dr owoidoho udofia, fmcpsych college registrar

NATIONAL POSTGRADUATE MEDICAL COLLEGE OF

NIGERIA

RESIDENCY TRAINING CURRICULUM AND

GUIDELINES ON SUBSPECIALTY OF

ORTHODONTICS

FACULTY OF DENTAL SURGERY

APPROVED BY THE SENATE ON 23RD

JULY, 2020

DR OWOIDOHO UDOFIA, FMCPsych

COLLEGE REGISTRAR

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NATIONAL POSTGRADUATE MEDICAL COLLEGE OF NIGERIA

FACULTY OF DENTAL SURGERY RESIDENCY TRAINING PROGRAMMES

TOWARDS THE AWARD OF THE FELLOWSHIP OF THE MEDICAL COLLEGE

IN

SUB SPECIALTY OF ORTHODONTICS FMCDS (Orthodontics)

Curriculum and guidelines for Residency training programme

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TABLE OF CONTENTS

CHAPTER I: INTRODUCTION ................................................................................................................................... 4

1.1 AUTHORITY ................................................................................................................................................... 4 1.2 VISION AND MISSION OF THE COLLEGE ........................................................................................................... 4 1.3 PHILOSOPHY OF THE FELLOWSHIP PROGRAMMES ....................................................................................................... 5

CHAPTER II: THE RESIDENCY TRAINING PROGRAMMES.......................................................................................... 7

2.1 ADMISSION REQUIREMENTS ......................................................................................................................... 7 2.2 REGISTRATION OF RESIDENTS ........................................................................................................................ 7 2.3 INSTITUTIONAL OBJECTIVES FOR THE FMCDS RESIDENCY PROGRAMME. ........................................................ 8 2.4 CONTINUOUS ASSESMENT ............................................................................................................................ 9 2.5 CONTINUING PROFESSIONAL EDUCATION ..................................................................................................... 9 2.6 STANDARDIZATION OF TRAINING INSTITUTIONS. ........................................................................................... 9 2.7 TRAINING FORMAT FOR FMCDS PROGRAMMES ........................................................................................... 10 2.8 TEACHING METHOD .................................................................................................................................... 10

2.8.1. Residency Coordinator: ....................................................................................................................... 10 2.8.2. Mode of Training: ............................................................................................................................... 10 2.8.3. Academic Programmes: ...................................................................................................................... 10 2.8.4. Clinical Programme: ............................................................................................................................ 11 2.8.5. Teaching and Research programme: ................................................................................................... 11 2.8.6 Call hours review: ................................................................................................................................ 11

CHAPTER III: PRE-RESIDENCY TRAINING CURRICULUM IN BASIC SCIENCES .......................................................... 12

3.1 EDUCATIONAL OBJECTIVES .......................................................................................................................... 12 3.2 THE PRIMARY EXAMINATION....................................................................................................................... 14

CHAPTER IV: JUNIOR RESIDENCY TRAINING (PART I FMCDS) ................................................................................ 17

4.1 GENERAL AIMS OF THE JUNIOR RESIDENCY PRORAMME: ............................................................................. 17 4.2. GENERAL EDUCATIONAL OBJECTIVES OF THE JUNIOR RESIDENCY PROGRAMME .......................................... 17 4.3 SPECIFIC OBJECTIVES : ................................................................................................................................ 18 4.4. FORMAT OF TRAINING ............................................................................................................................... 19

ORAL AND MAXILLOFACIAL SURGERY ........................................................................................................... 21 RESTORATIVE DENTISTRY AND PROSTHODONTICS ........................................................................................ 25 PAEDIATRIC DENTISTRY ................................................................................................................................ 35 ORTHODONTICS ........................................................................................................................................... 39 PERIODONTOLOGY ....................................................................................................................................... 43 ORAL MEDICINE ........................................................................................................................................... 49 COMMUNITY DENTISTRY .............................................................................................................................. 53 ORAL AND MAXILLOFACIAL PATHOLOGY....................................................................................................... 57 INTERNAL MEDICINE AND GENERAL SURGERY .............................................................................................. 61

CHAPTER V: SENIOR RESIDENCY TRAINING IN DENTAL SURGERY SUBSPECIALTIES............................................... 65

ENTRY REQUIREMENT....................................................................................................................................... 65 GENERAL INSTRUCTIONAL OBJECTIVES ............................................................................................................. 65 FORMAT OF TRAINING ...................................................................................................................................... 66

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SENIOR RESIDENCY TRAINING IN ORTHODONTICS ............................................................................................. 68 Training format ............................................................................................................................................ 68 TRAINING STRATEGIES .................................................................................................................................. 69 CLINICAL AND OPERATIVE SKILLS .................................................................................................................. 70 RESEARCH TRAINING .................................................................................................................................... 70 TEACHING AND COMMUNICATION SKILLS .................................................................................................... 71 MANAGEMENT SKILLS .................................................................................................................................. 71

CHAPTER VI: EVALUATION ................................................................................................................................... 72

A. FORMATIVE EVALUATION ............................................................................................................................ 72 B. COLLEGE CERTIFYING EXAMINATIONS. .......................................................................................................... 72 PART I FELLOWSHIP EXAMINATIONS FORMAT. .................................................................................................. 73

EXAMINATION FORMAT FOR PART I FMCDS.................................................................................................. 73 SUMMARY OF BLUE PRINT FOR PART 1 MCQ EXAMINATION QUESTIONS ...................................................... 75 EXAMINATION FRAME WORK FOR PART I EXAMINATION .............................................................................. 78

EXAMINATION FORMAT FOR PART II FMCDS EXAMINATION .............................................................................. 79 BLUEPRINT FOR PART II EXAMINATION ......................................................................................................... 83

CHAPTER VII: THE POSTGRADUATE DOCTOR OF MEDICINE (MD) DEGREE PROGRAMME ..................................... 84

PREAMBLE........................................................................................................................................................... 84 PHILOSOPHY ........................................................................................................................................................ 84 AIMS AND OBJECTIVES ........................................................................................................................................... 84 ENTRY REQUIREMENT FOR MD PROGRAM ................................................................................................................... 84 METHOD OF APPLICATION ....................................................................................................................................... 85 PROGRAMME DURATION ........................................................................................................................................ 85 RESEARCH PROPOSAL ............................................................................................................................................. 85 FINAL ASSESSMENT OF DISSERTATION ......................................................................................................................... 85 COLLEGE BASED COURSES ........................................................................................................................................ 85 DENTAL SURGERY COURSE SYNOPSES ......................................................................................................................... 87

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CHAPTERI:INTRODUCTION

1.1AUTHORITYThe National Postgraduate Medical College of Nigeria started the fellowship programmes in 1970 under

the Nigerian Medical Council. This later transmitted, in 1979 through the promulgation of Decree 67 of

September, 1979, into the National Postgraduate Medical College of Nigeria (NPMCN) , a postgraduate

medical institution with the main mandate of overseeing professional training and examinations in various

specialties of medicine and dentistry with “the responsibility of conducting professional postgraduate

examination of trainees in the various specialized branches of Medicine, Surgery, Paediatrics, Obstetrics

and Gynaecology and Dental Surgery”. This was the premier medical academic cum professional

programme in sub-Saharan Africa. The programme is unique in combining academic and professional

training in medical postgraduate courses.

The Faculty of Dental Surgery was established along with specialties of Medicine but unlike Medicine,

the first primary FMCDS examinations was conducted in May 1979 for 3 candidates which was 7 years

after those of specialties of Medicine.

1.2VISIONandMISSIONOFTHECOLLEGEVision statement

The National Postgraduate Medical College of Nigeria aims to produce medical and dental specialists of

the highest standards who will provide world class services in teaching research and health care.

Mission statement

The mission of the College is to plan, implement, monitor and evaluate postgraduate programmes

required to produce medical and dental specialists of the highest quality, competence and dedication who

will provide teaching and optimal healthcare for the people. Lifelong learning will be maintained by

continuing professional development programmes of the college.

Vision Statement of the Faculty

The Faculty of Dental Surgery of the National Postgraduate Medical College of Nigeria aims to produce

highly competent specialist surgeons in various subspecialties of the discipline of Dentistry which

includes Oral and Maxillofacial Surgery, Restorative Dentistry, Prosthodontic, Paediatric Dentistry,

Orthodontics, Periodontology, Community Dentistry, Oral and Maxillofacial Pathology and Oral

Medicine who will provide world class services in teaching, research and oral health care.

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1.3PhilosophyoftheFellowshipProgrammesThe Faculty of Dental Surgery recognizes the universality of Medicine and the need for lifelong learning

for practicing specialist/consultant dental surgeons. Therefore specialists/consultants certified by the

Faculty must be adequate in knowledge, skills and attitude to practice in Nigeria and be able to adapt to

practice anywhere in the world and be of good character. In addition, the certified specialist/consultant in

any of the Dental Surgery subspecialties, should possess management skills to lead the health team, offer

humane and ethical clinical services. In addition he/she should be able to assume other higher

administrative and leadership responsibilities/roles.

The changing pattern of oral diseases in Nigeria and the evolving global pattern of training of Dental

Specialists require a modification of the existing dental training programme of the National Postgraduate

Medical College of Nigeria to address present universal trend while laying the foundation for future

changes. Hence, there is the need to have separate curriculum details for specialists in various

subspecialties in dental surgery which include:

a) Oral and Maxillofacial Surgery, FMCDS (Oral and Maxillofacial Surgery)

b) Restorative Dentistry, FMCDS (Restorative Dentistry)

c) Prosthodontics, FMCDS (Prosthodontics)

d) Paediatric Dentistry, FMCDS (Paediatric Dentistry)

e) Orthodontics, FMCDS (Orthodontics),

f) Periodontology, FMCDS (Periodontology),

g) Community Dentistry, FMCDS (Community Dentistry),

h) Oral and Maxillofacial Pathology FMCDS (Oral and Maxillofacial Pathology),

i) Oral Medicine, FMCDS (Oral Medicine).

The level of training of the specialists in each subspecialty of the discipline of Dental Surgery should also

prepare them as dental teachers and researchers for our dental schools. Such an expert would therefore be

adequately equipped to fit into any level of dental health set-up with a high degree of educational and

professional competence. The Fellowships of the Medical College in Dental Surgery FMCDS are

therefore designed not only to achieve these aims but also to prepare the specialists adequately for

management and professional leadership roles in the society.

In summary, this competency-based and community-oriented curriculum is designed to train

specialist/consultant Dental Surgeons who are competent in the four major areas of dental health-related

activities namely:

1. Professional Practice in one of the Dental Surgery subspecialties

2. Education

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3. Research

4. Health Services Management.

The training programme operates at three levels namely, the Primary stage, Junior residency (Part I) and Senior residency (Part II). Minimum training periods of twenty-four (24) and thirty-six months (36) have been maintained for the junior residency (Part I) and senior residency (Part II) respectively. A clear definition of the objectives for each stage of the programme is provided in this handbook, which also contains detailed outline of the tasks involved, and competencies to be acquired during each of the several postings, which constitute the residency training programme. To reinforce the strategic role of formative evaluation, the use of the “Resident’s Portfolio or Logbook” is introduced.

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CHAPTERII:THERESIDENCYTRAININGPROGRAMMES

The National Postgraduate Medical College of Nigeria publishes periodically in its Gazette the list of

accredited centres for the residency training programme in Dental Surgery. These centres are normally re-

visited at regular intervals of five years to ensure acceptable standards of both training facilities and the

training programme itself. Thus, the lists of accredited centres are updated on the recommendation of the

Faculty Board of Dental Surgery.

It is the responsibility of each accredited center to provide resources – men, money, materials and

management – for the training of its Residents. The center is also expected to monitor the progress of

each Resident and provide appropriate feedback to him. Besides, the Fellow in charge of each training

center provides annual report on the performance of each Resident under him. This is in addition to the

overall programme review reported on the prescribed Annual Report Forms, which are available at the

office of the College Registrar. Training institutions are expected to issue a Certificate of training to each

Resident to confirm completion of the prescribed training, or as required by College regulations.

2.1ADMISSIONREQUIREMENTSAdmission into the Residency Training Programme in Dental Surgery is open to all dental practitioners

with basic dental degrees registrable with the Medical and Dental Council of Nigeria. The practitioner

should have completed or have been exempted from the National Youth Service Corps. During the period

of post-registration experience preceding admission to the Residency Training Programme, candidates are

expected to have passed the Primary Fellowship Examination.

2.2REGISTRATIONOFRESIDENTSIn compliance with College Bye-Laws, all Residents undergoing the FMCDS residency training must be

registered simultaneously with their respective training centres and with the College. The registration of

each Resident with the College must be processed through and supported by his/her training center.

Registration with the College confers on the Resident the status of Associate Fellow of the College.

Application forms for registration as Associate Fellows are obtainable from the Head of each accredited

training center. All completed forms should be returned to the College Registrar not later than four

months from the date of admission into the residency programme. All associate fellows must purchase

relevant handbooks. Candidates not registered, as Associate Fellows of the College will not be allowed to

sit for the Part I or Part II Fellowship Examinations of the College.

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2.3INSTITUTIONALOBJECTIVESFORTHEFMCDSRESIDENCYPROGRAMME.The global goal for the residency programme in Dental Surgery is to train the Resident in a chosen Dental

subspecialty up to the level of a Consultant in the specific area. He/she should therefore be able to

demonstrate adequate level of competence in the four specific areas of professional practice, research,

education, as well as health services management.

By the end of his/her training each Resident should have acquired the knowledge, skills and attitude that

will enable him to:

1. Diagnose and manage all diseases and emergencies in his/her chosen subspecialty.

2. Provide specialized dental services and design solutions for clinical problems that may arise in

the course of patient management.

3. Establish a clinical practice (in the subspecialty) designed to cater for the changing needs of

society.

4. Administer and supervise the day-to-day running of such a practice.

5. Guide and teach junior colleagues through formal didactic sessions and in the course of routine

patient care and adequately impart knowledge to other members of the profession.

6. Practice with high ethical and administrative integrity, with full sense of responsibility for his/her

duties, the ability to communicate with those who seek his/her advice, and with deep concern and

respect for his/her patients and colleagues

7. Direct his/her own continuing life-long education by selecting appropriate resources in

accordance with his/her educational needs.

8. Plan, initiate, execute and report both hospital and community based research on any problem

related to his/her subspecialty and communicate/ disseminate his/her findings in an intelligible

manner to the appropriate audience or through appropriate media locally or internationally.

9. Offer adequate management and professional leadership in their roles as Consultant Dental

Specialists.

10. Act as a leader of a health team or health organization and by his/her performance command the

respect of other members of the team or organization.

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2.4CONTINUOUSASSESMENTSince the overriding objective of the Fellowship Programmes is to produce specialists in various

subspecialties of Dental Surgery to meet the health needs of the nation, the departments offering such

training must ensure that their resident’s training programmes are continuously assessed and their yearly

performances recorded. This provides the opportunity of detecting and correcting deficiencies in trainees

at an early stage. The exercise also helps in improving the overall quality of the training programme.

Assessment of residents should be on the skills and competences expected at their levels. This includes

the ability to diagnose cold and emergency conditions in Dental Surgery, to discuss the aetiology and

outcome of such cases and the ability to discuss and apply their management strategies. Assessment

should also take into cognisance the residents’ ability to discuss contemporary prevention strategies of

oro-dental diseases locally and globally. The residents’ communication skills, interactions with patients’

relations, community and other health personnel, referral responsibilities and the ability to work as a team

member should be assessed.

A well trained resident is expected to be able to carry out researches that answer questions on the

aetiology, progress, investigation, treatment, complications and prevention of diseases in Oro-Dental and

Maxillofacial complex by analyzing, interpreting and communication information that relates to the

determinants and status of health and wellness, and allows the development of effective interventions.

He/she should be able to be a team leader or member, build alliances, develop capacity, work in

partnership with agencies and other health practitioner to the benefit of his/her patients and community.

2.5CONTINUINGPROFESSIONALEDUCATIONNo formal educational programme can encompass all aspects of evolving medical knowledge and skill.

Therefore, an important aspect of the training programme is to inculcate the habit of continuous self-

driven professional education and development, both during the programme and for life. Residents are

therefore required to continually upgrade their knowledge by maximally utilizing online academic and

peer reviewed resources, attending relevant local or international conferences, seminars, workshops, and

courses and participating regularly in Journal Clubs in their respective institutions.

2.6STANDARDIZATIONOFTRAININGINSTITUTIONS.Since the availability of appropriate training institutions is essential for the production of highly effective

professionals, the Faculty aims to strengthen accredited training institutions through timely accreditation

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visits and performance assessment. This is to ensure that the trainees are provided with the globally

accepted excellent academic and professional training.

2.7TRAININGFORMATFORFMCDSPROGRAMMESThe FMCDS residency programmes are normally preceded by the successful completion of basic science

training at the primary fellowship level. The residency programme consists of two successive phases

lasting a minimum period of twenty-four and thirty-six months respectively viz:

(a) Junior Residency - 24 months

(b) Senior Residency - 36 months

2.8TEACHINGMETHODThe FMCDS residency programmes are student based / problem based learning. Hence the resident needs

to undertake a considerable amount of independent study. This may include preparing group

presentations, reading, writing up clinical notes, essay and report. The supervising consultants are to act

as facilitators of learning and to make sure that the resident meets the requirement of training as set forth

in this schedule.

2.8.1.ResidencyCoordinator:Each accredited training centre is to appoint residency training coordinators for FMCDS programmes

whose duties are to draw the clinical postings roster for each resident on assumption of training and

ensure that the resident acquaints himself/herself with the residency training programme of the National

Postgraduate Medical College. He is also to ensure strict compliance of the resident with the rules and

regulations of training and training schedule of the College.

2.8.2.ModeofTraining:Mode of training shall include a mixture of tutorials, seminars, presentations, clinical rotations, and,

depending on the subject of choice, laboratory based sessions and practical.

2.8.3.AcademicProgrammes:This shall include seminars, tutorials, and clinical presentations of six contact hours per week.

a) There shall be one (1) joint tutorial sessions of two hours per week in each department of rotation

b) There shall be one seminar session of two hours per week in each department of rotation.

c) There shall be one Clinical presentation of two hours per week in each department of rotation.

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A total of 576 academic contact hours is required for the junior residency training programme while a

total of 888 academic contact hours is required for the senior residency training programme (This takes

into cognizance the period of annual leave for the trainees).

2.8.4.ClinicalProgramme:Since the FMCDS residency trainings are clinically oriented programmes, the resident is expected to have

not less than six (6) clinical contact hours per day. This translate to a minimum of 30 contact hours per

week and 3062 contact hours for the junior residency training programme and 4662 contact hours for the

senior residency programme (This takes into cognizance the period of annual leave and public holidays).

The residents rotating through Oral and Maxillofacial Surgery should have additional ward rounds of at

least six (6) hours per week. Also residents are required to take calls as directed by each training

institution.

2.8.5.TeachingandResearchprogramme:Residents in training should be involved and integrated in ongoing research programme especially in the

subspecialty/field of the resident. Also, the resident should be involved in supervised teaching and

clinical demonstration to the undergraduate students and house doctors.

Laboratory work: Residents rotating through Restorative Dentistry, Prosthodontics, Orthodontics, Oral

and Maxillofacial Pathology and Oral Medicines must have six (6) contact hours per week in the

laboratory.

2.8.6Callhoursreview:In addition, all residents are expected to take calls of 40 units per month in their respective

units/departments. The senior registrar and the junior residents on call should give a two (2) hour

review per week of the call period. The call review must be duly signed by the supervising

consultants in the Faculty residency training log book.

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CHAPTERIII:PRE-RESIDENCYTRAININGCURRICULUMINBASICSCIENCES

Training at this level is self-directed / self-instructional and often takes place outside the training

institutions. However, intensive update courses are usually organized twice a year by the National

Postgraduate Medical College of Nigeria in collaboration with the West African College of Surgeons as

well as other bodies, and advertised on the College website, at training institutions and in National

Newspapers.

A trainee is eligible to sit for the primary examination if he/she has Bachelor of Dental Surgery (BDS or

B.ChD) degree or its equivalent that is registered with the Medical and Dental Council of Nigeria.

Candidates are strongly advised to seek appointment as demonstrators or tutors in Basic Medical Sciences

departments of Medical and Dental schools for about a year before attempting the Primary Fellowship

Examination. This advice however does not prevent those who are not able to secure an appointment as

demonstrators from sitting the examination.

A Pass in the Primary Fellowship Examination is regarded as a prequalification for position in accredited

training institutions.

3.1EDUCATIONALOBJECTIVESThe Primary Fellowship Examination seeks to establish the trainability of candidates applying for

admission into the FMCDS residency programmes. The training at this stage is meant to reinforce and

broaden the candidate’s knowledge in Basic Medical and Dental Sciences particularly in areas relevant to

dental surgery. These areas include:

1. General Physiology.

2. Physiological Chemistry

3. General Anatomy and Applied Anatomy (including Histology and Embryology with special

emphasis on Head and Neck)

4. Oral Biology.

5. General Pathology (including Medical Microbiology, Bacteriology and Virology) in relation to

Dentistry.

6. Pharmacology.

By the end of basic science training, each candidate should be able to demonstrate adequate knowledge of

1. The structure and functions of the living cell including its metabolism and replication.

2. Human anatomy as a basis for understanding surgical pathology, and the rationale for surgical

approaches.

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3. Human embryology as a basis for understanding various congenital malformations of:

(a) The oro-facial region;

(b) The gastro-intestinal tract;

(c) The cardio-respiratory system;

(d) The central nervous system;

(e) The muscular-skeletal system and

(f) The genitourinary system.

4. Human histology (including oral and dental histology), and histochemistry as well as human

cytology as a basis for understanding surgical pathology and the laboratory diagnosis of diseases.

5. Human physiology as a basis for understanding the structure and functions of the human

muscular-skeletal system and reactions of the system to stress, trauma and disease.

6. Body homeostasis including:

(a) Water, electrolyte, as well as acid-base metabolism and regulation

(b) Endocrine and nervous control of body systems

(c) Respiratory system, Oxygen and energy supply, transportation and utilization

(d) General principles of human nutrition

(e) Haemodynamics, structure and functions of the blood and cardio-vascular system.

(f) The structure and functions of the genito-urinary system

(g) Structure and functions of the gastro-intestinal system.

7. The basic principles of pharmacology of drugs, especially:

(a) Drugs used in anesthesia and the relief of pain

(b) Antimicrobials and chemotherapeutic drugs

(c) Drugs acting on the cardiovascular, genitourinary, respiratory and gastro-intestinal

systems.

(d) Cancer chemotherapeutic and immune-suppressive drugs.

8. General Pathology include:

(a) Cellular and histopathology

(b) Microbiology as applied to surgical wounds and infections

(c) Wound healing

(d) Chemical Pathology

(e) Haematology

(f) Immunology

(g) Oncology.

9. Physiological Chemistry:

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a) Carbohydrates, Lipids, Amino Acids, Proteins

b) Porphyrins and bile pigments

c) Protein synthesis, enzymes.

d) Metabolism of Carbohydrates, Lipids, Proteins, Amino acid, Purines and pyrimidines

10. Oral Biology:

Oral histology, dental anatomy and cytology.

Oral Physiology – including structures and functions of Saliva

3.2THEPRIMARYEXAMINATIONA three-hour examination (Computer Based Test) which will be a Multiple Choice Question paper (“one

best option type”) to cover the subject areas outlined above. The pass mark for the Primary FMCDS

examination will be determined using the Modified Angoff standard setting.

