CODA.org: Accreditation Standards for OMS Residency Programs

Commission on Dental Accreditation 1

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Accreditation Standards for 20

Advanced Dental Education 21

Programs in Oral and 22

Maxillofacial Surgery 23

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Oral and Maxillofacial Surgery Standards

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Accreditation Standards for

Advanced Dental Education Programs in

Oral and Maxillofacial Surgery

Commission on Dental Accreditation

211 East Chicago Avenue

Chicago, Illinois 60611

(312) 440-4653

https://coda.ada.org/

Copyright 2023

Commission on Dental Accreditation

Oral and Maxillofacial Surgery Standards

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Document Revision History

Date

Item

Action

February 12, 2021

Accreditation Standards for Advanced Dental Education

Programs in Oral and Maxillofacial Surgery

Adopted and

Implemented

February 12, 2021

Revised Standards 4-4 and 4-6 through 4-8; Deletion of

Standard 4-6.1; and Addition of 4-8.2 and 4-18 through

4-20

Adopted

August 6, 2021

Revised Mission Statement

Adopted

January 1, 2022

Revised Standards 4-4 and 4-6 through 4-8; Deletion of

Standard 4-6.1; and Addition of 4-8.2 and 4-18 through

4-20

Implemented

January 1, 2022

Revised Mission Statement

Implemented

August 11, 2023 Revised Accreditation Status Definitions Adopted and

Implemented

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Table of Contents

Mission Statement of the Commission on Dental Accreditation ........................................................... 5

ACCREDITATION STATUS DEFINITIONS ...................................................................................... 6

Programs That Are Fully Operational ............................................................................................. 6

Programs That Are Not Fully Operational ...................................................................................... 6

Preface .................................................................................................................................................... 8

Definitions of Terms Used in Oral and Maxillofacial Surgery ............................................................ 10

STANDARD 1 - INSTITUTIONAL COMMITMENT/PROGRAM EFFECTIVENESS .................. 13

USE OF SITES WHERE EDUCATIONAL ACTIVITY OCCURS ................................................ 16

STANDARD 2 - PROGRAM DIRECTOR AND TEACHING STAFF ............................................. 17

STANDARD 3 – FACILITIES AND RESOURCES .......................................................................... 21

STANDARD 4 - CURRICULUM AND PROGRAM DURATION ................................................... 23

BASIC SCIENCES ........................................................................................................................... 27

PHYSICAL DIAGNOSIS ................................................................................................................. 27

CLINICAL ORAL AND MAXILLOFACIAL SURGERY ............................................................. 28

MINIMUM CLINICAL REQUIREMENTS .................................................................................... 28

Outpatient Oral and Maxillofacial Surgery Experience ................................................................ 28

General Anesthesia and Deep Sedation ....................................................................................... 290

Admissions .................................................................................................................................. 312

Major Surgery ................................................................................................................................ 31

STANDARD 5 - ADVANCED DENTAL EDUCATION RESIDENTS ...................................... 367

ELIGIBILITY AND SELECTION ................................................................................................... 36

EVALUATION ................................................................................................................................. 38

DUE PROCESS ............................................................................................................................ 3940

RIGHTS AND RESPONSIBILITIES .......................................................................................... 3940

STANDARD 6 – RESEARCH ........................................................................................................ 4041

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Mission Statement of the

Commission on Dental Accreditation

The Commission on Dental Accreditation serves the public and dental professions by developing and

implementing accreditation standards that promote and monitor the continuous quality and improvement of

dental education programs.

Commission on Dental Accreditation

Adopted: August 5, 2016; Revised August 6, 2021

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ACCREDITATION STATUS DEFINITIONS

PROGRAMS THAT ARE FULLY OPERATIONAL:

Approval (without reporting requirements): An accreditation classification granted to an educational

program indicating that the program achieves or exceeds the basic requirements for accreditation.

Approval (with reporting requirements): An accreditation classification granted to an educational

program indicating that specific deficiencies or weaknesses exist in one or more areas of the program.

Evidence of compliance with the cited standards or policies must be demonstrated within a timeframe

not to exceed eighteen (18) months if the program is between one and two years in length or two

years if the program is at least two years in length. If the deficiencies are not corrected within the

specified time period, accreditation will be withdrawn, unless the Commission extends the period for

achieving compliance for good cause. Identification of new deficiencies during the reporting time

period will not result in a modification of the specified deadline for compliance with prior

deficiencies.

Circumstances under which an extension for good cause would be granted include, but are not limited

to:

• sudden changes in institutional commitment;

• natural disaster which affects affiliated agreements between institutions; faculty support; or

facilities;

• changes in institutional accreditation;

• interruption of an educational program due to unforeseen circumstances that take faculty,

administrators or students away from the program.

Revised: 8/17; 2/16; 5/12; 1/99; Reaffirmed: 8/23; 8/18; 8/13; 8/10, 7/05; Adopted: 1/98

PROGRAMS THAT ARE NOT FULLY OPERATIONAL: A program which has not enrolled and

graduated at least one class of students/residents and does not have students/residents enrolled in each

year of the program is defined by the Commission as not fully operational. The accreditation

classification granted by the Commission on Dental Accreditation to programs which are not fully

operational is “initial accreditation.” When initial accreditation status is granted to a developing

education program, it is in effect through the projected enrollment date. However, if enrollment of the

first class is delayed for two consecutive years following the projected enrollment date, the program’s

accreditation will be discontinued, and the institution must reapply for initial accreditation and update

pertinent information on program development. Following this, the Commission will reconsider

granting initial accreditation status. The developing education program must not enroll

students/residents with advanced standing beyond its regularly enrolled cohort, while holding the

accreditation status of “initial accreditation.”

Initial Accreditation is the accreditation classification granted to any dental, advanced dental or

allied dental education program which is not yet fully operational. This accreditation classification

provides evidence to educational institutions, licensing bodies, government or other granting agencies

that, at the time of initial evaluation(s), the developing education program has the potential for

meeting the standards set forth in the requirements for an accredited educational program for the

specific occupational area. The classification “initial accreditation” is granted based upon one or

more site evaluation visit(s).

Revised: 8/23; 7/08; Reaffirmed: 8/18; 8/13; 8/10; Adopted: 2/02

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Other Accreditation Actions:

Teach-Out: An action taken by the Commission on Dental Accreditation to notify an accredited

program and the communities of interest that the program is in the process of voluntarily terminating

its accreditation due to a planned discontinuance or program closure. The Commission monitors the

program until students/residents who matriculated into the program prior to the reported

discontinuance or closure effective date are no longer enrolled.

Reaffirmed:8/23; 8/18; Adopted: 2/16

Discontinued: An action taken by the Commission on Dental Accreditation to affirm a program’s

reported discontinuance effective date or planned closure date and to remove a program from the

Commission’s accredited program listing, when a program either 1) voluntarily discontinues its

participation in the accreditation program and no longer enrolls students/residents who matriculated

prior to the program’s reported discontinuance effective date or 2) is closed by the sponsoring

institution.

Intent to Withdraw: A formal warning utilized by the Commission on Dental Accreditation to

notify an accredited program and the communities of interest that the program’s accreditation will be

withdrawn if compliance with accreditation standards or policies cannot be demonstrated by a

specified date. The warning is usually for a six-month period, unless the Commission extends for

good cause. The Commission advises programs that the intent to withdraw accreditation may have

legal implications for the program and suggests that the institution’s legal counsel be consulted

regarding how and when to advise applicants and students of the Commission’s accreditation actions.

The Commission reserves the right to require a period of non-enrollment for programs that have been

issued the Intent to Withdraw warning.

