DENTAL RESIDENCY PROGRAMS IN COMMUNITY HEALTH CENTERS Adding residents to your health center can enhance your dental

program in many ways but you must be prepared for the requirements and responsibilities of a residency program. The residency should never be a side project of the health center. It must have buy-in by all involved and be planned carefully by a team from your health center consisting of at a minimum administrators, dentists, IS, and accounting representatives. Specific goals should be set with interdepartmental buy-in. If done properly you can achieve the following with a residency program: Increased access, production and encounters. Stabilize your dentist staff by creating a different niche from which you can recruit dentists. There are dentists with a good deal of experience in a wide range of skills that do not enjoy the business end of private practice and do like to teach. Stabilize your dental staff as a whole due to a more stable dentist staff. Increase the quality of care delivered at your health center form more experienced dentists that stay longer. Expand the services typically provided to your dental patients Create a supply of dentist whom you know and know your health center to fill future positions

CHC Requirements for a Healthy Residency Program 1. The number one goal of a having resident in your health center must be to provide a valuable teaching experience to your residents everything else is secondary. 2. A dentist needs to be in the clinic during all times the resident is providing patient care. 3. The dentist staff must understand what is legally required of them and what is ethically required to be a good mentor to residents. They also need to understand that they are legally responsible for the work done by the resident while they mentor. 4. Dont just assume that a successful dentist in your CHC will also be a successful mentor. Mentoring is a skill set that comes naturally to some, can be learned by others and just doesnt work for some. Discuss all of this ahead of time with your staff to insure they are prepared and have a desire to be mentors. Mentors are also required to do formal written evaluations of the residents typically 3 times/ year. 5. Develop a monitoring plan with your mentoring dentists. Typically a lot of checks should be done in the beginning and less as the mentor dentist becomes comfortable with the residents work. The more complicated procedures like molar endodontics should be checked completely throughout the residency. 6. Residencies have very specific requirements for their accreditation including what their residents must achieve during their residency year. Be very familiar with those requirements to insure youll be able to achieve them before adding residents. The clinic must provide the range of services, beyond restorative care, needed for resident requirements: a. Endodontics including molars b. Crowns and Bridge

c. Metal framework Partials and dentures d. Crown lengthening and other periodontal surgery procedures e. Some clinical exposure to implants (not required by CODA yet but highly sought after by residents) f. Oral surgery: surgical extractions, soft tissue and, if possible, partial bony impactions g. Access to medical consults h. If you cant supply these procedures you will have to bring in dentists/ specialists that have these skill sets or outsource the, This needs to be discussed with your administration and the residency program pre-residents. 7. Chair and staffing availability is critical and this must be carefully thought through with a staffing/ chair utilization plan determined before the decision to add on a residency program. Residents will decrease a mentoring dentists production but if carefully planned a resident can increase the overall usage of chairs thus increasing productivity. In general, you need a chair/ resident that either is not currently being used or is being underused on a consistent basis. Accreditation requires that a resident have a dental assistants working with them at all times when they are in the clinic. 8. If your center has a policy of limiting very short appointments to increase encounters numbers, you should not add residents. This would not be an environment they can achieve their clinical requirements. Quadrant/rubber dam dentistry is the teaching environment needed. 9. The Dental Director will be required to spend about ___% of their time on residency issues: a. Recruiting of residents b. Monitoring clinical progress and formally evaluating the residents c. Filling our residency reports d. Instructing and helping the residents get a State resident license. e. Monitoring an resident behavior or clinical issues and following residency procedures for resolution of those issues 10. Clinic must see children and adults. The percentage of adults should be at least 30-35% to have enough new procedures and variety of procedures needed to support the resident requirements. 11. Residents are employees of the sponsoring residency program and not employees of the health center but they do function as one. You will need to insure that the residents participate in your in-boarding processes that are automatic for your employees. Since they are not employees, youll need some bridge process that flags them and insures that they are properly oriented. 12. Residents can spend up to 20% of their time doing didactic work. This depends on the residency program and how it is set up. This must be reviewed before deciding to add residents. 13. It is important to understand the # of vacation days that resident programs allow. 14. Video-conferencing is required so a clinic not only needs the equipment but assurance of appropriate IS support when conferencing problems arise. 15. While a resident requires a minimum of one chair and one DA, as the resident progresses it is ideal to allow the resident to work out of more chairs. This may be when the dentists take vacation. Allowing residents more chairs as the year progresses is a big recruitment plus.

Residents want the ability to discover what production they are capable of and this could be a good recruiting strategy. 16. There will be administrative costs that may not be covered depending on what residency program you sign up for. Your administration will need to commit to these potential costs: a. Recruitment b. Social events: not required but helps create a cohesive program c. Graduation dinner: again not required but a good thing to do d. IS costs for equipment maintenance and employee time e. Increased equipment needs: handpieces, instruments etc. f. Possible increased staffing needs: depending on current staffing and chairs g. Some administrative support costs 17. The better recruitment strategy you develop the better chance you have of selecting a resident that will be successful in your program. Determine a recruitment strategy ahead of time: a. Will you interview by phone or in-person? b. Know the recruitment requirements of the residency: MATCH or PASS c. It takes time to recruit good residents!!! Nothing better than a great resident but a very long year with one that isnt so good. d. Will you take internationally trained dentists? There are specific considerations involved with this decision including Visa issues. e. You should have a clinic presentation packet including specific information you can send to the resident that highlights both your program and the geographic area of your center. Residents are very interested in the area they will be living in. 18. You should set up an evaluation process to determine if the residency has achieved the goals youve set for the CHC.