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Curriculum and Clinical Training in Oral Health for Physicians and Dentists

Report of Panel 2 of the Macy Study

Professionals and curriculum experts convened for this report were drawn from multiple medical and dental disciplines, representing eight medical and dental academic institutions in the United States and Canada. This report emphasizes the importance of common medical and dental curricula in oral-systemic health and cross-cutting domains and highlights the need and opportunities for interprofessional collaboration.

This report articulates educational goals and strategies needed to prepare dental and medical graduates for their next phase of practice or clinical training. Those considerations that speak to specialty training or to clinicians already in practice are beyond the immediate scope of the report. The panel recognizes the imperative of subsequent deliberations concerning quality of care and postgraduation competencies.

	Background

Top Background Biomedical knowledge, attitudes,... Curriculum and Educational... Towards a shared responsibility... Oral cancer and... Oral health manifestations of... Bisphosphonate drug-related... References

 
Across health professions, there is a growing appreciation of the need to address patient care systemically and holistically. The development of two separate health professions—one medical and one dental—has its origins in the early nineteenth century,¹ but advances in biomedical science have blurred this distinction from both diagnostic and therapeutic standpoints. The knowledge and skills physicians need related to clinical dentistry and the knowledge and skills dentists need related to clinical medicine are progressively overlapping. The two professions hold common biomedical science foundations, which include growing evidence of the relationship of oral to systemic health. A goal of this report is to identify learning objectives in oral and systemic health that will enhance each profession’s capacity to improve and maintain the oral and overall health of individuals and populations.

Another goal of this report is to draw attention to the cross-cutting competencies for all health professions students in order to promote the common attitudes, knowledge, and skills necessary for effective practice and interprofessional collaboration in today’s health care environment. While many different curricular innovations have been proposed for the health professions, broad agreement exists on the need for reforms that are responsive to the emerging science, which includes oral-systemic linkages, as well as other demographic, sociocultural, and environmental factors.

Oral Health in America: A Report of the Surgeon General² reminded educators, practitioners, and the public of the fundamental fact that oral diseases and disorders present a systemic burden. The report brought attention to the importance of oral health for overall health and to the evidence for profound oral health disparities—disparities that can be aggravated by health professionals’ lack of oral health knowledge. Subsequently, The Face of a Child: Surgeon General’s Conference on Children and Oral Health³ convened many health constituencies to consider ways to address pediatric oral health disparities. In 2003, the National Call to Action to Promote Oral Health specifically called for revamping health professions education to include oral health content as a key step towards eliminating oral health disparities.

In an earlier study, Dental Education at the Crossroads: Challenges and Change (1995),⁴ the Institute of Medicine (IOM) had already recommended closer integration of dentistry with medicine and the health care system as a whole. This IOM report predicted that scientific and technological advances in molecular biology, immunology, and genetics, along with an aging population with more complex health needs, would increasingly link dentistry and medicine, leading to the need for changes in dental education.

As physicians come to see oral health as a legitimate domain of involvement for their profession, and dentists acquire better understanding of the systemic implications of oral disease, asking the right questions will be as much a matter of perspective as of knowledge and skills. Cultivating such a perspective will require significant change in the curricula of both professions. This report is intended to promote curricular change by defining the attitudes, knowledge, and skills that underlie such a perspective.

	Biomedical Knowledge, Attitudes, and Skills: Oral-Systemic Health

Top Background Biomedical knowledge, attitudes,... Curriculum and Educational... Towards a shared responsibility... Oral cancer and... Oral health manifestations of... Bisphosphonate drug-related... References

 
Existing standards in medicine^5,6 and dentistry^7–9 already support the inclusion of oral-systemic health learning objectives in the predoctoral curriculum. Therefore, in many ways, organizational precedent is established for the articulation of common and collaborative educational practices. Learning objectives for knowledge, attitudes, and skills in the areas of basic sciences, as well as the applied clinical sciences, overlap. At the same time, a number of areas will require different degrees of breadth or depth of coverage in the curriculum, depending on whether these areas are serving principally the preparation of a dentist or a physician. Common systemic and oral conditions that both medical and dental students should know are emphasized in this section.

