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Dentistry General Practice Residency Program

The General Practice Residency Program in Dentistry at the San Juan VA Hospital is a one-year program approved by the Commission on Dental Accreditation of the American Dental Association. It is composed of two Dental Resident positions. The hospital is approved by the Joint Commission on Accreditation of Hospitals Organization (JCHAO).

The Program goals should include preparation of the graduate to:

1. Act as a primary care provider for individuals and groups of patients.  This includes providing emergency and multidisciplinary comprehensive oral health care; providing patient focused care that is coordinated by the general practitioner; directing health promotion and disease prevention activities; and using advanced dental treatment modalities.

2. Plan and provide multidisciplinary oral health care for a wide variety of patients including patients with special needs.

3.  Manage the delivery of oral health care by applying concepts of patient and practice management and quality improvement that are responsive to a dynamic health care environment.

4. Function effectively within the hospital and other health care environments, including consultation and referral (interdisciplinary health care teams).

5. Apply scientific principles to learning and oral health care.  This includes using critical thinking, evidence or outcomes-based on clinical decision-making and technology-based information retrieval systems.

6.  Utilize the values of professional ethics, lifelong learning, patient centered care, adaptability and acceptance of cultural diversity in professional practice.

7. Understand the oral health needs of communities and engage in community service.

8. Train Residents to be competent in pain and anxiety control utilizing behavioral and pharmacological techniques.

9. Understand and practice medical risk assessment and quality assurance, in relationship to hospital administrative standards.

10. Obtain informed consent.

11. Manage dental and medical emergencies.

12. Manage inpatient or same-day surgery patients.

13. Train residents to be competent in operative dentistry, periodontal therapy, endodontic therapy, and restoration of edentulous spaces with fixed and removable appliances.

The program | Postgraduate Level

The program is conducted on a postgraduate level providing further instruction in the didactic and clinical aspects of dentistry under the supervision of experienced clinicians.  Scheduled assignments or rotations are made to other services of the hospital where medico-dental treatment relationship is emphasized.  Residents are assigned 70 hours to an anesthesia rotation with supervised practical experience in the following: 

  1. preoperative evaluation
  2. assessment of the effects of behavioral and pharmacologic techniques
  3. venipuncture technique
  4. patient monitoring
  5. airway management and intubation
  6. administration of pharmacologic agents
  7. prevention and treatment of anesthetic emergencies
  8. assessment of patient recovery from anesthesia

Students/Residents are assigned 70 hours to a rotation in internal medicine that has supervised practical experience, to include:

  1. obtaining and interpreting the patient’s chief complaint, medical, and social history, and review of systems
  2. obtaining and interpreting clinical and other diagnostic data from other health care providers
  3. using the services of clinical, medical and pathology laboratories
  4. performing a history and physical evaluation and collect other data in order to establish a medical assessment

Residents are assigned 40 hours to a rotation at ENT.  Instructions in ENT will enable the Resident to:

  1. To provide and expose Dental Residents with additional experience
  2. To provide clinical experience in Head and Neck cancer patients while rotating through this clinic.
  3. To increase their knowledge in the anatomy of head and neck region

Training activities and experience are offered in the following categories:  inpatient care, post-hospital care, outpatient care, operating room, journal clubs, literature review, conferences, case reports and presentations.  Attendance to general dental staff meetings and continuing education courses at the University of Puerto Rico School of Dental Medicine as assigned are required.  At VA Hospital, residents are supervised by staff dentists.  One resident will always be on call after 4:00 PM.

Residents correlate the basic biomedical sciences with clinical experience by applying them in an intelligent, logical manner.  For that reason, our program makes full use of the available patient population where a great variety of interesting medico-dental conditions exist.  The resident is required to develop a comprehensive treatment plan for each case assigned, taking into consideration the patient’s medical, emotional, and dental conditions.  On selected cases this treatment plan is presented to the staff in a case presentation session.  In this presentation, the resident applies all the knowledge of the basic biomedical sciences in order to validate and justify the diagnosis and treatment plan.  At the same time, the staff shares with the resident their knowledge and experience.  The resident is expected to institute and complete treatment to a number of these cases to be eligible for VA certificate of training.

Program Administration

The Program is conducted by a director with the cooperation of the Dental Training Committee of which the former is chairman.  The supervision of the program is accomplished by the consultant and attending staff, Chief, Dental Service, Resident Review Board and Chief of Staff.

The Dental Training Committee is advisory in nature and participates in the determination of admissions criteria and procedures, selection, and recommendation of candidates for admission, coordination of training facilities, evaluation of progress and promotion of participating trainees.  Written non-discriminatory policies are followed in selecting residents.

