The Oral and Maxillofacial Surgery (OMS) Residency Training Program, offered by the US Army Dental Activity (DENTAC), Fort Gordon, Georgia, is a four-year advanced education program leading to specialty certification in OMS for selected US Army Dental Corps officers. Upon successful completion of training, a resident will be awarded a certificate of completion and the skill identifier 63N9C by the Office of The Surgeon General of the US Army. The program is fully accredited by the Council on Accreditation of the American Dental Association and its graduates are recognized as qualified to take the examination of the American Board of Oral and Maxillofacial Surgery..
Purpose of the Program:
The purpose of this program is to train selected dental officers in all aspects of OMS. The resident will learn the background sciences and develop the clinical experience necessary to select those techniques which meet the biological, physiological, and mechanical requirements for oral rehabilitation. The clinical aspect will require attention to detail, precision, and perfection of various techniques. The interrelation of other clinical specialties with OMS is also emphasized. The didactic phase will be presented through formal courses, staff lectures, consultant visits, hospital conferences, library research, literature reviews and seminars.
Period of Training:
The period of training is four years and will consist of a minimum of 48 weeks each year.
The program will be supervised by the Dental Education Committee. The committee is composed of the Director of Graduate Dental Education, Fort Gordon and Program Directors for other clinical specialties. The OMS Residents will be under the direct supervision and guidance of the Program Director and the Assistant Program Directors. Resident progress is reported monthly to the Dental Education Committee. A formal written report is submitted quarterly to US Army Dental Command. Close communication between resident and mentor will ensure training progress. A weekly resident/mentor conference is scheduled for this purpose.
Scope of Training:
The formal biomedical science program of instruction is supplemented by other less formal means of instruction during the four year program. This serves to broaden the OMS resident's knowledge and to provide a practical end or clinical approach to much of the fundamental knowledge which has already or will be acquired. The resident attends and participates in regularly scheduled staff teaching conferences, lectures, seminars, specialty teaching conferences, literature reviews and other formal teaching sessions specified in the training schedule. Instruction periods are conducted in anesthesiology, surgical anatomy, general and oral pathology, pharmacology, physiology, microbiology, physical diagnosis, diagnostic clinical laboratory procedures, and the conduct of research. Portions of this training are in cooperation with the medical staff. Supplemental instruction afforded by professional training in other departments of the hospital is scheduled with planned programs or resident duties.- responsibilities and time, designed to reach a well-defined objective. The logical coordination of the oral and maxillofacial surgical treatment with other dental and medical treatment programs, consistent with optimum treatment and care to the patient, is emphasized. The clinical application of basic sciences is included in the format of lectures, seminars, discussion periods, clinical conferences and teaching sessions conducted by the OMS staff and by other members of the hospital staff. Maximum resident participation in the presentation of formalized discussion and lectures is emphasized.
The OMS Residency Training Program conducted is composed of combined clinical and hospital experiences, closely integrated with an intensive study of the biomedical sciences. Instruction, training and experience provided include:
Orientation and Introduction of Graduate Oral Surgery
Pharmacology and Biochemistry
Physical Diagnosis and Examination
Clinical Laboratory Procedures
Otolaryngology/Head and Neck Oncology
Trauma Rotation/Augusta State Medical Prison and UT Health Sciences
Emergency Room Services
Diagnosis and Treatment Planning
Research and Independent Study with the Department of Clinical Investigations
Teaching Lectures, Conferences and Seminars
Seventeen of the 48 months of training are devoted to off-service rotations. The first year resident begins with an introduction and initiation to the OMS inpatient and outpatient services. Skills in exodontia, local anesthesia and IV sedation techniques are monitored and expanded. The resident is introduced to exodontia techniques under outpatient general anesthesia, as well as, major operating room procedures. Surgical assisting and performance of individual procedures are emphasized according to the resident's skill level and past experiences. Hospital admissions and charting procedures are introduced and the resident works closely with the chief resident as he or she prepares to rotate off-service. Physical findings and examination procedures are emphasized through lectures and conferences, as well as with direct patient demonstrations. The principles of trauma assessment and care are reviewed and, during July through October, the resident gains primary experience in OMS trauma treatment through weekly rotations to the Augusta State Medical Prison under the guidance of Augusta University OMS staff. In addition, the resident begins to function on call with the chief resident and alone with the chief resident as his immediate backup. Starting in the fall, one month rotations in Cardiology followed by 2 months on internal medicine wards allow the resident to hone their primary skills in physical diagnosis and the essentials of disease treatment and management. The resident then begins a 5 month rotation on the Anesthesia Service. During the rotation necessary skills are gained to evaluate preoperative patients and, while under direct supervision, numerous general anesthesia techniques are performed. Physiology, pharmacology and physical diagnosis are reviewed and the resident is prepared to safely deliver general anesthesia. The year concludes with a one month rotation on the Intensive Care Unit, bringing together aspects of Medicine and Anesthesia.
