Howard University Hospital, a 482-bed award winning university and teaching hospital, has proudly served the global community with a commitment to innovative patient care, teaching and research.

The mission of Howard University Hospital is to serve as a major academic health care center that is committed to the needs of a diverse local, national, and international community. The mission is accomplished through excellence in service, education and research. The primary aspect of the hospital's mission is to meet the needs of our patients in a manner that is customer focused. This includes a commitment to ensuring that the patients'need for pain management is given priority.

General Dentistry Practice

The General Dentistry Practice Residency Program at Howard University is a one-year postdoctoral education program which offers the dentist an opportunity for advanced comprehensive clinical experience in a hospital environment. In addition, the trainee receives postdoctoral training in the sciences basic to dental practice. This program is designed to increase the resident's knowledge of oral and systemic interrelationships and manifestations in healthy individuals and, also, in those with abnormalities and diseases; to broaden clinical experiences; and to further prepare the trainee in the management of the total oral health of a wide range of ambulatory and medically compromised patients. Emphasis is placed on the management of patients with conditions not commonly seen in the dental school clinics.

Synopsis
The program's goals and objectives of providing excellent education in postgraduate general dentistry, and developing practitioners of the highest caliber, nationally and internationally, are consistent with the University's mission and vision. At the completion of the program, the residents become confident and compassionate general practitioners proficient in:

1. The evaluation, diagnosis, and treatment of the majority of dental emergencies.

2. Patient evaluation as it relates to medical history, dental history, physical examinations - including head and neck, interpretation of laboratory test results, and correlating these findings with the treatment plan.

3. Evaluation, management, and treatment of dental patients with medical, physical and psychiatric disabilities.

4. Understanding hospital organization and protocol in the admission, consultations, and the treatment of dental/oral and maxillofacial diseases with the concept of a total health care team.

5. The multiple clinical skills required by a general dentist in the provision of a comprehensive dental care.

6. Anticipation, recognition and the management of medical emergencies that may arise in the course of dental treatment.

7. Diagnosis of oral/dental pathoses, treatment planning, operative and preventive dentistry, fixed and removable prosthodontics, oral surgery, periodontics, and endodontics.

8. Utilization of a variety of pharmacotherapeutic agents and understand their indications, contraindications, and interactions as they relate to dental care.

9. Recognizing dental anxiety, alleviating anxiety and pain through behavior management techniques, and conscious sedation (oral, nitrous oxide, intravenous) techniques.

10. Providing dental treatment in the operating room, and demonstrating knowledge of operating room protocol and infection control.

11. Efficiently utilizing dental auxiliary personnel.

12. Critically evaluating professional literature, and possessing the knowledge to carry out dental research.

13. Application of principles of ethical behavior in personal conduct, in decision-making, and in interaction with patients, staff and members of the community.

14. Performance of professional responsibilities, social obligations, and preparation to play leadership roles in their communities.

15. The didactic phase of the program consists of such medical and dental sciences as: Anesthesiology, Advanced Oral Surgery, Advanced Radiographic Interpretation and Diagnosis, General Dentistry Conference Series, Oral and Maxillofacial Pathology, Oral Physiology, Principles of Medicine, Physical Diagnosis and Problem Case/Patient Care Conference Seminar.

Diagnostic and clinical experiences are provided in multiple settings to complement the didactic phase of the program.

Internal Medicine Rotation (two weeks) enhances the residents' proficiency in history and physical, radiographic, laboratory studies evaluations and other techniques used in the diagnosis of systemic diseases. It also enhances the residents' understanding of the relationship between oral and system health and diseases.

Anesthesiology rotation (three weeks) enhances the residents' knowledge and clinical skills in patients' evaluation, assessment of medical risks and ASA classification of general anesthesia patients. The pharmacologic agents used in general anesthesia induction, its reversal and the indications and contraindications for patients in different ASA categories.

Oral and Maxillofacial Surgery rotation (three weeks) enhances the residents' proficiency in physical evaluations, admissions, venipuncture, operating room procedures/patient management and nitrous oxide/intravenous (I-V) sedation.

On-Call rotation to the Emergency Medicine Department is year-long, and each resident is assigned to the Emergency Medicine Department approximately seven (7) times per month. This rotation enhances the residents' proficiency in pre-operative evaluation, medical risk assessments, and the diagnosis and treatment of acute dental/oral and maxillofacial injuries/diseases.

