Advanced Dental Education General Practice Residency Program
The University of Nebraska Medical Center College of Dentistry offers a one-year general practice residency. The program is accredited by the Commission on Dental Accreditation, a specialized body recognized by the Council on Postsecondary Accreditation and the United States Department of Education. The program is based at the University Medical Center Hospital and Clinics in Omaha. The hospital is a 779-bed facility that serves as a referral center for Nebraska and surrounding states. UNMC is a major transplant center with a national and international reputation. The program has entered into a collaborative agreement with the Veteran’s Administration Western Iowa Nebraska Health Care System. The VA program offers a second clinical and hospital site for training which expands the range of experiences offered residents.
Statement of Purpose:
The purpose of the General Practice Residency program at the University of Nebraska Medical Center and Veteran’s Administration Western Iowa Nebraska Health Care System is to train dental residents to deliver comprehensive health care in both the inpatient and outpatient environment as part of a larger team of health care providers with full consideration of the patient's dental and medical needs. Furthermore, the program strives to instill in the resident office management and production skills that can be translatable to their private practice experience after completing their residency.
Goals of the Program, Objectives and Associated Outcomes Measures
- Develop the capacity in the generalist to participate in the provision of comprehensive health care in the traditional dental environment as well the hospital and associated health care settings (CODA 1-8 Focus – general dentistry, hospital setting).
Obj 1a: to provide foundation knowledge regarding hospital operations, functions and credentialing. (Standard 2-11)
Obj 1b: to develop skills in responding to and directing consultations in the hospital floor or with other clinical services and meeting the needs of the patient as a general dentist. (Standard 2-3, 2-9, 2-11)
Obj 1c: to develop skills in physical assessment and the understanding of the interplay between the systemic and oral environments. (Standard 2-9)
- Provide resident learning experiences which focus on the primary care provider role in the delivery of general dentistry patient care, emergency care, referred care, health promotion, disease prevention and the application of behavioral management techniques as relevant to comprehensive health care of the medically, mentally and physically compromised patient as well as the "healthy" patient population (CODA 1-8 Focus – general dentistry, patient care and special needs).
Obj 2a: to expand on existing foundation knowledge/skills in the areas of operative dentistry, endodontics, periodontics, prosthodontics (fixed/removable/occlusion) and oral surgery (exodontia, biopsy, pre-prosthetic surgery, TMJ management). (Standard 2-4)
Obj 2b: to develop skills in responding to and directing medical/dental emergency care and pain/anxiety management in the clinical and emergency room setting. (Standard 2-3, 2-5, 2-7)
Obj 2c: to develop skills in physical assessment and the understanding of the interplay between the systemic and oral environments. (Standard 2-7, 2-9)
Obj 2d: to develop referral skills as well as skills in the diagnosis, assessment, temporization, prevention, health promotion, transitional and management of patient needs. (Standard 2-3).
Obj 2e: to develop skills and knowledge base in oral, IV and inhalation sedation and the structuring of the treatment environment or management plan for behavioral modification of patients having varied health backgrounds and oral needs. (Standard 2-6)
- Train a generalist capable of interacting with other members of an interdisciplinary health care team in a variety of health care situations including Services to the community. (CODA 1-8 Focus – general dentistry with intra and inter disciplinary interaction and community service).
Obj 3a: to foster and build relationships between the generalist and other health care members. (Standard 2-3)
Obj 3b: to develop the skills and knowledge to provide dental care in non traditional settings and environments including the organization and delivery of community service efforts. (Standard 2-3)
Obj 3c: to provide general understanding and application of laboratory and diagnostic techniques in systemic disease. (Standard 2-7)
Obj 3d: to develop knowledge basis in the diagnosis, treatment and management of systemic disease. (Standard 2-7)
- Refine the clinical skills a generalist brings to the program, providing an opportunity to individualize certain aspects of training while taking into account varying abilities, background and career goals and by applying critical thinking principles, evidence/outcomes based care, and use of information databases in clinical decision making and practice management. (CODA 1-8 Focus – general dentistry and resident education).