Staffing

The VA Hospital dental staff consists of six general practice dentists, with two general practice residents, one periodontist, one endodontist, two prosthodontists, one oral and maxillofacial surgeon, fifteen dental assistants, one dental assistant supervisor, four dental laboratory technicians, three dental hygienists, two receptionist, and one secretary.  The principal staff members who participate in the teaching program are:

  • Julio De Jesus, D.M.D Chief, Dental Service
  • Luzanne Domenech, D.M.D., Staff Dentist, Director, Dental General Practice Residency Program
  • Mariely Santini, D.M.D., Staff Dentist
  • Marietta Colon, D.M.D., Staff Dentist
  • Luis A. Alejandro, B.S., D.M.D., Staff Dentist
  • David Diaz, DMD., Staff Prosthodontist
  • Carolyn Burleson, D.M.D., Staff Prosthodontist
  • Edwin Del Valle, B.S., D.M.D., Board Certified Staff Oral and Maxillofacial Surgeon
  • Miguel Gonzalez, D.M.D., Board Certified Staff Periodontist
  • Arhimazda Jimenez, B.S., D.M.D., Endodontist
  • Julianna Torres, D.M.D, Staff Dentist

Facilities

The Hospital

The VA Caribbean Healthcare System is located adjacent to the Puerto Rico Medical Center. This hospital consists of beds for medical, surgical, psychiatric, spinal cord injury, and rehabilitation medicine patients plus medical, surgery, coronary and psychiatric intensive care units. There are specialized units in the Medical Service including Medical Intensive Care and Medical Stepdown Unit (MSDU), Coronary and Coronary Stepdown Unit (ICCU), Hematology-Oncology Ward, Hemodialysis Units and telemetry throughout the hospital.  There is an active Outpatient Department with clinics in Internal Medicine-Preoperative Evaluation, Internal Medicine PACT Continuity Clinics, as well as all the Internal Medicine subspecialties including Cardiology, Gastroenterology, Pulmonary, Neurology, Dermatology, Infectious Diseases, Antiretroviral Treatment, Rheumatology, Nephrology, Endocrinology & Diabetes Mellitus, Allergy and Immunology, Hematology-Oncology and Geriatrics.  Other departments at our institution include Physical Medicine and Rehabilitation (PM&R), Psychiatry, Nuclear Medicine, Radiology, General Surgery, and other surgical specialties such as ENT, Urology, Ophthalmology, Anesthesiology, Orthopedic.

Diagnostic and treatment facilities include audiology and speech pathology, a prosthetic and sensory aids section, an orthopedic shop, a modern pharmacy serving both inpatients and outpatients, complete physical medicine and rehabilitation facilities, general medical research facilities which include the latest equipment and general laboratory facilities, diagnostic cardiac laboratory, as well.  Medical and patients’ libraries, medical illustration services and automated data processing facilities are available.

Community Living Center

The Community Living Center consisting of skilled nursing care and a Blind Rehabilitation Center which was inaugurated on March 20, 1990.  Patients in this unit are provided necessary dental services consistent with their oral health needs and their medical, psychosocial, and functional conditions.  These services include treatment for dental emergencies as well as diagnostic, preventive, restorative, and rehabilitative services.  Interdisciplinary assessment and assignment of appropriate roles ensure a coordinated approach to these patients.

The Dental Clinic

The Dental Clinic is located on the second floor of the hospital outpatient clinical area. The physical facilities consist of a waiting area, Chief Dental Service’s office, secretary’s office, dentists’ private offices, receptionist area, twenty-one operatories, one recovery area, one sterile instruments room, one soiled instrument room, one sterile storage room, a modern dental laboratory. Operatories have available modern dental equipment designed for more efficient methods of dental practice. The dental service has one digital panoramic x-ray, CBCT and 16 digital periapical units. Three self-contained mobile dental unit are available to provide service in the wards and in the hospital operating room.

Term, Salaries and Privileges

The program starts on July 1st and ends on June 30th of each year.  Uniforms are provided.  The annual stipend at present is $58,216.  The resident is entitled to 28 days annual leave and 15 days sick leave.  Upon satisfactory completion of the requirements of the program, the resident will receive a certificate of training from the Department of Veterans Affairs.

ADMISSION REQUIREMENTS

Applicants must meet the following requirements:

  1. Be a graduate of a dental school approved by the Commission on Dental Accreditation of the American Dental Association.
  2. Have competency in speaking, reading, and writing both English and Spanish.
  3. Be in the upper one half of the class.
  4. Be recommended by the dean of the dental school.
  5. Approve the National Board Examinations.
  6. Personal interview.
  7. Be physically fit for the program as determined by a complete medical examination performed at the VA Medical Center.

APPLICATION PROCEDURES    

  1. File completed VA application in original and two copies not later than November 15th prior to the academic year for which applying.  
  1. Request from the registrar of the Dental School to forward an official transcript of grades.
  1. Submit a copy of the scores of the National Board Examinations.
  1. Request a recommendation letter from the dean of the dental school to be addressed to the Chief, Dental Service, VA Medical Center.  Letter must mention the grade point average and ranking of the last semester.

All correspondence should be forwarded to:

Dr. Luzanne Domenech Dental Service

VA Caribbean Healthcare System10 Casia St.

San Juan, PR  00921-3201

Telephone:  Ext. 132601 or 132602

FAX: