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DENTAL ROTATIONS AND DIDACTICS

About the rotation sites:

Cambridge Health Alliance is a nationally recognized, award-winning healthcare system that serves the residents of Cambridge, Somerville and Boston's Metro-North region. It includes the Cambridge Hospital, Somerville Hospital, and Whidden Hospital campuses, more than 12 primary care practice clinics, the Cambridge Public Health Department, the Alliance Foundation for Community Health, and Network Health - a growing Medicaid health plan.

The Alliance is a unique model that incorporates public health, clinical care, academics, and research. As an integrated system, it offers a wide variety of services including medical specialties, surgical specialties, obstetrics, and primary care for all ages. It also offers unique programs for multicultural populations and, through its Harvard-affiliated Department of Psychiatry, is a strong, regional provider of critical mental health services.

Windsor Street Health Center, located in a newer, multi-purpose community center at 119 Windsor Street in Cambridge, is one of Alliance's busiest primary care sites. Health care services provided include adult and pediatric primary care medicine, mental health services, and dentistry. Windsor Street serves as the primary site for provision of outpatient dental care at the Alliance, with seven dental operatories and over 10,000 patient visits per year.

The Harvard Dental Center (HDC) is the clinical site of the GPR program at Harvard School of Dental Medicine. It is located on the first floor at 188 Longwood Avenue in Boston. This facility is also utilized by the postdoctoral programs in endodontics and periodontics and the residents practice side by side with world renowned Harvard faculty. The HDC is a modern facility with 24 dental operatories, a radiology facility, laboratory, sterilization area, reception area and business office.

About the Experience:

Building upon existing residencies for dentists and physicians within Harvard-affiliated hospitals, the didactic and clinical experience of general practice dental and medical residents will be interwoven to provide adjunctive training and experience in the provision of limited primary preventive care as oral physicians in addition to responsibilities for dental care.

The GPR curriculum at Cambridge Health Alliance has rotations in Medicine, Emergency Medicine, Anesthesia, OMFS and pediatric dentistry which afford the residents the opportunity to interact with physician residents in providing limited primary care are oral physicians and will also familiarize the medical residents with knowledge and experience about the reciprocal relationship between orofacial and systemic illness. The impact of this program is evaluated for effectiveness, knowledge and attitudes of faculty, staff, residents and patients.

Rotation Descriptions:

Anesthesia: This is a three week, full time assignment to the Department of Anesthesiology. Residents participate in the administration of general anesthesia to inpatients and ambulatory surgery patients under direction of a staff anesthesiologist. The rotation is supervised by Dr. James Quinn, Chief of Anthesiology at Cambridge Health Alliance, and a Clinical Instructor in Anaesthesia at Harvard Medical School.

Primary Care Medicine: This is a three week, full time assignment to the Department of Medicine to observe and participate in the management of non-dental patients from admission to discharge in accordance with ambulatory care and hospital protocols. The rotation is supervised by faculty of the CHA Department of Medicine.

Emergency Medicine: This is a one week, full time assignment to one of the thre CHA emergency rooms with duties to be assigned by the designated emergency room physician.

Oral Physician: Consists of didactics, case conference and supervised clinical experience at CHA and Harvard affiliated sites including: 1. Case studies to integrate medical, dental and social history with vital signs and physical examination information; 2. Individually monitored exercise in the use and interpretation of electronic patient records; 3. Oral manifestations of local and systemically administered drugs; 4. Pathophysiology and management of the orofacial implications of systemic disease and interventions such as dialysis, radiation and chemotherapy;
5. Medical grand rounds; 6. Medical and dental care of two or more members of one family; and 7. Discussion on cultural sensitivity for staff, clinicians and patient care.

Patient Care Activities:

Clinical Dental Services: Residents are responsible for the comprehensive and emergency dental care of patients at both the Windsor Street Health Center (a total of 21 weeks) and the Harvard Dental Center (a total of 17 or 18 weeks) interspersed throughout the year. They are supervised by full-time and voluntary part-time dental staff, both general dentists and specialists, all of whom are faculty of Harvard. The clinical schedules are typically from 8:30am to Noon and from 1:00pm to 5:00pm at HSDM and 8:30am to 12:15pm and 1:15pm to 5:00pm (with some early evening and Saturday hours interspersed) at the Windsor Clinic.

Oral & Maxillofacial Surgery: Each resident is assigned to OMFS rotation for four weeks (24 hrs per week). The residents participate in oral surgery dental care in the ambulatory clinic and shadowing oral surgeons in their private offices.

Pediatric Dentistry: Each resident is assigned to this rotation for four weeks (24 hrs per week) under the supervision of Dr. David Okuji either at the Windsor Dental clinic (regular hours and Saturday Clinic) or in the hospital OR.

After Hours On-call Duty: Each resident is required to perform emergency first call duties for the Cambridge Health Alliance hospitals and the Harvard Dental Center on a rotational basis. Program faculty members provide second call service on a rotational basis as well.

Didactic Program:

GPR Seminars are held throughout the year. Topics span all the various medical/dental and public health disciplines including literature review and case presentation. Some are arranged specifically for the residents and some are ongoing presentations in which the residents participate. The seminar schedule is coordinated by Dr. John A. Zdanowicz, Director, General Practice Residency Program, Instructor in Restorative Dentistry and Biomaterials Sciences at Harvard.