Obj 4a: To develop skills in critical thinking and analysis of care outcomes applied to clinical practice. (Standard 2-10)
Obj 4b: To develop an understanding of databases and evidenced based care. (Standard 2-10, 2-14)
Obj 4c: To foster an understanding of basic principles of practice management. (Standard 2-10)
- Develop appropriate attitudes, behavior, preventive and business practices in regard to the profession by providing the opportunity for professional development as a clinician, teacher, researcher, manager, community advocate and administrator (CODA 1-8 Focus – general dentistry, education patient care and community service.
Obj 5a: to develop skills in literature review and the preparation and presentation of a position paper to laymen or a collection of peers within the health care field. (Standard 2-14)
Obj 5b: to develop ethical behaviors compatible with the profession and the appreciation of diversity. (Standard 2-3, 2-10)
Obj 5c: To foster the concept of life-long learning and professional growth including service to the community. (Standard 2-3)
Requirements for Certification:
Upon successful completion of the one-year residency program at UNMC, the resident will receive a certificate. The following criteria will be utilized in evaluating the resident for certification. As part of the current competency and proficiency movement in postgraduate general dentistry, it will be the resident’s responsibility to provide documentation of their experiences during the residency. (Competency statements are available on-site for review or can be made available upon request.) Documents will be gathered and presented for review by the faculty on a periodic basis. Documents will be stored through the use of a portfolio. Criteria for successful evaluation will be:
- Completion of all off site and UNMC rotations with an over-all satisfactory evaluation by the attending staff or their designee.
- Completion of all medical and dental records in accordance with established quality assurance guidelines.
- Completion of check out of materials and supplies.
- Completion of dental treatment on a sufficient number of patients that demonstrate quality comprehensive care.
- Demonstration of a high degree of professionalism through interplay with other health care professionals in the dental treatment of patients who are medically, mentally, and physically challenged as well as participation in a community service project.
- Satisfactory completion of record and patient care audits in accordance with established quality assurance guidelines.
- Satisfactory participation in the program's clinical and didactic curriculum.
- Completion of one manuscript suitable for publication in a peer refereed journal or participation in clinically based research or formal presentation of a self- investigated topic to a collection of peers within the academic or professional community.
Currently, there are five one-year positions available.
July 1 through June 30 of the following calendar year.
DIRECTOR OF THE PROGRAM
The program has a full-time director responsible for the day-to-day administration of the clinic. The director also spends a significant percentage of time with the residents in both clinical and educational components of the program. The current director has over 20 years of private dental practice experience which will be an invaluable resource to the residents as they transition from the dental school environment to preparing for private practice.
Residents receive guidance, supervision, education and treatment planning advice from both generalists and specialists throughout the program. Specialists are available for consultation on a regularly scheduled basis and include endodontics, oral pathology, oral surgery, pediatric dentistry, periodontics, prosthodontics, and oral-maxillofacial prosthetics.
Patients are scheduled by the residents for consultation or supervision of treatment with a specialist when the resident feels the patient has need for special consideration.
Residents are provided with dental assistant support to allow for utilization of four-handed dentistry. A billing / insurance specialist and clinic scheduler are available to ensure efficient administration of patient scheduling, records and finances. Several dental hygienists are also employed to help provide preventive, diagnostic, periodontal and other adjunct services to our patients .
CLINCAL AND BUSINESS OPERATIONS MANAGER
The program also has an operations manager responsible for managing all of the administrative functions, patient/staff relations, and financial affairs of the clinic and program.
FACILITIES AND EQUIPMENT
The Adult General Dentistry Clinic is located in the University of Nebraska Durham Outpatient Care Center which adjoins the University Hospital.
Within the clinic there are six fully equipped operatories, consultation room, laboratory, sterilization area, radiographic imaging room with a Conebeam 3-D System and a Digital Pantomograph unit, resident's room, scheduling office, billing office, and a restroom. In addition, there is a combined waiting area shared with the Oral Surgery and Maxillofacial Prosthetic Reconstruction Clinic.
