Medicine III: Hospital Clerkship Program

Academic Year 2006/2007

Dental students in the clinical setting. (Images courtesy of Ryan Smart.)

This course gives the dental student not only an understanding of the complexity of issues associated with the medically compromised patient but the ability to comfortably manage such patients in the dental setting as well.

This practicum enables the student to assess the level of compromise in the history and physical examination of a medically compromised patient and modify dental care appropriately and to be competent in the assessment and management of a medically compromised dental patient in a clinical setting.

• Coagulation: Simplified?
• von Willebrand Factor
• Hemophilia
• Hemophilia: Inhibitors
• von Willebrand’s Disease

  Syllabus

  Objectives Determine and record the physiologic and behavioral status of the patient. Use the information gathered to guide and direct the examination process. Perform a systemic and complete examination of the head and neck area. By use of appropriate examination and testing methods, determine a final diagnosis and prognosis. Treat those patients with oral manifestations of systemic disease and appropriately modify therapy as required by specific circumstances. Learn to respect the medically compromised patient. Apply the knowledge gained in clinical medicine in the comprehensive care of patients. Participate in case study workshops which help in the transition of the student from preclinical to clinical setting. Participate in problem-based learning sessions, which improve the clinical decision-making skills and develop the critical thinking skills of the student. Through rotation, learn to assess a large variety of medically compromised patients and gain extensive experience in physical examinations and laboratory test evaluations. Learn to recognize and manage a case of child abuse identified in a dental setting. Learn and manage temporomandibular joint problems in the dental setting. Learn preventive strategies for medical emergencies. Appropriately identify and manage medical emergencies in the dental setting. Understand and appropriately manage a patient with hematologic and/or oncologic problems. In a clinical setting, understand common medical therapeutics associated with management of common systemic conditions, and appropriately modify anesthetic, analgesic and antibiotic medications. Identify a tissue that needs to be biopsied for evaluation, and appropriately identify disease status. Provide sufficient depth and scope of biomedical science knowledge in modern biology that can be translated into clinical practice. Describe the rationale for conducting a literature review. Learn how to identify victims of domestic violence and strategies to help patients cope. Understand medical conditions commonly seen in the pediatric developmentally disabled population. Provide students with tools in diagnosing and treating temporomandibular disorders. Forensically identify, by slides and case review, possible causes of death. Examine and determine the oral health needs of the patient awaiting organ transplant. Identify the oral health needs of the compromised renal patient.

  1. General Directions

  ALL STUDENTS MUST WEAR THE WHITE COAT.

  On all clinical rotations, students must be professionally dressed. Appropriate clinic attire is mandatory.

  Ladies: Long hair tied back, professional attire, and no dangle earrings. Gentlemen: Shaved/trimmed, necktie, and no sneakers.

  2. Grading

  A major part of the Medicine III exam grade will be based upon participation and evaluation during the following rotations: Medical Record Review, Dental Record Review, Problem-based Learning, Oral Medicine, Clinical Research & Writing, Pharmacology, and Renal Clinic.

  Knowledge and skills gained in the Clinical Medicine Program over the three years is cumulative. The examination given at the end of the rotations will include questions from Rotations not mentioned above.

  The Rotation Directors will contribute questions towards the exam, with emphasis on the practical aspect of Clinical Medicine.

  Attendance will also be a part of the final grade. A student with an excused absence only will be allowed to make up that session within the next major group rotation. All other absences will be given an incomplete for a grade and 10 points will be deducted from the final grade. The syllabus must be collected prior to the start of rotations. It is expected that the material will be read before attending the rotations.

  The Management of the Medically Compromised Patient: Do's, Don'ts, Drug-Drug interactions (Medicine IIB) information will be incorporated into the HCP training and learning.

  2.1. Examination

  • The Medicine III exam will be administered during the 5th week of the 5-week rotation block.
  • 40 multiple choice questions contributed by the rotation directors will be administered. This will account for 40% of the final grade.
  • Additionally, during the rotation, student performance will be graded for the following 6 rotations: Dental Record Review, Clinical Research & Writing, Pharmacology, Problem Based Learning (PBL) cases, Oral Medicine and Medical Record Review (MRR). Each will carry a 10 point weight. These 6 graded rotations will account for 60% of the final grade.

    Calendar

    Session	Type	Title
    1	Lecture	Hospitalized Medical Record Review Rotation
    2	Lecture	Outpatient Dental Record Review Rotation
    3	Lecture	Problem Based Learning (PBL) Rotation
    4	Lecture	Chronic Medical Condition Patient Rotation
    5	Lecture	Forensic Dentistry and Bioterrorism Rotation
    6	Lecture	Hematology/Oncology Rotation
    7	Lecture	Domestic Violence and Intimate Partner Violence (IPV) Rotation
    8	Lecture	Emergency Medical Care Rotation and Emergency Room (ER) Clinical Experience Rotation
    9	Lecture	TUSDM Emergency Code Protocols and Code Cart Rotation
    10	Lecture	Clinical Research and Writing Rotation
    11	Lecture	Pharmacology Rotation
    12	Lecture	Child Abuse Rotation
    13	Lecture	Temporal Mandibular Dysfunction (TMD) Clinical Experience Rotation
    14	Lecture	Ear Nose Throat (ENT) Tumor Board, ENT Clinical Experience Rotation and Oral Health Assessment
    15	Lecture	Renal Clinical Experience Rotation and Oral Health Assessment
    16	Lecture	Pediatric Developmentally Disabled Patient (PDDR) Clinical Experience Rotation
    17	Lecture	Transplant Clinical Experience Rotation
    18	Lecture	Oral Medicine Clinical Experience Rotation
    19	Lecture	Medicine in the Dental Clinic