Revised: 2/16; 8/13; Reaffirmed: 8/23; 8/18

Withdraw: An action taken by the Commission when a program has been unable to demonstrate

compliance with the accreditation standards or policies within the time period specified. A final

action to withdraw accreditation is communicated to the program and announced to the communities

of interest. A statement summarizing the reasons for the Commission’s decision and comments, if

any, that the affected program has made with regard to this decision, is available upon request from

the Commission office. Upon withdrawal of accreditation by the Commission, the program is no

longer recognized by the United States Department of Education. In the event the Commission

withdraws accreditation from a program, students currently enrolled in the program at the time

accreditation is withdrawn and who successfully complete the program, will be considered graduates

of an accredited program. Students who enroll in a program after the accreditation has been

withdrawn will not be considered graduates of a Commission accredited program. Such graduates

may be ineligible for certification/licensure examinations.

Revised 6/17; Reaffirmed:8/23; 8/18; 8/13; 8/10, 7/07, 7/01; CODA: 12/87:9

Denial: An action by the Commission that denies accreditation to a developing program (without

enrollment) or to a fully operational program (with enrollment) that has applied for accreditation.

Reasons for the denial are provided. Denial of accreditation is considered an adverse action.

Reaffirmed:8/23; 8/18; 8/13; Adopted: 8/11

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Preface

Maintaining and improving the quality of advanced dental education programs is a primary aim of the

Commission on Dental Accreditation. The Commission is recognized by the public, the profession

and the United States Department of Education as the specialized accrediting agency in dentistry.

Accreditation of advanced dental education programs is a voluntary effort of all parties involved. The

process of accreditation ensures residents, the dental profession, specialty boards and the public that

accredited training programs are in compliance with published standards.

Accreditation is extended to institutions offering acceptable programs in the disciplines of advanced

dental education: dental public health, endodontics, oral and maxillofacial pathology, oral and

maxillofacial radiology, oral and maxillofacial surgery, orthodontics and dentofacial orthopedics,

pediatric dentistry, periodontics, prosthodontics, advanced education in general dentistry, general

practice residency, dental anesthesiology, oral medicine, and orofacial pain. Program accreditation

will be withdrawn when the training program no longer conforms to the standards as specified in this

document, when all first-year positions remain vacant for a period of two years or when a program

fails to respond to requests for program information. Exceptions for non-enrollment may be made by

the Commission for programs with “approval without reporting requirements” status upon receipt of a

formal request from an institution stating reasons why the status of the program should not be

withdrawn.

Advanced dental education may be offered on either a certificate-only or certificate and degree-

granting basis.

Accreditation actions by the Commission on Dental Accreditation are based upon information gained

through written submissions by program directors and evaluations made on site by assigned site

visitors. The Commission has established review committees to review site visit and progress reports

and make recommendations to the Commission. Review committees are composed of representatives

nominated by dental organizations and nationally accepted certifying boards. The Commission has

the ultimate responsibility for determining a program’s accreditation status. The Commission is also

responsible for adjudication of appeals of adverse decisions and has established policies and

procedures for appeal. A copy of policies and procedures may be obtained from the Director,

Commission on Dental Accreditation, 211 East Chicago Avenue, Chicago, Illinois 60611.

This document constitutes the standards by which the Commission on Dental Accreditation and its

site visitors will evaluate advanced dental education programs in each discipline for accreditation

purposes. The Commission on Dental Accreditation establishes general standards which are common

to all disciplines of advanced dental education, institutions and programs. Each discipline develops

discipline-specific standards for educational programs in its discipline. The general and discipline-

specific standards, subsequent to approval by the Commission on Dental Accreditation, set forth the

standards for the educational content, instructional activities, patient care responsibilities, supervision

and facilities that should be provided by programs in the particular discipline.

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As a learned profession entrusted by the public to provide for its oral health and general well-being,

the profession provides care without regard to race, color, religion, gender, national origin, age,

disability, sexual orientation, status with respect to public assistance, or marital status.

The profession has a duty to consider patients’ preferences, and their social, economic and emotional

circumstances when providing care, as well as to attend to patients whose medical, physical and

psychological or social situation make it necessary to modify normal dental routines in order to

provide dental treatment. These individuals include, but are not limited to, people with

developmental disabilities, cognitive impairments, complex medical problems, significant physical

limitations, and the vulnerable elderly. The Standards reconfirm and emphasize the importance of

educational processes and goals for comprehensive patient care and encourage patient-centered

approaches in teaching, research and oral health care delivery.

The profession adheres to ethical principles of honesty, compassion, kindness, respect, integrity,

fairness and charity, as exemplified in the ADA Principles of Ethics and Code of Professional

Conduct and the ADEA Statement on Professionalism in Dental Education.

General standards are identified by the use of a single numerical listing (e.g., 1). Discipline-specific

standards are identified by the use of multiple numerical listings (e.g., 1-1, 1-1.2, 1-2).

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Definitions of Terms Used in

Oral and Maxillofacial Surgery

Accreditation Standards

The terms used in this document (i.e., shall, must, should, can and may) were selected carefully and

indicate the relative weight that the Commission attaches to each statement. The definitions of these

words as used in the Standards are as follows:

Must or Shall: Indicates an imperative need and/or duty; an essential or indispensable item;

mandatory.

Intent: Intent statements are presented to provide clarification to the advanced dental education

programs in oral and maxillofacial surgery in the application of and in connection with compliance

with the Accreditation Standards for Advanced Dental Education Programs in Oral and Maxillofacial

Surgery. The statements of intent set forth some of the reasons and purposes for the particular

Standards. As such, these statements are not exclusive or exhaustive. Other purposes may apply.

Examples of evidence to demonstrate compliance include: Desirable condition, practice or

documentation indicating the freedom or liberty to follow a suggested alternative.

Should: Indicates a method to achieve the standard; highly desirable, but not mandatory.

May or Could: Indicates freedom or liberty to follow a suggested alternative.

Graduates of discipline-specific advanced dental education programs provide unique services to the

public. While there is some commonality with services provided by specialists and general dentists,

as well as commonalities among the specialties, the educational standards developed to prepare

graduates of discipline-specific advanced dental programs for independent practice should not be

viewed as a continuum from general dentistry. Each discipline defines the educational experience

best suited to prepare its graduates to provide that unique service.

Competencies: Statements in the advanced dental education standards describing the knowledge,

skills and values expected of graduates of discipline-specific advanced dental education programs.

Competent: Having the knowledge, skills and values required of the graduates to begin independent,

unsupervised discipline-specific practice.

In-depth: Characterized by thorough knowledge of concepts and theories for the purpose of critical

analysis and synthesis.

Understanding: Knowledge and recognition of the principles and procedures involved in a

particular concept or activity.

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Institution (or organizational unit of an institution): a dental, medical or public health school,

patient care facility, or other entity that engages in advanced dental education.

Sponsoring institution: primary responsibility for advanced dental education programs.

Affiliated institution: support responsibility for advanced dental education programs.

A degree-granting program a planned sequence of advanced courses leading to a master’s or

doctoral degree granted by a recognized and accredited educational institution.

A certificate program is a planned sequence of advanced courses that leads to a certificate of

completion in an advanced dental education program recognized by the American Dental

Association.

Resident: The individual enrolled in an accredited advanced dental education program.

International Dental School: A dental school located outside the United States and Canada.

Evidence-based dentistry: Evidence-based dentistry is an approach to oral health care that requires

the judicious integration of systematic assessments of clinically relevant scientific evidence, relating

to the patient’s oral and medical condition and history, with the dentist’s clinical expertise and the

patient’s treatment needs and preferences.