Every dental operatory in the Adult General Dentistry Clinic is identically equipped. All are plumbed with nitrous oxide, oxygen and central vacuum. The operatories each contain a new digital radiographic unit and computer workstation. The dental units are state-of-the-art equipment with fiber optic capabilities and electric hand-pieces. An intra-oral camera system is also available along with Orascoptic fiber optic head lamps. A surgical endodontic microscope and a CEREC System for porcelain restoration fabrication are also available for resident’s use. Rotary Endodontic and Implant Placement Systems, including handpieces, are frequently utilized as well as a soft-tissue laser. Several new complete sets of oral surgery instruments are available.
A portable radiographic and dental unit as well as two portable pulse oximeters are available for treatment rendered in the operating room or on the patient floors.
While on rotation at the VA Clinic, residents will enjoy working in the state-of-the-art, newly remodeled, stand-alone dental facility which boasts updated equipment, cabinetry, plumbing, and fixtures. The clinic houses twelve operatories, private offices, a resident’s office area, a reception area, a dental laboratory with a full- and part-time lab tech., a large conference room, a staff lounge and restrooms.
Since the program is located at the University Medical Center, an extensive library facility is immediately available for the resident's use. The McGoogan Library within the University Hospital has all necessary medical and most major dental publications. The C.Y. Thompson Library in Lincoln can supply other dental references or minor publications required for resident use. Library loan or courier service can provide journals, articles or books quickly. In addition, extensive audiovisual files are in the Medical Center Library for the resident's review. Computer access to internet reference sites is available in the clinic's resident room. The VA also maintains library services.
Dental residents spend approximately 75% of their time providing dental care to a wide variety of patients. These groups include:
- Medical/Dental inpatients referred for evaluation and treatment
- Medically, mentally, physically challenged outpatients
- Well outpatients
- Geriatric patients
- Social Services patients
- Emergency walk-ins
- Military Veterans
Residents will participate in the screening of patients admitted to the program and the development of definitive treatment plans. The treatment plans are presented to the attending staff in the dental clinic and at weekly treatment planning meetings. At that time, the attending staff will review the treatment plan with the residents and make recommendations, review options of treatment and discuss rationale of treatment plan decisions. An active Nebraska state dental license is necessary to participate in this program and to receive the stipend. Incoming residents will be provided with additional information regarding temporary state licensure.
Special emphasis is given to oncology, liver transplant, heart transplant, pancreas transplant, cardiac valve replacement, HIV patients and their problems. The dental residency program works closely with these services preparing and managing these patients.
The dental residency program will provide the resident with a wide variety of operating room experiences in both general dentistry and oral surgery. Dental rehabilitation cases on patients with medical, psychological and social disorders serve as the main source of patients. Dental residents are also required to assist the oral surgeons or perform delegated procedures under the supervision of the oral surgeons while on rotation at the VA hospital.
Training in physical evaluation will be provided during the first months of the program to allow the residents to more actively participate in the care of patients. Additional experience in physical evaluation will be provided during the rotations in Emergency Medicine, Oral and Maxillofacial Surgery, and Anesthesia. By the completion of the program residents will be capable of performing a complete history and physical, and ordering appropriate laboratory tests prior to performing the necessary dental treatment for each patient. The residents will be able to manage the patient from admission to discharge, determining when consultations or assistance in patient management are necessary. The residents will also learn to dictate all portions of the patient's dental and medical records. Inpatient care is also provided as consultant to all the medical services at UNMC especially those relating to transplantation and cardiac surgery.
Each dental resident is assigned to emergency on-call duty by the Program Director. Dental residents will alternate call as scheduled and will on occasion support the oral surgery residents in order to gain trauma experience.
Dental residents will be expected to provide palliative care to patients admitted to the Emergency Room. The experience will include common general dental problems as well as minor and major traumatic injuries.
Residents will not be required to stay on-site when on call.
