Program Manual
The University of Michigan
ADVANCED EDUCATION IN GENERAL DENTISTRY
Introduction:
The Advanced Education in General Dentistry (AEGD) program at the University of Michigan was established in 1992. It is a function of the Department of Cariology, Restorative Sciences, and Endodontics. The Advanced Education in General Dentistry Program is accredited by the Commission on Dental Accreditation, a specialized accrediting body recognized by the Council on Postsecondary Accreditation and by the United States Department of Education. The program is a twelve-month commitment of didactic and clinical training.
Program Objectives:
An AEGD program provides advanced training in clinical dentistry and basic sciences and refines skills necessary to provide comprehensive dental care for a diverse patient population. The program is specifically designed to expand the scope of experience and depth of knowledge to enhance a resident's skills in general dental practice. The specific objectives of the University of Michigan AEGD program are to prepare residents to:
1) Act as a primary care provider for individuals and groups of patients.
This includes: providing emergency and multidisciplinary comprehensive oral health care; providing patient focused care that is coordinated by the general practitioner; directing health promotion and disease prevention activities, and using advanced dental treatment modalities. Program emphasis will be on Esthetic Dentistry, Applied Dental Technology, Practice Management principles and strategies, and Community Health Care.
2) Plan and provide multidisciplinary oral health care for a wide variety of patients including patients with special needs.
3) Manage the delivery of oral health care by applying modern concepts of patient and practice management and quality improvement that are responsive to a dynamic health care environment.
4) Function effectively and efficiently in multiple health care environments within interdisciplinary health care teams.
5) Apply scientific principles to learning and oral health care. This includes using critical thinking, evidenced or outcomes-based clinical decision-making, and technology-based information retrieval systems.
6) Utilize the values of professional ethics, lifelong learning, patient centered care, adaptability, and acceptance of cultural diversity in professional practice.
7) Understand the oral health needs of communities and engage in Community Service.
Requirements:
The requirements for successful completion of the program include attendance, participation, and satisfactory completion of didactic requirements, as well as satisfactory clinical performance. This is the expected minimum, however, there are a vast array of opportunities available to the motivated resident. The training received is a direct function of the Resident's desire and motivation to advance their knowledge and clinical skills. The program does not record or report didactic or clinical grades for matriculation purposes. A Certificate of Training is earned upon successful completion of all requirements.
Resident Evaluation:
Residents should expect to receive on-going feedback on their performance during the program. Residents will be formally evaluated three times during the program. The purpose of the evaluations is to assist residents in self-assessment and goal setting to maximize the educational experience. The evaluation will consist of written reports by clinical faculty and faculty supervising rotation assignments. These will be compiled by the Program Director. An individual counseling session will be scheduled with each resident to discuss the evaluation outcomes.
Resident Due Process:
The Bulletin of the University of Michigan School of Dentistry should be reviewed for an explanation of the due process procedures for resolving conflicts and grievances during the program. See attached pages for review.
Stipend:
Each resident will receive a stipend of $35,000 for the 2008-2009 resident year. Based on the Tax Reform Act of 1986, the University of Michigan has no obligation to withhold state or federal taxes. However, the University does report the dollar amount to the federal government for the calendar year. Federal and state tax obligations are the responsibility of the resident.
Residents are registered and credentialed within the School of Dentistry. As such, they enjoy all rights and benefits as students of the University. These benefits include but are not limited to: student rates on tickets, books, etc.; use of University recreational facilities on campus, and use of the University Health Service. Additional information can be obtained through the Department Office. Student identification cards should be picked up during orientation week. Retirement benefits or health care insurance are not offered as part of the stipend package and are the responsibility of the resident.
Educational Loan Deferment:
The AEGD program qualifies as an educational experience that may defer payment of educational loans. This may apply to all monies one has received for undergraduate or predoctoral training. It is the responsibility of each resident to explore opportunities for their own loan deferment. Assistance may be provided through the Student Loan Office of the School of Dentistry.
Time Away from the Program:
Each resident will be allowed 5 days of paid time away from the program during the year. This time will include both vacation and sick time. This is in addition to all federal holidays observed by the school and the vacation over the Christmas holidays. Only 2 vacation days will be allowed during the month of June. All requests for time away must be submitted using the on-line Time Away System available on the University of Michigan School of Dentistry MiTools web site. Patients having appointments will not be rescheduled to accommodate vacations as a matter of policy.
Sick Leave:
If illness or other emergency prevents your attendance, the resident should call the AEGD clinic (734-764-1532) as soon as possible so that arrangements can be made to care for your patients. The Voice Mail System will receive your message outside of clinic hours, if necessary. It is expected that any responsibilities missed will be made up as soon as possible.
