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Oral and Maxillofacial Surgical Pathway |
The Division of Oral and Maxillofacial Surgery in the Department of Surgery has developed a Discipline Based Pathway for its six year integrated M.D./OMFS program. This pathway includes courses of Internal Medicine and Neurology required for graduation and four months of anesthesia experience required to comply with residency requirements. The remaining clinical rotations will emphasize fields related to OMFS training.
Sites
and Personnel
Drexel University College of Medicine
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Hahnemann University Hospital |
Allegheny General Hospital |
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Coordinator: |
Coordinator: |
It is the overall goal of the Division of Oral and Maxillofacial Surgery to design a curriculum to enable residents to become competent in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and soft tissue of the oral and maxillofacial region. The six years of training are designed to integrate advanced biologic sciences with progressive clinical training. The OMFS discipline based pathway provides the framework necessary to integrate anesthesia and the surgical subspecialties related to the specialty of OMFS and prepare the resident for their PGY1 and PGY2 preliminary general surgical experience.
Click here for a summary table of the OMFS Pathway.
All required rotations must be fulfilled at home sites.
Goals and Objectives of Rotations
MEDICAL INTENSIVE CARE
UNIT
Purpose
This rotation offers an opportunity for the OMFS resident to work
jointly with a medical RI in the management of patients with critical illnesses
requiring the facilities of an ICU. These problems range from post-operative
complications through an entire array of medical illnesses including overdoses,
serious infections, respiratory failure and multiple organ failure.
Objectives
The OMFS resident will become exposed to intensive care medicine as
practiced by medical intensivists, with a comprehensive approach to patients
medical problems as modified by the high level of technical care necessary and
available in the ICU.
Duties of Resident
The OMFS resident will become responsible for writing notes and will
progress to performance procedures such as insertion of central lines,
Swan-Ganz catheters, etc. Residents will become familiar with ventilatory
management as practiced in the ICU under the direction of pulmonary
intensivists. The R1 will be responsible for direct supervision of the OMFS
resident. Both will work under the supervision of the teaching R3 in the MICU.
The OMFS resident will develop familiarity with:
- An internist's approach to critically ill patients, with comprehensive assessment of patient problems.
- An opportunity to function in the highly technical intensive care environment.
- Techniques and procedures common to intensive care patients.
ANESTHESIA
Purpose
The purpose of the Anesthesia Rotation is to help OMFS residents
develop competence in anesthesia skills for adult and pediatric patients.
Objectives
At the completion of the anesthesia rotation, the resident should be
able to:
- Evaluate preoperative patients for IV sedation or general anesthesia.
- Assess a patient's ability to tolerate anesthesia/surgical stress.
- Classify the physical status of patients.
- Manage medically compromised patients.
- Use monitoring systems to continually evaluate patients' vital signs (cardiac monitoring, blood gases, ventilators, etc.)
- Perform CPR and advanced cardiac life support procedures (all residents certified in CPR and ACLS).
- Develop technical skills in airway control, endotracheal intubation, intravenous techniques, continuous intravenous drub therapy.
- Gain knowledge in drug pharmacology, pharmacodynamics, interactions and specific effects of anesthetic agents on patients.
- Knowledge of rapid sequence induction as well as standard induction and intubation techniques.
- Evaluate laboratory data as it specifically relates to the anesthesia/surgical patient.
- Interpret chest x-rays for anesthesia purposes.
- Review of basic pulmonary and cardiovascular physiology in dynamic situations.
- Exposure to the management of both geriatric and pediatric patients in the normal course of anesthesia delivery at a tertiary care institution.
Duties of Resident
In order to meet the objectives of the rotation the resident spends
four continuous months on general anesthesia at one of the University
Hospitals. The oral and maxillofacial surgery resident, after a suitable period
of supervision as determined by the anesthesia faculty, is assigned his/her own
anesthesia room and is given the responsibility for pre-operative patient evaluation
and pre-operative management of the patient's general anesthetic. The oral and
maxillofacial surgery resident on the anesthesia rotation performs at the level
of a first year anesthesia resident. He/she takes call on a regular rotation
with the anesthesia residents.
OTOLARYNGOLOGY
Purpose
The OMFS resident will be given intensive training in all aspects of
head and neck surgery on the service of the Department Chair at Drexel
University Hospital. The OMFS will be exposed to the comprehensive management
of head and neck oncology patients, including clinical experience in tumor
resection and surgical reconstruction.
Objectives
At the completion of this rotation, the resident should be able to:
- Gain experience in the management of head and neck oncology patients.
- Understand the general principles of diagnosis and staging of head and neck oncology patients.
- Develop technical skills in osseous and soft tissue resection, neck dissection and flap reconstruction.
- Understand the inter-relationships between head and neck surgery and OMFS.
- Gain experience in the latest chemotherapeutic and radiation therapy protocols.
- Gain experience in microvascular and microneural anastomosis techniques.
Duties of Resident
The OMFS resident will assume the responsibilities of and ENT resident
on rotation with the otolaryngology service and be directly responsible to the
Chair and attending faculty. The OMFS resident will attend all conferences
including tumor board, take call and gain experience in the management of
post-op patients in the ICU and the wards.