Attitudes and Values to Support Clinical Practice
Fundamental attitudes support and enhance the ability of a health care provider to deliver patient care in a coherent, systemic fashion that includes attention to oral-systemic health as well as the environmental, sociocultural, and other factors that define an individual’s life experiences. Educational approaches that span dental and medical curricula should create in students an appreciation and value for the following:

• sharing with patients, families, and other health professionals responsibility for the oral and systemic health of patients and the public;
  
• using and updating foundational basic and clinical science knowledge in oral and systemic health;
  
• taking a complete medical history (including oral health history);
  
• performing a complete physical exam (including the oral exam and mental health status);
  
• recognizing and responding to behavioral factors in health care (including habits affecting oral health);
  
• working collaboratively in the care of patients’ oral and systemic health;
  
• making appropriate use of technology, including its limitations; and
  
• utilizing both medical and surgical approaches to disease management (for example, in the treatment of dental caries).
  

Knowledge
To address oral-systemic connections in collaborative patient care, educational sequences will need to present foundational knowledge and clinical material. Educational strategies should be designed so that medical and dental students can have access to the type, breadth, and depth of information required by their respective profession. By graduation, medical and dental students should be able to demonstrate knowledge within the following areas.

Basic and clinical science principles

• anatomy/embryology
  
• histology
  
• biochemistry
  
• cell and system physiology
  
• principles of molecular biology
  
• pathology, including oral cancer
  
• pathophysiology of major diseases, including basics of caries and periodontal diseases
  
• neurological sciences
  
• microbiology and immunology, including oral pathogens in caries and periodontal diseases
  
• principles of medical therapeutics and pharmacology, including oral impact of common medications
  
• endocrinology, including reproductive health
  
• genetics (fundamentals, major syndromes including cleft lip and palate)
  
• nutrition (importance for oral health)
  

Clinical presentation of major diseases and conditions (including oral manifestations of systemic diseases or other oral-systemic interactions)

• hypertension and cardiovascular diseases
  
• diabetes, including interaction with periodontal health
  
• obesity, including increased risk for caries and periodontal disease
  
• eating disorders (oral and systemic manifestations and conditions)
  
• hematological disorders, including bleeding diatheses, leukemia, and lymphomas—presentation in head, neck, and oral areas
  
• oral and pharyngeal cancers
  
• caries
  
• periodontal diseases
  
• sexually transmitted diseases, including oral manifestations
  
• impact of medications and other therapies on oral health (e.g., radiation, transplantation, immune suppression, anticoagulation, etc.)
  
• HIV-AIDS and other immune disorders, including oral manifestations and Sjögren’s syndrome
  
• other infectious diseases and common oral pathology (thrush, herpes, varicella, leukoplakia, lichen planus, etc.)
  
• common mental health conditions, including depression, and the oral impact of medication
  
• substance abuse (alcohol, tobacco, drugs, and related oral conditions, e.g., "meth-mouth")
  
• abuse/violence and trauma, including child abuse and neglect (especially oral and craniofacial manifestations)
  
• pain syndromes (tooth pain, temporomandibular joint dysfunction)
  
• human development across the life span—special issues for children and the elderly
  
• issues in the medical and dental care of patients with disabilities and special needs
  

Skills
For both physicians and dentists, a number of clinical skills have become specialized in relation to each area of patient care. A more contemporary, collaborative approach is needed in which dentists and physicians are each competent to do the following:

• interview patients using effective communication skills across the life cycle, including cultural and linguistic competency and the correct use of interpreters
  
• obtain a medical history, including sexual history and gender orientation
  
• obtain an oral and dental health history
  
• perform appropriate portions of the general physical exam, including vital signs, and assess general habits
  
• perform head and neck examination, including oral exam (dental exam, recognition of caries, periodontal diseases, dental erosion from eating
  