Michigan State Dental License:
Residents are required to have graduated from dental school and must have passed the National Board Examination. There is no specific requirement to have a Michigan Dental license to fulfill the clinical responsibilities of the AEGD Program.
Malpractice Insurance:
Malpractice insurance is provided by the School of Dentistry for all responsibilities fulfilled through the AEGD program in all clinical settings. Residents will always work in a setting supervised by the program faculty. The insurance coverage does not extend beyond the responsibilities of the AEGD program.
Employment Outside the Program:
By accepting the twelve-month commitment to the AEGD program, each resident must realize that this is his or her primary professional responsibility. One can expect to spend more than the scheduled clinic and didactic time each week to take full advantage of the educational opportunities the program offers. For this reason, employment outside the AEGD program is discouraged.
Resident Schedules and Attendance:
Each resident will receive a copy of the program schedule with clinical and didactic assignments. The schedule is reviewed and updated on a regular basis, as needed. No deviations in the schedule are allowed without the approval of Dr. Fasbinder, the Program Director. Attendance is mandatory for all clinical and didactic activities. Comprehensive patient care in General Dentistry, Prosthodontics, Periodontics, Oral Surgery, and Endodontics is held on a weekly basis.
Clinic hours are generally 8:15 a.m.- 12:00 p.m. and 1:15 p.m.- 5:00 p.m. Monday through Friday. Residents are expected to be prompt for all scheduled activities, especially patient appointments. When scheduled in the clinic, patient care is considered the primary responsibility. In the event of open clinic time due to patient cancellations, residents are still expected to be in the clinic to treat fill-in or emergency patients. Only in the absence of fill-in patients will the resident be free to use the time constructively. If a resident leaves the clinic, the Clinic Coordinator must know where to reach the resident should the need arise. Residents may be required to attend early morning (7:00 a.m.) or evening seminars (after 5:00 p.m.) as necessary. As a matter of policy, scheduled clinical rotations will take precedence over lectures and seminars.
Treatment Planning Conferences:
Residents and faculty members meet regularly for Treatment Planning Conferences. The aim of the conferences is to develop advanced skills in the management of patients who present with complex dental problems. Diagnosis and treatment planning through a problem-oriented approach is emphasized. Cases are documented with full mouth intraoral photographs, full mouth radiographs, diagnostic casts and appropriate dental record completion.
Didactic Courses:
Residents are scheduled to attend several academic courses in conjunction with other graduate level students within the School of Dentistry. A Periodontics course dealing with surgical and nonsurgical management of periodontal patients is taken in the fall semester. Advanced Operative Dentistry #746 is an in-depth course on esthetic dental materials and techniques also taken in the fall term. Oral Pathology #614 is a clinically-oriented review of Oral pathology which is taken in the winter term. Residents are expected to participate in all required assignments and activities of the courses including examinations.
Clinic Rotations:
Several Clinical Rotations out of the AEGD Clinic have been designed to meet specific training objectives of the program. The Clinical Rotations may be within other clinics at the Dental School as well as sites distant from the school. Each resident is expected to conform to the practices and policies of the clinic hosting the rotation. If need be, each resident is expected to provide their own transportation to and from rotation. A Community Outreach Rotation is scheduled in various community dental clinics around the state of Michigan. Additional rotations may be added to the program as they become available.
Comprehensive training in General Dentistry at the post-doctoral level is comprised of many experiences and varied modalities. Diligent tracking and evaluation of these are imperative to provide the resident with varied and enriching experiences that are challenging but not overwhelming. Scheduled counseling sessions with the resident three times per resident year give the faculty an opportunity to discuss the resident’s progress in the program. Part of the evaluation includes the ability to confirm the resident’s participation in the program including clinical, laboratory, and classroom experiences.
By signing a Resident Briefing Document the resident acknowledges that s/he has participated in all required clinical, laboratory, and classroom experiences that are part of the AEGD program during the evaluation period. These documents will be part of each evaluation session.
Patient Assignment:
Patients are accepted for treatment in the AEGD Clinic with several objectives in mind. The primary goal is to provide residents with patients with complex needs desiring comprehensive dental care. During the first four to six months of the program, the Program Director will screen all patients for assignment to ensure equitable distribution of patients as to variety and quantity. Residents are encouraged to identify specific treatment desires to the Program Director to fill these needs.
For the remainder of the program, residents will also screen patients for acceptance into the program. This provides an opportunity for residents to act as the initial contact for patients into the dental health care system. The resident will then present the case to the Program Director for assignment.
All patients assigned to a resident become part of their “Patient Family.” Each resident is responsible for the dental care of his or her Patient Family for the duration of the program. This ensures that the resident retains the overall responsibility for treatment outcomes. Residents will also be responsible for coordinating referrals, where indicated, for their patients. Cases completed early in the year are expected to be followed in order to complete their maintenance care.