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Blueprint for the Primary Phase of the Fellowship Programme and Examination in Dental Surgery

LEARNING OBJECTIVE AREA

CREDIT UNITS

SPECIFIC TOPICS No. of Objective Questions

TAXONOMY Percentage course coverage LVL I LVL II LVL III

A. Structure of the Human body Systems and organs (General Applied Anatomy)

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Head and Neck I 10 2 4 4 5 Cardiovascular System 5 1 2 2 2.5 Central Nervous System 5 1 2 2 2.5 Digestive System 5 1 3 1 2.5 Endocrine System 5 2 2 1 2.5 Genito-Urinary System 5 3 2 0 2.5 Hematologic System 5 1 2 2 2.5 Musculoskeletal System 10 4 4 2 5 Respiratory System 3 1 1 1 1.5

B. Function of the Human body Systems and organs ( Applied Physiology)

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Physiology of Saliva 3 0 1 2 1.5 Mastication and deglutition 3 0 0 3 1.5 Cardiovascular System 3 0 1 2 1.5 Central Nervous System 3 1 1 1 1.5 Digestive System 3 2 1 0 1.5 Endocrine System 10 3 3 4 5 Genito-Urinary System 3 2 1 0 1.5 Haematologic System 5 1 1 3 2.5 Musculoskeletal System 3 0 1 2 1.5 Respiratory System 3 1 1 1 1.5

C. Human Biochemical Mechanisms (Applied Medical Biochemistry)

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Cardiovascular System 2 0 0 2 1 Central Nervous System 10 2 4 4 5 Digestive System 10 2 4 4 5 Endocrine System 2 0 1 1 1 Genito-Urinary System 2 0 1 1 1 Hematologic System 2 0 1 1 1 Musculoskeletal System 2 0 1 1 1 Respiratory System 2 0 1 1 1

D Human embryology 3

Oro-facial development 2 0 1 1 1 Gastro-intestinal development 2 0 1 1 1 Cardio-respiratory development 2

0 1 1 1

Musculoskeletal development 2 0 1 1 1 Genito-Urinary development 2 0 1 1 1

E. Applied Head and neck anatomy

3 Musculoskeletal development of head and neck 3

0 0 3 1.5

Nervous system of head and neck 3

0 1 2 1.5

Clinical significance of Cranial nerves e.g. facial palsy, paraesthesia, anaesthesia 3

0 0 3 1.5

Typical and atypical facial pain 3 0 1 2 1.5 F. Oral embryology and histology

3 Development of face and oral cavity 3

0 0 3 1.5

Dental hard tissues 3 0 0 3 1.5 Development of the tongue 3 0 0 3 1.5 Periodontal tissues 3 0 1 2 1.5 Maxillary and mandibular bone development 3

0 1 2 1.5

Structure of the oral mucosa 3 0 0 3 1.5 Development of salivary gland tissues 3

0 2 1 1.5

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Tooth and tooth eruption 3 0 2 1 1.5 G. Occlusion 3 Development of occlusion and

malocclusion 3 0 1 2 1.5

Factors interacting in development of malocclusion e.g. genetic, skeletal, soft tissue 3

0 1 2 1.5

H. General Pathology 5

Head and Neck pathology 2 0 1 1 1 General Pathology 2 0 1 1 1 Oral Microbiology 2 0 1 1 1

I. Principles of Therapeutics and other Clinical Interventions

3

Pharmacodynamics 2 0 1 1 1 Pharmacokinetics 2 1 1 0 1 Pharmacology of specific groups of drugs 2

0 1 1 1

Rational use of drugs 1 0 1 0 0.5 Fluid and electrolyte therapy 2 0 1 1 1 Use of blood and blood products

2 0 1 1 1

J. Genetic interactions in head and neck disorders

3 General inheritance patterns 1 0 0 1 0.5 Chromosomal abnormalities 1 0 0 1 0.5 Genetic abnormalities 1 0 1 0 0.5 Associations, Malformations,

Sequences

1 0 0 1 0.5

Embryonic basis of malformation

1 0 1 0 0.5

Environmental factors in fetal

development

1 0 0 1 0.5

Genetic counselling, Ethical and social implications of genetic testing

1 0 1 0 0.5

TOTAL 32 200 100

Level I = Recall (facts), Level II = Comprehension and application, Level III = Analysis, synthesis and evaluation

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CHAPTERIV:JUNIORRESIDENCYTRAINING(PARTIFMCDS)

4.1GENERALAIMSOFTHEJUNIORRESIDENCYPRORAMME:• To provide dental graduates with the opportunity to enhance their academic, scientific and

clinical skills as part of their career development

• To introduce or reinforce and develop the principles of scientific research methodology.

• To provide advanced knowledge and foster critical analysis of scientific and clinical approach

and further inculcate appreciation of the benefit of continuing professional education

• To build on the residents foundation in the basic and clinical sciences in order to increase their

understanding of oral disease processes and clinical and public health measures used in the

disease management.

4.2.GENERALEDUCATIONALOBJECTIVESOFTHEJUNIORRESIDENCYPROGRAMMEThe primary goal of the junior residency programme is to equip Residents with relevant competencies for

the routine management of all common oral and dental conditions at a level of proficiency higher than

that of the undergraduate. By the end of Part I FMCDS training, each Resident should have developed

core competencies in knowledge, understanding, skills and attitudes beyond the level of the first degree to

fulfill the following objectives:

a) Knowledge and Understanding.

Residents should be able to:

1. Recognize the clinical technical and scientific rationale for the clinical procedures.

2. Apply the principles of scientific method to clinical work.

3. Explain the principles of basic and clinical sciences relevant to clinical dentistry.

4. Discuss their in-depth knowledge in the field.

5. Describe how the provision of general clinical dentistry is affected by medical social and

demographic factors

6. Discuss the role of clinical, technical, and ancillary personnel in general patient management and

oral health.

7. Recognize how the expertise / knowledge gained may be best applied for the benefit of the

individual and the community.

8. Explain the principles underlying the development of evidence based dentistry.

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b) Skills:

Residents should be able to:

1. Collate, analyze and assimilate research data to a standard sufficient for publication

2. Obtain relevant information efficiently, analyze and interpret the relevant literature.

3. Use communication, presentation, data handling, team working and information technology skills

to support their academic, clinical and research learning.

4. Demonstrate a higher degree of clinical experience than the graduate dentist.

5. Use diagnostic, treatment planning and operative skills together with an awareness of current

developments in dentistry.

6. Integrate all aspects of dentistry for the betterment of dental oral and general health.

c) Attitudes:

Residents will have:

a) An active and critical attitude towards research and publication

b) An expectation to enhance clinical skills and understanding by further study and be prepared

to aid others in their acquisition of understanding and expertise.

c) The desire to maintain a high ethical standard and by personal example enhance the role of

the dentist in the society.

d) The ability to modify skill to the changing needs of the individual and the community.

e) Knowledge of personal limitations and an active attitude towards learning, recognizing the

benefits of continual updating of knowledge and clinical skills.

4.3SPECIFICOBJECTIVES:By the end of the Part I FMCDS training, each Resident should be able to:

1 Manage a full care patient.

2 Diagnose and formulate a comprehensive treatment plan for all oro-facial disorders

and emergencies.

3 Manage common oro-facial disorders and emergencies at a higher level of

proficiency than that of the undergraduate.

4 Recognize occasions for and the mode of patient referrals.

5 Make effective use of the library to write up cases, clinical presentations, seminars

as well as protocols for proposed studies.

6 Provide primary oral health care at the various levels of the health delivery system.

19

4.4.FORMATOFTRAININGThe junior residency programme, which lasts a minimum of twenty-four months is divided into clinical

units of posting and each resident is supposed to rotate through all these units as follows:

Oral and Maxillofacial Surgery - 2 months

Restorative Dentistry - 2 months

Prosthodontics - - 2 months

Pediatric dentistry - 2 months

Periodontology - 2 months

Oral Medicine - 2 months

Oral and Maxillofacial Pathology - 2 months

Community Dentistry - 2 month

Orthodontics - 2 month

Oral Diagnosis/Radiology - 2 months

Internal Medicine - 2 months

General Surgery - 2 Months

The junior Resident doctor must spend additional three months in his/her primary subspecialty before

presenting himself/herself the Part I examinations.

20

CONTACT HOURS AND CREDIT POINTS FOR PART I FMCDS

A junior resident is to rotate through all the twelve (12) clinical units in 24 months. The minimum total

credit points will be 180 units in 24 months. A junior resident is expected to attend at least two local or

international conferences and the certificate of attendance should be submitted with the Log Book before

the Part I Examination.

Unit

Course Code Months

Contact academic

hrs per week

Contact clinical rounds per week (hrs)

Laboratory rounds per week (hrs)

Ward rounds/ field per week

(hrs)

Contact call hours per week

Credit Points

Oral and Maxillofacial Surgery

DEN 710

2 6 30 - 6 32 15

Restorative Dentistry DEN 711 2 6 30 6 - 32 15

Prosthodontics DEN 712 2 6 30 6 - 32 15

Paediatric Dentistry DEN 713 2 6 30 3 3 32 15

Periodontology DEN 715 2 6 30 6 - 32 15

Oral medicine DEN 716 2 6 30 6 - 32 15

Oral and Maxillofacial Pathology

DEN 717

2 6 18 18 - 32 15

Community Dentistry DEN 718 2 6 30 3 3 32 15

Orthodontics DEN 719 2 6 30 6 - 32 15

Oral diagnosis/Oral radiology

DEN 720

2 6 30 6 - 32 15

Internal Medicine INT. MED 721 2 6 30 - 6 32 15

General Surgery SURG. 722 2 6 30 - 6 32 15

Total 24 180

21

ORALANDMAXILLOFACIALSURGERYINSTRUCTIONAL OBJECTIVES

The purpose of this clerkship is to provide a learning experience for the Resident so that the trainee is able

to perform all simple oral surgical procedures on. Where the resident chooses in this subspecialty, the

competence of the trainee is further improved and expanded at the senior residency level. By the end of

this two-month clerkship in oral and maxillofacial surgery, each junior Resident should be able to:

1. Understand the basic scientific principles underlying every procedure in oral and maxillofacial

surgery.

2. Be conversant with the practical steps for each surgical procedure.

3. Be aware of the general and specific indications for, as well as complications associated with each

procedure.

4. Be conversant with surgical instruments, sutures and appliances employed in operative and post-

operative care of surgical patients.

He should also be able to:

1. Take a comprehensive history from, examine an oral surgery patient and finally arrive at a logical

impression or provisional diagnosis for every case of oral and maxillofacial surgery.

2. Carry out or where applicable request for relevant modern investigations, both clinical and laboratory.

Residents should be conversant with recent changes in radiologic and biochemical investigations.

3. Manage surgically.

(a) Small cystic lesions

(b) Simple impacted 3rd molars

(c) All residual tooth fragments indicated for extractions and perform incisional and excisional

biopsies.

4. Carry out:

(a) Incision and drainage of abscesses

(b) Closure of small oro-antra fistulae

(c) Minor frenectomies in children

(d) Manual reduction of T.M.J. dislocation

(e) Routine pre-prosthetic surgery including alveoloplasty.

5. Extract all teeth indicated for extraction under local or general anaesthesia.

6. Describe the pathophysiology of trauma, its aerodynamics and metabolic consequences.

22

7. Provide pre-operative management of surgical emergencies including initial investigation and

resuscitation.

8. Treat all mandibular fractures requiring closed reduction.

9. Describe the pathology, clinical features, diagnosis and management of surgical infections including

localized alveolar osteitis

10. Recognize, investigate and treat appropriately all types of oro-facial infections and wounds.

11. Carry out appropriate post-operative and follow-up care as well as patient’s rehabilitation.

Course Outline for Oral and Maxillofacial Surgery Posting:

Module 1. Surgical Emergencies

1. Trauma

2. Severe facial infections including cellulitis eg Ludwig’s Angina.

Module 2. Surgical Procedures

a) Management of post extraction complications

b) Pericoronitis and third molars

c) Management of cysts.

d) Management of jaw fractures

e) Management of TMJ Diseases

f) Management of cleft lip and palate and other developmental anomalies

g) Condylectomies, arthroplasty and release of TMJ Ankylosis

h) Management of Chronic jaw infections.

Module 3. Advanced surgical procedure

a) Management of Salivary gland tumours.

b) Preprosthetic Surgery

c) Tooth transplantation/ re-implantation

d) Cadwell luc antrostomy

e) Tumours and surgical ablation of hard and soft tissues

f) Maxillofacial rehabilitation

g) Orthognathic surgery and distraction osteosynthesis.

23

Blueprint for the Part I of the Fellowship Programme and Examination in Oral and Maxillofacial Surgery

LEARNING

OBJECTIVE AREA

CREDIT UNITS

SPECIFIC TOPICS

No. of Objectiv

e Questio

ns

TAXONOMY Percentage course coverage LVL I LVL

II LVL III

Module 1. Surgical Emergencies

5

Trauma 2 0 1 1 1 Severe facial infections including cellulitis e.g Ludwig’s Angina.

1 0 0 1 0.5

Module 2. Surgical Procedures

5

Management of post extraction complications 2 0 0 2 1 Pericoronitis and third molars 1 0 0 1 0.5 Management of cysts 1 0 0 1 0.5 Management of jaw fractures 2 0 1 1 1 Management of TMJ Diseases 1 0 1 0 0.5 Management of cleft lip and palate and other developmental anomalies

1 0 0 1 0.5

Condylectomies, arthroplasty and release of TMJ Ankylosis

1 0 1 0 0.5

Management of Chronic jaw infections 2 0 1 1 1

Module 3. Advanced surgical procedure

5

Management of Salivary gland tumours 1 0 0 1 0.5 Preprosthetic Surgery 2 0 1 1 1 Tooth transplantation/ re-implantation 1 0 1 0 0.5 Cadwell luc antrostomy 1 0 0 1 0.5 Tumours and surgical ablation of hard and soft tissues

1 0 1 0 0.5

Maxillofacial rehabilitation 1 0 0 1 0.5 Orthognathic surgery and distraction osteosynthesis 1 0 0 1 0.5

TOTAL 15 22 11 Level I = Recall (facts), Level II = Comprehension and application, Level III = Analysis, synthesis and evaluation

24

Curriculum Showing Relative Time Commitment

Junior Residency

No. of sessions

(A)

Mean session

Duration (hrs)

(B)

Contact hours

Total (A) x (B)

Seminars

Module 1

Total

12

12

2

24

Tutorials

Module 2

Total

12

12

2

24

Ward rounds

36

3

108

Presentations

Module 3

Total

12

12

2

24

Clinic hours 60 6 360

Total contact hrs

540

25

RESTORATIVEDENTISTRYANDPROSTHODONTICSThe primary goal of this clerkship is to provide each Junior Resident with a broad academic background

and a comprehensive clinical and laboratory exposure in all aspects of Restorative Dentistry including

endodontics and Prosthodontics.