Formative Assessment*: guiding future learning, providing reassurance, promoting reflection, and

shaping values; providing benchmarks to orient the learner who is approaching a relatively

unstructured body of knowledge; and reinforcing students’ intrinsic motivation to learn and inspire

them to set higher standards for themselves.

Summative Assessment*: making an overall judgment about competence, fitness to practice, or

qualification for advancement to higher levels of responsibility; and providing professional self-

regulation and accountability.

*Epstein, R.M. (2007) Assessment in Medical Education. The New England Journal of Medicine,

387-96.

Oral and Maxillofacial Surgery Terms:

Oral and maxillofacial surgery teaching service: that service in which the resident plays the

primary role in the admission, management and/or discharge of patients.

General anesthesia: is a controlled state of unconsciousness, accompanied by partial or complete

loss of protective reflexes, including inability to maintain an airway independently and respond

purposefully to physical stimulation or verbal command, produced by a pharmacologic or non-

pharmacologic method, or combination thereof.

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Deep sedation: is a controlled state of depressed consciousness, accompanied by partial loss of

protective reflexes, including the inability to continually maintain an airway independently and/or

to respond purposefully to verbal command, and is produced by a pharmacologic or non-

pharmacologic method, or a combination thereof.

Board Certified: as defined by the American Board of Oral and Maxillofacial Surgery.

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STANDARD 1 - INSTITUTIONAL COMMITMENT/PROGRAM EFFECTIVENESS

The program must develop clearly stated goals and objectives appropriate to advanced dental

education, addressing education, patient care, research and service. Planning for, evaluation of and

improvement of educational quality for the program must be broad-based, systematic, continuous and

designed to promote achievement of program goals related to education, patient care, research and

service.

The program must document its effectiveness using a formal and ongoing outcomes assessment

process to include measures of advanced dental education resident achievement.

1-1 The program must document success of graduates in obtaining American Board of Oral

and Maxillofacial Surgery certification.

1-2 The program must document participation in a national, standardized and

psychometrically validated in-service examination.

Example of Evidence to demonstrate compliance may include:

• OMSITE

Intent: The Commission on Dental Accreditation expects each program to define its own goals and

objectives for preparing individuals for the practice of oral and maxillofacial surgery and that one of

the program goals is to comprehensively prepare competent individuals to initially practice oral and

maxillofacial surgery. The outcomes process includes steps to: (a) develop clear, measurable goals

and objectives consistent with the program’s purpose/mission; (b) develop procedures for evaluating

the extent to which the goals and objectives are met; (c) collect and maintain data in an ongoing and

systematic manner; (d) analyze the data collected and share the results with appropriate audiences;

(e) identify and implement corrective actions to strengthen the program; and (f )review the

assessment plan, revise as appropriate, and continue the cyclical process.

The financial resources must be sufficient to support the program’s stated goals and objectives.

Intent: The institution should have the financial resources required to develop and sustain the

program on a continuing basis. The program should have the ability to employ an adequate number

of full-time faculty, purchase and maintain equipment, procure supplies, reference material and

teaching aids as reflected in annual budget appropriations. Financial allocations should ensure that

the program will be in a competitive position to recruit and retain qualified faculty and residents.

Annual appropriations should provide for innovations and changes necessary to reflect current

concepts of education in the advanced dental education discipline. The Commission will assess the

adequacy of financial support on the basis of current appropriations and the stability of sources of

funding for the program.

The sponsoring institution must ensure that support from entities outside of the institution does not

compromise the teaching, clinical and research components of the program.

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Examples of evidence to demonstrate compliance may include:

• Written agreement(s)

• Contract(s)/Agreement(s) between the institution/program and sponsor(s) related to facilities,

funding, and faculty financial support

Advanced dental education programs must be sponsored by institutions, which are properly

chartered, and licensed to operate and offer instruction leading to degrees, diplomas or certificates

with recognized education validity. Hospitals that sponsor advanced dental education programs must

be accredited by an accreditation organization recognized by the Centers for Medicare and Medicaid

Services (CMS). Educational institutions that sponsor advanced dental education programs must be

accredited by an agency recognized by the United States Department of Education. The bylaws, rules

and regulations of hospitals that sponsor or provide a substantial portion of advanced dental education

programs must ensure that dentists are eligible for medical staff membership and privileges including

the right to vote, hold office, serve on medical staff committees and admit, manage and discharge

patients.

United States military programs not sponsored or co-sponsored by military medical treatment

facilities, United States-based educational institutions, hospitals or health care organizations

accredited by an agency recognized by the United States Department of Education or accredited by an

accreditation organization recognized by the Centers for Medicare and Medicaid Services (CMS)

must demonstrate successful achievement of Service-specific organizational inspection criteria.

The authority and final responsibility for curriculum development and approval, resident selection,

faculty selection and administrative matters must rest within the sponsoring institution.

The institution/program must have a formal system of quality assurance for programs that provide

patient care.

The position of the program in the administrative structure must be consistent with that of other

parallel programs within the institution and the program director must have the authority,

responsibility and privileges necessary to manage the program.

1-3 There must be adequate bed availability to provide for the required number of

patient admissions and appropriate independent care by the oral and

maxillofacial surgery service.

1-4 Oral and maxillofacial surgeons who are members of the teaching staff

participating in an accredited educational program must be eligible to practice

the full scope of the advanced dental education discipline in accordance with their

training, experience and demonstrated competence.

Examples of evidence to demonstrate compliance may include:

• Details of bylaws and credentialing process that document that oral and maxillofacial

surgeons are allowed to practice those aspects of the advanced dental education

discipline for which they have documented evidence of training and experience

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• List of procedures performed that show scope, and/or hospital privileges list

1-5 The educational mission must not be compromised by a reliance on residents to

fulfill institutional service, teaching or research obligations. Resources and time

must be provided for the proper achievement of educational obligations.

Intent: All resident activities have redeeming educational value. Some teaching experience

is part of a residents training, but the degree to which it is done should not abuse its

educational value to the resident.

Examples of evidence to demonstrate compliance may include:

• Clinic assignment schedule

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USE OF SITES WHERE EDUCATIONAL ACTIVITY OCCURS

The primary sponsor of the educational program must accept full responsibility for the quality of

education provided in all sites where educational activity occurs.

1-6 All arrangements with major and minor activity sites, not owned by the

sponsoring institution, must be formalized by means of current written

agreements that clearly define the roles and responsibilities of the parties

involved.

Intent: Ownership may entail clinical operations, and not necessarily the physical facility.

1-7 Documentary evidence of agreements, for major and minor activity sites not

owned by the sponsoring institution, must be available. The following items must

be covered in such inter-institutional agreements:

a. Designation of a single program director;

b. The teaching staff;

c. The educational objectives of the program;

d. The period of assignment of residents; and

e. Each institution's financial commitment

Intent: An “institution (or organizational unit of an institution)” is defined as a dental,

medical or public health school, patient care facility, or other entity (e.g., OMS practice

facility) that engages in advanced dental education. The items that are covered in inter-

institutional agreements do not have to be contained in a single document. They may be

included in multiple agreements, both formal and informal (e.g., addenda and letters of

mutual understanding).

1-8 Rotations to an affiliated institution which sponsors its own accredited oral and

maxillofacial surgery residency program must not exceed 26 weeks in duration.

1-9 All standards in this document must apply to training provided in affiliated

institutions.

If the program utilizes off-campus sites for clinical experiences or didactic instruction, please review

the Commission’s Policy on Accreditation of Off-Campus Sites found in the Evaluation and

Operational Policies and Procedures manual (EOPP).