Graduate General Dentistry Clinic:
The clinic is arranged with a centralized concept of storage with standardized instrument trays. All units in the clinic are equipped with fiber optic units for both the high and low speed handpieces. All operatories have cart systems equipped for efficient fourhanded dentistry. This allows for the efficient utilization of resources. Residents are expected to take an active role in maintaining the level of materials and supplies in the clinic by identifying shortages to the assistant as they occur.
Infection Control:
The AEGD Clinic utilizes the infection control policies of the School of Dentistry as outlined in the Infection Control Manual. A copy of the manual is available on the Dental School website and is expected to be reviewed by each resident for strict compliance. You are required to take an online Infection Control Tutorial and pass the online quiz upon your arrival to the program. The website address is: https://intranet.www.dent.umich.edu/clinical_resources/infectioncontrol/facultystaff/section1/.
Professional Appearance and Demeanor:
Residents are expected to conduct themselves with the highest degree of professional integrity, ethics and appearance at all times. The clinic areas in any teaching facility are the places where faculty, residents, staff and patients meet for the combined purposes of patient care and education. A professional appearance reflects certain aspects of the institution's commitment to a respectful, caring, professional attitude by everyone involved in providing excellent patient care. A professional image is a critical factor in a patient's selection of a health care provider. Therefore, it is the responsibility of each resident, faculty and staff member to maintain appropriate dress and a well-groomed personal appearance at all times. A clean clinic coat (School of Dentistry specification) will be worn at all times in the clinic. Each resident is responsible for purchasing his or her own clinic coats. They can be obtained at Dental Stores located in room B310. Clinic coats are not to be worn outside the clinic environment or outdoors. Garments worn under the coat shall not extend below the coat sleeve or over the collar. They will be laundered through the Dental Stores service at no cost to the resident.
Patient Business Office:
This office is located on the first floor of the dental school. The counselors in the Patient Business Office (PBO) will work with patients who have documented treatment plans to maximize insurance benefits, arrange payment plans and schedules, and monitor collection of fees. Residents should work closely with the PBO to monitor the collections from their patients during treatment. A representative from the PBO will meet with the residents during orientation to discuss their function in greater detail.
Patient Fee Schedule:
The AEGD Clinic uses the graduate fee schedule for dental services as published by the School of Dentistry. It is identical to fees charged in any graduate level clinic at the school. A copy will be distributed to each resident.
Telephones:
The AEGD Clinic has several telephones for use in appointing/confirming patients, and other business related to the clinic operations.
Prescriptions
Those residents who have a DEA number and Michigan controlled substance license may sign their own prescriptions if approved by the faculty member. As of May 23, 2007, a National Provider Identifier (NPI) is required for all prescriptions as a latest addition to the HIPAA. In the absence of a DEA number, a faculty member will sign the prescription. It is imperative that the patient's medical history be reviewed prior to prescribing any medication. An entry in the patient record will be made for all medications prescribed listing the medication, dose, amount, instructions for use, cautions, and refills allowed. In all cases of prescribed medications, the faculty will be informed prior to discharge of the patient.
Photographic Support
The AEGD Clinic has a Canon digital camera, retractors, and mouth mirrors for use in documenting casework. Each of the computers in the laboratory is capable of downloading digital images taken with the Canon camera. Each resident will purchase a memory card for the digital camera. Please see the administrative support staff to pay for the card prior to the Digital imaging seminars.
Keys:
Each resident will be issued keys to the AEGD Laboratory for after-hour access. Building access is through the bar code on the resident's M-Card. The Clinic is not to be used after-hours to treat patients. The central suction does not function outside of the usual clinic hours.
Laboratory Space:
Each resident will be given keys to a specific lab bench with overhead storage area assigned in the dental laboratory. It is the resident's responsibility, individually and as a group, to maintain the cleanliness of the laboratory. Each resident will participate in the rotating schedule for cleaning and maintenance of the plaster laboratory as well. Several pieces of equipment (articulator, surveyor, lab handpieces, etc.) will be assigned to each resident for use during the program. Each resident is personally and financially responsible for the return of this equipment at the end of the program. All necessary equipment and supplies are stocked and available for resident use within the dental laboratory. Specific lab instruments (waxing instruments, favorite hand instruments, etc.) are to be stocked by each resident at their expense.
Laboratory Support:
The AEGD program utilizes the services of several external commercial laboratories. Residents will be asked to do laboratory procedures that would provide unique or useful educational experiences or those procedures consistent with what would be expected in a general practice setting. Any services from a commercial laboratory will be requested through completion of a laboratory work order. Dental laboratory account numbers, AEGD program PO number, and laboratory telephone numbers are posted in the lab area. Cases should be turned into the Clinic Coordinator for shipment to the commercial laboratory. Laboratory work orders must be completed for all work submitted and will be cosigned by a faculty member prior to sending the case.
