Statement of Intent

This program intensively trains general dentists to understand and competently manage very difficult medically, mentally, emotionally and physically compromised adult and child patients utilizing the resources and facilities of a hospital. Advanced training is provided in all areas of dentistry to augment the skills acquired during predoctoral education.


Program Objectives


Structure of the Program

This is a 12-month rotating residency in general dentistry. Eight first-year (R1) residents are accepted. Our program serves four area hospitals and one community clinic (outlined below) with one or two residents in each location. The University of Washington Medical Center and School of Dentistry serve as the home base. The program is rewarding and very demanding (residents spend 60 - 80 hours per week with their responsibilities). Up to three R2 positions are available for residents interested in pursuing an additional year of training, with the focus of the R2 program being upon preparing for involvement with academia and pursuing topics of individual interest to each resident.

The R1 resident's year is spent as follows:

Subject

Location

Duration

General Dentistry

UWMC/UWSOD

4.5 months

General Dentistry

VAMC

3 months

Pedodontics

CHRMC/OBCC

6-7 weeks

Oral Surgery

HMC

6-7 weeks

Anesthesia

ANES

6-7 weeks

University of Washington/Veteran's Affairs Medical Centers (UWMC/VAMC)

7.5 month rotation in General Dentistry (3 months at the VAMC, 4.5 months at UWMC/UWSOD). During these rotations, the resident is involved with the medical work-up, management and comprehensive dental care of a wide variety of compromised patients. Consultations are provided to all medical services in both hospitals. Typical experiences include: head and neck cancer patients, bone marrow transplantation patients, pre-and post- organ transplantation patients, hemophilic patients, immunocompromised patients, a wide variety of patients with common and unusual systemic diseases, mentally retarded patients, phobic patients, geriatric patients, and physically challenged patients. Significant experience is gained in techniques of intravenous conscious sedation and restorative dental care of generally anesthetized patients in the operating room.  Note that the UW site is split between a clinic in the School of Dentistry, and a small residual presence in the UW Medical Center hospital.  Residents on the UW rotation will spend significant time at both sites.

Odessa Brown Children's Clinic and Children's Hospital and Regional Medical Center (CHRMC/OBCC)

6-7 week pediatric rotation divided between the two sites. OBCC is a low-income, well-child clinic where all phases of pediatric dentistry and behavior management skills are refined. CHRMC provides experience primarily with the medical work-up, management and rendering of comprehensive dental care to a wide variety of medically, physically, and mentally compromised infants and children utilizing operating room dentistry.

Harborview Medical Center (HMC)

6-7 week rotation in Oral and Maxillofacial surgery. Residents assist the Oral Surgeons in the ward management of oral surgery patients, selected orthognathic reconstruction cases, treatment of emergent and non-emergent head and neck trauma, and assume the primary responsibility for the Oral surgery outpatient clinic. Principles of dentoalveolar surgery including flap technique, sectioning of teeth, removal of impacted third molars, and biopsies of hard and soft tissue pathology are emphasized during this rotation. Significant operating room experience is available as well.

VAMC, Department of Anesthesia (ANES)

6-7 week rotation in techniques of General Anesthesia. Residents render inhalation and regional anesthesia both under direct and limited supervision. This rotation introduces the techniques of anesthetic care, with emphasis on gaining proficiency in patient assessment, venipuncture technique, patient monitoring, pharmacology of anesthetic medications, managing emergent situations, post-anesthetic recovery, and airway maintenance. State-of-the-art computerized simulation programs are a feature of this rotation.


"Home-Call" Duty

The program enjoys an active after-hour emergency call service to the community. As such, the residents have the opportunity to treat a wide range of emergencies from major maxillofacial trauma to minor toothaches. Call is handled primarily at UWMC and some experience is provided at HMC and CHRMC on a rotating basis.


