Advanced Education in General Dentistry

24 Months (AEGD-2) Program

Introduction

The Advanced Education in General Dentistry 24 Months (AEGD-2) at Dental Health Activity-Hawaii (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.

Schofield Barracks, Fort Shafter, 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 25th Infantry Division, nicknamed “Tropic Lightning”. Schofield Barracks Dental Clinic is the home base for the AEGD-2 program where most of the training is conducted. Twenty miles away on Moanalua Ridge is Ft. Shafter and Tripler Army Medical Center. Tripler’s highly visible pink walls are a familiar landmark to Honolulu residents. The hospital oral surgery rotations take place at Tripler Oral Surgery Clinic. The pediatric dentistry rotations take place at both Fort Shafter (Bhaskar Dental Clinic) and Tripler.

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, Suite 1900, Chicago, IL 60611.

Program Philosophy

The AEGD-2 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 presenting a lecture and presenting a completed research project.  

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. b. 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.  

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.

Bhaskar Dental Clinic – a 17-chair facility. Training held here includes Pediatric Dentistry.

Tripler Oral Surgery Clinic – is a 6-chair hospital dental clinic. Training held here includes hospital Oral Surgery.

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 JCAHO 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 database searches. Interlibrary loan services are available for material not owned by Tripler Army Medical Center.  

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 program. Each resident is assigned a laptop computer with internet access. DENTAC-Hawaii is part of the Tripler Army Medical Center LAN with share capability, MS Outlook for e-mail communication, and a computerized patient appointment system, Corporate Dental System (CDS) to mention only a few features. There is an AEGD-2 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, 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 Tripler Army Medical Center/DENTAC-Hawaii 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.  
Didactic Assignments:

Treatment Planning Conference - One presentation per resident per training year. One resident will present a patient’s diagnostic data and problem list, then discuss the sequenced treatment plan 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 during orientation. The course includes lectures, demonstrations, and supervised patient treatment.

BLS Training – 8 hours for certification or 4 hours for recertification.
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.

General Policies
Resident Advisor: The Director of the AEGD-2 Program will serve as the resident advisor. The Director will meet with all of the residents monthly. The purpose of the meeting is for the dissemination of information, policy and schedule changes, etc. Residents with questions or problems of a personal nature may see the Director on an individual basis.
Activities Calendar: The activities calendar is located on the share drive and is kept up to date by the Program Director. It contains specific information including lectures, consultant visits, treatment planning conferences, and special events. It also contains information on DENTAC-Hawaii activities that all residents are expected to attend, but are not directly related to the residency. These include Commander’s Calls and Leader Professional Development meetings.

Physical Training: Physical fitness and weight control has an increased emphasis in today’s Army. A notation of performance on the Army Physical Fitness Test and conformation to the Army height and weight control standards is mandatory on all Officers Evaluation Reports. Physical fitness is the Soldier’s personal responsibility. Officer residents are required to pass two physical fitness tests during each training year.

Authorized Absences: Residents may be granted 14 days of ordinary leave to be taken during the Christmas holiday period and 14 days during the last two weeks of June. With rare exception, passes and leave will not be routinely granted during the training year. Leave requests will be submitted to the Program Director. Final approval will depend upon several factors, including the residents’ performance during the training program, research paper progress, and duty commitments.

Civilian Employment: Due to the demanding academic and clinical curriculum, residents are not allowed to practice outside the military work place.