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General Practice Residency inDentistry ProgramVA Portland Health Care System3710 SW US Veterans Hospital RoadP-3 DENTPortland, OR [email protected]

GPR Program2VA Portland Health Care SystemGeneral Practice Residency in DentistryThe VA Portland Health Care System offers a general practice residency in dentistry programapproved by the American Dental Association’s Commission on Accreditation.The VA Portland Health Care System http://www.portland.va.gov/ is located on a hillsidewithin Sam Jackson Park and overlooks the city of Portland and the Cascade Range,including Mt. Hood and Mt. St. Helens. This area is known as the medical and dental centerfor the entire state of Oregon and southwestern Washington. In addition to the VeteransAffairs Medical Center, the University Hospitals and the Oregon Health Sciences UniversitySchools of Dentistry, Medicine, and Nursing are located nearby.VAPORHCS includes a tertiary-care hospital located near downtown Portland, Oregon andthe Vancouver Division, located near downtown Vancouver, Washington. VAPORHCS alsooperates eight Community Based Outpatient/ Outreach clinics which together serve thePortland/Vancouver metropolitan area, NW Oregon, the central Willamette Valley, CentralOregon, and SW Washington State. The Portland campus is a tertiary care, teaching, andresearch facility classified by VHA as a 1a complexity level facility, which along with the PugetSound Healthcare system in Seattle acts one of two referral facilities for the entire NorthwestNetwork VISN 20.Over 400 residents rotate through VAPORHCS each year in the various specialties ofmedicine and allied health fields. VAPORHCS and its satellite outpatient clinics provide over218,000 outpatient visits annually. There is an active research program, excellent medicallibrary, and a full-service medical media department.

GPR Program3The VAPORHCS general practice residency is a comprehensive post-graduate dentaleducational program designed to provide practical clinical and didactic experience. Thisresidency will provide clinical experience in all aspects of general dentistry as practiced in ahospital setting. In addition to refining their skills in clinical dentistry, the dental resident willlearn to manage patients with complex medical histories and how to communicate effectivelywith other hospital professionals in a larger scale hospital setting.CLINICAL FACILITIESThe main clinic is located in VAPORHCS’s hospital building which opened in 1988. This 23operatory clinic includes a fully equipped dental laboratory, as well as special operatories forendodontics, periodontics, implants, oral surgery, maxillofacial prosthodontics, and dentalhygiene. Additional features include digital radiography with Cone Beam CT, digital intraoralscanner, and CEREC milling machine. A dental operatory and assistant is assigned to eachresident, so that they can practice dentistry most efficiently. This arrangement providesvaluable experience to facilitate the residents’ eventual transition to a private practiceupon completion of their training.We also have a dental clinic located at our Vancouver, Washington division of thePortland VAMC. This is a 12 chair clinic where each resident works for approximately 2months out of the year in a block rotation. This site is located 13 miles north of the mainhospital - residents are expected to report to the Vancouver site; no transportation isavailable for the resident between the two sites.Additional training and experience is provided at the OHSU Schools of Medicine and Dentistry,where the resident will attend courses and seminars.VAPORHCS has a comprehensive library containing over 7600 books and 660 journal titles,including a collection of dental journals. The libraries of the medical and dental schools arealso available to the GP resident. Residents have access to online resources. The VA has aninstitutional license w/ Lexi-Comp.

GPR Program4GOALS AND OBJECTIVES1. Act as a primary care provider for individuals and groups of patients. This includes:providing emergency and multidisciplinary comprehensive oral health care; providingpatient focused care that is coordinated by the general practitioner; directing healthpromotion and disease prevention activities; and using advanced dental treatmentmodalities.2. Plan and provide multidisciplinary oral health care for a wide variety of patientsincluding patients with special needs.3. Manage the delivery of oral health care by applying concepts of patient and practicemanagement and quality improvement that are responsive to a dynamic health careenvironment.4. Function effectively within the hospital and other health care environments.5. Function effectively within interdisciplinary health care teams.6. Apply scientific principles to learning and oral health care. This includes using criticalthinking, evidence or outcomes-based clinical decision-making, and technology-basedinformation retrieval systems.7. Utilize the values of professional ethics, lifelong learning, patient centered care,adaptability, and acceptance of cultural diversity in professional practice.8. Understand the oral health needs of communities and engage in community service.