• disorders, cleft palate and other anomalies, mucosal changes, signs of oral cancer)
  
• assess basic mental health status of patients
  
• provide patient education and health counseling (e.g., use motivational interviewing or other techniques for patient behavioral change in nutrition, substance use, or oral hygiene habits) In addition, skills are needed that relate to the appropriate use of laboratory data and to decision making and treatment planning with patients and their families so practitioners can:
  
• order appropriate laboratory, radiographic, and other diagnostic tests as indicated, including biopsy of suspicious oral lesions
  
• critically integrate information from physical exam, history, and laboratory, radiographic, and other data to arrive at a differential diagnosis
  
• formulate treatment options for the patient and discuss those options with patients, including risks and benefits of the proposed treatment plans as well as risks and benefits of not pursuing the treatment options available, and obtain related informed consent (or parental permission for a child)
  

Cross-Cutting Competencies for Health Professionals
Over the last decade, a number of groups and individuals have emphasized the importance of adopting educational competencies that reach across the health professions. Overarching competencies presented here are taken principally from the 2003 IOM’s Health Professions Education: A Bridge to Quality.¹⁰ This landmark report concluded that all health professionals should be educated to 1) provide patient-centered care, 2) work in interdisciplinary teams, 3) employ evidence-based practice, 4) apply quality improvement approaches, and 5) utilize informatics. These competencies define an orientation that is beyond but inclusive of oral-systemic connections. In fact, cross-cutting competencies are essential for the future of a responsive and responsible approach to health.

While the external environmental pressures for medicine and dentistry to continue educational change have been described elsewhere in the literature, the issues are important enough to restate here. They represent concerns that must orient and sustain the curriculum of the future for the preparation of both dentists and physicians and for all those who enter health care professions.

A Changing Environment.
Cross-cutting domains respond to the changing environment in which all health professionals will practice. This landscape includes evolving science and technologies, an increasing use of informatics in health care and practice, and an emphasis on accountability and quality improvement across health systems. Demographic shifts include population growth and an increasingly diverse society, with minorities now constituting one-third of the entire population and almost half of children under age six.¹¹ There are rising numbers of elderly people—many of whom have complex and chronic health needs—and increased survival of individuals with disabilities and other special health care needs. At the other end of the age span are the 40 percent of children who live in poor or low-income families¹²—poverty rates for children being twice that of adults.¹³ Low socioeconomic status or being in a minority group places individuals of any age at greater risk for oral health disparities and difficulty accessing dental care. Finally, globalization, with its implications for distribution of resources, commerce, and travel, has the potential to dramatically affect many aspects of health and health care.

Preparing for the Future.
Cross-cutting competencies recognize that not only must medical and dental educators strive to graduate practitioners who are competent to meet present clinical needs; they must also prepare students to practice in a future health care environment that may be very different from the current one. Physicians and dentists will need to become more adept at integrating new knowledge, comfortable at the interface of their disciplines and others, and capable of applying this knowledge collaboratively as caregivers on the patient’s health care team. Practitioners will also need a more robust understanding of the overall wellness of patients, so that health promotion and disease prevention become goals for individual patients as well as communities. Health systems will increasingly emphasize accountability and quality improvement and will leverage contractual arrangements to accomplish these goals. All health practitioners must be prepared to respond as part of the health care workforce in the face of widespread public health threats. On a daily basis, practitioners will need the ability to work and communicate with our increasingly diverse patient population. To take on these challenges, educators must train a culturally and linguistically competent and representative health workforce.

Integrating New Knowledge into Evidence-Based Practice.
To integrate new knowledge and assess the biomedical literature, graduates must be sophisticated users of science and technology. The goal is not to make every dental or medical school graduate a research scientist, but rather to make every graduate a man or woman of science—that is, a sophisticated consumer of research.¹⁴ While the scientist is the producer of research, it is the practitioner who is the consumer of that knowledge. Openness to new ideas, critical thinking skills, and the ability to interpret scientific results will be needed to translate new evidence into practice.