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STANDARD 2 - PROGRAM DIRECTOR AND TEACHING STAFF

The program must be administered by one director who is board certified in the respective advanced

dental education discipline of the program. (All program directors appointed after January 1, 1997,

who have not previously served as program directors, must be board certified.)

Intent: The director of an advanced dental education program is to be certified by a

nationally accepted certifying board in the advanced dental education discipline. Board

certification is to be active. The board certification requirement of Standard 2 is also

applicable to an interim/acting program director. A program with a director who is not

board certified but who has previous experience as an interim/acting program director in a

Commission-accredited program prior to 1997 is not considered in compliance with Standard

2.

Examples of evidence to demonstrate compliance may include:

For board certified directors: Copy of board certification certificate; letter from board

attesting to current/active board certification

(For non-board certified directors who served prior to January 1, 1997: Current CV

identifying previous directorship in a Commission on Dental Accreditation- or Commission

on Dental Accreditation of Canada-accredited advanced dental education program in the

respective discipline; letter from the previous employing institution verifying service)

The program director must be appointed to the sponsoring institution and have sufficient authority

and time to achieve the educational goals of the program and assess the program’s effectiveness in

meeting its goals.

Documentation of all program activities must be ensured by the program director and available for

review.

2-1 Program Director: The program must be directed by a single responsible

individual who is a full time faculty member as defined by the institution.

Intent: Other activities do not dilute a program director’s ability to discharge his/her

primary obligations to the educational program.

The responsibilities of the program director must include:

2-1.1 Development of the goals and objectives of the program and definition of a

systematic method of assessing these goals by appropriate outcomes

measures.

2-1.2 Ensuring the provision of adequate physical facilities for the educational

process.

2-1.3 Participation in selection and supervision of the teaching staff. Perform

periodic, at least annual, written evaluations of the teaching staff. This

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must include documentation of evaluation of the members of the teaching

staff by the residents at least annually.

Intent: In some situations, the evaluation of the teaching staff may be

performed by the chairman of the department of oral and maxillofacial surgery

in conjunction with the program director.

2-1.4 Responsibility for adequate educational resource materials for education

of the residents, including access to an adequate health science library and

electronic reference sources.

2-1.5 Responsibility for selection of residents and ensuring that all appointed

residents meet the minimum eligibility requirements, unless the program

is sponsored by a federal service utilizing a centralized resident selection

process.

2-1.6 Maintenance of appropriate records of the program, including resident

and patient statistics, institutional agreements, and resident records.

Examples of evidence to demonstrate compliance may include:

• Copies of faculty meeting minutes

• Sign-in sheets

• Monthly records of outpatient visits by category

• Resident surgical logs/other electronic record databases

• Evaluations of teaching staff

2-2 Teaching Staff: The teaching staff must be of adequate size and must provide for

the following:

2-2.1 Provide direct supervision in all patient care settings appropriate to a

resident’s competence and level of training.

Intent: Faculty is present and available in clinics, emergency rooms and operating

rooms for appropriate level supervision during critical parts of procedures.

Examples of evidence to demonstrate compliance may include:

• Faculty coverage for clinic, operating room and call schedules

• Patient records

2-2.2 In addition to the full time program director, the teaching staff must have

at least one full time equivalent oral and maxillofacial surgeon as defined

by the institution per each authorized senior resident position. One of the

teaching staff who is not the program director must be at least half-time

faculty as defined by the institution.

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CODA authorized

enrollment per year

(n)

Required

Program Director

F.T.E.

Required

minimum F.T.E.

of second

faculty member

Required

cumulative

additional F.T.E. of

faculty who are not

program director

Required Total faculty

F.T.E. for program

1

0.5

2

1

0.5

1.5

3

1

0.5

2.5

4

n

1

0.5

n – 0.5

n + 1

2-2.3 Eligible oral and maxillofacial surgery members of the teaching staff, with

greater than a .5 FTE commitment appointed after January 1, 2000, who

have not previously served as teaching staff, must be diplomates of the

American Board of Oral and Maxillofacial Surgery or in the process of

becoming board certified. Foreign trained faculty must be comparably

qualified.

2-3 Scholarly Activity of Faculty: There must be evidence of scholarly activity

among the oral and maxillofacial surgery faculty.

Examples of Evidence to demonstrate compliance may include:

a. Participation in clinical and/or basic research particularly in projects funded

following peer review;

b. Publication of the results of innovative thought, data gathering research

projects, and thorough reviews of controversial issues in peer-reviewed

scientific media; and

c. Presentation at scientific meetings and/or continuing education courses at the

local, regional, or national level.

2-4 The program must show evidence of an ongoing faculty development process.

Intent: Ongoing faculty development is a requirement to improve teaching and

learning, to foster curricular change, to enhance retention and job satisfaction of

faculty, and to maintain the vitality of academic dentistry as the wellspring of a

learned profession.

Examples of evidence to demonstrate compliance may include:

Participation in development activities related to teaching, learning, and assessment

Attendance at regional and national meetings that address contemporary issues in

education and patient care

Mentored experiences for new faculty

Scholarly productivity

Presentations at regional and national meetings

Examples of curriculum innovation

Maintenance of existing and development of new and/or emerging clinical skills

Documented understanding of relevant aspects of teaching methodology

Curriculum design and development

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Curriculum evaluation

Student/Resident assessment

Cultural Competency

Ability to work with students/residents of varying ages and backgrounds

Use of technology in didactic and clinical components of the curriculum

Evidence of participation in continuing education activities

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STANDARD 3 – FACILITIES AND RESOURCES

Institutional facilities and resources must be adequate to provide the educational experiences and

opportunities required to fulfill the needs of the educational program as specified in these Standards.

Equipment and supplies for use in managing medical emergencies must be readily accessible and

functional.

Intent: The facilities and resources (e.g.; support/secretarial staff, allied personnel and/or technical

staff) should permit the attainment of program goals and objectives. To ensure health and safety for

patients, residents, faculty and staff, the physical facilities and equipment should effectively

accommodate the clinic and/or laboratory schedule.

The program must document its compliance with the institution’s policy and applicable regulations

of local, state and federal agencies, including but not limited to radiation hygiene and protection,

ionizing radiation, hazardous materials, and bloodborne and infectious diseases. Policies must be

provided to all residents, faculty and appropriate support staff and continuously monitored for

compliance. Additionally, policies on bloodborne and infectious diseases must be made available to

applicants for admission and patients.

Intent: The program may document compliance by including the applicable program policies. The

program demonstrates how the policies are provided to the residents, faculty and appropriate

support staff and who is responsible for monitoring compliance. Applicable policy states how it is

made available to applicants for admission and patients should a request to review the policy be

made.

Residents, faculty and appropriate support staff must be encouraged to be immunized against and/or

tested for infectious diseases, such as mumps, measles, rubella and hepatitis B, prior to contact with

patients and/or infectious objects or materials, in an effort to minimize the risk to patients and dental

personnel.

Intent: The program should have written policy that encourages (e.g., delineates the advantages of)

immunization for residents, faculty and appropriate support staff.

All residents, faculty and support staff involved in the direct provision of patient care must be

continuously recognized/certified in basic life support procedures, including cardiopulmonary

resuscitation.

Intent: Continuously recognized/certified in basic life support procedures means the appropriate

individuals are currently recognized/certified.

The use of private office facilities as a means of providing clinical experiences in advanced dental

education is only approved when the discipline has included language that defines the use of such

facilities in its discipline-specific standards.