GPR Program5RESIDENCY PROGRAM OVERVIEWClinical Dentistry Disciplines1. Restorative DentistryClinical work in this specialty provides the resident with varied experiences to improvehis/her proficiency in operative procedures. This includes experience incomposite/amalgam restorations, crown and bridge, and implant restorations. Lectures anddemonstrations by the staff members on special techniques are presented throughout theyear.:2. Oral SurgeryThe resident will spend considerable time in oral surgery under the supervision of our oralsurgeon and full-time attending staff. Residents will perform extractions and be trained insurgical procedures in the dental clinic and the hospital operating rooms. Other thanroutine extractions, oral surgery performed and/or observed will include removal ofimpacted teeth, tori removal, osseous and soft tissue surgery, biopsies, and implantsurgical placement. Training in IV sedation will be provided including a didactic courseas well as practical experience with the oral surgeon. Residents will also perform alimited number of oral surgery cases in the operating room.:3. ProsthodonticsThe resident has the opportunity to spend plentiful time in this specialty. The program isparticularly strong in this field, as there are a great number of prosthodontic casesavailable. The resident experiences all phases in the fabrication of full dentures, partialdentures, crowns, bridges, immediate dentures, and special prostheses for patients whohave undergone surgical removal of tumors of the oral cavity and face. Implantexperience will be provided for treatment planning, work-up of cases, implantrestorations, and limited but available experience in implant surgery.:4. PeriodonticsDiagnosis, etiology and rationale of periodontal treatment are presented. Theimportance of follow-up home care and professional maintenance is stressed.Specific periodontal treatment is presented by lecture, demonstration and supervisedtreatment. Residents will be trained in periodontal surgical techniques by our staffperiodontists. Experience in both emergency cases and management of chronicperiodontal disease is available. Implant treatment planning will also be discussed withthe periodontal staff providers who place implants.:5. EndodonticsThe staff supervise this specialty. Both the theory and techniques of conventional andsurgical endodontics are presented. Training in use of rotary system, lateral condensation,and use of apex locator. A microscope is also available for use.:

GPR Program66. Geriatric Dentistry/Extended CareAn integral part of the resident’s Vancouver rotation will be working with an extended carepopulation consisting of a 120-bed nursing home, an adult day care program (about 63active patients), a Rehabilitation Program (20 in-patient beds), a Chemical AddictionRehabilitation Service (30 beds), a newly opened Post-Traumatic Stress DisorderProgram (15 beds) and a facility for patients awaiting liver transplants.Dental Service also serves as a consultant for the home care program, and theCommunity Nursing Home program; both based in Vancouver. Upon completion of theextended-care rotation, we expect residents to demonstrate increased competency inpatient assessment (medical and dental), interdisciplinary communication skills, patienttransfer techniques, and planning and dental treatment of these complex patients.:The clinical program is oriented toward a general practice schedule in that fixed periods oftime are not spent within each specialty area. Rather, treatment is provided as in privatepractice so that each day is varied and residents are able to control their own appointmentschedules. It is a flexible program where residents may pursue individual interests whilecompleting required assignments in various fields of dentistry.OFF-SERVICE ROTATIONS1.AnesthesiologyOne hundred (100) hours are devoted to an anesthesiology rotation in the VAMCoperating rooms. Residents will experience starting IV’s, intubation, and monitoringpatients during general anesthesia. Resident will also help perform pre-op assessmentswith guidance from anesthesiology staff.2.Emergency Medicine RotationThis 40-hour block assignment to the VAMC Emergency Department provides clinicalexperience to enable the resident to evaluate and manage systemic emergencies,especially those that may occur in the dental office.3.Liver TransplantThis 40-hour block assignment provides clinical experience in risk assessment,history and physicals, admission, discharge and care of inpatients and outpatients preand post transplant.4.Community ServiceDental residents will be involved in providing dental education and screenings for theVeterans in possible VA Stand Down services which take place in different locations atdifferent years. In addition, during Cancer Awareness Week in April, dental residents willparticipate with Oregon Health Sciences University in providing Head and NeckScreening exams to the community.:::

GPR Program7Didactic Program1. Moderate Sedation CourseCourse offered by DOCS Education / OHSU School of Dentistry, aimed at providinga comprehensive foundation for how to administer intravenous sedation. Topicsrange from pharmacology to venipuncture technique to conducting a history andphysical.2. Advanced Cardiac Life SupportSuccessful completion of this course will result in certification in ACLS which isrequired for performing IV sedations.3. Literature Reviews and Journal ClubsResidents abstract and report on classic and current literature dealing with assignedtopics. Staff dentists run sessions on a variety of dental topics4. Hospital Dentistry SeminarsResidents will prepare presentations on various pertinent medical topics as theyaffect the oral structures and dentistry.5. Implant BoardStaff restorative dentists, implant surgeons, and residents meet monthly to discussimplant cases in order to approve patients for implant surgery. Discussions willinvolve the medical, restorative, and surgical facets of treatment planning implantcases.6. Continuing Education CoursesResidents will have the chance to attend the annual session of the Oregon DentalAssociation held each spring. This will allow residents not only to attend a variety ofcourses but also allow networking with local dentists in the area.7. Treatment Planning SeminarsThis seminar is aimed to provide advice and guidance on complex treatment plansthat residents encounter. Prosthodontists and general dentists will be available toconsult different approaches to treatment plans.Various lectures from attending providers will be given throughout the year on topics suchas bisphosphonate therapy, hospital protocols, and dental trauma. Our periodontist willgive a series of lectures on periodontal topics and suturing. Several other consultants willalso provide instruction, such as representatives from Straumann and practicemanagement firms.