A number of educational programs have been developed for the dental residents. These educational programs are designed to provide the residents with additional exposure to both medical and dental problems and developments. The following programs are regularly scheduled for the resident's benefit:
- Educational seminars presented by guest lecturers, attending staff or specialists in Medicine/Dentistry
- Educational seminars presented by the residents
- Periodontal Treatment planning and Case Conference
- Implant Treatment Planning and Case Conference
- Journal Club/Ethical Dilemmas
- Practice Management
- Operative Dentistry
- Fixed and Removable Prosthetics; including implants and introduction to maxillofacial prosthetic concepts
- Continuing education for credit
- Joint conferences with other residency programs
- Lunch and Learn seminars with representatives of dental supply companies
Educational seminars presented by the attending staff, guest lecturers or medical/dental specialists will focus on advanced techniques in the individual's specialty or interest areas. Educational seminars presented by the residents will focus on management of dental patients with special needs or complex management and also on implant placement/restoration patient cases.
Oral Pathology conferences are presented by an oral pathologist. The conferences review and augment the resident's knowledge of oral and general pathology as well as oral medicine.
Oral Surgery conferences are presented by various medical or oral surgery attending staff or residents. The subjects covered include a variety of dental and medical problems, techniques important to diagnosis and management of patients and techniques or problems in oral surgery. Seminar subjects will cover basic and special considerations for inpatient and outpatient care of dental patients undergoing combined medical and dental procedures. Principles of fluid balance, laboratory interpretation, pain management, TMJ disorders, infection and medication management are just a few examples of subjects presented. A physical assessment course is also provided through the Oral Surgery Service.
Treatment planning/case review seminars are weekly presentations of difficult or unusual dental patients. The residents are requested to present the patient's medical and dental problems, how they affect the patient and his/her treatment, and what treatment was prescribed and carried out. The program focuses the majority of its didactic efforts into the Friday morning treatment planning and case conference. The conference has associated with it operative dentistry, prosthodontia, practice management, literature reviews, professional ethics, ethical dilemmas and systemic disease in dentistry lectures on a rotation basis. Supplemental guest lectures are also provided on topics of interest to the program; TMD, Implants, etc.
Residents will spend one month in the Anesthesia rotation and two weeks in a rotation of Emergency Medicine. The length of the VA rotation is dependent upon the total number of residents in the program and currently is six months in duration.
The resident's rotations will be supervised by the various attending staff and residents on the specific services. The residents are expected to participate in patient care while on rotation and assist the physicians or oral surgeons during procedures and examinations. The rotations are designed to increase the resident's exposure to clinical medicine and allow them to utilize and apply diagnostic skills learned during their training in the residency program.
The University of Nebraska Medical Center College of Dentistry policy requires that all entering students in programs requiring patient contact must be vaccinated or exhibit active immunity to tetanus, measles*, mumps, diphtheria, chicken pox, polio, rubella and Hepatitis B and have had a TB skin test within the last six months, unless the student has a previous positive test/medical contraindication. Each entering student must verify at the time of matriculation that he or she has completed the accepted routine of vaccinations. An immunization record is required in order for the student to be registered. *Anyone born after 1957 is required to have two measles shots to assure immunity, with the second one given after 1980.
SAFE WORK ENVIRONMENT
The program follows State, Federal, and National regulatory bodies with respect to asepsis and safety within the workplace. Emergency preparedness and safe work environment materials are available for review. Some of these documents will be provided to the resident during orientation.
CARDIOPULMONARY RESUSCITATION (CPR)
Each student is required to be certified and maintain certification in basic CPR. A copy of the current and valid certification in basic CPR must be maintained at the College of Dentistry. Certification in Advanced Life Support (ACLS) also is encouraged.
STIPEND AND EMPLOYEE STATUS
Due to a review of GME funding status, resident stipends for the year beginning July 1, 2012, are not established. Once known, they will be communicated to all residents. Current academic year stipends = $43,915.00. GME-eligible postgraduate students are eligible for a flexible benefit package which includes choices among health, life, and disability insurance. Future income is contingent upon continued availability of federal funds and, therefore, is subject to change at any time.
