United States Department of Veterans Affairs

VA Long Beach Healthcare System

General Practice Residency Program in Dentistry

About the Program

Eric Yamaura, D.D.S., Director
Phone: 562-826-5407
Fax #: 562/826-8007

I. OVERVIEW

The VA Long Beach Healthcare System includes a 232-bed tertiary care teaching center affiliated with the University of California, College of Medicine at Irvine and several Veterans Health Clinics. Over 250,000 veterans in the greater Los Angeles area and Orange County are provided comprehensive healthcare. While a full range of medical services are available, the VA Long Beach Healthcare System is nationally recognized for its comprehensive Cancer and Spinal Cord Injury Centers.

The population treated within the VA hospital setting has significant dental needs. Concomitantly, patients typically have an array of debilitating physical, psychological, and medical conditions that complicate their dental treatment. The staff and residents are highly trained in the management of these complex and difficult patients. The spectrum of dental care ranges from unscheduled emergency procedures to comprehensive evaluation and treatment of eligible inpatients and outpatients, which encompasses virtually all specialty areas in dentistry. Many of the patients admitted to the hospital and nursing home are given routine examinations or referred for dental related problems. Special emphasis is placed on providing treatment to patients with dental conditions associated with or exacerbating compelling medical problems, such as head and neck cancer, spinal cord injury, diabetes, cardiac valvular dysfunction, vascular grafts, orthopedic prostheses, and implants utilizing synthetic materials.

The Dental Service enjoys support from other services within the Medical Center, such as radiology and laboratory. Additionally, it provides broad consultative services to ENT, Radiation Therapy, Orthopedics, Psychiatry, Medicine, Spinal Cord Injury, and the Nursing Home Care Unit. Emergency services are provided for head and neck trauma, cranial fractures, and oral infections. Associated functions and activities of the Dental Service include resident training and patient education.

The Dental Service is staffed by 10 full-time and part-time dentists, including full-time specialists in endodontics, prosthodontics, and oral and maxillofacial surgery, 9 residents (4 general practice, 4 endodontic, and 1 oral and maxillofacial surgery), 13 assistants, and 2 laboratory technicians.

II. RESIDENCY PROGRAM

The General Practice Residency in Dentistry is a one-year program designed to provide clinical and didactic training in hospital dentistry at the post-doctoral level. Four resident
positions are available. The program is accredited by the Commission on Dental
Accreditation of the American Dental Association. A certificate is awarded to the resident upon successful completion of the program.

This residency will prepare the resident to deliver total oral health care by providing instruction and experience involving ambulatory and hospitalized patients with a wide spectrum of medical conditions. This hospital training program will enable the resident to develop a level of understanding of oral health as an integral and interactive part of total health. It will also offer the opportunity to work with other health care professionals in the hospital and broaden clinical exposure to conditions not commonly seen in the clinic of a dental school.

III. GOALS AND OBJECTIVES

1. Enhance and advance knowledge and diagnostic and clinical skills in general dentistry.

2. Provide advanced educational opportunities which enable the resident to apply
scientific principles to learning and oral health care.

3. Provide comprehensive oral health care management of medically compromised patients through a broad understanding of the interrelationship of dental and medical conditions and the physical, psychological, social, and emotional needs of the patient.

4. Participate and function in interdisciplinary health care teams in a hospital setting.

5. Expand knowledge of veterans’ issues, medical conditions, and oral health needs.

IV. OUTLINE OF TEACHING PROGRAM

A. Orientation

At the beginning of the residency year, an orientation period will expose the resident to the administration and functions of the Medical Center and Dental Service. The following subjects are included in this period of instruction:

1. Tour of the medical center to visit other services and departments for general familiarization.

2. Overview of hospital organization, functioning, application for privileges,
and the credentialing process.

3. Standard procedures in the medical center related to resident responsibilities, patient care, and the use of computerized medical records and digital radiography.

4. General policies and procedures of the dental service, such as patient
eligibility and on-call responsibilities.

5. Dental Examination Room procedures, records and policies.

6. Hospital Dentistry Course for medical risk assessment and dental
management of the medically compromised patient.

B. Dental Rotations

Clinical experience is provided primarily during two to three-month rotations in which the patient case mix is designed to maximize exposure to a specific discipline, thereby concentrating and enhancing learning during this focused period of time. The use of rotations, however, does not preclude comprehensive multidisciplinary oral health care, as residents are expected to comprehensively address total oral health care needs.

1. Restorative Dentistry and Fixed Prosthodontics

In this rotation, the resident will focus on operative dentistry and fixed prosthodontics. Experience will be gained in the use of various types of restorative techniques and dental materials, as well as the indications for their use in clinical practice. Exposure to the restoration of osseointegrated implants will also be provided. Formulation of treatment plans and presentation of cases before staff will be required.

2. Prosthodontics

This rotation will include experience in the fabrication of complete and removable partial dentures, as well as special prostheses used in oral and maxillofacial surgery such as stents for pre-prosthodontic, orthognathic, and implant surgery.

3. Endodontics

This clinical rotation will include the diagnosis and treatment of endodontic problems and emergencies. While attending seminars and meetings with the endodontic residents, the resident will be exposed to the complete spectrum of non-surgical, surgical, and microsurgical procedures, including a variety of canal preparation and obturation techniques and the use of rotary instruments.

