Advanced Education General Dentistry Program
United States Army Dental Activity, Hawaii

Introduction

The Advanced Education General Dentistry Program (AEGD/2yr) at DENTAC-Hawaii is a two-year training program providing professional education at the post doctorate level.  It encompasses supervised training and clinical experience in all major specialty areas of dental practice.  It is designed to train competent, productive, efficient clinicians that are able to skillfully and confidently manage patients requiring complex multi-disciplinary treatment.  Of equal importance is the objective of training residents to be well-rounded, outstanding officers in the United States Army.

The program emphasizes a practical approach in both clinical and didactic training.  The resident is provided with considerable experience and close guidance from a faculty of board certified, highly trained specialists.  Residents are chosen from among the most outstanding dental graduates in the nation.  They are expected to demonstrate the interest and enthusiasm necessary to derive maximum benefit from the program.  Participating in the program represents an exceptional opportunity for the recent graduate to develop both as a dentist and as an Army Officer.

“Aloha!”  Scattered across 250 miles of the Pacific, Hawaii’s eight major islands are home to some 1.1 million people – including about 130,000 military personnel and their dependents. Hawaii is most assuredly a tropical paradise.  It has beautiful beaches, spectacular mountains and sunsets, great weather, active volcanoes, jungles, gushing waterfalls, rain forests, expansive canyons, tropical gardens and flowers blooming all year around to mention just a few of its natural features. There is so much to do in the way of recreational opportunities: swimming, surfing, scuba diving and snorkeling, bicycling, hiking, fishing, camping, hunting, sailboats and sailplanes, and great golfing.

Schofield Barracks and Tripler Army Medical Center are located on the island of Oahu, “the Gathering Place.”  At the foot of the Waianae mountain range in central Oahu is Schofield Barracks – the largest Army base on the island and home of the 25^th Infantry Division, nicknamed “Tropic Lightning”.   Schofield Barracks Dental Clinic is the home base for the AGD/1yr program where most of the training is conducted.  Twenty miles away on Moanalua Ridge near Ft. Shafter is Tripler Army Medical Center.  Its highly visible pink walls are a familiar landmark to Honolulu residents.  The hospital oral surgery, pediatric dentistry, and orthodontic rotations take place at Tripler Dental Clinic.

The program in advanced general dentistry is accredited by the Commission on Dental Accreditation (and has been granted the accreditation status of “approval without reporting requirements”).  The Commission is a specialized accrediting body recognized by the United States Department of Education.  The Commission on Dental Accreditation can be contacted at (312) 440-4653 or at 211 East Chicago Avenue, Chicago, IL 60611.

Program Philosophy

The AEGD/2yr Program is a comprehensive learning experience involving training in all disciplines of dental practice.  It is predominately clinically oriented but includes a didactic component of approximately 20 percent.

The clinical phase of the program stresses comprehensive care facilitated by continuous simultaneous rotations through all of the specialties of dentistry.  It is designed to emphasize the basic general dentistry concepts of total patient treatment and continuity of care.  Residents are expected to provide total dental treatment within their capabilities, and to coordinate referrals to the appropriate specialist when indicated.

Patient screening, selection and assignment are directed toward providing the resident with patients requiring a broad range of dental treatment.  Isolated, independent rotations have been avoided wherever possible. Mentors have been given sufficient flexibility to enable the resident to schedule patients from other services during their specialty rotation, allowing continuity of care.

The didactic component is an important aspect of the program providing each resident with a broad academic background from which sound clinical judgments can be made regarding diagnosis, treatment planning, and the selection of appropriate treatment methods for the patient. The didactic phase is scheduled on a regular basis and includes lectures, seminars, literature reviews, treatment planning conferences, and special projects.  The special projects include writing an original case or literature review paper, preparation of a table clinic, and presenting a lecture.  

Program Goals and Objectives

  The program provides advanced training in clinical dentistry and in the application of basic sciences to clinical dentistry.  It is designed to provide graduated dentists with the opportunity to enhance their skills in the various disciplines comprising general dentistry.   Its objective is the development of the skill and confidence required:

1. To increase the resident’s competence and confidence in the various clinical disciplines which are integral components of the general practice of dentistry so they can evaluate, diagnose, plan and coordinate comprehensive treatment for a wide variety of patients.

2. To enhance the resident’s ability to make judgments in examination, diagnosis, treatment planning and decision-making during the course of patient treatment, and in assessing post treatment outcomes.

3. To improve the resident’s ability to interact with all health care practitioners in providing for the patients’ total health care needs.

4. To enhance the resident’s understanding of, and experience in, the efficient delivery of quality dentistry so they may effectively manage a modern practice to include: supervision and utilization of auxiliaries, development of practice productivity, and understanding of efficient scheduling concepts.

5. To increase the resident’s interest and appreciation for dental literature and to develop a commitment to continuing dental education. 

Expectations of Graduates

1.  

   Serve as the dentist of first contact with the patient and provide a means of entry into the oral heath care system.

2. Evaluate the patients’ total oral health needs, provide professional general dental care and refer the patient, when indicated, to appropriate specialists while preserving the continuity of care.

3. Develop responsibility for the patients’ comprehensive and continuous oral heath care and when needed, act as the coordinator for the patients’ total oral heath care.