Programme Aims:

The aim of the course is to enable dentists acquire advanced knowledge and skills in the field of

Restorative Dentistry. The course is designed to provide the foundations for:

• Enhanced general dental practice

• Specialist practice

• Specialist training in Restorative Dentistry.

• Specialist training in the Restorative Mono-subspecialties of Endodontics and Prosthodontics.

• Clinical academia.

Specifically, the course aims to provide:

a) Clinical and laboratory practice involving treatment planning, clinical procedures and technical work

for Restorative cases requiring both routine and complex treatments.

b) An evidence base for Restorative Dentistry.

Programme Intended Learning Outcomes:

A. Knowledge and understanding of:

1. An advanced knowledge and understanding of the literature within Restorative Dentistry.

2. A broad knowledge of subjects directly related to Restorative Dentistry.

3. A full appreciation of the mechanisms of clinical audit.

Teaching strategy;

Teaching for A1 and A2 is mainly by pre-arranged seminars, tutorials and clinical presentations (104)

which are completed during the rotation in Restorative Dentistry. Each seminar has a structured reading

list prioritized where necessary into essential and recommended reading.

B. Subject-specific/professional skills.

1. The ability to diagnose and formulate appropriate treatment options including an organized sequence

of delivery.

2. The ability to assess prognosis of the preferred treatment option based on clinical outcome studies and

audit.

3. The ability to recognize the need for continuous reassessment of patient’s response as treatment

progresses.

4. The ability to undertake restorative treatment to advanced standards.

26

5. The ability to formulate a clear laboratory prescription, understand the technical procedures involved

and actively participate, as appropriate, in the laboratory work.

6. The ability to specify or provide an appropriate maintenance programme based on risk assessment.

7. The ability to treat patient with respect and without prejudice.

8. The ability to appreciate one’s limitations and to take advice or refer a patient when appropriate.

By the end of his training, the Junior Resident should have acquired an in-depth knowledge of the

following:

1. Simple intra-coronal restorations e.g. amalgam, composite fillings.

2. Inlays (all types)

3. Crowns and bridges (all types)

4. Endodontics and Surgical Endodontics.

5. Removable prostheses (all types)

6. Maxillofacial and cleft palate prostheses

7. T.M.J. dysfunction and speech rehabilitation

8. Management of deep caries

9. Implantology

10. Science of Dental Materials

Besides, he/she should be able to:

1. Carry out the following tooth preparations

(a) Acrylic jacket crown

(b) Three-quarter crown

(c) Full veneer crown

2. Complete the following procedures on patients:

(a) Anterior root fillings

(b) Posterior root fillings

(c) Jacket crowns (porcelain and/or acrylic)

(d) Gold crowns (three-quarter or full veneer)

(e) Metallic bridge.

3. Survey partially edentulous casts and design them for removable partial dentures. In addition he

should be able to carry out the following treatment;

(a) Metallic partial dentures

(b) Acrylic partial dentures.

27

(c) Full upper/full lower dentures.

(d) Overdenture and immediate dentures.

(e) Denture repairs and relining.

(f) Observe and participate in fabrication of Maxillofacial Prosthesis.

(g) Occlusal splints and special appliances.

(h) Observe and participate in implant therapy.

In addition to 1-3 above, each Resident should present two case reports for discussion of alternative

treatment.

Programme Features:

The 4 month posting in Restorative Dentistry comprises of two main areas.

1. Supervised clinical and laboratory practice involving treatment planning, clinical procedures and

technical work for selected cases including some complex treatments.

2. Review of the clinical and scientific evidence base for Restorative Dentistry

3. By means of seminars, lectures and practical classes.

Residents are expected to have a high degree of clinical exposure under expert tutor.

Curriculum and Structure

The seminar programme is based on 6 compulsory modules:

• Conservative and Fixed Prosthodontics.

• Complete Prosthodontics.

• Dental Material Science.

• Endodontics.

• Implantology

• Removable Partial Prosthodontics.

28


Junior Residency

No. of sessions

(A)

Mean session

Duration (hrs)

(B)

Contact hours

Total (A) x (B)

Seminars

Conservation

Endodontics

Materials Science

Prosthodontics

Implantology

Total

3

2

2

3

2

12

2

24

Tutorial

Conservation

Endodontics

Materials Science

Prosthodontics

Implantology

Total

4

2

1

4

1

12

2

24

Laboratory rounds

Crown and bridge

Metal based denture

Porcelain facing of metal

36

3

108

29

Fabrication of hollow obturator

Splints

Presentations

Conservation

Endodontics

Materials Science

Prosthodontics

Implantology

Total

4

2

1

4

1

12

2

24


Special clinic

Courses

Occlusion & restorations

TMD

Implant

Total

1

1

1

3

2

6

Total contact hrs.

540

30

COURSE CONTENT:

MODULE 1

Removable Prosthodontics and Implantology:

Impression techniques

Complete denture fabrication.

Denture design and construction

Overdentures.

Articulators, types and selection.

Registration and Facebow techniques

Shade matching and aesthetic problems

Surveying

Chrome Cobalt Removable Partial Dentures.

Casting procedures.

Occlusion.

Anatomy and mandibular movement.

Occlusal examination, terminology.

Diagnosis and treatment planning.

Equilibration procedures.

Splints and provisional appliances.

Anterior guidance and posterior occlusion.

Occlusion schemes and philosophies.

Advanced techniques for studying occlusion.

Principles of Implantology.

MODULE 2.

31

Dental Materials Sciences.

Introduction and perspective.

Solid structures.

Physical Properties.

Mechanical properties.

Composite Resins.

Glass-ionomer cements.

Aspects of adhesion

Dental amalgam

Impression materials.

Bases and liners.

Biocompatibility of dental materials

Gypsum products and investments

Noble and precious metals

Cast and wrought base metal alloys

Ceramics

Cariology, endodontics, and adhesive dentistry.

Review of Dental Caries.

Pulpal protection and linings.

Adhesive restorative materials - composite resins, glass- ionomer cements and enamel dentine bonding.

Instruments.

Principles of cavity preparation

Moisture control

Matrices and wedging

32

Restorative placement techniques.

Tooth wear

Direct restorations.

The core science of endodontics

The advanced science of endodontics

Current Concepts in endodontics

Direct / indirect composite inlays.

MODULE 3.

Fixed Prosthodontics

Resin – bonded bridges.

Porcelain jacket crown.

Porcelain veneers.

Composite resin veneers.

Dentine-bonded ceramic crowns and inlay.

Periodontal non-surgical root debridement and maintenance.

Simple and complex RCT procedure.

Restoration of root filled teeth.

Porcelain fused to metal and FGC crowns.

CAD/CAM

Diagnostic Wax up.

Occlusal analysis +/- adjustments.

Occlusal rehabilitation splint.

Basic composites- anterior and posterior.

Polychromatic anterior composite veneer of fractured incisor.

33

Resin – bonded Ceramic crown(s).

Ceramic veneer(s) to include diagnostic- wax up and cosmetic trial.

Blueprint for the Part I of the Fellowship Programme and

Examination in Prosthodontics


CREDI

T UNITS

SPECIFIC TOPICS No. of

Objective Questions

TAXONOMY Percentage course

coverage LVL I LVL II LVL III

Module 1. Complete dentures

5

Impression Techniques 1 0 1 1 0.5 Bite Registration procedure 1 0 0 1 0.5

Face bow record and transfer 1 0 0 1 0.5

Teeth selection and Try in procedure 1 0 0 1 0.5

Processing of complete dentures 1 0 0 1 0.5

Management of problems associated with complete

dentures 1 0 0 1 0.5

Management of complex cases (Flabby ridge, single complete

dentures 1 0.5

Module 2. Partial Dentures 5

Patient Assessment 1 0 0 1 0.5 Abutment teeth assessment 1 0 0 1 0.5 Classifications of partially

edentulous saddle 1 0 0 1 0.5

Secondary impression and duplication of cast 1 0 0 1 0.5

Surveying 1 0 0 1 0.5 Partial denture design 1 0 1 0 0.5

Processing and finishing of RPD 1 0 1 0 0.5

Module 3. Advanced Prosthodontics

5

Overdenture treatment 1 0 0 1 0.5 Immediate dentures 1 0 1 0 0.5

Precision attachments 1 1 0 0 0.5 Implants treatment 1 0 1 0 0.5

Maxillofacial rehabilitation 1 0 1 0 0.5 Occlusal rehabilitation 1 0 1 0 0.5 Peri-prosthetic mouth

preparation 1 0 0 1 0.5

Orthognathic surgery 1 1 0 0 0.5 TOTAL 15 22 11


34

Blueprint for the Part I of the Fellowship Programme and Examination in Restorative Dentistry

LEARNING OBJECTIVE

AREA

CREDI

T UNITS


Objective Questions



Module 1. Cariology , endodontics, and adhesive

dentistry 5

Management of Dental caries 1 0 0 1 0.5 Principles of cavity Preparation 1 0 0 1 0.5

composite resins, glass- ionomer cements and enamel

dentine bonding. 1 0 0 1 0.5

Tooth wear 1 0 0 1 0.5 Direct restorations 1 0 0 1 0.5

Direct / indirect composite inlays 1 0 0 1 0.5

Moisture control 1 0 0 1 0.5

Module 2. Endodontics 5

Management of crack teeth 1 0 0 1 0.5 Pulp diseases and therapy 1 0 0 1 0.5

Complex endodontics 1 0 0 1 0.5 Endodontic emergencies 1 0 0 1 0.5

Surgical endodontics 1 0 0 1 0.5 Periodontal non-surgical root debridement and maintenance 1 0 1 0 0.5

Restoration of root filled teeth. 1 0 0 1 0.5

Module 3. Fixed prosthodontics

5

Patient assessments 1 0 0 1 0.5 Abutment teeth assessment 1 0 0 1 0.5

Veneers 1 1 0 0 0.5 Crowns and Bridges 1 0 1 0 0.5

Occlusal rehabilitation 1 0 1 0 0.5 Laboratory procedures for

crowns and bridges 1 0 1 0 0.5

Implant 1 0 0 1 0.5 CAD/CAM 1 1 0 0 0.5


35

PAEDIATRICDENTISTRYPaediatric courses are designed to provide the basic principles and foundation knowledge related to dentistry for the child patient. The course is designed to help the Resident provide comprehensive oral health care for children.

The major thrust of this posting is to train the junior Resident to be able to perform at a higher level than

the undergraduate in Children’s Dentistry. By the end of junior residency in pediatric dentistry, each

Resident should be able to:

1. Obtain a comprehensive but reliable history from a paediatric dental patient and parents/guardians.

2. Perform informative clinical examination and relevant investigations to arrive at a diagnosis.

3. Produce a comprehensive treatment plan for any child including the handicapped and children with

behavioral problems.

4. Recognize indications for the use of local, relative and general anesthesia.

5. Manage a child patient under relative and general anesthesia.

6. Carry out with or without collaboration, the comprehensive treatment planning and management of

minor orthodontic cases.

7. Carry out in conjunction with the orthodontic unit, the oral surgery unit and/or the Plastic Surgery

unit and the speech therapist a comprehensive examination, treatment planning and the management

of children with cleft lip and/or palate and other congenital oro-facial defects.

8. Produce two well-documented bookcases of patients managed during the period. Such cases should

involve multidisciplinary oral rehabilitation.

9. Carry out the following procedures

(a) Root canal therapy on four anterior teeth

(b) Acid-etch restorations on (i) six fractured incisors (i) two labial facings

(c) Acrylic and/or porcelain jacket crowns on four anterior teeth.

(d) Stainless steel crowns on two primary teeth

(e) Pulpotomy on four primary molars

(f) Complete management of two fractured incisors

(g) Proper application of fissure sealants on two separate occasions

(h) Topical fluoride application, six times.

(i) Comprehensive treatment planning for two child patients.

(j) Fabrication of two custom-made cast core gold posts.

(k) Routine exodontias for child patients.

36

Course Outline overview: The course in paediatric dentistry is divided into four modules. Each module

represents a systematic approach to child dental health care.