Curricular Choices, Professional Ethics.
To ensure that medical and dental students have skills in evidence-based practice and lifelong learning, for collaborative teamwork, cross-cultural communication, and other broad competencies, difficult curriculum decisions will have to be made and priorities reassessed. Inordinate devotion to traditional curricula and technical skills will come at the price of not preparing students for success in a world of increasing diversity and complexity, intensifying competition, and continual change. Such choices may shortchange students in skills needed to care for diverse populations or to engage in quality improvement. Similarly, without additional knowledge in oral-systemic health interactions, medical and dental students will be less able to care for patients with complex health conditions, to promote oral health and address disparities in vulnerable populations, and to work collaboratively as members of the same health care team for patient care and public advocacy.

All curricular innovations support the health enterprise’s core ethical mandate to improve the health of individual patients and of the public. An increased recognition of the importance of professionalism in both medicine and dentistry has accompanied the changes altering the face of health care.^15–18 Underlying principles of ethics and professionalism must remain the bedrock of professional training—even, or especially, as the landscape of health practice changes. Content in this arena must be reinforced and revitalized to keep pace with the challenges of contemporary practice. Dental and medical professionals are equally bound by these tenets.

Attitudes and values, knowledge, and skills, from a consideration of cross-cutting competencies, are listed in Table 1.

	Curriculum and Educational Strategies

Top Background Biomedical knowledge, attitudes,... Curriculum and Educational... Towards a shared responsibility... Oral cancer and... Oral health manifestations of... Bisphosphonate drug-related... References

In the area of cross-cutting competencies, curriculum development can provide the context for more interprofessional collaboration and, potentially, cost efficiencies for the involved schools. Some examples of curricula and educational strategies in both oral-systemic content and cross-cutting competencies are provided.

Curriculum in Oral-Systemic Health Content
To optimize learning of new oral-systemic health content for medical students, a spiral curriculum is suggested (i.e., the information is offered in basic science courses and then reinforced at successively higher levels of training and by clinical experiences). The University of Washington School of Medicine¹⁹ has implemented such an oral health curriculum (Table 2).

New strategies to better integrate oral and systemic learning objectives and promote interprofessional collaboration include alignment of dental schools with other professional schools. Effective strategies already employed at some schools include training with physical and occupational therapy (University of Southern California School of Dentistry), incorporating dental training with nursing (New York University College of Dentistry), basic science courses for dental and medical students (many schools), and largely common dental and medical curricula for the first two years (Harvard School of Dental Medicine).

Service-Learning
The use of service-learning experiences in underserved communities is one strategy that dental and medical schools have both used to promote cross-cutting competencies such as cultural competency, professionalism, and social responsibility, while providing unique clinical experiences for students. Service-learning experiences in dental schools were given a boost by the Robert Wood Johnson Foundation program Pipeline, Profession, and Practice: Community-Based Dental Education. Augmented by grants from The California Endowment and W.K. Kellogg Foundation, the Pipeline program has supported service-learning, cultural competency education, and recruitment/retention of underrepresented minorities at fifteen dental schools in the United States.^22,23 Columbia University College of Dental Medicine, known for its extensive outreach programs to the underserved neighborhoods surrounding the school, provided the prototype for the Robert Wood Johnson Pipeline program.

Other schools providing extended community-based clinical experiences for dental students include the University of Colorado School of Dentistry and the University of Medicine and Dentistry of New Jersey-New Jersey Dental School. The University of North Carolina School of Dentistry includes a service-learning requirement and enhances the learning process from these experiences by the use of student self-reflection exercises.²⁴ The University of Pitts-burgh School of Dentistry mandates a community-service requirement for first-year dental students in non-dental settings.²⁵ The University of Washington School of Dentistry’s new RIDE (Regional Initiatives in Dental Education) program will combine extended community clinical rotations with interprofessional education for dental, medical, and dental hygiene students.²⁶ The RIDE program builds on the successful WWAMI (Washington, Wyoming, Alaska, Montana, Idaho) program for regional and community-based medical education at the University of Washington School of Medicine.²⁷

Many more examples exist of efforts by medical and dental schools to support cross-cutting competencies. It is hoped that this report will promote the sharing of these educational innovations.

