The Oral and Maxillofacial Surgery Residency Program

David J. Dattilo, D.D.S. , Program Director

Length of program: 6 years integrated M.D. and certificate
Number of position(s): 12 (2 at each level)

Prerequisites:

• Candidate must have Dental Degree from a United States and/or Canadian Dental school.
• Foreign graduate must have at least spent their third and fourth years of Dental School in the United States and/or Canadian ADA accredited school or currently have a Pennsylvania Dental License.*
• National Board Exam Part I

* State Board of Dentistry, 33.102, Pennsylvania Code.

The six-year Oral and Maxillofacial Surgery Residency Program is an accredited, advanced dental specialty program designed to prepare residents for practice and consultation in oral and maxillofacial surgery (OMFS), possible subspecialty training and academic leadership within the specialty.

This intensive M.D./OMFS program integrates two years of medical school, two years of general surgery or anesthesiology and three years of clinical/didactic oral and maxillofacial surgery training into a single, six-year program whereby successful graduates:

• Obtain a medical degree
• Complete a two-year residency in general surgery or anesthesiology
• Receive certification as a specialist in oral and maxillofacial surgery
• Become eligible to take the American Board of Oral and Maxillofacial Surgery examination

The OMFS training portion of the program consists of one internship year, four months of OMFS clerkship rotations during medical school, eight months of OMFS rotations during general surgery or anesthesiology and a chief resident year. Through 100 didactic lectures, 6,000 outpatient visits and 350 inpatient surgical cases annually, a teaching staff of one full-time and eight part-time faculty prepares residents to:

• Interact well with peers and colleagues in dentistry, medicine and surgery
• Practice the full scope of the OMFS specialty with a broad-based world view of the health sciences
• Provide holistic care and maintain compassionate and ethical relationships with patients, peers and support staff
• Identify diseases/disorders not generally in the immediate scope of their expertise and make appropriate referrals
• Teach effectively and become members of teaching faculties
• Obtain American Board of Oral and Maxillofacial Surgery certification

Scope of Training

The Division of Oral and Maxillofacial Surgery provides training in the full scope of the specialty, with special emphasis in facial trauma, facial aesthetic and reconstructive surgery, orthognathic sur-gery, temporomandibular joint surgery, preprosthetic surgery and implantology. The division has successfully implemented and developed new techniques in laser surgery, transmandibular implantation and bone grafting.

In addition to didactic and clinical training, residents learn how to function within a dynamic tertiary-care, Regional Resource (Level I) Trauma Center. Responsibilities increase to match the residents' level of training, and by program completion, residents are fully competent to perform medi-cal histories and physicals, place physician's orders and consultations, develop pre- and postoperative reports, maintain charts, dictate operative reports, coordinate care with other specialists, present at conferences, write patient correspondence and address many insurance issues.

Didactic Training
OMFS residents receive comprehensive didactic training through a series of conferences. In addition, residents are provided a stipend for the purchase of books, have access to the division's library and frequently are asked to research literature for topics as they relate to current cases or contemporary issues. Senior and advanced junior residents are strongly encouraged to develop and present lectures in-house and throughout the community.

Clinical Training
OMFS clinical training consists of ambulatory dentoalveolar patient treatment, trauma call coverage, inpatient floor coverage and assisting attending physicians in the operating room. Responsibilities are assigned according to level of training.

Except for the intern (PGY-1) and chief (PGY-6) years, rotations on the OMFS service may be either a medical school clerkship, general surgery rotation or a couple weeks between terms while in medical school. In all cases, OMFS residents are expected to continue participation at the appropriate level.

Extracurricular Courses
OMFS residents at Allegheny General Hospital are provided numerous educational opportunities outside the basic curriculum of the program. Through the Office of Graduate Medical Education and through the program's own endowment, residents are provided financial support for course registration fees and travel expenses.

