Rotations and Competencies
Residents are assigned to the Department of Anesthesia for a four week rotation. Residents will be given instruction in principles and techniques of general anesthesia. During this rotation, the resident will learn about pre-operative evaluation of the patient, selection of pharmacological agents for anesthesia and sedation, patient monitoring, intubations and venipuncture techniques.
Residents will be provided with reading assignments and course objectives for the rotation. The resident will be required to pass competencies for this rotation to be considered for a successful completion.
Residents will participate in SIM Lab training sessions twice monthly to acquire/refine skills necessary to satisfy the anesthesia competencies
Residents will participate in simulated medical emergency scenarios held in the outpatient dental clinic as arranged and conducted in the SIM Lab.
Anesthesia Rotation Competencies
- Evaluation- Evaluate the patient’s physical status, relate it to the planned surgical procedure(s), and help determine choice of anesthesia.
- Preparation- Appropriately prepares the equipment, the monitors and the operating room for MAC/GA.
- Pharmacology- Understand basic pharmacology, pharmacokinetics, and interaction of commonly used anesthetic and sedative medications as well as secondary medications utilized during general anesthesia (e.g., muscle relaxants, analgesics, etc.) Provide administration of pharmacologic agents as indicated.
- Fluids & Electrolytes- Understand the basic principles of fluid and electrolyte balance.
- Airway- Manage routine/non-complex airways using bag-valve-mask, LMA, nasal and oral intubation techniques.
- Venipuncture- Perform routine/non-complex venipuncture and insertion of intravenous catheters for the infusion of fluid.
- MAC- Demonstrate proper monitoring technique during Monitored Care Anesthesia.
- Recovery- Participate in the management of patients during recovery from anesthesia.
The Department of Dentistry will provide each resident with the Conscious Sedation Manual and ADA Modules for Sedation.
- This manual will serve as a basis for the didactics to be presented during lecture time.
- The residents will be responsible for reviewing this manual, mastering the modules presented and familiarizing themselves with the drugs.
- The residents will participate in bi-monthly SIM Lab sessions, during which time they will develop/improve competencies in venipuncture, airway management and intubation. The resident will also participate in on going physical assessment and heart/lung SIM Lab competencies.
- On the first day of the anesthesia rotation, the dental resident will present to the anesthesia office at 6:00 am.
- The dental resident will present each day to the pre-op area at 6:00am. In this way, they will observe and participate in H/P, physical evaluation and venipunctures.
- While on anesthesia rotation, it will be the responsibility of the dental resident to schedule any lab cases at 2:00 pm to ensure an optimal experience.
- Following pre-operative engagement, the dental resident will participate intraoperatively or as determined by the anesthesia preceptor. While intubation experience are valuable it is the objective of this rotation to provide clinical experiences that will be of maximal benefit in their daily G.P.
Residents are assigned to Family Medicine Center for a 1 week rotation. The purpose of the Family Medicine rotation is to coordinate the training in physical assessment, patient work-up, admission, following patient’s course and stay, and discharge. The residents will use SIM Lab acquired skills to perform heart and lunch evaluations as part of the physical assessment and history and physical procedures. There is cross-over with these topics in the Anesthesia, Emergency Medicine, and Physical Assessment lectures.
Required reading assignments will be given to the resident to enhance the basic understanding of the history/physical process.
The resident will also provide a basic understanding to his medical colleagues about the oral cavity, oral pathology, and dental problems often presented to the physician.
Family Medicine Rotation Competencies
- Participate in rounds and develop an understanding of the physical assessment of the patient.
- Develop skills to recognize and understand the patient’s history with respect to the physical exam.
- Understand vital signs, EKG’s, lab tests and patient complaints.
- Develop an understanding of medications and the effects on the body systems especially for the medically compromised patient.
- Be able to perform a heart and lung exam.
Residents will spend one week in the Emergency Department under the supervision of the Emergency Medicine attendings. During this week the residents will gain a better understanding of the evaluation, triage, and treatment of medical emergencies.
A prerequisite for this rotation is the completion of BLS and ACLS. The resident will be exposed to a wide variety of conditions and injuries from the simple sprains and colds to the acute illnesses and trauma seen in a Level 1 Trauma Center.
Some emphasis will be placed on oral-maxillo-facial-trauma and coordination with EENT, OMFS, and plastic surgery. The resident will also become proficient in the treatment of the emergency dental patient.
Emergency Medicine Rotation Competencies
- Evaluate, diagnose, and become familiar with the treatment of the ED patient.
- Become proficient in history taking and physical examinations.
- Become familiar with diagnostic test (lab and radiology) ordering.
- Develop some expertise with suturing techniques under the direction of the ED staff.
- Chart maintenance and completeness.
- Completion of BLS and ACLS (Orientation Week).
- Gain an understanding of the medical emergencies that can arise in a dental office.
- Gain experience in treating severe dental infections, wound debridement, and minor and major oral/facial trauma.
- Understand the indications/integrations of medical/dental consults.
The Radiology Rotation is one week long designed to give the residents’ a dedicated exposure to all modalities and types of contemporary imaging procedures with emphasis on the types of studies used in the diagnosis of oral facial trauma and pathology. Digital radiography, archiving and 3-D applications are stressed. The resident will be assigned to a staff radiologist and have some required reading to supplement the rotation. The radiology experience on-going through-out the year enhanced by the ED experience and in working with the trauma team and the OMFS’s, plastics, and EENT on staff.
Radiology Rotation Competencies
- Have an understanding of radiographic anatomy and pathology.
- Acquire an expertise in evaluating skull, facial bone, mandible and cervical spine radiographs.
- Have a complete understanding of the application and interpretation of diagnostic radiography (CT scan, MRI, angiography, ultrasound, 3-D reconstruction and conventional and contrast radiography).
- The resident will contribute to the teaching file and present 3 cases of interest to the dental staff.
EENT, Plastic/Reconstructive Surgery, Hyperbaric Medicine
A dedicated 3 day rotation is divided among these disciplines.
EENT, Plastic/Reconstructive Surgery, Oncology, Hyperbaric Medicine Rotation Competencies
- EENT - The Otolaryngology service rotation will consist of an assigned time during which the resident will develop and refine clinical assessment skills involving the head and neck region, as well as increase their knowledge of the disease processes and current treatment modalities. The residents will have an additional exposure to admission, management, and discharge of these patients while on this service.
- Plastic and Reconstructive Surgery - The resident will be exposed to the treatment of trauma, pathology, and reconstruction to the head and neck service while on the Plastic and Reconstructive Surgery rotation. The ED and surgical experience from OMFS and ENT all come together as a multidisciplinary specialty approach to treating patients.
- Oncology - The Oncology Rotation will expose the resident to the multidisciplinary treatment approach of the cancer patient to the systemic and oral effects of ionizing radiation and chemotherapy. This rotation will also give the resident the treatment rationale, diagnostic approach (early recognition) and follow-up of oral/head/neck cancers. The resident will have the opportunity to follow the patient’s pre, para, and post treatment.
- Hyperbaric Medicine - The resident will be exposed to this assigned rotation as cases permit to become familiar with wound management and treatment of surgical cases for the treatment of osteoradionecrosis.
Residents spend 3 days in the Pathology department. The purpose is to demonstrate the importance of specimen care, multidisciplinary care, CBC platelets, and more.