Educational Methods
Educational methods are suggested by content area and level of the learner. For example, basic science learning objectives in oral-systemic topics for first- and second-year students lend themselves to didactic sessions supported by online learning materials and visual aids, with case presentations and examples for relevance as appropriate. Clinical sciences add more case examples and eventually patient cases to didactic materials.

Development of cross-cutting competencies, including interprofessional collaboration, must emphasize experiential methods. Ideally, students from the different health professions will participate in experiential activities together, such as small-group and case discussions, role-playing, and joint service-learning experiences. Other activities include self-assessment and self-reflection, journaling, and using interactive online materials where available. Case examples should include oral and systemic components to increase the relevance for dental and medical students, respectively; other health profession examples could also be included in cases, and these students could be included in service-learning experiences as well. These objectives should also be reinforced through a spiral curriculum, with relevance reinforced by case examples that integrate specific medical and dental course content.

Similarly, assessment approaches may also be developed by type of content and level of the learner. Multiple-choice tests may be appropriate in basic science courses, while questions geared to case examples will be more appropriate for clinical materials. Skills in cultural competency and communication can be demonstrated through direct observation in clinical encounters and objective structured clinical examinations (OSCEs). Educational approaches should be consistent with principles of adult learning that stress experiential learning, learner self-assessment, and integration of material into the learner’s previous knowledge base.

Interprofessional Collaboration
The attitudes associated with interprofessional collaboration—especially medical-dental collaboration—will be served by bringing medical and dental students together wherever possible. Institutions where dental and medical schools are both located often share basic science courses, as mentioned earlier. However, these opportunities are just the beginning of possible opportunities for shared learning, few of which have been tried. As suggested, some experiences might include pairing medical and dental students in service-learning sites. Others might include rotations in dental clinics for medical students and rotations in medical clinics and on hospital rounds for dental students. Since there are fewer than half as many dental schools as medical schools, strategies involving both medical and dental students will be limited in some locales. However, it should be possible to provide medical students with rotations in community health centers containing dental clinics, in hospital-based dental clinics, or in private dental offices. Where medical and dental students are co-located, there are opportunities for innovative, joint learning experiences in cross-cutting competencies such as cultural competency and ethics/professionalism, as well as in basic medical and oral health interviewing and examination skills. In some cases, joint electives may be offered for additional curriculum in topical areas (e.g., public health, complementary and alternative medicine). Dental students could also mentor medical students in certain oral health skills. Oral screening and application of fluoride varnishes are two examples.²⁰

Faculty Development
Faculty development presents significant challenges. Few medical faculty have received any training in oral health. However, those working in primary care fields of pediatrics and family medicine—both of which have included oral health competencies in some portion of required training—often appreciate the importance of oral health issues and their predominance in underserved populations. Faculty in oncology or genetics and those who participate in oral surgery involving the craniofacial complex (craniofacial plastic surgeons, otolaryngologists) or who see patients in emergency rooms will also have some overlapping areas of expertise that can be tapped for medical student training. Resources to support medical faculty may be found in some hospitals and in regional or hospital-based craniofacial teams, even when there are not co-located dental schools.

Dental school faculty who work in departments of oral medicine, oral and maxillofacial surgery, and periodontology will typically have more expertise in systemic health issues and can provide leadership within the dental schools. An even larger number of faculty members of co-located medical and dental schools will be able to provide resources for teaching the oral exam in the medical curriculum.

Faculty in pediatric dentistry, special needs, or geriatrics programs generally will be familiar with many of the systemic medical issues as well as sociocultural and ethical issues in care of vulnerable populations. All dental schools are required to have some curriculum in the behavioral sciences and the ethical and legal aspects of dentistry; faculty in these courses might be tapped to strengthen teaching and assessment in this area.