Module 1. – Assessment/Examination of Children

a. Course and Clinical Forms Overview

b. Principles of Child Management

c. Ethics of Child Dental Management

d. Physical, Oral and Occlusal Assessment

e. Behavioral Assessment

f. Soft and Hard Tissue Assessment

Module 2 – Behaviour Management of Children

a. Non-Pharmacologic Behaviour Modification

b. Local Anesthesia and Analgesia

c. Conscious Sedation

d General Anesthesia

e. Management of Adolescents and Children who have Disabilities

f. Medically compromised children

g. Emergency Care and Child Abuse

Module 3 – Oral Diseases in Children

a. Caries Epidemiology / Risk Assessment, Infant Care and Oral Hygiene Instruction

b. Early Childhood Caries

c. Pulp Therapy

d. Fluoride therapy and Fissure sealants

e. Management of Soft tissue lesions.

f. Management of patients with genetic disorders

g. Management of oral mucosal lesions in children

Module 4 – Restorative Procedures for Children

a. Morphological differences between primary and permanent teeth and impact on tooth restoration

b. Restoration of Primary Teeth (Class I, II, III and temporary Crowns)

c. Appropriate use of dental materials (amalgam, GIC, Composite)

37

d. Trauma and Management of trauma

e. Paediatric Prosthetics

f. Stainless Steel Crowns and Anterior Crowns

g. Extraction and Space Maintainers

h. Treatment Planning and Referral Protocol


Examination in Paediatric Dentistry


CREDIT UNITS


Objective Questions



Module 1 and 2 Assessment, Examination

and child behaviour management

5

Principles of Child Management 1 0 0 1 0.5 Ethics of Child Dental Management 1 0 0 1 0.5

Physical, Oral and Occlusal Assessment 1 0 0 1 0.5 Behavioural Assessment and Non-

Pharmacologic Behaviour Modification

1 0 0 1 0.5

Soft and Hard Tissue Assessment 1 0 0 1 0.5 Local Anaesthesia and Analgesia,

Conscious Sedation General Anaesthesia

. Medically compromised children 1 0 0 1 0.5

Emergency Care and Child Abuse Management of Adolescents and Children

who have Disabilities 1 0 1 0 0.5

Module 3 Oral Diseases in Children

5

a. Caries Epidemiology / Risk Assessment, Infant Care and Oral Hygiene Instruction 1 0 0 1 0.5

Pulp Therapy 1 0 0 1 0.5 Early Childhood Caries 1 0 0 1 0.5

Fluoride therapy and Fissure sealants 1 0 0 1 0.5 Management of Soft tissue lesions. 1 0 0 1 0.5

Management of patients with genetic disorders 1 0 1 0 0.5

Management of oral mucosal lesions in children 1 0 1 0 0.5

Module 4. Restorative procedure for Children

5

Morphological differences between primary and permanent teeth and impact on tooth

restoration 1 0 0 1 0.5

Restoration of Primary Teeth (Class I, II, III and temporary Crowns) 1 0 0 1 0.5

Appropriate use of dental materials (amalgam, GIC, Composite) 1 1 0 0 0.5

Trauma and Management of trauma 1 0 1 0 0.5 Paediatric Prosthetics 1 0 1 0 0.5

Stainless Steel Crowns and Anterior Crowns 1 0 1 0 0.5

Extraction and Space Maintainers 1 0 0 1 0.5 Treatment Planning and Referral Protocol 1 1 0 0 0.5


38


Junior Residency

No. of sessions

(A)

Mean session

Duration (hrs)

(B)

Contact hours

Total (A) x (B)

Seminars

Module I and 2

Total

8

8

2

16

Tutorial

Module 3

Total

8

8

2

16

Laboratory rounds

Paediatric Dentistry

8

3

24

Presentations

Module 4.

Total

8

8

2

16


Total contact hrs

312

39

ORTHODONTICSThe aim of the rotation through clerkship in orthodontics is to introduce the Resident to the practice of

orthodontics. By the end of junior residency training, the trainee should

1. Know the biological principles underlying the practice of orthodontics.

2. Be conversant with basic orthodontic instruments and their uses.

3. Be aware of the general and specific indications for common orthodontic procedures as well as the

complications associated with each procedure.

He/she should also be able to:

1. Carry out a detailed examination of orthodontic cases.

2. Diagnose and formulate appropriate treatment plan for simple orthodontic problems.

3. Implement the treatment of simple orthodontic cases using removable appliances.

4. Take adequate care of orthodontic emergencies.

5. Trace and analyze cephalometric radiographs.

The orthodontic course is divided into three modules. The first module addresses the basic principles

involved with understanding the aetiology of malocclusion, classification of malocclusion and the

treatment planning. The second module introduces the residents to the principles of patient management

and patients’ evaluation of treatment. The third course delves specifically into the management of

malocclusion traits and helps the residents comprehend the principles involved with treatment planning

and patients evaluation.

Orthodontics Course Outline:

Module 1 – Development of Malocclusion

a. Course and Clinical Forms Overview

b. History and Scope of Orthodontics and Orthodontic Practice

c. Epidemiology of Malocclusion

d. Development of the Occlusion

e. Health Risks Associated with Malocclusion

f. Normal Development of Oral Function

g. Growth of Facial Skeleton and Theories of Facial Growth

h. Development and Eruption of the Teeth

i. Aetiology of Malocclusion

40

j. Classification of Malocclusion

Module 2 – Assessment and Management of Malocclusion

a. Examination of the Orthodontic Patient

b. Classification of Malocclusion

c. Assessment of Crowding and Space Analysis

d. Principles of Treatment Planning

e. Interceptive Orthodontics

f. Serial Extraction

g. Physiology of Tooth Movement

h. Removable Appliances

i. Functional Appliances

j. Fixed Appliances

Module 3 – Advanced Orthodontic Management Principles

a. Radiology of Orthodontics

b. Angle Class I Malocclusion – Features and Treatment

c. Angle Class II Division I Malocclusion – Features and Treatment

d. Angle Class II Division 2 Malocclusion – Features and Treatment

e. Angle Class III Malocclusion – Features and Treatment

f. Principles of Retention and Stability

g. Surgical Treatment of Malocclusion

h. Treatment of Cleft palate

i. Adult Orthodontics

j. Management of Unerupted Canine

k. Third Molars and Their Role in Orthodontics

l. Oral habits

m. Current Concepts in Orthodontics.

41

Table of Specifications for the Part I of the Fellowship Programme and Examination in Orthodontics

LEARNING

OBJECTIVE AREA

CREDIT UNITS


Objective Questions



Module 1 Development of malocclusion

5

Epidemiology of Malocclusion And Development of the Occlusion 1 0 1 0 0.5

Health Risks Associated with Malocclusion 1 0 0 1 0.5 Normal Development of Oral Function 1 0 0 1 0.5

Growth of Facial Skeleton and Theories of Facial Growth 1 0 0 1 0.5

Development and Eruption of the Teeth 1 0 0 1 0.5 Aetiology of Malocclusion 1 0 0 1 0.5

Classification of Malocclusion 1 0 0 1 0.5

Module 2. Assessment and management of Malocclusion

5

Examination of the Orthodontic Patient Classification of Malocclusion 1 0 0 1 0.5

Assessment of Crowding and Space Analysis and Principles of Treatment

Planning 1 0 0 1 0.5

Serial Extraction and Interceptive Orthodontics 1 0 0 1 0.5

Physiology of Tooth Movement 1 0 0 1 0.5 Removable Appliances 1 0 0 1 0.5 Functional Appliances 1 0 1 0 0.5

Fixed Appliances 1 0 0 1 0.5

Module 3. 5

Radiology of Orthodontics Angle Class I, II and II Malocclusion –

Features and Treatment Management of Unerupted Canine

1 0 0 1 0.5

Principles of Retention and Stability 1 0 0 1 0.5 Surgical Treatment of Malocclusion 1 1 0 0 0.5

Adult Orthodontics 1 0 1 0 0.5 Treatment of Cleft palate 1 0 1 0 0.5

Third Molars and Their Role in Orthodontics 1 0 1 0 0.5

Oral habits 1 0 0 1 0.5 Current Concepts in Orthodontics 1 1 0 0 0.5


42


Junior Residency

No. of sessions

(A)

Mean session

Duration (hrs)

(B)

Contact hours

Total (A) x (B)

Seminars

Module 1

Total

4

4

2

2

8

Tutorial

Module 2

Total

4

4

2

8

Laboratory rounds

Orthodontics

4

3

12

Presentations

Module 3

Total

4

4

2

8

Clinic hours

20

6

120

Total contact hrs 156

43

PERIODONTOLOGYThe junior posting in periodontology is for 2 months. The purpose of the postgraduate program is to

enable the successful postgraduate student to practice periodontology, including surgical oral implant

therapy, at a specialist level. This demands that along with the development of technical skills, the

postgraduate doctor must acquire a thorough understanding of the biological functions of the human

tissues and the science of periodontology. Furthermore, the postgraduate student must be able to

understand and critically evaluate the periodontal and related literature, e.g. implant literature. Additional

aims are to give the postgraduate student exposure and training in teaching and research.

.

By the end of his/her training in periodontology, each Resident should be able to:

1. Describe the biology of the periodontium.

2. Explain the etiology and the different pathologies of periodontal tissues.

3. Diagnose the different pathologies of periodontal tissues

4. Explain the different methods available for the prevention of periodontal pathologies.

5. Carry out a detailed treatment for periodontal pathologies

6. Participate effectively in seminars on periodontology and formally present periodontal cases at

scientific meetings.

7. Understand, interpret and supply current indices for the assessment of periodontal diseases.

The program involves specific courses on various aspects of periodontology and implant dentistry as well

as in most other fields of Dentistry. The sources of knowledge are research articles and well-substantiated

clinical evidence.

Clinical courses

Weekly seminars, tutorials and clinical presentations will be given on the clinical management of patients

with various forms of periodontal problems.

Clinical practice

Inherent to the program is the clinical training, at least 20 hours per week, where the postgraduate student

will acquire proficiency in all diagnostic and therapeutic areas of periodontology, including surgical

aspects of implant dentistry. The postgraduate doctor will be responsible for the treatment of patients with

various periodontal problems and such treatments must be recorded in the Faculty log book and signed by

the supervising consultant.

44

COURSE OUTLINE

Module 1 – Basic periodontology 1. Development of Periodontium.

2. Normal Periodontium.

3. Gingiva.

4. Tooth Supporting Structures.

5. Developmental Aspects of the Periodontium.

6. Ageing and the Periodontium.

7. Biochemistry of Normal Periodontal Connective Tissue.

8. Diseased Periodontium.

9. Mammalian Cell Cycle and Growth Regulation.

10. Gene Expression and Regulation of Protein synthesis.

11. Structure, Biosynthesis and Regulation of Collagen.

12. Non-Collagenous Proteins and Receptors For matrix metalloproteinases

13. Proteins.

14. Proteoglycans.

15. Inflammation and Wound Healing.

16. Gingival crevicular fluid and saliva.

17. Diagnostic Markers.

18. Periodontal Regeneration.

Module 2. Etiology and pathology of periodontal diseases

1. Periodontal Microbiology.

2. Oral Infection and Immunity.

3. Normal Microflora of Oral Cavity.

4. Streptococci species

5. Black Pigmented Bacteriodes.

6. Aggregatibacter Actinomycetemcomitans.

7. Veillonella, Wolinella, Campylobacter.

8. Spirochaetes.

9. Microbial Interactions with the Host

10. Molecular Biology of Host-Microbe Interaction in Periodontal Diseases.

11. Cells Involved in the Immune System.

12. The Complement System.

45

13. Cell Migration and Inflammation.

14. Antibodies and Receptors.

15. T-Cell Receptors and the Mhc Molecule.

16. Cell Co-Operation in Antibody Response.

17. Antigen Presentation.

18. T-Cell and B-Cell Interaction.

19. Cytokine Action.

20. Antibody Response in Vivo.

21. Diagnostic Immunologic Techniques.

22. Diagnostic Microbiology.

23. Dental Calculus and Predisposing Factors.

24. Influence of Systemic Diseases and Disorders of Periodontium.

25. Smoking and Periodontal Diseases.

26. Periodontal Pathology.

27. Defense Mechanism of Gingiva.

28. Gingival Inflammation.

29. Gingival Enlargement.

30. Acute Gingival Infections.

31. Gingival Diseases in Childhood.

32. Desquamative Gingivitis.

33. The Periodontal Pocket.

34. Mechanism of Tissue Destruction.

35. Bone Loss – Mechanisms and Pattern.

36. Periodontal Response to External Forces.

37. Masticatory System Disorders.

38. Types of Periodontics.

39. HIV/AIDS and the Periodontium.

40. Periodontal Medicine.

41. Pulpo-Periodontal Lesions and Furcation involvement.

46

Module 3. Epidemiology of periodontal diseases diagnosis, prognosis and treatment 1. Clinical Diagnosis.

