures.
  • To provide training in initial management of maxillofacial fractures.
  • To provide training in working collaboratively with other members of the healthcare team.

Emergency Dentistry - Day Call Rotation

Goals: The purpose of this rotation is to provide the resident with experience in diagnosing and treating urgent problems related to the oral cavity primarily for patients in an inpatient setting. These problems may include those similar to what would be encountered in an after-hours emergency situation, such as acute infection of dentoalveolar origin, acute disorders of the oral mucosa, hemorrhage of the oral cavity, and traumatic injuries to the dental and maxillofacial structures. These problems also include diagnosing and managing pain, infection and fevers of a possible odontogenic source as well as providing dental clearance before medical procedures, including full organ transplants, bone marrow transplants, chemotherapy, radiation therapy, cardiac surgery. Palliative and/or definitive dental care may also be provided to patients who are admitted for long-term hospital stays. 

Objectives:

  • To provide the resident training and experience in the oral-facial urgencies and emergencies.
  • To provide experience in wound debridement and suturing.
  • To provide experience in treatment of dentoalveolar fractures.
  • To provide training in initial management of maxillofacial fractures.
  • To provide training in dental clearance for patients with medical complexity.
  • To provide training in working collaboratively with other members of the healthcare team.

Oral Medicine, Pathology & Radiology Rotation

Goals: This rotation is designed to provide continued training in oral medicine, radiology and pathology concepts and practices for the general practitioner. Residents spend individualized and small group time with faculty in the following seminar topics: radiographic interpretation, CBCT interpretation, histology slides review, clinical presentation of cases. This series is composed of monthly case presentations and designed to expose residents to the basic principles of oral medicine and oral pathology with emphasis on:

  • Diagnostic work up of patients with oral medical problems.
  • Biopsy techniques.
  • Common head and neck pathoses, oral mucosal disorders, and oral manifestations of systemic diseases and their treatments.
  • Histopathology of common oral hard and soft tissue disorders.
  • Topical and systemic treatments for oral medical problems and oral mucosal disease.

Objectives: At the end of the year-long seminar, the resident will be expected to:

  • Be familiar with the clinical presentations of the most common oral mucosal diseases.
  • Be familiar with the diagnostic work up of oral medical problems and oral mucosal diseases, including history taking, biopsy, direct and indirect immunofluorescence, culture, and serological tests.
  • Be familiar with the common treatment modalities for oral mucosal disorders.

Temporomandibular Disorders, Orofacial Pain, Sleep Dentistry

Goal: The goal of the clinical rotation is to provide the resident the skills required to assess, diagnose and treat routine TMJ system disorders (TMDs) and orofacial pain disorders.  

Objectives: The resident should be able to:

  • Diagnose orofacial pain emanating from the TMJ, masticatory muscle and associated structures.
  • Diagnose and treat certain TMJ and masticatory muscle disorders.
  • Provide conservative therapy for TMDs.
  • Understand the role of the specialist in treating TMDs and be able to refer as needed.
  • Understand different therapies that are available in the treatment of various TMDs and be able to integrate these into a comprehensive treatment plan.
  • Understand categories of certain neuropathic pain.
  • Understand characteristics of neuropathic disorders.
  • Understand management of neuropathic disorders.
  • Understand categories of certain headache disorders.
  • Understand characteristics of headache disorders.
  • Understand management of headache disorders.

Off-Service Rotations

It’s important for the residents to be able to connect the role of dentistry to other components of overall health in order to provide high-quality, integrated and comprehensive care. During this general practice residency, residents are exposed to the processes for diagnosis and management of systemic health problems that may influence diagnosis and treatment planning for oral conditions and diseases.

Additionally, residents are exposed to the importance and processes for collaborative care with other healthcare professionals in the hospital setting.

Off-service rotations include:

Anesthesiology Rotation

Goal: Under supervision, the resident will acquire knowledge and skills in the delivery of local anesthetic agents, conscious sedation and general anesthetic agents in an operating room setting. The resident will have a valid concept of a positive, sequential approach to pre-, peri- and post-operative anesthesiology policies and procedures.

Objectives: Upon completion of the rotation, the resident will gain exposure to:

  • Assess, treat and monitor patients receiving general anesthesia.
  • Record and evaluate pre-, peri- and post-operative patients.
  • Obtain intravenous access on patients.
  • Manage the airway and intubate patients.
  • The use and nature of action of various anesthetic agents.
  • Experience in patient monitoring.
  • Experience in prevention and treatment of anesthetic emergencies.
  • The organization and function of an Anesthesiology Service through lectures, seminars and staff meetings.

Emergency Medicine Rotation 

The resident will be assigned full-time to the Emergency Department during this rotation. The resident will rotate on eight-hour shifts as scheduled by the Emergency Department and participate at the level of a 4th year medical student. The resident will be expected to know how to perform a history and physical and obtain vitals prior to starting this rotation. This rotation is not limited to dental or maxillofacial emergencies. The resident will participate in medical emergencies presenting to the ED. 

Goal: Under supervision, the resident will acquire knowledge and skills in the approach to the evaluation and management of common medical urgencies and emergencies.