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3-1 Clinical facilities must be properly equipped for performance of all ambulatory

oral and maxillofacial surgery procedures, including administration of general

anesthesia and sedation for ambulatory patients.

3-2 There must be a space properly equipped for monitoring patients' recovery from

ambulatory surgery, general anesthesia and sedation.

3-3 An adequate and accessible dental laboratory facility must be available to the

residents to utilize for patient care.

3-4 Adequate onsite computer resources with internet access must be available to the

residents.

3-5 Adequate on call facilities must be provided to residents when fulfilling in-house

call responsibilities.

3-6 Adequate and accessible diagnostic imaging facilities must be available to

residents to utilize for patient care.

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STANDARD 4 - CURRICULUM AND PROGRAM DURATION

The advanced dental education program must be designed to provide special knowledge and skills

beyond the D.D.S. or D.M.D. training and be oriented to the accepted standards of the discipline’s

practice as set forth in specific standards contained in this document.

Intent: The intent is to ensure that the didactic rigor and extent of clinical experience exceeds pre-

doctoral, entry level dental training or continuing education requirements and the material and

experience satisfies standards for the discipline.

Advanced dental education programs must include instruction or learning experiences in evidence-

based practice. Evidence-based dentistry is an approach to oral health care that requires the judicious

integration of systematic assessments of clinically relevant scientific evidence, relating to the

patient’s oral and medical condition and history, with the dentist’s clinical expertise and the patient’s

treatment needs and preferences.

Examples of Evidence to demonstrate compliance may include:

• Formal instruction (a module/lecture materials or course syllabi) in evidence-based practice

• Didactic Program course syllabi, course content outlines, or lecture materials that integrate

aspects of evidence-based practice

• Literature review seminar(s)

• Multidisciplinary Grand Rounds to illustrate evidence-based practice

• Projects/portfolios that include critical reviews of the literature using evidence-based practice

principles (or “searching publication databases and appraisal of the evidence”)

• Assignments that include publication database searches and literature appraisal for best

evidence to answer patient-focused clinical questions.

The level of discipline-specific instruction in certificate and degree-granting programs must be

comparable.

Intent: The intent is to ensure that the residents of these programs receive the same educational

requirements as set forth in these Standards.

If an institution and/or program enrolls part-time residents, the institution must have guidelines

regarding enrollment of part-time residents. Part-time residents must start and complete the program

within a single institution, except when the program is discontinued. The director of an accredited

program who enrolls residents on a part-time basis must ensure that: (1) the educational experiences,

including the clinical experiences and responsibilities, are the same as required by full-time residents;

and (2) there are an equivalent number of weeks spent in the program.

4-1 An advanced dental education program in oral and maxillofacial surgery must

encompass a minimum duration of four (4) years of full-time study.

4-2 Each resident must devote a minimum of 120 weeks to clinical oral and

maxillofacial surgery.

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Intent: While enrolled in an oral and maxillofacial surgery program, full-time rotations on

the oral and maxillofacial surgery service while doing a non-oral and maxillofacial surgery

residency year or full-time service on oral and maxillofacial surgery during vacation times

during medical school may be counted toward this requirement.

Examples of evidence to demonstrate compliance may include:

• Complete schedule of resident activity

4-2.1 Fifty-two weeks of the time spent on the oral and maxillofacial surgery

service must be at a senior level of responsibility, 26 weeks of which must

be in the final year.

Intent: Senior level responsibility means residents serving as first assistant to

attending surgeon on major cases. Resident serves as first assistant for the majority of

surgical procedures performed during this rotation. They are to be present for most

pre- and post-operative patient visits.

4-2.2 Rotations to affiliated institutions outside the United States and Canada

must not be used to fulfill the core 120 weeks clinical oral and

maxillofacial surgery training experience. Surgical procedures performed

during foreign rotations must not count toward fulfillment of the 175

major surgical procedures.

4-2.3 Rotations to a private practice must not be used to fulfill the core 120

weeks clinical oral and maxillofacial surgery training experience.

4-3 The residency program in oral and maxillofacial surgery must include education

and training in the basic and clinical sciences, which is integrated into the

training program. A distinct and specific curriculum must be provided in

anesthesia, clinical medicine and surgery.

The integrated clinical science curriculum must include off-service rotations,

lectures and seminars given during the oral and maxillofacial surgery training

program by oral and maxillofacial surgery residents and attending staff.

Intent: Course work and training taken as requirements for the medical degree and

the general surgery residency year provided within integrated MD or DO/oral and

maxillofacial surgery training programs may also qualify to satisfy some of the

clinical science curriculum requirements.

When assigned to a required rotation on another service (surgery, medicine,

anesthesiology, and eight weeks of additional off-service elective), the oral and

maxillofacial surgery resident must devote full-time to the service and participate

fully in all the teaching activities of the service, including regular on-call

responsibilities.

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Intent: Beyond the required 56 week rotations, residents may take call on the oral and

maxillofacial surgery service when on additional rotations (oral pathology, etc.).

Examples of evidence to demonstrate compliance may include:

• Lecture schedules

• Curriculum; behavioral objectives

• Attendance sign-in sheets

• Policy of anesthesia department related to on-call participation by residents if residents

are not permitted to be on-call

• Rotation schedules

4-3.1 Anesthesia and Medical Service:

The combined assignment must be for a minimum of 32 weeks. A

minimum of 20 weeks must be on the anesthesia service and should be

consecutive. Four of these 20 weeks should be dedicated to pediatric

anesthesia. The resident must function as an anesthesia resident with

commensurate level of responsibility. A minimum of 8 weeks must be on

the medicine or medical subspecialty services.

Intent: It is desirable that four weeks of the required 32 weeks, not fulfilled by the 20

weeks on anesthesia and 8 weeks on medicine or medical subspecialty services be an

experience in pre-anesthetic risk stratification and perioperative medical assessment

of the surgical patient. The experience beyond the 20 weeks rotation on the anesthesia

service may be at the medical student or resident level, and may include the rotations

on medical/anesthesia specialty services (e.g., Medicine, Cardiology, Critical Care,

Pediatrics, anesthesia perioperative medicine clinic). The 20 week Anesthesia Service

time can be during medical school as long as the oral and maxillofacial surgery

trainee functions at the anesthesia resident level.

Examples of evidence to demonstrate compliance may include:

• Resident on-call anesthesia and medicine schedules

• Resident anesthesia and medical service rotation schedules

• Anesthesia records

4-3.2 Surgical Service:

A minimum of 16 weeks of clinical surgical experience must be provided.

This experience should be achieved by rotation to a surgical service (not to

include oral and maxillofacial surgery) and the resident must function as a

surgery resident with commensurate level of responsibility.

Intent: The intent is to provide residents with adequate training in pre- and post-

operative care, as well as experience in intra-operative techniques. This should

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include management of critically ill patients. Oral and maxillofacial surgery residents

operate at a PGY-1 level of responsibilities or higher, and are on the regular night

call schedule.

Examples of evidence to demonstrate compliance may include:

• Resident rotation schedules

4-3.3 Other Rotations:

Eight additional weeks of clinical surgical or medical education must be

assigned. These must be exclusive of all oral and maxillofacial surgery

service assignments.

Examples of evidence to demonstrate compliance may include:

• Resident rotation schedules

4-4 Departmental seminars and conferences, directed by participating members of

the teaching staff, must be conducted to augment the biomedical science and

clinical program. They must be scheduled and structured to provide instruction

in the broad scope of oral and maxillofacial surgery and related sciences and

must include retrospective audits, clinicopathological conferences, tumor

conferences and guest lectures. The majority of teaching sessions must be

presented by the institutional teaching staff and may include remote access

educational opportunities. The residents must also prepare and present

departmental conferences under the guidance of the faculty.