4. Periodontics

The clinical content will include the diagnosis and prognosis of periodontal disease, treatment planning, instrumentation, and periodontal surgical procedures and techniques, including flap design, osseous surgery, and soft and hard tissue grafting.

5. Oral and Maxillofacial Surgery

Experience will include performing surgical procedures in the dental clinic, as well as the general surgery-operating suite. Practical experience in IV sedation and major and minor oral surgery procedures, including exodontia, reduction of maxillary and mandibular fractures, placement of osseointegrated implants, and the treatment of pathology of the oral cavity will be provided. The resident will also observe interesting cases of teaching value throughout the year in this department.

C. Medical Rotations

1. Internal Medicine
Assignment to this rotation should develop the resident's capacity for recognition of symptoms of systemic diseases. During this two-week course of training, emphasis will be placed on cardiovascular diseases. Observing and assisting a staff physician in the work-up of patients will help correlate physical diagnosis, laboratory findings, and imaging and other studies with history and symptoms.

2. Anesthesia
The resident will be assigned to the Anesthesiology Service for instruction in the administration of general anesthesia for major surgery. Experience will be obtained in various types of general anesthetics with emphasis placed on pre- and post-operative care of patients receiving general anesthesia.

3. Same-Day Surgery

This area of training will teach the resident to obtain, record, and interpret comprehensive medical histories and to observe and perform complete physical examinations on patients anticipating outpatient surgical procedures. The resident will also assist in the preoperative insertion of intravenous lines.


V. TEACHING CONFERENCES & MEETINGS

A. General Dentistry Literature Review

A general dentistry literature review will be held twice a month. Each general practice resident will participate by reading and alternately presenting current and historical dental literature. This literature will cover a variety of medical and dental topics with the exception of endodontics and oral pathology, which will be covered by appropriate staff and guest lecturers.

B. Multidisciplinary Treatment Planning

Each resident will work-up and present cases to the program director and other attending staff on a monthly basis. This includes a complete treatment plan for a medically compromised patient with difficult or unusual medical and/or dental problems.

C. Hospital Staff Meetings

The dental resident is encouraged to attend teaching conferences conducted by various departments (i.e., Medical Service Noon Conferences, Clinical Pathology Conferences, etc.), whenever relevant topics are presented.

VI PERIODS OF INSTRUCTION

The year consists of fifty-two teaching weeks with a tentative distribution of time in each rotation as follows:

A. Hospital Dentistry Course - 1 week

B. Orientation - 1 week

C. Dental Rotations

1. Restorative Dentistry and Fixed Prosthodontics - 12 weeks
2. Removable Prosthodontics – 12 weeks
3. Endodontics and Periodontics - 11 weeks
4. Oral and Maxillofacial Surgery – 10 weeks

D. Medical Rotations

1. Internal Medicine - 2 weeks
2. Anesthesia - 2 weeks
3. Same-Day Surgery – 1 week

VII ADDITIONAL PROGRAM INFORMATION

A. Salary

Approximately $43,500 per year

B. Vacation and Sick Leave

Residents are allotted twenty (20) days of leave, which can be used in any combination for vacation and/or sick leave. In addition, residents receive ten federal holidays

C. Professional Liability Coverage

General Practice Residents receive professional liability coverage through the Department of Veterans Affairs for residency-related clinical activities for the duration of the program. Outside activities are not covered by this policy.

D. Due Process Policy

Residents have access to due process through the Equal Employment Opportunity Office in the medical center.

E. Outside Professional Activities

Limited outside professional activities, including continuing education programs, may be allowed at the discretion of the program director and Chief, Dental Service.

VIII APPLICATION REQUIREMENTS

A. Graduation from a United States or Canadian dental school, which has been approved by the American Dental Association Council on Dental Education

B. Participation in Postdoctoral Application Support Service (PASS)

C. Participation in Postdoctoral Dental Matching Program

D. Personal interview upon invitation

E. United States citizens are given first consideration

F. The program complies with the Equal Employment Opportunity policy of the Department of Veterans Affairs which provides equal opportunity to all regardless of race, color, creed, national origin, ancestry, sex, marital status, disability, religious or political affiliation, age or sexual orientation.

IX APPLICATION PROCEDURE FOR PROGRAM

The following materials must arrive by the November 1 deadline.

1. PASS materials

2. Application for Residents may be completed on screen and printed, or printed then completed on a typewriter. This application form should be completed, signed, and mailed to:

General Practice Residency Program
VA Long Beach Healthcare System Dental Service (12/160)
5901 East 7th Street
Long Beach, CA 90822

3. College (undergraduate) transcripts (in sealed official college envelope)

4. Other information you wish to include

Application materials will not be returned to the applicant.

Services

Services
Dental Service
Medical Patient Services
Mental Health Care
Pharmacy
Primary Care
Research
Spinal Cord Injury/Disorders
Surgical Patient Services
Comprehensive Rehabilitation
Geriatrics and Extended Care
Diagnostics & Molecular Medicine
Human Resources
Library Services
Patient Business Office
Patient Education
Pastoral Care
Social Worker
Veterans' Affairs
Veterans & Family Assistance