Didactics

Residents meet for approximately 6 to 8 hours per week for formal didactic seminars, as well as many informal sessions at each site. The didactic series covers a wide variety of topics including internal medicine, physiology, anatomy, physical diagnosis, conscious sedation, medical emergencies, Basic Life Support, Advanced Cardiac Life Support, pharmacology, forensics, intraoral photography, basic and innovative dental procedures, literature review and practice management. We encourage residents to request presentations on topics of interest. Each resident is asked to present one lecture during the year on a dental or medical topic of their choice. Each resident will also present several cases per year as part of our Grand Rounds and clinical cases teaching exercises.

Residents are welcome to register for the continuing dental education courses at reduced fees sponsored by the Division of Continuing Dental Education as time permits within the residency program.


Competencies

Central to the program’s educational structure are our rather extensive Competency Statements.  It is intended that by the end of the program, each resident will have the didactic training and clinical experiences necessary to achieve a level of Competency (or better) in each of the areas listed.   Normally, this is not difficult given reasonable effort and dedication on the part of the resident.  Note that while the list may seem daunting, it really is a good indicator of what our graduates are capable of.  Please note that successful residents are awarded a Certificate of Completion.  Residents who have difficulty meeting the competencies will be offered remediation to the fullest extent possible.  If remediation proves impossible to bring the resident to a level of competency in all the areas listed, he/she will be given a Certificate of Participation instead of a Certificate of Completion.

Please take the time to view our full list of Competency Statements. We are proud of what our residents can do!


Program Directors:

Dr. Ana Martinez and Dr. Robert (Bob) Nieman serve as co-directors of the General Practice Residency Program.

Dr. Martinez hails originally from Peru where she graduated from the Cayetano Heredia Peruvian University Dental School and also did her Residency in Dentistry and Management for patients with special needs, proceeded to Witten/Herdecke Private University Dental School in Germany – Major studies in Restorative Dentistry and Dentistry of patients with special needs, then the University of Connecticut Health Center in Farmington, Connecticut, where she completed a Residency and Fellowship in the Advanced Education in General Dentistry (AEGD).  Currently she holds hospital appointments at UWMC and Harborview Medical Center.

Dr. Nieman earned his DDS degree from the University of Washington in 1979.  He completed a one year General Practice Residency at Michael Reese Hospital, Chicago,IL in 1980 before returning to Washington to open a private practice and serve as part time attending in the UWMC's Dental Clinic where he currently maintains his hospital appointment. Dr. Neiman has served as an instructor, lecturer and clinical attending for the GPR program for over 23 years.

Our perceived Strengths, Weaknesses, and a “Seattle Quirk”:

Strengths:


We are proud to say that our GPR program has a reputation for giving the residents an incredible education in medicine as it relates to dentistry.  Several unique factors come together to make this possible:

  1. We have the luxury of rotating the residents through four different hospitals, the Dental School clinic and our low-income pediatric clinic.  (All of the hospitals have up-to-date clinics and state of the art support facilities.)  As a result, we are able to offer an incredibly diverse experience in hospital and community dentistry, one of the finest in the nation. 
  2. The hospitals we serve are well-funded, tertiary medical centers in the Pacific Northwest and our dental services are well respected.  As a result we see patients present with extremely complex medical histories, of virtually every shape and form.  Our hospitals offer one of the most active transplant services in the nation, and so we see patients pre-transplant when they have end-stage organ disease (cardiac, liver, lung, pancreas, kidney, bone marrow) and we see them peri- and post-transplant as well.  We have a large hemophilic population, many with inhibitors [antibodies], and therefore manage very complex bleeding disorders.  We have a large population of neurodevelopmentally/intellectually disabled patients who require GA or IV sedation to complete their care. 
  3. We are home to the Seattle Cancer Care Alliance, consisting of the Fred Hutchinson Cancer Research Center, the University of Washington, and the Children’s Hospital and Regional Medical Center.  As part of the Alliance, we see all varieties of head and neck cancer patients undergoing surgical, chemotherapeutic and radiation therapies, and we boast one of only two Neutron radiation treatment facilities in the nation.  We work with the bone marrow and stem cell transplant services to manage the patient pre-, peri-, and post-transplant, including the neutropenic stage.  We also actively work with a large hyperbaric oxygen (HBO2) treatment facility at a neighboring hospital.
  4. Our VA facility offers a superb prosthodontic and geriatric experience, free of the burden of financial constraints.  It is not uncommon for residents to do large case reconstructions on compromised patients in this lovely facility.
  5. Our pediatric rotation is superb at giving the resident experience in both the behavioral and technical aspects of pediatric dentistry.  After only a week or so at Odessa Brown, the residents become very comfortable working with pedo patients; by the end of the rotation they are extremely competent with this age group (and more importantly the parents!).  At CHRMC, the residents participate in the operating room on children with syndromes, craniofacial abnormalities, and all varieties of complex medical issues.
  6. Our oral surgical experience at Harborview (a low income/low socioeconomic status facility) amply prepares the residents for all aspects of routine and complex dentoalveolar surgery.  Large numbers of patients are seen on a daily basis.
  7. Finally, our minimum of 6 weeks of anesthesia experience is unprecedented for teaching airway management, emergency care, and pharmacology.  In this rotation, the motivated resident will advance to the level where they will essentially run a case with limited supervision from pre-op through induction and intubation, into the surgical phase, and finally extubation and stabilization in the recovery facility.
  8. The didactic program is strong, intensive, and the faculty are both knowledgeable and interested in resident teaching.  We have faculty representation from all specialties and a wide variety of generalists as well.  We are proud to say that our faculty take great pride in treating the residents as colleagues, for we recognize that we learn just as much from the residents while they learn from us.