The dental resident will be responsible for the timely payment of established program fees and will receive a salary. Established program fees which are the responsibility of the Resident include $1000.00 per semester equipment tax fee ($2000.00 total) and background check fee of $30.00.
Student Loans and Loan Deferment
Currently, Postgraduate students are considered students of the College of Dentistry for financial aid purposes. Postgraduate students may get financial aid information from the UNMC Financial Aid Office and student loan payments for postgraduate students can be deferred.
Postgraduate students shall have fifteen (15) scheduled working days of paid Leave per year. Leave includes vacation, sick leave, and professional development leave. Leave in excess of fifteen (15) days per year must be taken as Leave Without Pay from the College or as Family Leave. Such extended leave may result in extension of the training program without pay. Leave requests must be submitted as per the policies of the program and the College.
Students are allowed to participate in private practice (moonlighting activities) but must arrange their schedules with the program director to prevent conflict with program responsibilities.
The University of Nebraska has in force professional liability insurance covering all enrolled students of the College of Dentistry performing services as part of the College's program.
Current coverage is $1,000,000.00 per person, per occurrence, with $100,000.00 deductible. The University provides self-insurance for the $100,000.00 deductible through the University's general and professional liability insurance program.
All postgraduate students are expected to get a Nebraska Dental License (temporary or regular) and federal and state DEA licenses before October 15 of the year of the commencement of their program. The postgraduate student must document efforts to obtain licensure to the Postgraduate Admissions Office by July 15. Failure to obtain Nebraska Dental License and federal and state DEA licenses by October 15 may result in a reduction of duties, reduction or elimination of stipend, an extension of time necessary to complete program requirements, or dismissal from the program. Failure to obtain licensure or maintain licensure during the course of the residency will result in dismissal from the program and no certification of participation.
It is possible for a student who has graduated from an A.D.A. accredited American or Canadian Dental School to obtain a temporary Nebraska Dental License during the time he or she is enrolled as a full-time postgraduate student. The temporary license is only for practice related activities within the College of Dentistry and does not allow extramural private practice. After acceptance into the postgraduate program licensure information may be obtained from the State of Nebraska Department of Health, Bureau of Examining Boards, P.O. Box 95007, Lincoln, NE 68509-5007. Telephone: (402) 471-2115.
For a regular license, the State Board accepts the results of the clinical examination given by the C.O.R.E. in 1995 (CRDTS/NERB), or CRDTS. The State Board also has provisions for licensure by credentials for individuals licensed by other states.
STATE OF NEBRASKA RESIDENCY
As employees of the University, GME-eligible postgraduate students are considered residents of the State of Nebraska.
Students accepted for postgraduate training in the general practice residency program must have a dental degree from a U.S.A. American Dental Association-accredited dental college or school. Additional criteria upon which applications are viewed include:
Grade point average
National board examination scores
Personal statement of goals (include explanation for choice of graduate field, expectations for learning in your chosen field of study, and anticipated career goals)
Other supporting evidence such as a CV or résumé
The General Practice Residency program participates in PASS. All applicants must follow the guidelines established by this service to be eligible for the program.
Those interested in applying to the program should complete the PASS Request for Applicant Agreement @ The Postdoctoral Application Support Service (PASS) is a central application service. With PASS, applicants complete one standard application, which is then distributed to each of the participating programs to which the applicant wishes to apply. PASS deals with the initial stages of the recruitment process, prior to the evaluation of applicants by the programs. PASS has been designed and is being administered by the American Dental Education Association (ADEA). This address is:
American Dental Education Association
Postdoctoral Application Support Service
1625 Massachusetts Avenue, NW Suite 600
Washington, D.C. 20036-2212
Telephone: (800) 353-2237
Fax: (202) 667-4983
Web Site: www.ADEA.org
Those individuals who have completed their application and meet standards for acceptance will be invited for an interview. Personal interviews are conducted by invitation. The application deadline is March 15, but may be extended until all open positions are filled.