Collaboration between medical and dental faculty and joint appointments will augment the resources available for teaching these topics. Critically, administrative leadership is needed, or at least buy-in, before such initiatives can be launched. It is hoped that this report will serve as an impetus for such changes. It is often useful to identify a faculty "champion" with interests in the respective areas who can provide leadership and advocacy for such changes.

	Towards a Shared Responsibility for Oral Health

Top Background Biomedical knowledge, attitudes,... Curriculum and Educational... Towards a shared responsibility... Oral cancer and... Oral health manifestations of... Bisphosphonate drug-related... References

 
The challenges in faculty development reflect the larger medical and dental cultures that have separated oral health from overall health for more than a century. This schism has, for the most part, been widespread despite the obvious common scientific foundations and missions of both fields. It has played out in journals, scientific meetings, sites of practice, and health insurance systems. As a result, physicians have not considered oral health in their domain, and dentists have not considered overall health issues as their responsibility. New scientific data on oral-systemic linkages and the drive to ameliorate oral health disparities are shifting this perception, calling for more collaborative approaches. Although numerous efforts have been geared at educating non-dental health professionals in oral health issues, relatively few efforts have targeted medical and dental students and the specific educational components that can help them understand each other’s professions and collaborate better to improve the health of individual patients and the public. The panel hopes that this report will support increased collaboration between the dental and medical professions as they work toward accepting a shared responsibility for the oral health of the public.

	ORAL CANCER AND OSTEORADIONECROSIS OF THE JAW

Top Background Biomedical knowledge, attitudes,... Curriculum and Educational... Towards a shared responsibility... Oral cancer and... Oral health manifestations of... Bisphosphonate drug-related... References

 
"Nothing prepared me for the destruction that I witnessed on Mr. J’s jaw caused by osteoradionecrosis. His jaw bone melted away on the X-rays until he had a fractured mandible, all because he had radiation treatment for oral cancer years ago. Mr. J developed root caries on one of his few remaining teeth. It had already advanced into the pulp, and when I saw him for dental pain, the X-ray showed a large area of bone loss that quickly progressed in spite of our treatment. This experience has shown me that people who have had radiation therapy for oral and pharyngeal cancer must be carefully followed for preventive dentistry and emerging dental needs. Even years after the original cancer treatment, they may be at risk for radiation-associated dental caries and osteoradionecrosis. It is critical that the dentist and the oncology team communicate closely about the care of patients who have had head and neck radiation treatment for oral or pharyngeal cancer."

—Ronald P. Strauss, D.M.D., Ph.D., reflections made while visiting University of North Carolina at Chapel Hill, School of Dentistry clinical rotation sites

	ORAL HEALTH MANIFESTATIONS OF METHAMPHETAMINE ADDICTION

Top Background Biomedical knowledge, attitudes,... Curriculum and Educational... Towards a shared responsibility... Oral cancer and... Oral health manifestations of... Bisphosphonate drug-related... References

 
"When I visited our dental students on extramural rotation at the State Correctional Institution, I was shocked by the number of patients I saw in the prison dental clinic who have ‘meth mouth.’ This is a condition in which aggressive dental caries occurs among persons who have a substance abuse problem with methamphetamine. It was easy to imagine that it would be nearly impossible for these patients to return to the community and find employment unless they got treatment for their addiction and also received dental rehabilitation. In a rural state like this, it is amazing to realize how quickly methamphetamine addiction has spread in nonurban settings; it is a true epidemic. One of the most startling aspects is how the characteristic oral deterioration can stigmatize the affected person even after the addiction has been managed. This made me think about how the social and psychological issues surrounding substance abuse may be compounded by oral health declines. For many of these individuals to return to productive community lives, they will require costly oral care to take them out of pain and restore their appearance and dental function; this is part of the process of rebuilding self-esteem."