Those are but a few of the things we are most proud to offer as part of the program.  However, there are other intangibles that add to the popularity of our program: We have the luxury of being in Seattle, one of the most gorgeous areas of the country, with hiking, camping, skiing, kayaking, sailing, whale watching, diving, and a wide variety of cultural events (from opera and ballet to alternative music and lifestyles) all readily available.  We are near Vancouver and Victoria, B.C., and Portland, OR.  Coffee with funny names is readily available on most street corners.  It is a wonderful place to spend a year, or more, of one’s life.  Many who come here end up wanting to settle into the area permanently.  And yes, it rains… but those of us who have lived here a long time gripe when we have too many dry days!

All of the above notwithstanding, we believe our greatest strength is resident satisfaction:  They agree the program is demanding and difficult at times, but they also agree it is worth every effort that goes into it.  Their surveys indicate they are very happy, enjoy being in Seattle, and are getting more than they thought they would from the program.  Most would readily choose this program again if they were to go back in time, and feedback from those who have been out a few years indicates they consider this to be one of the best things they ever did.  This kind of feedback is what we are most proud of.

Weaknesses:

Simply said, we are what we are, and we do what we do really well.  However, we are not everything for everybody.  Because the educational focus of the program is on the management of extremely medically complex patients, applicants should know that our patient population generally is not seeking “luxury dentistry” such as cosmetic dentistry nor implant dentistry.  A few cases are done in our clinics, but they are generally managed by the attendings with the residents participating secondarily.  Our philosophy is that this cosmetic dentistry education can be easily acquired in most continuing dental education courses, yet the medically compromised activity we can provide is something that is virtually impossible to replicate outside of a hospital-based residency program.

The other aspect of the program a few applicants find undesirable is simply the amount of time the residents spend devoted to the program.  We actually think this is a wonderful strength because the educational payoff is so incredibly high, but we agree that it is something that must be considered carefully prior to applying.

Quirk:

An unusual aspect of our program is that we rotate the residents every 6-12 weeks, making it impossible to start a case in July and continue to treat it through June.  Our approach is definitely comprehensive care:  When on rotation, each resident will work-up and treat all aspects of the patient’s care they are capable of, or make the decision to seek specialist intervention.  When it becomes time to rotate to another service, the residents will transfer the care to their colleague who will continue the original treatment plan.  We work extensively with the residents in the treatment planning stage to not only identify what needs to be done, but how to sequence and transition care so that the actual execution of the dentistry can be done by any person on the team.  This makes for a superb learning experience for the future practices of the residents, and the residents all agree the uniqueness of this experience is one of the best aspects of the program.