Objectives: Upon completion of this rotation the resident will:

  • Learn to perform a rapid history and physical on emergency department patients with emphasis on evaluation of the airway, vital signs, and the cardio-respiratory and central nervous systems.
  • Learn the common signs and symptoms seen in patients presenting with altered mental status, shock, airway compromise, chest pain, shortness of breath and allergic reactions.
  • Learn the standard treatment of common emergencies, particularly those involving altered mental status, unstable vital signs, cardio-respiratory compromise, chest pain, shortness of breath and allergic reactions.
  • Gain experience with the pharmacology of drugs used in emergency settings, specifically those used for advanced cardiac life support, pain management, sedation, allergic reactions and in the patient with sudden loss of consciousness.
  • Gain experience with simple maneuvers and interventions used to establish and maintain an airway and support respiration.
  • Learn to order and correctly interpret common lab data and radiography to aid in diagnosis of medical conditions.
  • Learn the organization and function of an emergency department.

History & Physical Rotation 

Goal: This rotation provides residents with the opportunity to observe and practice physical diagnosis and patient assessment from a medical perspective. Residents should be able to perform a history and physical examination upon completion of this course, and be able to evaluate a patient's medical condition(s) and suitability for dental treatment, given the patient's medical history. Each resident will develop the ability to:

  • Recognize significant deviations from normal health status which may affect dental treatment.
  • Make informed judgments on the risk of dental procedures to both hospitalized and ambulatory patients.
  • Identify the need for medical consultation.

Objectives: Upon completion of this clinical experience, each resident will be able to:

  • Take, record, and interpret a complete medical history.
  • Conduct a review of systems
  • Identify potential problems with general anesthesia
  • Recognize indications for requesting an EKG and/or chest x-ray
  • Recognize significant deviations from normal health status which may affect dental treatment
  • Make informed judgments on the risk of dental procedures to both hospitalized and ambulatory patients
  • Identify the need for medical consultation
  • Understand the indications for, and interpretations of, laboratory studies and other techniques used in the diagnosis of oral and systemic diseases
  • Recognize indications and process for ordering labs
  • Interpret the physical evaluation performed by a physician with an understanding of the process, terms and techniques employed
  • Use the techniques of physical examination (i.e. inspection, palpation, percussion and auscultation)
  • Conduct a physical examination of a patient’s general appearance, skin, head and neck, thorax and lungs, abdomen, lymph nodes, heart, blood pressure and pulse, and neurologic and mental status
  • Practice listening to basic heart and lung sounds
  • Evaluate physical examination findings

Clinical Application in Inpatient, Operating Room and Ambulatory Patient Care:

  • Clinical experience in medical risk assessment is essential; observation is only of introductory value. Clinical experience must be provided through residents' work-ups of inpatients or same-day surgery patients and may be reinforced during assignments to the emergency, anesthesia, internal medicine or other services of the hospital.
  • Residents must record the findings of the medical history and physical examination in the patient's record and arrive at a medical risk assessment. In some cases, this may duplicate the efforts of the physician of record; however hospital policy requiring a physical examination of record by a physician should not preclude residents’ obtaining experience in this area.
  • Clinical experience in medical risk assessment must be supervised, reviewed and critiqued by attending staff
  • When providing dental care for ambulatory patients, residents must, during the initial visit, obtain and document a comprehensive medical history, perform a regional examination of the head and neck, assess blood pressure and pulse, and arrive at a medical risk assessment prior to initiating dental care. These procedures should be repeated periodically depending on the patient's needs.

The duties of the resident are the same as those of a PGY1 medicine resident. Training is received under the direct supervision of the PA’s and NP's of the department. While on the rotation the resident will attend any didactic programs offered.

Oral & Maxillofacial Surgery Rotation 

Goals: The purpose of the general practice resident rotation in the Section of Oral and Maxillofacial Surgery is to provide experience in the care and management of patients admitted for surgery. This includes admitting history and physical examination; prescription and administration of medication for control of pain and infections pre- and post-operatively (with emphasis on the actions, interactions, indications, contraindications, and toxic reactions of those drugs), methods of handling tissue to minimize trauma; and the initiation, development and completion of the patient's record.

Objectives: Upon completion of this rotation, the resident should be able to:

  • Demonstrate proficiency in skills and techniques for standard operating room protocol including:
    • Scrubbing
    • Gowning
    • Surgical draping
    • Pre-operative preparation of patients
    • Instrument preparation and handling
  • Describe the duties of various personnel working in the suite, including scrub nurses and circulating nurses.
  • Explain the scheduling protocol used in the operating room.
  • Actively participate in the following procedures:
    • Screening and medical history
    • Observing and recording a physical examination
    • Prescribing pre-operative and post-operative medications
    • Assisting in the performance of surgical procedures
    • As applicable, the direct performance of surgical procedures
    • Writing progress notes, operative reports, and discharge summaries
    • Post-operative care and evaluation of patients, including:
      • Changing dressings
      • Insertion of intravenous catheters
      • Prescribing appropriate medication for pain control
      • Prescribing appropriate medication for infection control