Clinical Experience

 

The dental anesthesiology resident will encounter a diverse and complex array of patient experiences as Jacobi is a level 1 trauma center, burn center, bariatric center, and an American Cleft Palate-Craniofacial Association Center of Excellence. Residents will experience the full spectrum of patient care, from outpatient intubated and non-intubated anesthesia for dental procedures in the dental clinic setting to advanced craniofacial, maxillofacial, and orthognathic procedures. While the emphasis will be on the provision of perioperative care for dental, including pediatric, special care, and/or oral surgery procedures, the resident will be exposed to all forms of anesthesia and pain control and all manner of OR cases. This includes general surgery, trauma surgery, pediatric surgery, plastic surgery, otorhinolaryngologic surgery, and more. Our dental anesthesiology residents are an integral part of the anesthesia team and receive didactic and clinical support from the department of anesthesiology. Resident responsibilities are commensurate with their level of training.

 

The clinical experience will also include opportunities for rotations in preadmissions testing, internal medicine, emergency medicine, pediatric medicine, critical (intensive) care medicine, pulmonology, and cardiology. 

 

The department of dentistry/OMFS at Jacobi Medical Center has two fully equipped dental anesthesia suites in which intubated and non-intubated care is provided to adult, pediatric, and special needs patients on an outpatient basis. Our residents also provide outpatient dental anesthesia care for special needs patients at the Rose F Kennedy Center. The newest addition to our program, Coney Island Hospital, provides residents with the opportunity to provide outpatient dental anesthesia for pediatric patients in a fast-paced surgical center environment.  

 

Our 36-month program is fully accredited by the Commission on Dental Accreditation (CODA) and meets requirements for board eligibility for certification by the American Dental Board of Anesthesiology (ADBA.) Upon successful completion of the program, graduates will be prepared to provide comprehensive anesthesia services for patients in the dental or maxillofacial setting. The dentist anesthesiologist will be competent to provide moderate sedation, deep sedation, and general anesthesia (intubated and non-intubated) for pediatric, adult, and special needs patients in the private practice and operating room environment.

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Didactics

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Lectures will be given on a regular basis; residents should expect to have lecture 1-2 times per week. Residents participate in anesthesiology grand rounds, journal club, and morbidity and mortality (M&M) conferences.

 

The following is a summary of the curriculum:  

• Introduction to Anesthesiology: This is a lecture series given to the incoming first year residents. It is designed to give an intensive introduction to the corpus of anesthesiology:  anatomy, physiology, pharmacology, pathology, patient evaluation, intraoperative and postoperative anesthetic management and management of emergencies, anesthesia equipment, and monitoring. In addition to the didactic lectures, the residents become certified in basic life support cardiopulmonary resuscitation (BLS-CPR,) advanced cardiac life support (ACLS,) and pediatric advanced life support (PALS.)

• Applied Biomedical Sciences Foundation to Dental Anesthesiology: The objective is to provide instruction in physiology, pharmacology, anatomy, biochemistry, pathology, physics, pathophysiology, and clinical medicine as it applies to anesthesia.

• Physical Diagnosis and Evaluation:  The objective is to provide instruction on taking, recording, and interpreting a complete medical history and physical examination and understanding the indications for and interpretations of diagnostic procedures and laboratory studies.

• Behavioral Medicine: The objective is to provide instruction on psychological components of human behavior as related to the management of anxiety and pain. To provide instruction on both pharmacologic and nonpharmacologic methods of management of anxiety and pain  for adult, pediatric, and special needs patients.

• Methods of Anxiety and Pain Control: The objective is to provide instruction on all methods of anxiety and pain control and pertinent topics such as anesthesia delivery devices, monitoring equipment, airway management,  and perioperative management of patients.

• Complications and Emergencies: The objective is to provide instruction on recognition, diagnosis, and management of anesthesia-related perioperative complications and emergencies.

• Pain Management: The objective is to  provide  instruction on the pathophysiology of pain, and the evaluation and management of acute and chronic orofacial pain. There is an emphasis on multimodal analgesic regimens (combination of local anesthetic, non-opioid, and opioid techniques,) the advantages/disadvantages, indications/contraindications of each technique, and instruction on proper prescribing practices and dependence liability.

• Research Methodology, Bioethics, and Practice Management: Bioethics provides residents instruction in: core ethical decision-making capacity, informed consent, consent for minors, confidentiality, and more. Research methodology provides instruction in biostatistics, epidemiology, study design, and more.  Practice management provides residents with instruction in: credentialing of dentist anesthesiologists in private practice, academic, and hospital settings; considerations for malpractice insurance; and considerations for the appropriate ordering, handling, storage of DEA scheduled controlled substances including ethical considerations of potential drug abuse, misuse and diversion; and record keeping, patient confidentiality and informed consent.

• Simulation Lab:  Jacobi Medical Center is home to a state-of-the-art simulation lab, the Institute of Medical Simulation and Advanced Learner (IMSAL.) Courses include airway and cardiac code team skills for adults and pediatrics. (For more information and a virtual tour of the simulation lab, please go to, click here)

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Research

 

All residents are expected to complete a research project or demonstrate scholarly activity. One of the many strengths of our program is that the program’s research requirements may be fulfilled in a way that is mindful of the individual residents unique interests, some examples include completing a literature review and preparing a paper worthy of publication or  presenting a case presentation or poster in front of a national audience of dentist anesthesiologists. Our program director and attendings are invested in mentoring residents along the way with their research projects.