Applying to the Program (R1)

Because of Federal funding requirements, only graduates from ADA-accredited (USA and Canadian) dental schools are eligible to apply.  Invitations for interview are issued to 24 people per year. Each candidate spends an entire day visiting with us so that they can tour our main clinics and hospitals and meet with the faculty and residents. Interviews are intended to both identify high-quality candidates for our program and allow each candidate an opportunity to evaluate our program for its appropriateness to their postgraduate training goals and expectations.

We ask that you apply to our program using the Postdoctoral Application Support Service (PASS). You may obtain information and receive their application materials at https://portal.passweb.org/, following the links to PASS.  Note that they are now featuring an on-line application, which streamlines the process considerably.  Your evaluators can now fill out a form on-line and submit it electronically as well.

Please note the following key dates: Our program deadline is October 15, 2008. Therefore, all application materials must be to PASS by October 1, 2008 in order to be considered. We will review them by October 17, 2008 and issue interview invitations immediately thereafter. Candidate Interviews are scheduled for November 14, 2008 and December 5, 2008. Only complete applications will be considered.

A few friendly words of experience/wisdom:

1)   PASS really gets overloaded in early September, simply due to the volume going up exponentially. If you can get your application in prior to the “wave”, you will be much better off.  In order to do so, we suggest you start considering programs and getting your letters of recommendation requested over the summer.  No matter what, be sure to call each program you have applied to and verify they have received your completed packet.

2)   Ask your evaluators to use utmost honesty in rating you on the electronic forms.  Applicants who are “perfect in everything” do not exist in real life, and we will generally discount those evaluations.  Select faculty, preferably full-time faculty, who know you well and will not only write about your dental skills, but also about you as an individual.  We read a lot of evaluations, and those that make the most impact are the ones that highlight the candidate as a complete person.

3)   We do read all materials and essays carefully, so tell us truthfully why you seek residency education and what you hope to get out of it.  Use your essay opportunity to explain unusual circumstances in your application materials and to highlight important personal strengths the forms may not reveal.  We are seeking to know you as a person through your writing.

4)   Experience tells us that our most successful residents do not always have perfect GPAs or Class Standings.  Please apply if you are interested, regardless of how you feel about your GPA or Class Standing.

For additional questions you may contact us by email at:

 

susanp@u.washington.edu

(please enter "GPR R1 Application" in the subject line)

OR, via mail/phone:

Ms. Susan Phillips
GPR Applications

University of Washington

Department of Oral Medicine

1959 NE Pacific Street, HSB # 318
Box 356370
Seattle, WA 98195-6370

Program Phone #:  206-543-7496

 

Applying to the Program (R2)

 

Eligibility Criteria:

All applicants must have successfully completed an ADA-accredited GPR program. Licensure in the State of Washington is suggested. Exemplary performance in their R1 Residency is mandatory.

Application for process:

Applicants must be a graduate from an ADA (US or Canadian) dental School; AND hold,or be eligible to apply for a Washington State Dental Licence, AND have completed at least 1 year of AEGD/GPR training - General Practice Residency, Oral Surgery or Anesthesiology experience preferred - AND qualify for GME funding.

Application materials for the GPR R2 position are submitted directly to the program director. 

Documents required are: Official transcript from dental school, verification of NBDE scores, Current Curriculum Vitae (CV), personal statement, and a minimum of 3 letters of recommendation (at least one from the post graduate program faculty and/or director).

For the 2009-2010 position, documents must be received by the program director no later than February 2, 2009.  Selected applicants will be invited for an interview.

If you have additional quesitons regarding the R2 position, please contact Dr. Ana Martinez at:

anams@u.washington.edu

(please enter "GPR R2 Application" in the subject line)

Please forward all requested documentation for R2 application to:

Ana Martinez DDS

GPR Program Director

University of Washington

Department of Oral Medicine

1959 NE Pacific Street, HSB # 318

Mail box # 356370
Seattle, WA 98195

 


Miscellaneous


Reminder: You must have all of your application materials to PASS by October 1, 2008.  Submit online!