Intent: The broad scope of oral and maxillofacial surgery includes, but is not limited to,

trauma, orthognathic, reconstructive/cosmetic, and pathology including temporomandibular

disorders and facial pain.

Examples of evidence to demonstrate compliance may include:

• Seminar schedules for at least one year

• Resident log of lectures attended

• Course outlines

• Sign-in sheets

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BASIC SCIENCES

4-5 Instruction must be provided in the basic biomedical sciences at an advanced

level beyond that of the predoctoral dental curriculum. These sciences must

include anatomy (including growth and development), physiology, pharmacology,

microbiology and pathology. This instruction may be provided through formal

courses, seminars, conferences or rotations to other services of the hospital.

Intent: This instruction may be met through the completion of the requirements for the

M.D./D.O. or any other advanced degrees.

4-5.1 Instruction in anatomy must include surgical approaches used in various

oral and maxillofacial surgery procedures.

Examples of evidence to demonstrate compliance may include:

• Resident log of lectures attended

• Course outlines

• Goals and objectives of biomedical sciences curriculum

• Sign-in sheets

• Schedule showing curriculum in the mandated areas for a typical year

PHYSICAL DIAGNOSIS

4-6 A didactic and practical course in physical diagnosis must be provided. This

instruction must be initiated in the first year of the program. Resident

competency in physical diagnosis must be documented prior to the completion of

the program.

Intent: A medical student/resident level course in physical diagnosis, or a faculty led,

formally structured and comprehensive physical diagnosis course that includes didactic and

practical instruction should be completed prior to commencement of rotations on the

anesthesia, medicine and surgical services. This is to ensure that residents have the

opportunity to apply this training throughout the program on adult and pediatric patients.

Examples of evidence to demonstrate compliance may include:

• Course outlines

• Course syllabi

• Course schedules

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CLINICAL ORAL AND MAXILLOFACIAL SURGERY

4-7 The program must provide a complete, progressively graduated sequence of

outpatient, inpatient and emergency room experiences. The residents’ exposure

to non-surgical management and surgical procedures must be integrated

throughout the duration of the program.

In addition to providing the teaching and supervision of the resident activities

described above, there must be patients of sufficient number and variety to give

residents exposure to and competence in the scope of oral and maxillofacial

surgery. The program director must ensure that all residents receive comparable

clinical experience.

Intent: The broad scope of oral and maxillofacial surgery includes, but is not limited to,

trauma, orthognathic, reconstructive/cosmetic, and pathology including temporomandibular

disorders and facial pain.

Examples of evidence to demonstrate compliance may include:

• Records kept by program director that show comparability of surgical experiences in

the various aspects of oral and maxillofacial surgery across years and among residents.

• Oral and Maxillofacial Surgery Benchmarks

MINIMUM CLINICAL REQUIREMENTS

OUTPATIENT ORAL AND MAXILLOFACIAL SURGERY EXPERIENCE

4-8 The program must ensure a progressive and continuous outpatient surgical

experience in non-surgical and surgical management, including preoperative and

postoperative evaluation, in a broad range of oral and maxillofacial surgery

involving adult and pediatric patients. This experience must include

dentoalveolar surgery, the placement of implant devices, management of

traumatic injuries and pathologic conditions including temporomandibular

disorders and facial pain, augmentations and other hard and soft tissue surgery,

including surgery of the mucogingival tissues. Faculty cases may contribute to

this experience, but they must have resident involvement.

Intent: Residents are to participate in outpatient care activities.

Examples of evidence to demonstrate compliance may include:

• Resident rotation schedules

• Outpatient clinic schedules

• Outpatient surgery case log

• Dentoalveolar-related didactic course materials

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4-8.1 Dental implant training must include didactic and clinical experience in

comprehensive preoperative, intraoperative and post-operative

management of the implant patient.

The preoperative aspects of the comprehensive management of the

implant patient must include interdisciplinary consultation, diagnosis,

treatment planning, biomechanics, biomaterials and biological basis.

The intraoperative aspects of training must include surgical preparation

and surgical placement including hard and soft tissue grafts.

The post-operative aspects of training must include the evaluation and

management of implant tissues and complications associated with the

placement of implants.

Examples of evidence to demonstrate compliance may include:

• Implant-related didactic course materials

• Patient records, indicating interaction with restorative dentists

4-8.2 The training program must include didactic and clinical experience in the

comprehensive management of temporomandibular disorders and facial

pain.

Examples of evidence to demonstrate compliance may include:

• Education in the diagnosis, imaging, surgical and non-surgical

management, including instruction in biomaterials.

• Didactic Schedules

• Resident case logs

• Clinic Schedules

GENERAL ANESTHESIA AND DEEP SEDATION

4-9 The off-service rotation in anesthesia must be supplemented by longitudinal and

progressive experience throughout the training program in all aspects of pain

and anxiety control. The ambulatory oral and maxillofacial anesthetic experience

must include the administration of general anesthesia/deep sedation for oral and

maxillofacial surgery procedures to pediatric, adult, and geriatric populations,

including the demonstration of competency in airway management.

Examples of evidence to demonstrate compliance may include:

• Resident’s anesthetic log

• Clinical tracking system

• Anesthesia records

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• Oral and Maxillofacial Surgery Benchmarks

4-9.1 The cumulative anesthetic experience of each graduating resident must

include administration of general anesthesia/deep sedation for a minimum

of 300 cases. This experience must involve care for 50 patients younger

than 13. A minimum of 150 of the 300 cases must be ambulatory

anesthetics for oral and maxillofacial surgery outside of the operating

room.

Intent: The cumulative experience includes time on the anesthesia rotation as well as

anesthetics administered while on the oral and maxillofacial surgery service.

Locations for ambulatory anesthesia may include dental school clinics, hospital

clinics, emergency rooms, and oral and maxillofacial surgery offices.

Examples of evidence to demonstrate compliance may include:

• Resident’s anesthetic log.

• Clinical tracking system.

• Anesthesia records.

• Oral and Maxillofacial Surgery Benchmarks

4-9.2 The graduating resident must be trained to competence in the delivery of

general anesthesia/deep sedation to patients of at least 8 years of age and

older.

4-9.3 The graduating resident must be trained in the management of children

younger than 8 years of age using techniques such as behavior

management, inhalation analgesia, sedation, and general anesthesia.

Examples of evidence to demonstrate compliance may include:

• Didactic Schedules

• Resident Anesthetic Logs

• Detailed curriculum plans

• Patient charts

• Simulation experience

4-9.4 The graduating resident must be trained in the anesthetic management of

geriatric patients.

Examples of evidence to demonstrate compliance may include:

• Didactic Schedules

• Resident Anesthetic Logs

• Detailed curriculum plans

• Patient charts

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• Simulation experience

4-9.5 The clinical program must be supported in part by a core comprehensive

didactic program on general anesthesia, deep sedation, moderate sedation,

behavior management and other methods of pain and anxiety control.

The didactic program must include lectures and seminars emphasizing:

a. Perioperative evaluation and optimization of patients of all ages,

b. Risk assessment,

c. Anesthesia and sedation techniques,

d. Monitoring, and

e. The diagnosis and management of complications.

4-9.6 Advanced Cardiac Life Support (ACLS) must be obtained in the first year

of residency and must be maintained throughout residency training.

Examples of evidence to demonstrate compliance may include:

• ACLS certification records and cards

4-9.7 Each resident must be certified in Pediatric Advanced Life Support

(PALS) prior to completion of training.