After an initial one month rotation in Pediatric Anesthesia at the Augusta University Children's Medical Center, the second year resident is devoted primarily to surgical rotations. This block of instruction includes a two month rotation on the General Surgery Service and one months on the Neurosurgery service. Here the resident is expected to gain experience with pre and post-operative care, fluid and nutritional requirements, insertion of central lines, chest tubes, etc., and basic surgical techniques. The resident then returns to OMS for the remainder of PGY2. One half day per week is devoted to craniofacial trauma management at the Augusta State Medical prison, and one half day toward finalization of a resident research project. During this time, patients are admitted to the OMS Service, physical exams are performed, and sedation and general anesthetics techniques are used for minor and major surgical procedures. An intense anatomy review is completed and the didactic schedule is weighted toward general pathophysiology, microbiology, pharmacology and oral pathology.
During PGY3, the resident completes their first 2 month trauma cycle to East Texas Medical Center/University of Texas Health Sciences in Tyler, TX. The resident returns to service for the winter months, and competes rotations in Head and Neck oncology with the Georgia Cancer Center and Augusta University Department of Otolaryngology, a 2 month rotation with the DDEAMC Department of Otolaryngology, and one month with Plastic Surgery. The resident then returns to the OMS Service, DDEAMC for the remainder of his or her training. The didactic schedule is geared toward a review of physiology, pharmacology, and a continuation of oral pathology. In June the third year resident assumes the duties and responsibilities of "Chief Resident."
The new Chief Resident assumes responsibility for the inpatient OMS Service, answers consultations from other services, is the primary surgeon of record for the majority of operating room cases, and actively participates in the training and teaching of the first, second, and third year residents. The fourth year resident must submit a scientific paper for publication based on clinical research or case reports and literature review. Diagnostic abilities, treatment planning, and surgical skills are honed during the last year. The resident will complete two months of trauma in the winter at East Texas Medical Center/University of Texas Health Sciences in Tyler, TX.
Lectures and Conferences:
Teaching conferences, seminars and literature reviews and guest speakers are programmed on a weekly basis and are made through the contribution of the OMS teaching staff and guest medical specialists. Resident participation is emphasized. Conferences are used to reinforce the physical diagnosis, physiology and pharmacology arms of the program. Oral pathology is integrated through interaction with the staff associated oral pathologist and the presentation of clinical-pathologic conferences. The residents attend a nationally renowned Pathology and Reconstruction review course in PGY3, and a OMS review course in PGY4. In PGY2, head and neck regional anatomy is studied through participation in a formalized dissection course taught by an anatomist at Fort Bliss, TX. Additional experience is gained through operating table during rotations with the OMS Service, General Surgery, Neurosurgery, Anesthesia and Head and Neck/ENT rotations.
The resident must prepare a paper suitable for publication as part of the requirements for graduation from the OMS Residency Training Program. The paper may be the result of a research project, clinical investigation or case presentation. As the resident enters his second year, a topic must be formally submitted for approval and necessary protocols are submitted through the Clinical Investigation Service, when appropriate. Due to re-writes and possible submission for publication, the project must be completed three months prior to residency completion. Deadlines for submission of a topic, a bibliography and first and second drafts will be delineated on a yearly basis. The Approving authority for the paper is the Program Director. If the project involves human use, the DDEAMC Clinical Investigation committee approval and assistance must be obtained. The goal of the paper is to develop an objective view of published scientific literature and develop knowledge and experience in submitting a paper for publication.
The resident is introduced to the library in the first month of training and regular assignments are made to aid in developing the resident's ability to critically read and evaluate professional literature. Literature reviews (Journal Club) are conducted throughout the four year program. The objectives of the literature review are to provide a means for group study of current professional literature, to amplify the knowledge of current concepts and practices of oral surgery and related medical fields, to stimulate interest in the study of scientific literature and to provide experience in critically evaluating the material read. The club regularly reviews multiple medical and dental publications.
Resident Teaching Responsibilities:
Graduated degrees of teaching responsibility are assigned to the OMS residents. The fourth year resident directly participates in the orientation and teaching of the first year resident during the initial two month OMS Service orientation. The first year resident responds to emergency calls with the fourth year resident for an established period of time prior to being allowed to respond independently. The fourth year resident is then responsible to act as a backup to the first year resident to insure proper patient management. The fourth year resident also participates in the supervision and teaching of the second and third year residents when they are on the oral surgery call roster. Teaching responsibilities are assigned in a balanced relationship with other activities and are maintained within the sphere of the fourth year resident's capabilities and surgical experience. .
Emergency Duty Roster:
Assignment to the emergency duty roster is integrated into all four years of the program. The on-call resident may be called for emergency consultation by the Dental Officer of the Day or by Emergency Room personnel. The on-call resident is called by the Emergency Room in all appropriate cases of head, neck, face and oral trauma and participates in the initial diagnosis, treatment and management of the traumatized patient. Experience is gained in a team concept of head and neck trauma and the resident works closely with representatives of the ENT Service. A trauma team concept agreement is enforced within this institution and guarantees primary experience in all phases of facial trauma.
Changes in the teaching schedule and program course of rotation will be made with the approval of the Dental Education Committee, as per those mandates of the Essentials of Training for Advanced Programs in OMS provided by the Council on Dental Education of the American Dental Association. Questions relating to this program may be addressed to: Commander, USA DENTAC, ATTN: Director, OMS Residency Program, Fort Gordon, Georgia 30905-5660.