2. Radiographic Diagnosis.

3. Advanced Diagnostic Techniques.

4. Risk Assessment.

5. Determination of Prognosis.

6. Treatment Plan.

7. Periodontal Treatment of Medically Compromised Patients.

8. Periodontal Treatment in Female Patients and Older Adults.

9. Treatment of Different Types of Periodontal Diseases.

10. Periodontal Instrumentation.

11. Treatment of Periodontal Emergencies.

12. Phase – I Periodontal Therapy Plaque Control Scaling and Root Planning.

13. Chemotherapeutic Agents in Periodontal Therapy.

14. Occlusal Evaluation and Therapy.

15. Role of Orthodontics in Periodontal Therapy.

16. Periodontal – Restorative Inter Relationship Maintenance Phase.

Module 4. Surgical phase

1. General Principles of Periodontal Surgery.

2. Surgical Anatomy of Periodontium and Related Structures.

3. Gingival Curettage.

4. Gingivectomy.

5. Periodontal Flap.

6. Resective Osseous Surgery.

7. Regenerative Osseous Surgery.

8. Management of Furcation Involvement and Pulpo-periodontal Lesions.

9. Periodontal Plastic and Aesthetic Surgery.

10. Recent Advances in Surgical Technology.

47

Module 5. Oral implantology

1. Biologic, Clinical and Surgical Aspects of Dental Implants.

2. Advanced Implant Surgery and Bone Grafting Techniques.

3. Prosthetic Aspects of Dental Implants.

4. Diagnosis And Treatment of Peri- Implant Complications


Examination in Periodontology


CREDIT UNITS


Objective Questions



Module 1and 2 Basic periodontology

5

Development of Periodontium, 2. Normal Periodontium. Gingiva. Tooth Supporting

Structures . 1 0 0 1 0.5

Ageing and Diseased Periodontium 1 0 0 1 0.5 Periodontal Regeneration 1 0 0 1 0.5

Etiology and pathogenesis of periodontal infection 1 0 0 1 0.5

Influence of Systemic Diseases and Disorders of Periodontium. 1 0 0 1 0.5

HIV and periodontium 1 0 0 1 0.5 Pulpo-Periodontal Lesions and Furcation

involvement 1 0 1 0 0.5

Module 3 Conservative management

5

Clinical Diagnosis, 2. Radiographic Diagnosis. Advanced Diagnostic Techniques. Risk Assessment and

prognosis, Treatment Plan. 1 0 0 1 0.5

Treatment of Periodontal Emergencies and Periodontal Treatment of Medically

Compromised Patients. 1 0 0 1 0.5

Periodontal Therapy Plaque Control Scaling and Root Planning 1 0 0 1 0.5

Chemotherapeutic Agents in Periodontal Therapy. 1 0 0 1 0.5

Occlusal Evaluation and Therapy. 1 0 0 1 0.5 Role of Orthodontics in Periodontal

Therapy. 1 0 1 0 0.5

Periodontal – Restorative Inter Relationship Maintenance Phase. 1 0 0 1 0.5

Module 4 and 5 5

General Principles of Periodontal Surgery. 1 0 0 1 0.5

Gingival Curettage, Gingivectomy Periodontal Flap. 1 0 0 1 0.5

Resective Osseous Surgery 1 1 0 0 0.5 Regenerative Osseous Surgery 1 0 1 0 0.5

Management of Furcation Involvement and Pulpo-periodontal Lesions. 1 0 1 0 0.5

Periodontal Plastic and Aesthetic Surgery. 1 0 1 0 0.5 Recent Advances in Surgical Technology 1 0 0 1 0.5 Diagnosis And Treatment of Peri- Implant

Complications 1 1 0 0 0.5


48

Curriculum showing relative time commitment

Junior Residency

No. of sessions

(A)

Mean session

Duration (hrs)

(B)

Contact hours

Total (A) x (B)

Seminars

Module I and 2

Total

8

8

2

16

Tutorials

Module 3 and 4

Total

8

8

2

16

Presentations

Module 5.

Total

8

8

2

16


Total contact hrs

312

49

ORALMEDICINEProgramme outline.

Oral medicine includes the diagnosis, medical treatment and research into conditions of the mouth, face,

salivary glands and jaws and the care of patients with special needs. It has a particular expertise in

mucosal and infectious diseases.

Aims and Objectives

The aim of the residency programme is to extend the knowledge and skills in Oral Medicine beyond that

obtained as an undergraduate to allow the candidate to become a competent practitioner in the field of

Oral Medicine

In particular, the rotation in Oral Medicine aims to provide:

§ An understanding of the aetiology, epidemiology and clinical presentation of well-characterized

disorders of the oral mucosa and salivary glands, and disorders of sensation of the mouth (pain and

abnormalities of taste)

§ An understanding and relevant investigation and management of such disease

§ An understanding of the process of learning and the dissemination of clinical knowledge

The objectives of the clinical training in Oral Medicine are to ensure that following completion of this

course, the Resident:

§ Has an understanding of the epidemiology of relevant orofacial diseases.

§ Is able to recognize the clinical features of most common relevant orofacial disorders

§ Is able to undertake a detailed clinical history and relevant clinical examination

§ Is able to undertake relevant clinical investigations (phlebotomy, sialometry, biopsy, cranial nerve

assessment)

§ Is able to arrange the necessary relevant special investigations

§ Is able to interpret and be aware of the significance of the result of relevant special investigations

§ Is able to provide effective long-term care of patients with relevant orofacial disease and be aware of

the limitations of such therapies

§ Be able to arrange necessary referral of patients to relevant specialists

§ Be able to provide relevant preventative advice both at a local and national level

§ Be able to interpret and assess the significance of current published work

§ Have the necessary Information Technology skills to write appropriate clinical reports

§ Be aware of general principals of clinical and laboratory-based research, and be able to independently

undertake relevant, simple research, including clinical audit

50

§ Be aware of emerging health trends to be able to appropriately adapt clinical and academic practice

Teaching strategy

§ A programme of lectures, seminars and clinico-pathological conferences reviewing clinical and

scientific aspects of relevant disease

§ Attendance at supervised clinics in all aspects of Oral Medicine

§ A research investigation leading to a dissertation

The curriculum includes aspects of the following subjects, which are relevant to oral medicine. Special

reference is given to problems of the patient with special needs, and covers.

Module 1. Evaluation and Diagnosis of Oral and mucosa lesions.

1. Oral Mucosal Disease

2. Oral Manifestations of Systemic Disease and HIV/AIDS

3. Oral Disorders associated with Aging

4. Oral Complications of Medical Therapy

5. Diseases of the Jaws and Teeth

6. Salivary Gland Disease.

7. Management of potentially malignant disease of the oral mucosa

Module 2. Oral Medicine Clinical Practice

1. Diagnosis and Treatment of Orofacial Pain

2. Oral/Dental Management of Medically Complex Patients

3. Rheumatology Pharmacology and Therapeutics

4. Diagnostic imaging interpretation

5. Molecular Basis of Oral and Mucosal leisions.

6. Immunological basis of oral diseases.

51

Module 3: Core Foundation Knowledge

1. Epidemiology and Biostatistics

2. Research Design and Evaluation

3. Medicine and Pathology

4. Biomedical Sciences

5. Dermatology

6. Pain Medicine

7. Educational Experience

8. Anesthesia

9. Internal Medicine

Table of Specifications for the Part I of the Fellowship Programme and

Examination in Oral Medicine


CREDIT UNITS

SPECIFIC TOPICS No. of Objective Questions

TAXONOMY Percentage course coverage

LVL I LVL II LVL III

Module 1. Evaluation and diagnosis of oral mucosal lesions

5

Oral Mucosal Disease 1 0 1 0 0.5 Oral Manifestations of Systemic Disease and HIV/AIDS

1 0 0 1 0.5

Oral Disorders associated with Aging 1 0 0 1 0.5 Oral Complications of Medical Therapy 1 0 0 1 0.5 Salivary Gland Disease. 1 0 0 1 0.5 Management of potentially malignant disease of the oral mucosa

1 0.5

Module 2. Oral medicine clinical practice

5

Diagnosis and Treatment of Orofacial Pain

1 0 0 1 0.5

Oral/Dental Management of Medically Complex Patients 1

0 0 1 0.5

Rheumatology Pharmacology and Therapeutics 1

0 0 1 0.5

Molecular Basis of Oral and Mucosal lesions. 1

0 1 0 0.5

Module 3: Advanced oral medicine

5 Immunological basis of oral diseases 1 0 1 1 0.5 Dermatology and oral medicine 1 1 0 0 0.5 Pain Medicine 1 0 1 0 0.5 Nephrology and Oral medicines 1 0 1 0 0.5


52

Curriculum showing relative time commitment Junior Residency

No. of sessions

(A)

Mean session

Duration (hrs)

(B)

Contact hours

Total (A) x (B)

Seminars

Module 1

Total

8

8

2

16

Tutorials

Module 2

Total

8

8

2

16

Laboratory

8

3

24

Presentations

Module 3.

Total

8

8

2

16


Total contact hrs

312

53

COMMUNITYDENTISTRY The junior residency positing in community dentistry is designed as foundation programme for those who

are planning to become specialists in the discipline. By the end of this elective clerkship, each Resident

should understand –

1. The basic principles of community oral health and their application to the community.

2. Public health administration (medical and dental), planning and organization of health services.

3. Define, describe and implement epidemiological procedures relevant to oral diseases with special

emphasis on caries and periodontal diseases.

4. Appreciate the role of public health measures in the reduction of oral diseases.

5. Discuss the various methods for the prevention of oral diseases.

6. Carry out the following preventive oral health procedures Application of (i) fissure sealants (ii)

topical fluorides (iii) Oral prophylactic measures notably scaling and polishing.

7. Provide home care advice and appropriate dietary counseling to patients.

8. Prepare and give talks on preventive oral health.

9. Effect a critical review of oral health research methods.

10. Participate effectively in seminars related to preventive aspects of oral health and lead group

discussion.

Competences expected:

To furnish the resident with the necessary knowledge and skill to effectively design and manage

community dental care at a district level

At the end of the module, the residents should be able to:

1) Discuss and monitor dental care for the aged

2) Select and interpret information for the description of oral health status and care

3) Analyze demographic trends and. surveillance of oral diseases

4) Plan for a district dental service

5) Use research studies for the prevention of oral diseases

6) Discuss health promotion and the integration of oral health in a multi sectoral-approach

7) Assess the utilization of dental services by the community.

8) Formulate policies on prevention of oral diseases.

9) Evaluate an oral health program

COURSE OUTLINE

Module 1

54

1. Introduction to Dental Public Health.

2. Current Concepts in Dentistry.

3. Research Methods in Clinical Dentistry.

4. Introduction to Bio-Statistics

5. Dental informatics and Teledentistry

6. Plaque control

7. Dietary counselling

Module 2

1. Dental Public Health - Foundations and Theory

2. Dental Public Health – Applications and Critique

3. Role of Behavioral sciences in dentistry

4. Oral Health education

5. Oral health promotion

6. Geriatric dentistry

7. Steps in planning oral health

8. Primary Health Care Approach- Oral health component

9. Pits and Fissure sealing

10. Minimal intervention dentistry

Module 3

1. Health service strategies

2. Utilization of dental services

3. Trends in Oral Diseases

4. Oral health Policy

5. Dental ethics and jurisprudence

6. Basic package of oral health care

55

Blueprint for the Part I of the Fellowship Programme and Examination in Dental Public Health

LEARNING

OBJECTIVE AREA

CREDIT UNITS


Objective Questions



Module 1: introduction to dental public health 5

Research Methods in Clinical Dentistry. 1 0 0 1 0.5 Dental informatics and Tele-dentistry 1 0 0 1 0.5 Dietary counselling and plaque control 1 0 0 1 0.5

Module 2. Foundations and theory of dental public

heath 5

Oral Health Education and promotion 1 0 0 1 0.5 Steps in planning oral health 1 0 0 1 0.5

Primary Health Care Approach- Oral health component 1 0 1 0 0.5

Pits and Fissure sealing and Minimal intervention dentistry 1 0 0 1 0.5

Module 3: oral health policy 5

Utilization of dental services and Basic package of oral care 1 0 0 1 0.5

Oral health Policy 1 0 1 0 0.5 Dental ethics and jurisprudence 1 0 1 0 0.5


56


Junior Residency

No. of sessions

(A)

Mean session

Duration (hrs)

(B)

Contact hours

Total (A) x (B)

Seminars

Module 1

Total 4

4

2

2

8

Tutorials

Module 2

Total

4

4

2

8

Field work

4

3

12

Presentations

Module 3

Total

4

4

2

8


Total contact hrs

156

57

ORALANDMAXILLOFACIALPATHOLOGY Two Months rotation in Oral Pathology is prescribed. During this period, candidates must have acquired

competences in the following areas:

1. Histopathological diagnosis

2. Oral histopathology laboratory techniques

3. Clinical oral pathology

4. Seminars, journal reviews and clinico-pathological conferences

5. Research methodology in oral pathology

6. Histopathological diagnosis

Teaching strategy

a) Observe /participate in routine biopsy diagnosis of at least 2 cases per week during the period of

posting, under the supervision of a consultant Oral Pathologist.

b) Attempt to interpret and diagnose not less than 30 cases from collection of cases in the archive of the

training institution, under the supervision of a consultant Oral Pathologist. Such cases must cover the

following disease categories:

Module 1

a) Inflammatory lesions of oral soft and hard tissues.

b) Cystic lesions

c) Odontogenic tumors

Module 2

a) Precancerous lesions

b) Epithelial non odontogenic tumors

c) Mesenchymal non odontogenic tumors

Module 3

a) Fibroosseous lesions

b) Salivary gland lesions

c) Vesiculobullous and autoimmune diseases.

