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Oral and Maxillofacial Surgery

Accredited by the Commission on Dental Accreditation, the Oral and Maxillofacial Surgery (OMS) Residency Program at Yale-New Haven Hospital teaches residents the full scope of skills needed to practice in either a hospital or private office, including the use of all current techniques of pain and anxiety control.

Two applicants are selected each year to enter the OMS program, which is affiliated with Yale School of Medicine. The four-year curriculum provides all the prerequisites and requirements needed to qualify for, and succeed in, the American Board of Oral and Maxillofacial Surgery's certification process.

Guidance from faculty and board-certified community practitioners

Indeed, our residents gain experience from providing a full range of ambulatory services in a modern outpatient clinic, with teaching and supervision provided by a full-time director, a part-time assistant director, and more than 20 board-certified voluntary faculty from community practices. The outpatient experience at Yale-New Haven Hospital's OMS Clinic is supplemented by rotations to Yale-New Haven Hospital where the OMS residents work alongside general practice and pediatric dental residents in new, modern facilities under the direction of OMS faculty common to both hospitals.

Major surgical experience is also gained in the emergency and operating rooms of Yale-New Haven Hospital, so that each resident receives a progressive education in both major and minor OMS.

Clinical teaching

Residents perform most services offered in Yale-New Haven Hospital's outpatient Oral and Maxillofacial Clinic - a spacious, state-of-the-art facility that sees a wide range of patients and is fully equipped to provide the full scope of OMS ambulatory surgery and anesthesia. Many patients come from poor, inner city neighborhoods and face multiple health issues. Thus, Yale-New Haven Hospital offers OMS residents a broad and thorough medical education. Patients are also referred regularly for OMS care from the General Dental and Pediatric Dental training programs at Yale-New Haven Hospital, as well as from private practices in the area.

Residents provide hands-on care from the beginning, although responsibilities are progressive and are based on skill and experience. Supervised operating experience is encouraged, with the complexity of the case matching the resident's ability.

On most days, formal teaching rounds take place in the morning, followed by clinical instruction, conferences, lectures and seminars. Afternoon work rounds are conducted by the chief resident. Faculty are consulted both formally and informally by all residents involved in patient care.

Rotations through medicine, anesthesia, emergency medicine, general surgery and more

While most of each of the four years is spent providing inpatient and outpatient OMS care at Yale-New Haven Hospital, residents gain added expertise from rotations through Anesthesia, Medicine, Emergency Medicine, General Surgery, Otolaryngology, Plastic Surgery and Oral Pathology. Each of these areas focuses on the following objectives:

Medicine (two months in PGY 1): Developing patient evaluation skills is the main thrust of this rotation. Residents spend much of their time focusing on body systems and functions, along with tools used to diagnose illness - particularly electrocardiography, general radiography and clinical laboratory tests. The resident will learn to take a comprehensive health history and become competent in reviewing systems, conducting physical examinations and accurately reporting and interpreting findings. Treatments of common medical illnesses will also be discussed, with emphasis on cardiac, pulmonary, hepatic, renal and endocrine conditions.

Anesthesia (five months in PGY 1): Participating in all department clinical and didactic activities, residents leave this rotation with the ability to evaluate the physical status of a patient, and assess whether there are physiologic risks to that patient receiving anesthesia. The resident will study anatomy and physiology of the respiratory, circulatory and nervous systems, as well as learn their responses to various preoperative medications, general anesthesia and pain control medications. Different techniques for administering and monitoring anesthesia will be learned, and patients of various degrees of complexity will be seen. The resident will become proficient in managing emergencies and complications related to anesthesia, including establishing and maintaining an airway; maintaining respiration and circulation; and performing both basic and advanced life support. Competence in managing both perioperative and postanesthesia recovery - including prevention, early detection and management of possible problems - is stressed.

Emergency Medicine (one month in PGY 2): Along with residents rotating from other programs within the hospital, the resident will focus on evaluating patients with a wide range of acute surgical and medical conditions. Additionally there are opportunities to perform minor procedures including suturing lacerations, abscess incision and drainage and minor orthopaedic procedures. Residents also become familiar with ECG and laboratory data analysis, use of emergency drugs, emergency airway management, cardiopulmonary resuscitation and neurologic evaluation.

General Surgery (four months in PGY 2): As a member of the General Surgery team, the OMS resident is assigned to a variety of surgical resident teams with a variety of general surgical emphases, including intensive care. The resident will admit and work up patients, prepare patients for the operating room, participate in operating room cases, manage postoperative patients and attend all rounds and conferences. Knowledge of general principles of surgery - including tissue handling and wound care - will be a focus, as well as preoperative assessment and management. Peri- and postoperative management of fluids, electrolytes, blood products and surgical nutrition will be stressed, along with preventing and managing common postoperative complications.

Treating critically ill or trauma patients is also a component

Plastic Surgery (three months in PGY 2): Conducted at Hartford Hospital and the Connecticut Children's Medical Center, the general principles and pathologies of plastic surgery are learned as residents experience the pre-, intra- and postoperative management of patients undergoing a variety of plastic surgery procedures, with emphasis on craniofacial. The resident is assigned to duties based on level of experience and participates in all reports, rounds and conferences.

Oral Pathology (one month in PGY 3): Residents spend one month at the Long Island Jewish Medical Center in New Hyde Park, N.Y., taking part in its accredited oral pathology training program. Duties include examining and evaluating patients, preparing specimens for histopathologic examination, reviewing histopathology specimens and presenting findings to supervising faculty. Residents also participate in all didactic activities, particularly clinicopathologic conferences.

All applications for positions in this residency program are made through the Postdoctoral Application Support Service (PASS) for The American Dental Association. Contact PASS at www.adea.org for further information.

All selections for residency are made through the Postdoctoral Dental Matching Program, contacted through www.natmatch.com/dentres/

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