PLASTIC SURGERY ROTATION
Purpose
The OMFS resident is given training in all aspects of plastic surgery
by a highly skilled mentor. He/she works closely with this service to develop
skills in both the technical and philosophical aspects of the specialty. There
is time to develop a thorough appreciation of the role of the plastic surgeon
in the general care of surgical patients as well as in the multiple injured
patient. Training especially emphasizes the need for coordination of efforts
for the success of treatment.
Objectives
At the completion of the plastic surgery rotation, the resident should
be able to:
- Gain experience n the management of general plastic surgery patients.
- Understand general principles of plastic surgery.
- Develop technical skills in soft tissue management.
- Gain experience in cosmetic and aesthetic surgery.
- Understand the inter-relationships between plastic surgery and OMFS.
- Gain experience in microvascular anastomosis techniques.
- Gain experience in the management of extremity injury and microsurgical techniques.
Duties of Resident
The oral and maxillofacial surgery resident will assume the
responsibilities of a plastic surgery resident on rotation with the plastic
surgery service. He/she is directly responsible to the plastic surgery
attending faculty. The oral and maxillofacial surgery resident will take call
on the plastic surgery service and respond to the emergency room and trauma
intensive care units as a plastic surgery resident. The oral and maxillofacial
surgery resident will be involved in patient work-up and patient management
during the hospital stay. The resident will also gain experience in the
management of patients undergoing cosmetic or aesthetic surgery.
TRAUMA SURGERY ROTATION
Purpose
During the Trauma Surgery rotation residents are trained to assess and
initially care for the multiply injured patient. They are given responsibility
to give direct hands-on care of such patients. This training provides the OMFS
resident with a broad scope of knowledge to recognize problems in the patient
that may not be in his/her immediate area of expertise. Moreover, the training
provides the OMFS resident with skills to be an active and viable member of a trauma
team in any traumatic event. Again, training affords technical skill, didactic
knowledge and interpersonal development.
Objectives
At the completion of the Trauma Surgery rotation the resident should be
able to:
- Triage and prioritize patients.
- Coordinate the involvement of multiple specialties in the care of multiply injured patients.
- Carry out treatment for traumatic, hypovolemic shock, acute airway management, fluid control, monitoring, central lines, chest tubes, catheter care, etc.
- Prepare acutely injured patients for immediate surgery.
- Understand the surgical and post-surgical management of the trauma patient.
Duties of Resident
During the Trauma Surgery rotation the resident is expected to:
- Attend rounds in-house and in the Trauma Unit with trauma attending staff and trauma fellows.
- Carry the trauma beeper on-call and respond to acute trauma events.
- Work up and perform overall assessment of major injuries.
- Write orders, progress notes and dictation.
- Assist at surgery (1st, 2nd 3rd assist) depending on manpower of service.
- Attend to wound management, wound care and wound complications.
The training on this rotation provides the OMFS resident with skills to be an active and viable member of a trauma team in any traumatic event. Training affords technical skill, didactic knowledge and interpersonal development.
Evaluation of Student Performance
Student evaluations for all clerkships will be completed utilizing the
standard evaluations of Drexel Universtiy College of Medicine, (Senior student
clinical rotation composite evaluation report). The summary of the evaluation
will be discussed with the student during a formal feedback session with the
Program Director at the completion of each elective. This will provide the
student with ongoing feedback of their weaknesses and evolving strengths
throughout the fourth year.
Evaluation of the Pathway by the Student
Ongoing evaluation of the Clinical pathway by the student will be critical
to the success of the system. At the completion of each rotation, students will
evaluate the rotation using standardized forms. This will include evaluation of
the teaching faculty, residents, support staff and clinical experiences for the
student during the rotation. This information will be considered by the Program
Director and faculty to assess the strengths and weaknesses of the Pathway.
Faculty Advisement
Faculty guidance and mentoring will occur longitudinally as students
prepare for a career in Oral and Maxillofacial Surgery. Each student will work
closely with the Pathway Director in structuring the specifics of their
fourth-year experience. Other faculty members within the department will also
be available to serve in an advisory capacity. An educational experience will
be constructed which builds upon the student's strengths and addresses
weaknesses as they prepare to enter the preliminary general surgical residency.
The Pathway is intended as a dynamic resource for student education and will be
keenly responsive at evaluation and feedback.
Faculty Curriculum Committee
The faculty curriculum committee will consist of the Pathway Director,
Pathway Coordinator, and one additional faculty member of the Division. This
team will carry out ongoing evaluation of the Pathway and make recommendations
for amendments to the original curriculum and Pathway design.
The provisions of
The Student Handbook of Drexel University College of Medicine are not to be regarded
as a contract between any student and the College of Medicine. The School of
Medicine may, at any time, change any provisions, curriculum requirements,
teaching facilities, affiliated teaching sites and/or their amenities, bylaws,
rules, regulations and policies as may be necessary in the interest of the
University, Drexel University College of Medicine, and its students.
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Revised for clarification 06/13/06 -- Specific questions or comments about the content of this page may be directed to the Division of Clinical Education