Postgraduate Programs
Oral & Maxillofacial Surgery
General Practice Residency
Postgraduate Dental Programs

Introduction

Howard University Hospital, through the College of Dentistry, offers postgraduate programs in the fields of Oral and Maxillofacial Surgery, and General Dentistry. These programs meet the educational requirements recommended for certification by the respective specialty boards. They are designed, also, to fulfill the requirements for postgraduate education in dentistry as proposed by the Council on Dental Education of the American Dental Association and the American Association of Dental Schools. The level of instruction in courses included in these programs is comparable to that of graduate dental courses. Research orientation, electives, and research opportunities are included. It is anticipated that the instructional phase of the postgraduate programs will dovetail with graduate programs in the College of Medicine and graduate programs which are being developed in the College of Dentistry. Therefore, the emphasis in these programs is on the total educational experience for the resident, in addition to the requisite technical training. Full-time enrollment is required of all residents participating in these programs.

Oral and Maxillofacial Surgery
Postgraduate Program

The program in Oral and Maxillofacial Surgery is a 4-year program beginning in July of each year. The program is designed to meet the requirements of the Council on Dental Education of the American Dental Association, and the American Board of Oral and Maxillofacial Surgeons.

Synopsis
The advanced specialty program in Oral and Maxillofacial Surgery of Howard University Hospital and the College of Dentistry encompasses forty-eight (48) months of full-time study. Each resident will devote a minimum of thirty (30) months to clinical oral and maxillofacial surgery, and twelve (12) of the thirty (30) months will be spent at the senior level of responsibility. All residents are assigned to the medical/surgical services for at least twelve (12) months. Most of the classroom basic sciences courses and the medical/surgical service rotations will be offered in the first twenty-four (24) months of the training program. The didactic phase of the oral and maxillofacial surgery curriculum is distributed over the four-year period of the program. Throughout the entire program, the resident has experiences in advanced clinical and hospital procedures. The four-year residency program in oral and maxillofacial surgery consists of a progressively graded sequence of hospital experiences in this specialty, formal courses, lectures and seminars designed to provide vertical integration of theory and practice at all levels of the program.

Specifically, at the end of the first year, the resident would have completed rotations through medicine and anesthesia and should be able to:

* Execute basic exodontia and minor oral surgery procedures
* Complete physical exam on all patients.
* Interpret radiographs and laboratory results with diagnostic accuracy leading to improvement in patients presenting symptoms.
* Train in both cardiopulmonary resuscitation and advanced cardiopulmonary life support.

The second year resident has eight months off-service rotations which includes: emergency medicine, general surgery, surgical intensive care, ear nose and throat surgery, neurosurgery and four months on oral and maxillofacial surgery service. At the end of the year, the resident should be able to:

* Evaluate patient's preoperative surgical risk.
* Evaluate and manage associated medical diseases.
* Select appropriate anesthetic techniques.
* Maintain proper patient nutrition.
* Manage fluid and electrolytes.
* Manage blood replacement therapy-indications and complications.
* Perform routine post-operative care and management.
* Execute complex exodontia and management of major maxillofacial trauma.
* Outline treatment protocols for pathology and reconstructive surgery.

The third year resident does two additional months of anesthesia rotation at the Veterans Administration Medical Center; then is assigned to oral and maxillofacial service for ten (10) months. At the end of the third year, the resident should be able to:

* Evaluate patient's preoperative surgical risk.
* Evaluate and manage associated medical diseases.
* Select appropriate anesthetic techniques.
* Maintain proper patient nutrition.
* Manage fluid and electrolytes.
* Manage blood replacement therapy.
* Perform routine postoperative care.
* Execute complex exodontias, and manage major maxillofacial trauma.
* Supervise junior residents.
* Assume duties of the chief resident when the chief is unavailable.

The fourth year resident, in addition to duties and expectations of the third year, is expected to:

* Supervise and teach junior residents.
* Perform administrative duties such as monthly on-call schedule; meet with sales representative to arrange workshops.
* Act as liaison between residents and department chairman and residents and other programs.
* Generate research paper suitable for publication.
* Be certified in Advanced Trauma Life Support.
* Be familiar with coding and nomenclature and hospital credentialing Procedures.
* Demonstrate competence in performing both minor and major oral and maxillofacial surgery procedures in a clinical setting and in the operating room.

Curriculum Outline
Anatomy/Cadaver Laboratory, Offered Years 1,2,3,4

This course consists of an intensive and orderly approach to the study of the Head and Neck. Stress is placed on relationships and fascial compartments. Cadavers are dissected. Audio-Visual aids consisting of an osteological collection, roentgenographs, models, museum exhibits and living subjects are used. Illustrated lectures are used to present the structures. Oral and Maxillofacial surgical procedures are emphasized. 2 hrs. Lec./2hrs. Lab/Wk.

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This article is reposted with thanks to Howard University Hospital.