Examples of evidence to demonstrate compliance may include:

• PALS certification records and cards

ADMISSIONS

4-10 Inpatient surgical experience must ensure adequate training in a broad range of

inpatient oral and maxillofacial surgery care, including admission and

management of patients.

MAJOR SURGERY

4-11 For each authorized final year resident position, residents must perform 175

major oral and maxillofacial surgery procedures on adults and children,

documented by at least a formal operative note. For the above 175 procedures

there must be at least 20 procedures in each category of surgery. The categories

of major surgery are defined as: 1) trauma 2) pathology 3) orthognathic surgery

4) reconstructive and cosmetic surgery. Sufficient variety in each category, as

specified below, must be provided. Surgery performed by oral and maxillofacial

surgery residents while rotating on or assisting with other services must not be

counted toward this requirement.

Oral and Maxillofacial Surgery Standards

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Intent: The intent is to ensure a balanced exposure to comprehensive patient care for all

major surgical categories. In order for a major surgical case to be counted toward meeting

this requirement, the resident serves as an operating surgeon or first assistant to an oral and

maxillofacial surgery teaching staff member. The program documents that the residents have

played a significant role (diagnosis, perioperative care and subsequent follow-up) in the

management of the patient.

Examples of evidence to demonstrate compliance may include:

• Department and institution general operating room statistics and logs

• Patient Medical Records

• Schedules showing that resident was present in pre- and post-operative visits

• Progress notes or resident logs showing resident was present during pre- and post-

operative visits

• Resident logbook of all procedures with which resident had active participation

4-11.1 In the trauma category, in addition to mandibular fractures, the surgical

management and treatment of maxillary, nasal and orbito-zygomatico-maxillary

complex injuries must be included.

Intent: Trauma management includes, but is not limited to, tracheotomies, open and closed

reductions of fractures of the mandible, maxilla, zygomatico-maxillary, nose, naso-frontal-

orbital-ethmoidal and midface region and repair of facial, oral, soft tissue injuries and

injuries to specialized structures.

4-11.2 In the pathology category, experience must include management of

temporomandibular joint pathology and at least three other types of procedures.

Intent: Pathology of the temporomandibular joint includes, but is not limited to, internal

derangement arthritis, post-traumatic dysfunction, and neoplasms. Management of

termporomandibular joint pathology may include medical or outpatient procedures. Other

Pathology management includes, but is not limited to, major maxillary sinus procedures,

salivary gland/duct surgery, management of head and neck infections, (incision and drainage

procedures), and surgical management of benign and malignant neoplasms and cysts.

4-11.3 In the orthognathic category, procedures must include correction of deformities

in the mandible and the middle third of the facial skeleton.

Intent: Orthognathic surgery includes the surgical correction of functional and cosmetic

orofacial and craniofacial deformities of the mandible, maxilla, zygoma and other facial

bones as well as the treatment of obstructive sleep apnea. Surgical procedures in this

category include, but are not limited to, ramus and body procedures, subapical segmental

osteotomies, Le Fort I, II and III procedures and craniofacial operations. Comprehensive

care should include consultation and treatment by an orthodontic specialist when indicated;

and a sleep medicine team should be included when indicated. Residents participate in the

pre- and post-operative care and intra-operative participation in the treatment of the

orthognathic patient and the sleep apnea patient.

Oral and Maxillofacial Surgery Standards

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Examples of evidence to demonstrate compliance may include:

• Evidence of collaborative care (with orthodontist and/or sleep medicine team)

• Oral and maxillofacial surgery record with orthodontic and/or sleep medicine

involvement

4-11.4 In the reconstructive and cosmetic category, both bone grafting and soft tissue

grafting procedures must be included. Residents must learn the harvesting of

bone and soft tissue grafts during the course of training.

Intent: Distant bone graft sites may include but are not limited to calvarium, rib, ilium,

fibula and tibia. Harvesting of soft tissue grafts may be from intraoral or distant sites.

Distant soft tissue grafts include but are not limited to cartilage, skin, fat, nerve & fascia.

Examples of evidence to demonstrate compliance may include:

• Patient records revealing evidence of hard - and soft-tissue harvesting and grafting to

maxillofacial region, including donor sites distant from oral cavity

4-11.5 Reconstructive surgery includes, but is not limited to, vestibuloplasties,

augmentation procedures, temporomandibular joint reconstruction,

management of hard and soft tissue maxillofacial defects, insertion of

craniofacial implants, facial cleft repair, peripheral nerve reconstruction

and other reconstructive surgery.

Intent: It is expected that in this category there will be both reconstructive and

cosmetic procedures performed by residents.

Cosmetic surgery should include but is not limited to three of the following

types of procedures: rhinoplasty, blepharoplasty, rhytidectomy,

genioplasty, lipectomy, otoplasty, and scar revision.

Examples of evidence to demonstrate compliance may include:

• Patient records revealing resident experience in reconstructive and cosmetic

surgery

4-12 Accurate and complete records of the amount and variety of clinical activity of

the oral and maxillofacial surgery teaching service must be maintained. These

records must include a detailed account of the number and variety of procedures

performed by each resident. Records of patients managed by residents must

evidence thoroughness of diagnosis, treatment planning and treatment.

4-12.1 Residents must keep a current log of their operative cases.

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4-13 Emergency Care Experience: Residents must be provided with emergency care

experience, including diagnosing, rendering emergency treatment and assuming

major responsibility for the care of oral and maxillofacial injuries. The

management of acute illnesses and injuries, including management of oral and

maxillofacial lacerations and fractures, must be included in this experience. A

resident must be available to the emergency service at all times.

4-13.1 Each resident must be certified in Advanced Trauma Life Support

(ATLS) prior to completion of training.

4-14 The program must provide instruction in the compilation of accurate and

complete patient records.

Examples of evidence to demonstrate compliance may include:

• Seminar or lecture schedule on patient record keeping

4-15 The program must provide training in interpretation of diagnostic imaging.

Ethics and Professionalism

4-16 Graduates must receive instruction in the application of the principle of ethical

reasoning, ethical decision making and professional responsibility as they pertain to the

academic environment, research, patient care, and practice management.

Intent: Graduates should know how to draw on a range of resources such as professional

codes, regulatory law, and ethical theories to guide judgment and action for issues that are

complex, novel, ethically arguable, divisive, or of public concern.

4-17 The program must include participation in practice and risk management

seminars and instruction in coding and nomenclature.

Intent: Parameters of Care should be taught either in a seminar setting, individually or

shown to be utilized throughout the program, i.e. Morbidity &Mortality Conferences.

Examples of evidence to demonstrate compliance may include:

• Seminar or lecture schedules on practice and risk management

• Familiarity with AAOMS Parameters of Care

Patient Safety

4-18 Residents must receive formal training in programs, policies, and procedures enhancing

patient safety.

Intent: An ongoing, comprehensive focus on promoting safety and quality improvement is an

essential part of quality patient care. Residents are exposed throughout training to

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theoretical and practical means to ensure that consideration of patient safety is routine and

consistent.

Examples of evidence to demonstrate compliance may include:

• Documentation of an active, ongoing clinical safety training program. This may

include participation in institution-wide programs, or documentation of training in

Crew Resource Management, Root Cause Analysis, or other safety-focused protocols

• Formative and summative evaluation of residents’ knowledge of and engagement and

compliance with safety initiatives (e.g. use of Benchmarks)

4-19 The program must have a formal program for medical emergency preparedness in its

ambulatory surgery clinics.

