Curriculum Overview

Objectives

Upon completion of this rotation, residents will gain:

• An introduction to basic emergency medicine
  
• Exposure to assessment and triage of patients
  
• Exposure to management of medical emergencies
  
• Experience in physical assessment and treatment of various patients (e.g. suturing lacerations)
  
• Experience in obtaining and interpreting the patient’s chief complaint, medical and social history and review of systems 
  
• Experience in obtaining and interpreting clinical and other diagnostic data from other health care providers 
  
• Experience using the services of clinical, medical and pathological laboratories
  
• Experience performing two history and physical evaluations and collecting data in order to establish a medical assessment
  
• Experience in selection and administration of medications for emergency medical treatment, especially pain and infection
  
• Exposure to the medical care of an economically underserved urban and rural population of patients
• Experience in placing IV lines for fluid and sedation

Content

During this one-week Emergency Medicine rotation, general practice residents will actively participate under the supervision of faculty and chief residents in the care of patients with the University of Colorado Hospital Emergency Department. The University Hospital serves as a primary care provider for indigent and medically underserved population of patients. The state-of-art Emergency Department (ED) serves as a major urban Level I trauma center, thus residents are exposed to a wide variety of urgent and emergent medical situations.

During their ED time, residents are encouraged to attend all seminars and lectures sponsored by the Department of Emergency Medicine while they are on rotation. Residents will get education sessions with attending and be assigned to their own patients.

It is required that two full H&P’s be completed in EPIC under H&P dentistry. These are to be cosigned by the attending in EPIC and the MR# provided to the GPR director. Completion of the two full H&P’s and daily evaluations from the attendings you are working with will be considered the evaluation mechanism.

Objectives

Upon completion of this rotation, residents will gain:

• Be able to perform and feel comfortable History and Physicals and Review of Symptoms for patients who are going to undergo deep intravenous sedation or general anesthesia in the operating room
• Be familiar with and participate with Oral and Maxillofacial Surgery procedures under deep intravenous sedation
• Be able to manage airways in patients by utilizing nasal airways and oral airways
• Be able to place intravenous catheters for fluid infusion
• Be able to evaluate a medically complex patient's physical status and relate that to the safety of the proposed procedures and where they should be treated safely
• Understand and learn how to utilize OMFS procedures

Content

During this one-week rotation, general practice residents actively participate in the care of surgery patients via assignment to the Oral and Maxillofacial Surgery Department the University of Colorado School of Dental Medicine. While on the OMFS rotation, clinical instruction is provided by the attending and resident staff of the OMFS Department at the University Of Colorado School Of Dental Medicine.

Residents will receive experience in:

• ​Performing Histories and Physicals
• Pharmacology of the medications used in both deep sedation and General Anesthesia
• Monitoring vital signs and sedation recording on sedated and general anesthetic patients
• Experiencing a wide variety of OMFS procedures in clinic and operating room
• Rounding on OMFS patients and taking call with the OMFS residents
• Procedures and protocols for assisting and monitoring the patient during recovery

In addition to this clinical training, residents are required to attend all seminars, lectures, etc., sponsored by the OMFS service.

Objectives

Upon completion of this rotation, residents will:

• Interact with various medical departments of the University Hospital by providing consultative and treatment services for hospitalized patients including dental care for kidney, heart, lung and bone marrow transplant patients.
• Answer acute dental emergency calls to the Emergency Medicine department at UCH
• Provide dental clearances for transplant patients, cancer patients prior to chemotherapy and head and neck cancer patients
• Request referrals, based on the medical and dental complexity of the patient’s needs
• Provide general dental treatment at a level beyond that achieved in dental school including advanced restorative, prosthodontic, periodontal, endodontic, osseous implants and oral surgical procedures
• Act as primary care provider by formulating and executing a comprehensive treatment plan for a wide range of medically complex ambulatory patients
• Incorporate a preventive program into each treatment plan and into the total care of each patient
• Diagnose and treat dental emergencies and provide immediate, palliative treatment for pain and infection
• Follow recognized infection control guidelines while providing treatment for patients with chronic infectious diseases
• Understand various aspects of practice management such as appointment scheduling, efficient utilization of auxiliaries, patient and staff rapport, effective time management, impact of financial considerations on treatment planning and risk management. Understand fundamentals of associateship contracts
• Complete laboratory work for your patients, write dental laboratory prescriptions, interact with commercial dental labs and evaluate the quality of the work provided by such labs
• Participate in the oral health needs of the local and/or state communities​

