Clinical Training

Overview

Residents obtain clinical experience in the hospital Dental Center.  The Center is operated like a private group practice.  The residents have the opportunity to treat a diversity of patient needs each clinical session.  Specialty clinics are scattered throughout the month so that the residents have the opportunity of working under the guidance of specialists on some of the more advanced cases.  The patient payor-mix includes as many patients on private insurance as there are on public assistance which allows the resident opportunities to provide more advanced dental care.  The Dental Center is covered by full and part time attendings and is open five days a week.  The residents have an office with a small library.  The residents find this space beneficial for completing paperwork, discussing cases and reading. 

The residents at Miami Valley Hospital provide their clinical care in an 11-operatory Dental Center.  Here residents work with trained support staff including hygienists, chairside assistants and expanded function dental auxiliaries.  Office visitations to various attendings' private practice during this clinical experience in the Dental Center allow the resident to relate the private office practice of dentistry to the hospital dental practice that they are engaged in.

Dental Center
Residents will be assigned to the Dental Center at Miami Valley Hospital during their residency year.  During this rotation, the residents will provide general dentistry services to patients presenting to the facility.  The Center provides a variety of opportunities to provide various general dentistry procedures under the supervision of general dentists and specialists.  Residents will work with assigned patients and assistants to provide both comprehensive and episodic care to patients presenting to the Center.  Specialists at the MVH Dental Center will provide resident training in Endodontics, Oral Surgery, Pedodontics, Periodontics and Implantology. Residents also learn to work with the hygienists in the preventive aspects of private practice.

Hospital Dental Service
The resident will spend approximately 1 1/2 months on this rotation throughout the year.  The resident will be responsible for all dental patients who are in the hospital to assure that their care is efficiently managed and follow-up occurs as necessary.  While on the rotation, the resident will be responsible for answering all consultation requests by the various departments within the hospital.  The resident will review his/her findings with an attending and will provide care in concert with the patient's medical care.  The resident will cover outpatient surgery (OPS) scheduled for patients on the dental service.  Residents receive valuable clinical dentistry experiences in the hospital ambulatory surgery areas – over 200 cases per year are done in this setting.  The practice has a large number of mentally retarded and developmentally disabled patients who are unable to be treated in the traditional outpatient dental setting.  The resident provides the work up and treatment in the ambulatory surgery area.  This includes communicating with the patient's physician, pre-op orders, complete dental evaluation and treatment under anesthesia, post-op orders, operative note and discharge summary.  Resident coverage is provided for these experiences by our attending general dentists.   This rotation allows the resident to become familiar with the dental care of hospitalized patients including patient assessment, treatment and follow-up.

Urgent Care Service (UC)
On this rotation, the resident will work with the Oral Maxillofacial Surgeons when they cover the Trauma Service at MVH. This experience will include assisting on their trauma cases as well as any follow-up which occurs during their rotation.  The resident will devote the remainder of his/her time to the treatment of patients presenting to the Dental Center at MVH with urgent dental needs.  The resident will be available to cover emergency surgical cases of the various attendings on staff at the hospital and serve as back-up when necessary for the resident on the Hospital Dental Service when more than one OPS case is scheduled at the same time.  During this rotation the resident will have many opportunities to develop his/her skills in the management of emergent dental conditions. This includes the management of pain, swelling, infections, trauma and bleeding.

Conscious Sedation
The General Practice Residency provides the residents with the opportunity to participate in a Conscious Sedation elective which when successfully completed qualify the resident for a Conscious Sedation Permit in Ohio.  The residents are all trained in ACLS early in the resident year which is required later for acceptance into the Conscious Sedation elective.  Residents must also satisfactorily complete their rotations in Family Practice, Internal Medicine and Anesthesia.  In addition, a series of lectures provides the residents with the necessary understanding of patient monitoring, pharmacology and airway management.  Didactically, at the end of the elective the resident will receive comprehensive testing in conscious sedation principles and emergency care of patients.  Satisfactory completion of this allows the resident with appropriate clinical cases to be recommended to the Ohio State Dental Board for a Conscious Sedation Permit.

Off-Service Rotations

Internal Medicine
Two weeks will be spent on the Internal Medicine Service at Miami Valley Hospital with the resident spending time on both the inpatient service and attending selected clinics in the Medical Surgical Health Center. The resident will attend morning conferences with the IM Resident Staff Team and round with the residents on their in-house patients.  The resident will also be directed to the Medical Surgical Health Clinic off site for certain specialty clinics which have been identified to be beneficial to the resident.  Reading assignments are part of this rotation.
 
Emergency Medicine
One week will be spent in the Emergency Department under the supervision of the Emergency Medicine Attendings and Physician Assistants.  During this week the resident will obtain a better understanding of the evaluation and treatment of medical emergencies.  The resident will also have an opportunity to develop some expertise in suturing techniques under the direction of the ER staff.

Anesthesia
Residents are assigned to work with the Anesthesia staff of MVH to learn the principles and techniques of general anesthesia.  During the rotation, the resident will learn about the pre-operative evaluation of patients, selection of pharmacologic agents for anesthesia and sedation, patient monitoring, intubations techniques and venipuncture techniques.  Residents will be provided with reading assignments and course objectives for this rotation.  The resident will be required to pass competencies for this rotation to be considered for successful completion of the Conscious Sedation Elective that the residency program offers.

Family Medicine
The Dental Resident will be assigned to a rotational schedule to work with the Family Medicine Residents in their Family Medicine Practice.  During the month of the assignment, the resident will be scheduled two days per week.  The residents will utilize this time to become more familiar with the medical evaluation and treatment of ambulatory patients with urgent and chronic medical conditions.  The goal of this rotation is to better prepare the Dental Resident for the physical evaluation of the ambulatory patient and the coordination of the patient’s dental and medical treatment in a dental ambulatory setting.

Resident Evaluation

Mentorship Program
Each resident is assigned different mentors during the course of the residency year to work with the resident as he/she progresses through the residency program.  The mentor will assist with resident needs, provide guidance in meeting the goals of the residency program as well as resident personal goals as well as providing input back to the resident regarding his/her performance during that quarter.  The mentor is available to discuss case management issues with the resident as well as help with treatment planning issues.  The mentor will review with the resident his/her performance during their assigned period.

At least three times per year, there is a structured evaluation process.  The mentors will review his/her observations of the resident’s performance.  The Program Director will also review the findings of the Attendings, Mentor and Off-Service Rotational Faculty as well as the resident procedure log.  At this time, the resident’s progress towards the residency goals will be reviewed with the resident.


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