Intent: Safety training is enhanced by immersing residents at all stages of training in policies

procedures, and practices which minimize the risk of harm to patients. Active participation

by residents, faculty, and appropriate clinical staff in regular routines, including mock

emergency drills, reinforces theoretical concepts and models the attention to patient safety

expected of the contemporary surgical team. Programs meet or exceed applicable minimal

institutional or regulatory requirements, and may develop and implement protocols custom to

their clinical facilities.

Examples of evidence to demonstrate compliance may include:

• Logs of mock emergency drills demonstrating participation by faculty, residents and

clinical staff

• Ongoing training using high fidelity simulation adapted to simulate the community-

based, ambulatory surgery environment

• Adherence to established emergency preparation recommendations, e.g. the AAOMS

Office Anesthesia Evaluation Manual

4-20 The program must routinely employ patient safety tools and techniques in its clinical

facilities.

Examples of evidence to demonstrate compliance may include:

• Documentation of routine procedural time-outs

• Checklists for preanesthetic preparation, patient and procedure readiness verification,

or similar

• Readily available cognitive aids (e.g. charts, placards, checklists, guides) for

management of anesthetic and or/medical emergencies

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STANDARD 5 - ADVANCED DENTAL EDUCATION RESIDENTS

ELIGIBILITY AND SELECTION

Eligible applicants to advanced dental education programs accredited by the Commission on Dental

Accreditation must be graduates from:

a. Predoctoral dental programs in the U.S. accredited by the Commission on Dental

Accreditation; or

b. Predoctoral dental programs in Canada accredited by the Commission on Dental

Accreditation of Canada; or

c. International dental schools that provide equivalent educational background and standing

as determined by the program.

Specific written criteria, policies and procedures must be followed when admitting residents.

Intent: Written non-discriminatory policies are to be followed in selecting residents. These policies

should make clear the methods and criteria used in recruiting and selecting residents and how

applicants are informed of their status throughout the selection process.

Admission of residents with advanced standing must be based on the same standards of achievement

required by residents regularly enrolled in the program. Residents with advanced standing must

receive an appropriate curriculum that results in the same standards of competence required by

residents regularly enrolled in the program.

Intent: Advanced standing refers to applicants that may be considered for admission to a training

program whose curriculum has been modified after taking into account the applicant’s past

experience. Examples include transfer from a similar program at another institution, completion of

training at a non-CODA accredited program, or documented practice experience in the given

discipline. Acceptance of advanced standing residents will not result in an increase of the program’s

approved number of enrollees. Applicants for advanced standing are expected to fulfill all of the

admission requirements mandated for residents in the conventional program and be held to the same

academic standards. Advanced standing residents, to be certified for completion, are expected to

demonstrate the same standards of competence as those in the conventional program.

Examples of evidence to demonstrate compliance may include:

• policies and procedures on advanced standing

• results of appropriate qualifying examinations

• course equivalency or other measures to demonstrate equal scope and level of knowledge

5-1 If the program has determined that graduates of U. S. or Canadian accredited medical

schools are eligible for admission, the candidate must obtain a dental degree from a

predoctoral dental education program accredited by the Commission on Dental

Accreditation prior to starting the required 120 weeks of core OMS training.

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EVALUATION

A system of ongoing evaluation and advancement must ensure that, through the director and faculty,

each program:

a. Periodically, but at least semiannually, assesses the progress toward (formative

assessment) and achievement of (summative assessment) the competencies for the

discipline using formal evaluation methods;

b. Provides to residents an assessment of their performance, at least semiannually;

c. Advances residents to positions of higher responsibility only on the basis of an

evaluation of their readiness for advancement; and

d. Maintains a personal record of evaluation for each resident which is accessible to the

resident and available for review during site visits.

Intent: (a) The evaluation of competence is an ongoing process that requires a variety of

assessments that can measure the acquisition of knowledge, skills and values necessary for

discipline-specific level practice. It is expected that programs develop and periodically review

evaluation methods that include both formative and summative assessments. (b) Resident evaluations

should be recorded and available in written form. (c) Deficiencies should be identified in order to

institute corrective measures. (d) Resident evaluation is documented in writing and is shared with

the resident.

5-2 The program director must provide written evaluations of the residents based

upon written comments obtained from the teaching staff. The evaluation must

include:

a. Cognitive skills;

b. Clinical skills;

c. Interpersonal skills;

d. Patient management skills; and

e. Ethical standards.

Examples of evidence to demonstrate compliance may include:

• Rotational evaluations

• Semi-annual summative/formative evaluations

• Oral and Maxillofacial Surgery Benchmarks

• AAOMS DVD on Professionalism, AAOMS Code of Professional Conduct, ADA

Principles of Ethics and Code of Professional Conduct, ADEA Statement on

Professionalism in Dental Education, Institutional ethics guidelines, lecture on ethics

5-3 The program director must provide counseling, remediation, censuring, or after

due process, dismissal of residents who fail to demonstrate an appropriate level of

competence, reliability, or ethical standards.

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5-4 The program director must provide a final written evaluation of each resident

upon completion of the program. The evaluation must include a review of the

resident’s performance during the training program, and must state that the

resident has demonstrated competency to practice independently. The final

evaluation must be a summative assessment demonstrating a progression of

formative assessments throughout the residency program. This evaluation must

be included as part of the resident’s permanent record and must be maintained

by the institution. A copy of the final written evaluation must be provided to

each resident upon completion of the residency.

Intent: The summative assessment may include utilization of formative assessments such as

Simulation training, Objective Structured Clinical Exam, Resident Surgical Log, Resident semi-

annual evaluations, Oral and Maxillofacial Surgery Benchmarks, and In-Service Training

Examinations.

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DUE PROCESS

There must be specific written due process policies and procedures for adjudication of academic and

disciplinary complaints, which parallel those established by the sponsoring institution.

RIGHTS AND RESPONSIBILITIES

At the time of enrollment, the advanced dental education residents must be apprised in writing of the

educational experience to be provided, including the nature of assignments to other departments or

institutions and teaching commitments. Additionally, all advanced dental education residents must

be provided with written information which affirms their obligations and responsibilities to the

institution, the program and program faculty.

Intent: Adjudication procedures should include institutional policy which provides due process for

all individuals who may potentially be involved when actions are contemplated or initiated which

could result in disciplinary actions, including dismissal of a resident (for academic or disciplinary

reasons). In addition to information on the program, residents should also be provided with written

information which affirms their obligations and responsibilities to the institution, the program, and

the faculty. The program information provided to the residents should include, but not necessarily be

limited to, information about tuition, stipend or other compensation; vacation and sick leave;

practice privileges and other activity outside the educational program; professional liability

coverage; and due process policy and current accreditation status of the program.

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STANDARD 6 – RESEARCH

Advanced dental education residents must engage in scholarly activity.

Intent: The resident is encouraged to be involved in the creation of new knowledge, evaluation of

research, development of critical thinking skills and furthering the profession of oral and

maxillofacial surgery.

6-1 Each graduating resident must demonstrate evidence of scholarly activity.

Examples of evidence to demonstrate compliance may include:

• Oral or poster presentations at scientific meetings aside from program curriculum

• Submission for publication of abstracts, journal articles (particularly peer reviewed) or

book chapters

• Active participation in or completion of a research project (basic science or clinical) with

mentoring

6-2 The program must provide instruction in research design and analysis.

Examples of evidence to demonstrate compliance may include:

• Didactic schedules demonstrating education in research design and analysis

• Participation in a clinical trials course

6-3 The program must provide instruction in the critical evaluation of scientific

literature.

Examples of evidence to demonstrate compliance may include:

• Didactic schedules demonstrating education in the critical evaluation of scientific

literature through journal club or other educational seminars