GPR ProgramDental Faculty:Octavia Lively, DDS (UW)Tim Bishop, DDS (UCSF)Laurissa Champion, DMD (OHSU / OHSU)Thomas Clark, DMD (OHSU)Arti Darnell, DDS (Maryland)Albert Fu, DDS (Pacific)Kathleen Hanson, DMD (OHSU)Carolyn Harakal, DDS (Maryland / Portland VA)Thomas Kaiser, DDS (VCU)Kevin Larsen, DMD (OHSU)Trang Pham, DDS (UCLA / OHSU)Jeff Rogers, DDS (VCU / SUNY Buffalo)Nels Walther, DMD (OHSU)Joy Wang, DDS, MSD (Buffalo / UF)Theodore Weesner, DDS (Minnesota / UT San Antonio)Craig Wong, DMD (OHSU / E. Orange NJ VAMC)8GPR Program DirectorAssistant chiefStaff PeriodontistFee-Basis DentistStaff DentistChiefStaff DentistStaff ProsthodontistStaff DentistFee-Basis DentistStaff PeriodontistStaff PeriodontistStaff DentistStaff Maxillofacial ProsthodontistStaff PeriodontistStaff Oral SurgeonDUTY AND LEAVEAppointment as a resident is for one year starting July 1st. The resident normally works inthe dental clinic or is on duty elsewhere in the hospital from 7:30AM-5:00PM Mon-Thurs and8:00-4:30 on Friday, with every other Friday off. Pagers are assigned to residents and therewill be a rotating duty roster amongst the five residents for a period of two weeks covering calloutside of normal clinic hours.Fifteen days of annual leave (vacation) is granted per year at the convenience of the DentalService.The current stipend for residents is approximately 58,000. Other benefits include: medicalinsurance, dental insurance, 10 federal holidays, scrubs, and free parking.Residents are expected to treat veteran patients in an ethical and compassionate manner.They must also relate well and respectfully to fellow workers, allied health careprofessionals, and the general public. Residents are expected to have a full-timecommitment to the program during their residency year. This in turn means on-timeattendance for all scheduled seminars and classes while also devoting time beyond regularclinic hours to address other duties such as medical record documentation and preparationfor presentations and patient care.A certificate is awarded by the Department of Veterans Affairs upon satisfactory completionof all program requirements.

GPR Program9Application InformationResidents must meet the following requirements: Be a citizen of the United States of AmericaBe a student in good standing or a graduate of a United States dental school whichhas been approved by the American Dental Association council on Dental EducationHave passed the National Board Examination - Part 1.Acquire a Postdoctoral Dental Match Program Code.All qualified candidates will receive equal consideration without regard to race, religion,color, national origin, sex, politics, marital status, non-disqualifying or mental handicap, ageor membership or non-membership in a labor organization.Our Dental Service participates in the American Dental Education Association PostdoctoralApplication Support Service, (ADEA PASS) and only accept applications through PASS. Inaddition, we participate in the Match Program.To Apply for This Residency, Complete the Following: Complete an official application through the Postdoctoral Application Support Service:ADEA PASS website: http://www.adea.org/PASSapp/Register in the Match Program: www.natmatch.com/dentres/index.htmThe following material must be received prior to October 1st of the year prior to aJuly appointment to be considered. Applications will be reviewed in the order they arereceived; preference may be given to those applications submitted earlier. Complete an application form (VA Form 10-2850b). Ensure at least 3 letters of recommendation are submitted (PASS ordirectly to the program) Curriculum Vitae (PASS or directly to the program)All supplemental materials should be sent to:Portland VA Health Care SystemDental Service P-3-DentATTN: Dental GPR Director3710 SW U.S. Veterans Hospital RoadPortland, Oregon 97239Phone: (503) 220-8262 x 52008Fax: (503) 220-3442E-mail [email protected]:Interviews will be arranged by invitation from the Program Director, once all of yourapplication materials have been received. These interviews are normally scheduled fromlate November through early January.

This area is known as the medical and dental center for the entire state of Oregon and southwestern Washington. In addition to the Veterans . implant cases in order to approve patients for implant surgery. Discussions will involve the medical, restorative, and surgical facets of treatment planning implant