—Ronald P. Strauss, D.M.D., Ph.D., reflections made while visiting University of North Carolina at Chapel Hill, School of Dentistry clinical rotation sites

	BISPHOSPHONATE DRUG-RELATED OSTEONECROSIS OF THE JAWS

Top Background Biomedical knowledge, attitudes,... Curriculum and Educational... Towards a shared responsibility... Oral cancer and... Oral health manifestations of... Bisphosphonate drug-related... References

 
"When Ms. L, a patient with advanced breast cancer, came to the dental clinic for an emergency visit, she complained of a painful tooth root ‘erupting’ in her lower jaw where an abscessed tooth had been pulled over a year ago. On examination, it was apparent that there was no tooth root in this area. Rather, she had necrotic exposed bone protruding towards her tongue. Her medical oncologist had been managing her metastatic bone disease with the intravenous bisphosphonate zoledronic acid for several years. Bisphosphonate-associated osteonecrosis of the jaws is a newly described, post marketing, adverse effect of this class of osteoclast-inhibiting drugs that creates significant morbidity and has no established effective treatment. Concomitant poor oral hygiene and periodontal disease may play a role in its development. New guidance from the dental, medical, and pharmaceutical communities suggests that prevention is of the utmost importance and involves coordination between the medical oncologist and dentist with optimizing oral health prior to implementing intravenous bisphosphonate use and continued oral health maintenance. Although thought to be a rare adverse event, numerous women are taking oral bisphosphonates such as alendronate and ibandronate for osteoporosis prevention, and cases are now being seen among this group."

—Lauren L. Patton, D.D.S., Professor, Department of Dental Ecology, University of North Carolina at Chapel Hill, School of Dentistry

	Acknowledgments

 
This report was funded by a grant from the Josiah Macy, Jr. Foundation to the Columbia University Center for Community Health Partnerships, with assistance from the Association of American Medical Colleges and the American Dental Education Association.

	Footnotes

 
A major study initiative, "New Models of Dental Education," funded by the Josiah Macy, Jr. Foundation, convened three panels of distinguished experts to examine issues related to the dental curriculum. This report is from Panel 2, held December 3–4, 2006, on the subject of curriculum and clinical training in oral health for physicians and dentists. Staffing the panel were Allan J. Formicola (The Macy Study), Richard W. Valachovic (American Dental Education Association), and Jacqueline E. Chmar (American Dental Education Association). There were twelve panelists:

• Wendy Mouradian, M.D., M.S., Director, Regional Initiatives in Dental Education (RIDE), University of Washington School of Dentistry (co-chair)

• Charles N. Bertolami, D.D.S., D.Med.Sc., Dean, University of California, San Francisco School of Dentistry (Dean, New York University College of Dentistry, beginning September 2007) (co-chair)

• Lisa Tedesco, Ph.D., Vice-Provost for Academic Affairs–Graduate Studies and Dean of the Graduate School, Emory University (moderator)

• Carol Aschenbrener, M.D., Executive Vice President, Association of American Medical Colleges

• Sonia J. Crandall, Ph.D., M.S., Professor, Family and Community Medicine, Wake Forest University School of Medicine

• Ronald M. Epstein, M.D., Professor, University of Rochester School of Medicine and Dentistry

• Marcio da Fonseca, D.D.S., M.S., Clinical Assistant Professor of Pediatric Dentistry, Nationwide Children’s Hospital

• N. Karl Haden, Ph.D., President, Academy for Academic Leadership

• Alexis Ruffin, Deputy Director, Institute for Improving Medical Education, Association of American Medical Colleges

• James J. Sciubba, D.M.D., Ph.D., Professor, Otolaryngology and Head and Neck Surgery, Johns Hopkins School of Medicine

• Susan Silverton, M.D., Ph.D., B.Sc., Academic Vice-President and Professor, Laurentian University

• Ronald P. Strauss, D.M.D., Ph.D., M.S., Distinguished Professor, University of North Carolina at Chapel Hill School of Dentistry

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Top Background Biomedical knowledge, attitudes,... Curriculum and Educational... Towards a shared responsibility... Oral cancer and... Oral health manifestations of... Bisphosphonate drug-related... References

 

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