Statement of Equal Educational Opportunity
In accordance with University policy, UNMC prohibits the denial of admission or of Medical Center privileges to students or applicants on the basis of race, color, sex, national origin, age, disability or religious or political beliefs. These privileges include but are not limited to admission, class assignments, scholarships, fellowships, assistantships, and financial aid, as well as housing and recreational facilities. Furthermore, student organizations must base their selection of students for membership in criteria which will not include race, color, religion, sex, national origin, age or disability.
Admittance to UNMC programs will not be denied to otherwise qualified disabled individuals solely by reason of their disability. Qualified disabled persons are those who meet the academic and technical standards for each program. These nonacademic skills are essential to successful program completion.
In summary, UNMC policies are in accord with:
Title VI of the Civil Rights Act of 1964
Title IX of the Educational Amendments of 1972
Sections 503 and 504 of the Rehabilitation Act of 1973
Sections 799A and 854 of the Public Health Services Act
Americans with Disabilities Act of 1990
The objective of the University of Nebraska Medical Center is to recruit and retain persons of high moral and ethical character. In accordance with this objective, the University of Nebraska Medical Center reserves the right to review a candidate's suitability for admission.
This is a general information publication. It is not intended to, nor does it, contain all regulations that relate to students or complete descriptions of postdoctoral programs. The provisions of this view book do not constitute a contract, express or implied, between any applicant, student or faculty member of the University of Nebraska Medical Center, the College of Dentistry, or the University of Nebraska system. The University of Nebraska reserves the right to withdraw courses at any time, to change tuition or fees, calendar, curriculum, degree requirements, graduate procedures, and any other requirement affecting students. Stipend support is contingent upon continued availability of federal funds. Changes will become effective whenever the proper authorities so determine.
Attending Staff and Adjunct Faculty
Alan L. Hergenrader, D.D.S., F.A.G.D., F.I.C.O.I., Clinical Instructor-Generalist, Assistant Professor and Director, UNMC General
Practice Residency Program
Timothy M. Durham, D.D.S., M.P.A., Clinical Instructor, Generalist, Professor, Assistant Dean for Patient Services and
William “Randy” Nordstrom, D.D.S., F.A.G.D., Clinical Instructor, Generalist, Staff Dentist, VA Dental Services
Alan F. Hancock, D.D.S., F.A.G.D., F.I.C.D., Clinical Instructor-Generalist, Chief, VA Dental Services,
Taryn M. Chesire, D.D.S., Clinical Instructor, Generalist and VA Residency Director
John “Travis” Kobza, D.D.S., Clinical Instructor, Generalist
Paul Sheridan, D.D.S., Clinical Instructor, Prosthodontics, Staff Prosthodontist, VA Dental Services
Alvin G. Wee, D.D.S., M.S., M.P.H., Clinical Instructor, Prosthodontics, Staff Prosthodontist, VA Dental Services
Jeffrey C. Markt, D.D.S., M.S. Associate Professor, Oral Facial Prosthodontics
Scott Morrison, D.D.S., M.S., Clinical Instructor, Periodontics
Steven Pryor, D.D.S., M.S., Clinical Instructor, Endodontics
Valmont Deza, D.D.S., M.D., Associate Professor and Director Oral and Maxillofacial
Leon F. Davis, D.D.S., M.D., Professor, Oral and Maxillofacial Surgery
Jason B. Untrauer, D.D.S., M.D., Assistant Professor, Oral and Maxillofacial Surgery
John Wewel, D.D.S., M.D., Assistant Professor, Oral and Maxillofacial Surgery
Further information may be obtained by contacting:
Postgraduate Dental Programs
Attn: Ms. Diane Thompson
UNMC College of Dentistry
40th & Holdrege Streets
P. O. Box 830740
Lincoln, NE 68583-0740
Fax: (402) 472-6668
Office of Financial Aid
984265 Nebraska Medical Center
Omaha, NE 68198-4265
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