Special courses offered by Continuing Medical Education and other services provide residents additional training in a variety of areas:

• Laser surgery
• Cadaveric dissection
• Sleep Disorders

Beyond the first year, residents are permitted one elective course requiring travel to another city. During the chief residency year, the program funds one of the following additional courses/rotations:

• Cosmetic rotation
• Cleft lip/plate rotation

In most cases, the program also funds travel expenses necessary for residents to attend conferences at which their submitted abstracts or posters have been accepted for presentation.

Program Overview

Oral and maxillofacial surgery, as defined by the American Association of Oral and Maxillofacial Surgery, is the specialty of dentistry that includes the diagnosis and surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial regions. It is the goal of the Division of Oral and Maxillofacial Surgery to provide the best possible learning environment, resources, instruction and clinical exposure wherein residents may develop the broad knowledge base and clinical expertise needed to practice the full scope of the OMFS specialty.

As an M.D./OMFS integrated program, medical school provides the basic science and medical knowledge base, the general surgery or anesthesiology service provides training in the total management of surgical patients, and the OMFS service provides training in the oral and maxillofacial surgical specialty. Elective clerkships during medical school, coupled with rotations during general surgery, meet the program's requirements in anesthesiology, head and neck surgery, and plastic surgery. Special courses provide additional training in cosmetic facial surgery, microsurgery and cleft lips/cleft palates.

The first year of the Oral and Maxillofacial Surgery Residency is the internship year. PGY-1 residents examine and treat patients in the outpatient clinic, maintain the in-house patient census, rotate on the call schedule 10 to 12 days monthly and assist/observe in the operating room when assigned. Medical school training also begins during the first year with the Introduction to Clinical Medicine course, which helps prepare residents for Step I of the U.S. Medical Licensing Examination (USMLE) and advanced standing admission to medical school. During March, April and May, trauma call and clinic duties are reduced significantly to allow residents time to study for the USMLE.

PGY-2
Having been accepted with advanced standing to the Drexel University College of Medicine, OMFS residents begin third-year medical clerkships during PGY-2. Continuation as a medical student depends on successful completion of the USMLE Step I. Failure of USMLE Step I results in removal from clerkships pending re-examination in October.

PGY-3
PGY-3 is the last year of medical school and consists of 13 senior medical clerkships, including clerkships in oral and maxillofacial surgery and anesthesiology needed to meet the requirements of the Oral and Maxillofacial Surgery Residency Program. Residents receive their medical degrees and take USMLE Step II at the end of this year.

PGY-4
Residents spend PGY-4 in the General Surgery or Anesthesiology Residency Program at Allegheny General Hospital as PGY-1 staff members. This is not merely a rotation, as residents are officially part of the General Surgery or Anesthesiology service. At the end of this year, USMLE Step III is taken.

PGY-5
Residents spend PGY-5 as PGY-2 staff members of the General Surgery or Anesthesiology Residency Program. A total of eight rotation months must be oral and maxillofacial surgery during this year.

PGY-6
The final year is chief resident year, with two residents sharing in chief responsibilities. The chief residents have significant responsibility for managing patients, covering the outpatient clinic and assisting in the training of junior residents. Completion of research and publication of a paper are expected during this year, and participation in additional subspecialty training courses is available to residents demonstrating interest and accomplishment.

Clinical Facilities

The Dental and Oral Surgery Center consists of a 7,561-square-foot physical plant, including a reception/waiting room, patient charts and billing area, an administrative suite, clinical space with 15 operatories, a limited prosthodontics laboratory and rooms for instrument preparation, X-rays, film developing and storage. The Dental and Oral Surgery Center was designed with an open bay concept wherein all operatories are equipped for four-handed general dentistry with mobile ADEC units, and three chairs have been specifically designated for the Oral Surgery Clinic.

Radiographic imaging capability consists of seven Belmont Combex DX 907 periapical machines located within the treatment areas and a separate imaging room with a Gentex Ortho Ralix 9000 Panorex and Cephalograph machine.



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