Continuing Dental Education Courses:
The School of Dentistry has a very extensive and diverse Continuing Dental Education program. Residents may attend the vast majority of these courses at a nominal fee, with the exception of clinical courses or those with limited enrollment. Residents are encouraged to review the Continuing Dental Education course book for courses of specific interest. Several courses will be required as part of the AEGD program, but elective courses are available and encouraged. The fees will be paid by the AEGD program for those courses scheduled by the Program Director. Attendance at elective courses must be with the approval of the Program Director and must not conflict with the didactic program schedule.
Professional Memberships:
Many dental associations offer reduced membership fees for residents in a post-graduate training program. Appropriate documentation of your enrollment in the AEGD program can be obtained from the Program Director upon request.
The Academy of General Dentistry will grant a graduate of an AEGD program 250 credit hours of continuing dental education credit towards Fellowship in the society. Residents are encouraged to avail themselves of this opportunity. The American Board of General Dentistry through the Academy of General Dentistry also considers the completion of an AEGD program satisfactory completion of the training requirement towards board certification in General Dentistry. Further information can be obtained from Dr. Fasbinder.
Dental Care for Family Members:
Dental care for immediate family members may be scheduled in the AEGD Clinic in accordance with prevailing graduate level assignment. Fees will be discounted 50% from the graduate level fees upon approval of the Program Director.
Caident Center:
This is the computing center located in the basement of the dental school. During orientation an access code will be distributed to each resident for use of the computers in the Caident Center. The center also is an excellent resource for videotapes and slide series on a wide variety of topics.
Dental Library:
Residents have access to the Health Sciences Library Cluster: Dentistry, Public Health, and Taubman Medical Library. Taubman Medical Library (contains the dental literature) and the Public Health Library are within a 5-10 minute walk of the Dental School.
Residents can search the entire MEDLINE database from 1966 to present using PaperChase Search Service 24 hours a day, 365 days a year with no cost to the end-user. MEDLINE is the electronic version of the Index to Dental Literature and Index Medicaus. Of the 4,000 journal titles indexed in the MEDLINE database, approximately 80% are available in the Health Sciences Library Cluster.
The entire university library catalogue (6.5 million volumes) is on-line and can be accessed by computers in the library or from remote sites. Orientation tours and database search workshops are provided to residents as part of their orientation to the school.
Emergency Dental Care:
Each provider is ultimately responsible for all dental emergency care their patients of record may require while they are part of the Graduate General Dentistry Clinic. In the event that the patient requires emergency dental care, patients should contact their provider. If the patient is unable to contact their provider, the second point of contact is the Graduate General Dentistry Clinic On-Call Doctor. The pager number for the On-Call Doctor will be available on a voice message through a telephone line of the Graduate General Dentistry Clinic. This number will also be made available to program patients of record through their appointment cards. The Doctor On-Call will be changed weekly per a published rotation schedule.
Once contacted by a patient, the Doctor will determine the appropriate care for the patient’s dental problem. If it is determined that the patient should be seen, the Doctor will page the General Practice Resident on-call at the University of Michigan Hospital. Call 936-6267 and ask the operator to page the “hospital dentist on call.” Discuss the patient’s situation with the General Practice Resident, and direct the patient to the hospital dental clinic. The dental clinic is located near the emergency room on level B1. If the General Practice Resident does not respond after adequate time to the page (15 minutes), call 936-6267 and ask them to page the attending, who is the second dentist on-call.
All after-hour calls received by providers in the Graduate General Dentistry Clinic will be documented, including patient information, chief complaint, and disposition, and provided to the Clinic coordinator the next clinic day for review and inclusion in the patient’s dental record.
Patients that are new to the dental school are initially screened in the Patient Admitting and Emergency Service Clinic (PAES) on the first floor. This is also where most of the emergency care is performed during school hours. However, once a patient is seen in the AEGD Clinic, they should not be referred to PAES for emergency treatment. On occasion, residents will be asked to see patients of other providers within the Graduate General Dentistry Clinic as their schedules allow due to cancellations or broken appointments. Residents are obligated to deal with patient emergencies in a compassionate and timely fashion. The treating provider should be informed in a timely manner of the emergency treatment of their patient.
Comments to the Commission on Dental Accreditation
The Advanced Education in General Dentistry Program is accredited by the Commission on Dental Accreditation, a specialized accrediting body recognized by the Council on Postsecondary Accreditation and by the United States Department of Education. A copy of the appropriate accreditation standards and/or the Commission’s policy on third-party comments may be obtained by contacting the Commission at 211 East Chicago Avenue, Chicago, IL, 60611, or by calling 1-800-621-8099, extension 4653.
updated on 2/19/2009
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