58

ORAL HISTOPATHOLOGY LABORATORY TECHNIQUES

I. Observe/participate in trimming of at least 1 surgical specimen per week a total of 12 specimens)

under the supervision of a consultant Oral Pathologist.

2. Observe and follow up to final stages of haematoxylin and eosin stained glass slides, at least 2 surgical

specimens, under supervision of an experienced Oral Histopathology Technologist.

3. Show good understanding of reason for request and interpretation of:

a) Special stains as an aid to histopathological diagnosis.

b) Exfoliative cytology and Fine needle aspiration cytology as an aid to diagnosis.

c) Immunocytochemistry as an aid to diagnosis.

d) Other additional diagnostic aids.

e) Saliva screening for HIV antigen and antibodies.

CLINICAL ORAL PATHOLOGY

Candidate must attend and participate actively at the Oral Pathology clinics, and by the end of the posting

show the following evidences:

a) At least 5 cases duly managed under the supervision of a consultant Oral Pathologist.

b) Three cases from whom the candidate has taken oral smears for exfoliative cytology.

c) At least 2 cases from which candidate have performed simple biopsies for histopathological

examination.

RESEARCH METHODOLOGY IN ORAL PATHOLOGY

Candidate must get himself/herself familiar with research activities in the department and must develop at

least 1 mock research proposal, using acquired research methodology in Oral Pathology to achieve

desired objective in the primary area of subspecialty.

59

Blueprint for the Part I of the Fellowship Programme and Examination in Oral and Maxillofacial pathology

LEARNING

OBJECTIVE AREA

CREDIT UNITS


Objective Questions



Module 1. Basic histopathology

5

Special stains as an aid to histopathological diagnosis 1 0 1 0 0.5

Exfoliative cytology and Fine needle aspiration cytology as an aid to diagnosis 1 0 0 1 0.5

Immunocytochemistry as an aid to diagnosis 1 0 0 1 0.5

Dental caries 1 0 0 1 0.5 Inflammatory lesions of oral soft and hard

tissues. 1 0 0 1 0.5

Cystic lesions 1 0 0 1 0.5

Module 2. 5

Odontogenic tumors 1 0 0 1 0.5 Precancerous lesions 1 0 0 1 0.5

Epithelial and mesenchymal non-odontogenic tumors 1 0 1 0 0.5

Module 3 5

Developmental anomalies 1 0 0 1 0.5 Oral cancers 1 0 0 1 0.5

Fibro osseous lesions 1 1 0 0 0.5 Salivary gland lesions, Saliva screening for

HIV antigen and antibodies 1 0 1 0 0.5

Vesiculobullous and autoimmune diseases. 1 0 1 0 0.5 TOTAL 15 14 7


60


Junior Residency

No. of sessions

(A)

Mean session

Duration (hrs)

(B)

Contact hours

Total (A) x (B)

Seminars

Module 1

Total

8

8

2

16

Tutorials

Module 2

Total

8

8

2

16

Laboratory

20

3

60

Presentations

Module 3

Total

8

8

2

16


Total contact hrs

312

61

INTERNALMEDICINEANDGENERALSURGERY

General Competencies

Residents must become competent in the following six areas at the level expected of a Dental surgical

practitioner. Training programs must define the specific knowledge, skills, and attitudes required and

provide the educational experience for residents to demonstrate:

1) Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and

the promotion of health. Dental Surgery residents must: demonstrate manual dexterity appropriate for

their training level. Be able to develop and execute patient care plans.

2) Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g.

epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

Dental Surgery residents are expected to: a) critically evaluate and demonstrate knowledge of pertinent

scientific information.

3) Practice-Based Learning and Improvement that involves investigation and evaluation of their own

patient care, appraisal and assimilation of scientific evidence, and improvements in patient care. Dental

Surgical residents are expected to: a) critique personal practice outcomes. b) Demonstrate recognition of

the importance of lifelong learning in surgical practice.

4) Interpersonal and Communication Skills that result in effective information exchange and teaming

with patients, their families, and other health professionals. Dental Surgical residents are expected to: a)

communicate effectively with other health care professionals. b) Counsel and educate patients and

families. c) Effectively document practice activities.

5) Professionalism as manifested through a commitment to carrying out professional responsibilities,

adherence to ethical principles, and sensitivity to a diverse patient population. Dental Surgical residents

are expected to: a) maintain high standards of ethical behavior. b) Demonstrate a commitment to

continuity of patient care. c) Demonstrate sensitivity to age, gender and culture of patients and other

health care professionals.

6) Systems-Based Practice as manifested by actions that demonstrate an awareness of and response to

the larger context and system of health care and effectively call on system resources to provide optimal

care. Dental Surgical residents are expected to: practice high quality, cost effective patient care.

62

Demonstrate knowledge of risk-benefit analysis. Demonstrate an understanding of the role of different

specialists and other health care professionals in overall patient management.

The Core Curriculum in General Surgery, is designed to:

(1) Provide residents with a strong knowledge base in the fundamentals of diagnosis and treatment of

surgical diseases during weekly core course didactic sessions

(2) Augment and solidify residents’ knowledge of essential topics in cardiothoracic, plastic,

reconstructive and burn surgery, Oncology and neurosurgery.

(3) The objective is to provide residents with first-hand experience managing surgical patients in a

variety of surgical areas. The intent is to develop skills in:

• Surgical diagnosis

• Pre- and postoperative patient management

• Development of technical skills by first-hand operative experience.

• Daily activities involving evaluating patients in an ambulatory setting, managing an inpatient bed

service, and performing and assisting in the operating room, including ambulatory surgery

Surgical Skills Curriculum

§ Introduction to tools, suture

§ Sutures, Suturing techniques / suture knot tying

§ Incisional biopsies

§ Preoperative, intraoperative and postoperative care

§ Fluid dynamics and management

§ Tracheostomies and tracheotomies

§ Chest tubes and thoracentesis

§ Basic laparoscopy

§ Critical care management

§ Endoscopy

§ Vascular malformations and management

§ Basic and intraoperative ultrasound

§ Trauma mobilization and management

63

The Core Curriculum in Internal Medicine, is designed to:

1. Provide residents with a strong knowledge base in the fundamentals of diagnosis and treatment of medical conditions,

2. Augment and solidify residents’ knowledge of essential topics in Cardiology, Endocrinology, Gastroenterology, Infectious Diseases, Nephrology and Neurology.

Medical Core Curriculum

Diagnosis and management of:

• Cardiothoracic disorders ; Hypertension • Endocrinology .Endocrinology Consultations including Diabetes: Patient Care and Clinical

Research and common disorders of other endocrine glands • Gastroenterology especially liver diseases • Infectious Diseases – tuberculosis, syphilis etc • Renal diseases including dialysis and kidney transplantation • Neurological conditions including upper and lower motor neuron disease • Advanced Cardiac Life Support • Medical diagnostic and therapeutic procedures • Hematological diseases and transfusion • Occupational Medicine • End-of-Life Care and Pain Management • Medical emergencies

Blueprint for General Surgery

LEARNING

OBJECTIVE AREA

CREDIT UNITS


Objective Questions



General surgery 15

Sutures and suturing techniques 1 0 0 1 0.5 Incisional biopsies 1 0 0 1 0.5

Pre-operative, intra-operative and post-operative care 1 0 0 1 0.5

Fluid dynamics and management 1 0 0 1 0.5 Tracheostomy and tracheotomy 1 0 0 1 0.5

Chest tube and thoracentesis 1 0 1 0 0.5 Basic laparoscopy 1 0 0 1 0.5

Vascular malformation and management 1 0 0 1 0.5 Trauma mobilization and management 1 0 1 0 0.5

Basic and intraoperative ultrasound 1 0 1 0 0.5 TOTAL 15 10 5

64

Blueprint for Internal Medicine

LEARNING

OBJECTIVE AREA

CREDIT UNITS


Objective Questions



Internal Medicine 15

Management of medical emergencies 1 0 0 1 0.5 Cardiothoracic disorders e.g hypertension 1 0 0 1 0.5

Endocrinology 1 0 0 1 0.5 Gastroenterology 1 0 0 1 0.5

Infectious diseases 1 0 0 1 0.5 Renal diseases 1 0 1 0 0.5

Advanced cardiac life support 1 0 0 1 0.5 Medical diagnostic and therapeutic

procedures 1 0 0 1 0.5

Dermatology 1 0 1 0 0.5 Haematological diseases and blood

transfusion 1 0 1 0 0.5

TOTAL 15 10 5

65

CHAPTERV:SENIORRESIDENCYTRAININGINDENTALSURGERYSUBSPECIALTIES

ENTRYREQUIREMENTAdmission to the senior residency programme for Dental Surgery Subspecialties takes place only after

successful completion of the junior residency i.e. a pass in Part I FMCDS or a recognized equivalent.

GENERALINSTRUCTIONALOBJECTIVESThe senior residency programme, Part II FMCDS in a specific subspecialty seeks to produce a specialist

dental surgeon with definite expertise in at least one of the various disciplines of dentistry. During this

phase of training, Residents are expected to perform at a much higher proficiency level than they did

during their junior residency and to assume a greater degree of responsibility for decision making in

patient care. By the end of the senior residency programme, each successful Resident is expected to be

able to perform effectively as a consultant dental surgeon. Deliberate opportunities are provided at this

stage to enable each Senior Resident participates in teaching junior colleagues, dental students and

ancillary dental staff. The trainee is also introduced to the principles of resource management, and

equipped with skills for research.

By the end of this training, each Resident should be able to:

• Establish and manage a consultant dental practice designed to cater for the varied and changing

needs of the Nigerian Society.

• Administer and supervise the day-to-day running of consultant dental units within a hospital

setting.

• Teach his/her junior colleagues and other members of team the principles and practice of dental

surgery through formal didactic sessions and in the course of routine patient care.

• Plan and perform a whole range of minor and major procedures particularly in the chosen

subspecialty of dentistry.

• Teach and guide junior colleagues through simple procedures.

• Plan, execute and report on a research project on any problem related to the practice of dentistry.

• Identify and design solutions for clinical problems, which arise in the course of patient

management.

66

FORMATOFTRAININGThe Part II of the FMCDS training programme extends over a period of thirty-six months (36). Each

Senior Resident is expected to be trained in one of the following subspecialty areas.

1. Oral and Maxillofacial Surgery

2. Restorative Dentistry

3. Prosthodontics

4. Paediatric Dentistry

5. Orthodontics

6. Periodontology

7. Community Dentistry

8. Oral and Maxillofacial Pathology

9. Oral Medicine

The Senior Resident is responsible directly to the consultant or head of unit for the day-to-day running of

the unit where the trainee has chosen to specialize. The Senior Resident supervises Junior Residents and

other members of the team. During his/her Senior Residency, each resident is expected to execute a

research project on a topic of choice in any aspect of his/her specialization as chosen from the list above.

Residents interested in M.D programme will register and submit their research proposal in the first or

second year and defend their dissertation at least six months before their final fellowship examinations.

For such residents; logbook assessment, general and subspecialty oral examinations (excluding

dissertation) will be done at the final fellowship examinations.

For residents who do not register for the MD programme, they will eventually have to defend their

dissertation and undergo oral examinations at the final Fellowship examinations. This project is to be

carried out under the supervision of two consultants, one of whom should be a Fellow of the National

Postgraduate Medical College of Nigeria in Dental surgery.

67

Contact hours per week for Senior Residents

The Credit units for Part II Fellowship examinations is as follows.

