Sepulveda Ambulatory Care Center - Dental Training

VA Sepulveda Ambulatory Care Center (SACC) is located approximately fifteen miles north of the city of Los Angeles in San Fernando Valley. The Medical Center is close to the junctions of the 118 and 405 freeways. The street location is at the corner of Plummer Street and Woodley. The main gate is on Plummer Street with one alternate gate on Woodley Ave. California State University at Northridge is located in the near vicinity. Our university affiliation is with UCLA School of Dentistry.

At SACC, complete health care services are provided in dentistry, medicine, psychiatry, physical medicine and rehabilitation, psychology, social work and surgery. There are over 50 nursing home patients admitted to the nursing home per year and approximately 220,000 outpatient treatment visits per year

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. Additionlaly, it provides broad consultative services to ENT, Radiation Therapy, Orthopedics, Psychiatry, Medicine and the Nursing Home Care Unit. Associated functions and activities of the Dental Service include resident training and patient education.

The Dental Service is staffed by 12 full-time and part-time dentists, including full-time specialists in endodontics, prosthodontics, periodontics and oral and maxillofacial surgery and 6 residents (a combination of PGY1 and PGY2 general practice), 11 dental assistants and 2 hygienists. 

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. 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.

Goals & Objectives

1. Enhance and advance knowledge and diagnostic and clinical skills in general dentistry.
2. Provide advanced educational opportunities which enable the resident to applyscientific 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.

PGY-1 Program Goals

1. Enhance and advance knowledge and diagnostic and clinical skills in general dentistry by having residents act as primary care providers for individuals and groups of patients.
2. Plan and provide multidisciplinary oral health care for a wide variety of patients including patient with special needs.
3. Manage the delivery of oral health care by applying concepts of patient and practice management and quality improvement.
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.
7. Utilize the value of professional ethics, lifelong learning, patient centered care, adaptability, and acceptance of cultural diversity in professional practice.
8. Understand the oral health needs, medical conditions and issue of veterans.

PGY-2 Program Goals

Broaden and develop the second year resident’s clinical knowledge and skills in the provision of comprehensive oral health care to veteran patients including patients needing extensive and complex clinical procedures:

1. Advanced restorative and prosthodontic dentistry
2. Periodontal surgery (i.e. grafting/osseous recontouring)
3. Oral and Maxillofacial Surgery
4. Advanced Dental Implantology

Gain invaluable experience in the complex interdisciplinary management of medically compromised geriatric patients:

1. Coordinates all same day surgery procedures with the various sections of the surgical service for preoperative clearance, admission and discharge of the patient as the Chief Dental Resident for all operating room cases.
2. Coordinates comprehensive dental treatment for head and neck cancer patients undergoing radiation and/or chemotherapy treatment, and is also involved in doing clearance exams for pre-orthopedic, pre-cardiac and pre-transplant patients. 
3. Coordinates the team’s comprehensive treatment plan for the medically compromised geriatric nursing home patients with the dental treatment of these patients by the dental staff.

Provide a variety of didactic and educational experiences which enhance the residents’ education:

1. Attend the VAMC monthly Clinical Education Series.
2. Attend the VAMC monthly Geriatric Research Education Clinical Care Conference.
3. Three month course in Orofacial Pain given by UCLA School of Dentistry.
4. Three month course in Advanced Dental Implantology given by UCLA School of Dentistry.

Increased leadership and teaching responsibilities

1. Serves as Chief Dental Resident for all operating room/same-day surgery cases.
2. Mentors and teaches all first year residents on a daily basis-clinical cases, treatment planning seminars, and literature review sessions.
3. Proctors and instructs all 4th year (senior) UCLA Dental Students in the Oral Surgery Clinic.

Outline

A. Orientation

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 clinical responsibilities.
5. Dental Examination Room procedures, records and policies.
6. Lectures on medical risk assessment and dental management of the medically compromised patient.

B. Comprehensive Dental Care

1. Restorative Dentistry and Fixed Prosthodontics - 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 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 in the Operating Room. 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- 2 weeks
2. Anesthesia- 2 weeks
3. Emergency Room – 2 weeks

4. ENT/ Head&Neck – 2 week

    

Conference & Meetings 

A. General Dentistry Literature Review

• Each general practice resident will participate by reading and alternately presenting current and historical dental literature.

B. Multidisciplinary Treatment Planning

• Each resident will work-up and present cases to the program director and other attending staff twice a month. 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 conferences conducted by various departments whenever relevant topics are presented.

Salary

Stipend offered

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

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.

Due Process Policy

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

Application Requirements

1. Graduation from a United States or Canadian dental school, which has been approved by the American Dental Association Council on Dental Education
2. Participation in Postdoctoral Application Support Service (PASS)
3. Participation in Postdoctoral Dental Matching Program
4. Personal interview upon invitation
5. United States citizens are given first consideration
6. 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.

Application Procedure for Program

1. PASS materials

2. 2x2 photo

   Jane Kwon DDS, Program Director
   VA Sepulveda Ambulatory Care Center
   Dental Service (160)
   Bldg.10, Rm 1C-100
   16111 Plummer Street
   North Hills, CA. 91343

All materials must ARRIVE by October 15th.
Application materials will not be returned to the applicant.