Content

Residents are based at Advanced Care Clinic for approximately 10 months. The majority of time is spent in hands-on patient treatment so residents gain a wide variety of experience by providing more complex dental treatment on the medically complex, ambulatory patient.

The concept of comprehensive care is stressed, with an emphasis on the "whole" patient (medical, financial and social status, patient motivation and desires). Patient needs are assessed and taken into consideration when formulating the treatment plan and performing treatment.

Residents are assigned to Oral surgery rotation, within the Advanced Care Dental Clinic, once every 6 weeks.  At this time you will be assigned only oral surgery cases.  You will work closely with our OMFS attending to perform procedures like full mouth extraction cases, alveoloplasty, extractions and bone grafts, biopsy, and surgical extractions of third molars, on patients of the pre-doctoral program.

Our On Call schedule is one week on every 6 weeks.  We encourage a buddy system, with one resident being first Call and the other resident being second Call.  This way, you always have a second pair of hands for the difficult cases and you learn twice as much!

Techniques of efficient time management are stressed to prepare residents for the transition from dental school to private practice. Residents also learn how to use a dental assistant’s and hygienist’s time appropriately, to be more efficient. Residents are encouraged to utilize a wide variety of materials and techniques, both analog and digital, with a focus on those not commonly taught in dental school. Although direct faculty supervision is always present, residents are encouraged to use their own judgment in making patient care decisions.

Didactic classes are held from 7:45 - 8:45 a.m. daily, with time after to have group huddles to evaluate the patient’s medical history and treatment plan and to clarify ongoing care before the clinic begins at 9:00 a.m. 

Residents receive:

• Daily feedback from faculty
• Quarterly evaluations by covering faculty
• Formal evaluations by the Program Director three times a year

• ​Prepare residents for careers in primary care dentistry
• Implement a didactic and clinical educational program of excellence for residents
• Prepare residents to provide advanced levels of patient care
• Prepare residents to perform community service in areas of need
• Prepare residents to provide oral health care in a hospital setting

Overall Objectives

• ​Train residents to be skilled in patient evaluation, laboratory diagnosis, medical history and suitable physical assessment.
• Provide each resident with a variety of patients with challenging histories in order to gain practical experience in the above skills.
• Enhance residents’ oral diagnostic and treatment-planning skills to meet the comprehensive dental needs of the patient.
• Provide didactic and clinical experiences that train the resident to provide quality comprehensive dental care utilizing current and innovative technology and theory, regardless of the patient's medical, mental, emotional or physical compromise.
• Instill a sense of how hospital dentists can serve the community, especially the underserved and low-socioeconomic patient populations.
• Educate residents to competently select and apply appropriate means of pain and anxiety control, including inhalation, oral, and intravenous techniques.
• Teach hospital and operating room protocol so residents may easily admit a patient, perform a history and physical examination, order and assess laboratory tests, consult with other medical specialists, administer pre- and post-operative care and perform treatment in an operating room setting.
• Provide intensive education in the recognition and management of medical emergencies in the dental setting.
• Ensure residents learn to diagnose and treat common dental emergencies and recognize when to refer more complex problems to the appropriate medical or dental specialists.
• Develop residents’ knowledge, skill and confidence to participate in a multidisciplinary treatment team.
• Enhance residents’ understanding of practice administration and supervision of auxiliary personnel.
• Develop residents’ ability to retrieve, critically review and assess pertinent scientific literature.​