4. Serve effectively as an Army Dental Officer in any duty position to which he or she may be assigned.  

"Inaugural DENTAC-HAWAII graduating class, 1999-2000

Left to Right: CPT Sanitago, CPT Chitnis, CPT Norkiewicz, CPT Wuerch, CPT Tricker

DENTAC-HAWAII graduating class, 2000-2001

Left to Right: COL Malone (Director), CPT Archibald, CPT  Crisler  , CPT Baus, CPT Cunningham, CPT Jepson, and        LTC Sundberg (Asst. Director)

CPT Jo, Clancy and Hall of 2001-2002 Class - Learning

Facilities

The program facilities includes the following :

Schofield Barracks Dental Clinic - is a 48-chair facility.  Training held here includes outpatient oral surgery, Periodontics, Endodontics, fixed and removable Prosthodontics, team dentistry, and comprehensive general dentistry.  Also housed here are a dental laboratory, resident’s room, and the administrative offices for the program.

Tripler Dental Clinic – is a 19-chair hospital dental clinic.  AGD/1yr training held here includes hospital oral surgery, orthodontics, and pediatric dentistry.

Library - The Medical Library at Tripler Army Medical Center normal hours of operation are from 8:00 a.m. to 4:30 p.m., Monday through Friday.  Residents have 24-hour access using their identification badges to the Medical Library.  The Medical Library is accredited by JACHO and has a staff of 2 medical librarians, both with Masters Degrees in Library Science, and 2 library technicians.  In addition to dental textbooks and journals, the medical library has 8 computer stations for access to the Internet for MEDLINE and other databases searches.  Interlibrary loan services are available for material not owned by TAMC.  

A small reference library has been set up in the residents’ room at Schofield Barracks Dental Clinic.  It includes the latest versions of textbooks in each specialty area, other textbooks, CD-ROMs, and training videos.

Information Management – DENTAC-Hawaii is on the cutting edge of utilizing computers in many aspects of its operations.  They are an integral part of the AEGD-2 Year program.  Each resident is assigned a laptop computer with Internet access.  DENTAC-Hawaii is part of the TAMC LAN with share capability, MS Outlook for e-mail communication, and a computerized patient appointment system, Corporate Dental Application (CDA) to mention only a few features.  There is an AEGD resident/mentor site on the LAN server where information such as current resident training calendars, resident forms, resident project formats, and recent Power Point lectures can be readily accessed.  There are digital cameras, scanners, slide scanners, and LCD projection for lecture and case preparations.  During orientation the residents will have training on computer utilization, software, digital photography, and logon procedures for logging on to the TAMC/DENTAC computer network.

Photography - Clinical photography is an essential and integral component of any postgraduate training program in dentistry.  Photographic documentation of patient treatment during the residency becomes an invaluable record of the resident’s educational experience and a very useful future reference source.  More importantly, the photographic slide is perhaps the most effective audiovisual aid available for patient education, teaching, and communication with colleagues.  

Clinical digital photographs are utilized as part of each resident’s Treatment Planning presentation.   Throughout the training year residents are encouraged to employ clinical photography as part of their learning experience.  Workshops in digital photography are conducted during orientation. 

Curriculum

Clinical Assignments:

Patients who present with problems requiring treatment in several disciplines are identified at examination.  These patients are assigned so each resident will encounter problems of increasing complexity as they progress through their training.  Patients are carefully screened and assigned to ensure that each resident receives an appropriate variety of clinical experiences.  Records of each resident’s clinical activities are maintained and evaluated monthly to assure that the desired quality and mix of patients are maintained.

Comprehensive care is one of the major objectives of the program.  Residents spend time throughout the course of the program providing comprehensive care.  This extends from the treatment planning phase through completion of patient care.  All comprehensive care is accomplished under the supervision of graduates of a two-year advanced training program in general dentistry.  The balance of each resident’s clinical time is spent under the supervision of specialists, and as much as possible, under the resident’s planned comprehensive care.  

Residents are assigned to a specific dental team with other staff dentist.  These dental teams are part of the Army’s Dental Care Optimization (DCO) to provide continuity of care by empanelling a specific group of patients per team.  The DCO concept also provides residents the opportunity to effectively manage a modern dental practice through utilization of auxiliaries, and through the development of practice productivity. 

Didactic Assignments:

Treatment Planning Boards - One presentation per resident.  One resident will present a patient’s diagnostic data and problem list, then the other residents will prepare a sequenced treatment plan.  The presenting resident will then discussed the sequenced treatment plan prepared with input from the Director, Assistant Director, and other appropriate mentors. Discussion of treatment plan rationale between residents and mentors will follow.

Patient Care Conferences – held throughout the year.  Residents present interesting cases or procedures encountered.  Progress with treatment planning patients is also discussed.

Literature Reviews - held throughout the year.  The supervising mentor assigns articles, which each resident must be prepared to discuss at the literature review meeting.  Supervising mentors are assigned on a rotation basis.

Journal Clubs - held throughout the year.  Each resident will be assigned to read and present a review of articles from a current dental journal.

Specialty Seminars - presented in block lectures during orientation month and throughout the year.

Nitrous Oxide/Conscious Sedation Training – formal 3-day course in conscious sedation held in the spring. The course includes lectures, demonstrations, and supervised patient treatment.

BLS Training – 8 hours for certification or 4 hours for recertification, during orientation.

ACLS Training – Formal two-day course for certification held towards the end of the academic year.

Consultant Visits – held throughout the year.  Guest specialty consultants present lectures not only to residents, but also to the entire DENTAC.

Teaching Staff

Primary Mentors

Additional Teaching Staff  

To contact the Program in Hawaii:

Ms Raquel M. Ericksen
Secretary, Advanced Education in General Dentistry Program
Ph. (808)433-8947/8908
E-Mail: raquel.eficksen@amedd.army.mil
or

COL Mark E. McClary
Director, Advanced Education in General Dentistry Program
Ph. (808)433-8946/8947
E-mail: mark.mcclary@haw.tamc.amedd.army.mil

For further information about the Pacific Regional Dental Activity and DENTAC Hawaii, click this link:

www.tamc.amedd.army.mil/offices/prdc/prdc.html