Clinicals of 36 hours per week for 156 weeks = 125 credit units

Calls of 32 hours per week for 156 weeks = 111 credit units

Seminars, tutorials and clinical presentation of 6 hrs per week = 62 Credit Units

Dissertation = 12 Credit Units.

Research methodology = 2 credit Units

Health management course = 2 Credit Units

TOTAL CREDIT UNIT = 314 Credit Units

Subspecialties Course

Codes

Months Contact

academic

hrs per

week

Contact

clinical

rounds per

week (hrs)

Laboratory

rounds per

week (hrs)

Ward /

field

rounds per

week (hrs)

Contact

call hrs

Per week

Restorative Dentistry DEN 811 36 6 30 6 - 32

Prosthodontics DEN 812 36 6 30 6 - 32

Peadiatric Dentistry DEN 813 36 6 30 3 3 32

Periodontology DEN 815 36 6 30 6 32

Oral medicine DEN 816 36 6 30 6 - 32

Oral and Maxillofacial

Pathology

DEN 817 36 6 18 18 - 32

Community Dentistry DEN 818 36 6 30 3 3 32

Orthodontics DEN 819 36 6 30 6 - 32

Oral and Maxillofacial

Surgery

DEN 810 36 6 30 - 6 32

68

SENIORRESIDENCYTRAININGINORTHODONTICSFMCDS (Orthodontics)

This course is designed to provide Senior Residents with advanced training in Orthodontics. The coursework will enable Senior Residents to acquire detailed knowledge of the principles and practice of Orthodontics. By the end of the training the residents should be able to demonstrate sufficient clinical competencies in areas such as

1. Orthodontic treatment methods and appliances for different malocclusions

2. Interdisciplinary planning and treatment for special handicapping malocclusions and developmental

disturbances such as cleft lip and palate; ectodermal dysplasia etc.

3. Interdisciplinary treatment planning for adults (pre-surgery, pre-

prosthetic/restorative)

4. Minor tooth movement

5. Orthognatic surgery orthodontics

6. Implant orthodontics

7. clinical examination including radiography (including cephalometric radiography);

8. diagnosis of models and measurement methods;

9. orthodontic treatment need, and appropriate timing of provision;

10. advice for patients about risk and benefit with and without treatment, duration of treatment and

retention, prognosis for stability;

11. biological and biomechanical principles of tooth movement and tissue regeneration;

12. differential diagnosis of normal and abnormal craniofacial and occlusal development;

13. significance of disturbances in function, occlusal development and tooth eruption;

TrainingformatThe course will include seminars, tutorials, clinical presentation, training in research methods, and a

supervised research project. It also includes courses of study in related disciplines.

At the end of the training the resident should be able to demonstrate:

1. The ability to evaluate the validity of research literature and its clinical applicability

2. The understanding of and ability to apply research methodologies

3. The ability to integrate theoretical and practical knowledge. 4. Moderate departmental seminars on Orthodontics.

5. A research project and dissertation demonstrating a candidate’s application of scientific method

to a problem of relevance to Orthodontics.

69


Senior Residency

No. of sessions

(A)

Mean session

Duration (hrs)

(B)

Contact hours

Total (A) x (B)

Teaching experience 20 2 60

Clinics

Orthodontics

660

6

3960

Research Methodology course

10

6

60

Academic programmes

Practicals

Tutorials

Seminars

Presentations

132

132

132

132

3

2

2

2

396

264

264

264

Total contact hrs

5208

He/she must have done at least the minimum number of advance orthodontic procedure/treatments as

specified in the Faculty log book and also must have the minimum required credit points in clinic

attendance, seminar presentation, tutorials and clinical conference presentation. The log book must be

submitted before the examination.

TRAININGSTRATEGIES It is the responsibility of residency programme director or the appropriate head of department to ensure

that every Resident is formally exposed to a systematic schedule of didactic teaching and clinical

practices which constitute the core knowledge for each clerkship. These exposures should take the form

of:

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(a) Seminars, group discussions and lectures

(b) Clinical and clinico-pathological conferences

(c) Discussions on the management of clinical problems during teaching ward rounds.

(d) Research Seminars

(e) Systematic review of contemporary literature on dentistry and its various disciplines.

(f) Journal Clubs.

Every institution accredited for postgraduate training in Dental Surgery is expected to write-up details of

those activities, which are geared towards the smooth and effective running of each subspecialty training

and indeed of the entire programme where full accreditation has been granted. The stated educational

objectives should form the basis and core knowledge for such institutional details.

CLINICALANDOPERATIVESKILLSEach accredited institution is also expected to design and execute a systematic programme of clinical and

operative skill acquisition with a view to satisfying the training and minimum requirements for each

subspecialty posting (Resident’s Logbook). In addition to those competencies itemized on the Resident’s

Logbook, special emphasis ought to be placed on key aspects of instrumentation viz:

1. Basic instruments are required for each clinical or operative procedure?

2. Alternatives can be used in the event of non-availability of the first-line choice of instrument?

3. Can they be used with safety?

4. Do you look after the instruments in order to prolong their life span?

RESEARCHTRAININGIt is mandatory for each training institution to have a research committee as well as a standing committee

on human ethics. The former’s function is to screen research proposals of Residents and other staff for

appropriateness, scientific content and relevance whilst the latter concerns with the ethical requirements

especially in situations where human subjects are to be used. Residents should be encouraged to design,

plan and execute research projects at levels compatible with their academic maturity, clinical

responsibility and professional competence. A departmental research seminar, held at least once every

two months, should serve as the forum at which researchers present their projects for discussion,

constructive criticisms and appropriate guidance by teachers and other colleagues. By the time a senior

registrar is registering for Part II examinations, the senior registrar must have attended at least three Local

or International conferences.

In addition a senior resident should have:

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• Presented at least two research papers at local or international conferences.

• At least two publication in a peer reviewed journal during the entire training.

TEACHINGANDCOMMUNICATIONSKILLSThe value of teaching and communication skills cannot be over-emphasized in the overall training of a

dental specialist. Through the hierarchical organization in dental and medical professions, Residents have

regular opportunity for teaching junior colleagues, other members of the health team, and patients. They

therefore begin to acquire teaching skills informally. Besides, Residents have the opportunity to attend the

educational methodology workshop held once a year at the College secretariat. Training Institutions are

encouraged to avail Residents of this great opportunity.

Competency in the various modalities of communication is acquired through the activities mentioned

above. It is however of utmost importance that Resident is additionally equipped with communication

skills in –

- Medical records documentation

- Case presentation

- Case referrals

- Discharge summary writing

- Scientific conference presentation

- Case presentation in the law court

- Scientific journal publication

- Examination writing.

MANAGEMENTSKILLSThe College Secretariat conducts Management Courses twice a year for Senior Residents from all

faculties. Besides, the need for expertise in Management in Dental practice is so great that training

institutions are expected to make deliberate efforts to give each Resident specific opportunity during

training to attend two of these and other available courses in Management.

Ideally each third or fourth year Senior Resident should be appointed into the management post of

“Administrative Chief Resident” for a period of at least six months each so as to give each of them an

opportunity to acquire some Management skills.

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CHAPTERVI:EVALUATIONThe Faculty of Dental Surgery of the National Postgraduate Medical College of Nigeria recognizes two

types of evaluation for its residency programme. These are formative evaluation (in-course assessment)

and summative evaluation (Part I and II Fellowship Examinations).

A.FORMATIVEEVALUATIONThe objectives of formative evaluation are as follows:

1. To diagnose the degree of convergence of educational goals and student’s achievement.

2. To provide a basis for feedback to students in order to help them improve their knowledge and

competence.

3. To furnish teachers and clinical supervisors with relevant information about the quality of their

teaching – its strength and weaknesses.

4. To serve as an effective tool for ensuring the maintenance of high quality health care for patients.

5. To certify students for admission to the Part I and Part II FMCDS Fellowship Examinations.

Each training institution is expected to conduct constant evaluation of the performance of its Residents.

Procedures that constitute minimum requirements for each clinical clerkship are assessed and graded as

the Resident carries them out. Once satisfactorily completed, such requirements are credited for the

Resident concerned at which point the Resident’s logbook is signed by the supervising consultant. To be

signed off for each subspecialty posting, the Resident must have been judged to have satisfactorily

completed the academic programmes, performed all the required procedures and acquired all the

mandatory competencies for the particular posting, failing which a remedial period may be recommended.

It is not compulsory to have an end-of-posting test, although this is highly recommended. Residents are

better prepared for their summative examinations if they have frequent written tests under examination

conditions. Such drills enable them to acquire appropriate examination techniques for both essays and

whilst still in training.

Finally, every training institution should forward an annual report on the progress of each Resident to the

College Registrar.

B.COLLEGECERTIFYINGEXAMINATIONS.The FMCDS Fellowship Examinations are held twice each year i.e. May and November. Candidates are

formally invited to send in their application via publications in at least one National Daily Newspaper

during the first week of June (for November Examinations) and the first week of December (for the

73

subsequent May Examinations). All candidates are therefore advised to watch out for and comply with the

requirements of these advertisements.

PARTIFELLOWSHIPEXAMINATIONSFORMAT.In order to be allowed to sit for the Part I FMCDS examination, candidates should satisfy the following

conditions:

a) They should have completed a minimum of 24 months of clinical training rotating through relevant

dental subspecialties including general medicine and surgery.

b) They should have satisfactorily performed all the prescribed procedures and completed all the clinical

requirements for each clerkship as stipulated in the Resident’s Portfolio.

c) They should have satisfactorily completed the prescribed number of academic, clinical and laboratory

contact hours.

d) Their respective head of department or the head of the postgraduate training institution should have duly

signed them up where they have been registered. To sign-up a candidate, the authorized officer(s) are

expected to sign.

(a) The certificate of training

(b) Relevant areas of the Resident’s Logbook.

(c) (a) and (b) are forwarded simultaneously with the candidate’s application for

admittance to the Part I FMCDS examination.

EXAMINATIONFORMATFORPARTIFMCDSAny resident who has not completed the minimum number of his/her academic requirements, clinical

requirements and laboratory requirements shall not be eligible to sit for the examination. (note c above)

The examination shall consist of three written papers, Clinical/practical examination and oral (viva-voce)

examinations. To be successful in the Part I Examination, a candidate must perform satisfactorily in all

eight (8) parts of the examination:

STANDARD SETTING: this will be determined before the examination using the MODIFIED

ANGOFF standard setting method.

1. Written Paper I (MCQ Best of four options) covering the following subjects.

(a) Restorative Dentistry

(b) Prosthodontics

(c) Periodontology

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(d) Paediatric Dentistry

(e) Community Dentistry

(f) Orthodontics

(g) Oral and Maxillofacial Surgery

(h) Oral and Maxillofacial Pathology

(i) Oral Medicine

(j) Oral Diagnosis and Radiology

(k) Internal Medicine and General Surgery in relation to dentistry

2. Written Paper II (Essay) covering section 1 (a-f).

3. Written Paper III (Essay) covering section (g-k)

4. Clinical/Practical Examination I

The first one shall be for the Restorative dentistry, Prosthodontics, Paediatric Dentistry,

Orthodontics, Periodontology and Community Dentistry. There shall be a minimum number of 35

stations. The OSCE shall examine all the domain of learning in all the clinical units under this part

of the examination.

5. Clinical/Practical Examination II

This will cover Oral and Maxillofacial Surgery, Oral and Maxillofacial Pathology and Oral

medicine and Oral Radiology. These shall normally follow the written examinations. There shall

be a minimum number of 35 stations. The OSCE shall examine all the domains of learning in all

the clinical units under this part of the examination.

6. Oral (viva voce) Examination I

The first viva covers the following subspecialties.

(a) Restorative Dentistry

(b) Prosthodontics

(c) Periodontology

(d) Paediatric Dentistry

(e) Community Dentistry

(f) Orthodontics

7. Orals (Viva Voce) Examination II

The second viva voce examination concerns itself with:

(a) Oral and Maxillofacial Surgery

75

(b) Oral and Maxillofacial Pathology

(c) Oral Medicine

(d) Oral Diagnosis and Oral Radiology

(e) Internal medicine and General Surgery in relation to Dentistry.

Both oral examinations shall normally follow the OSCE examinations.

8. Log book/Resident portfolio assessment.

SUMMARYOFBLUEPRINTFORPART1MCQEXAMINATIONQUESTIONS

COURSES/ SPECIALTY

No. of Objective Questions

TAXONOMY Percentage course coverage (%)

LVL I LVL II LVL III

Oral and Maxillofacial Surgery 22 0 8 14 11 Prosthodontics 22 2 7 13 11 Restorative dentistry 22 2 4 16 11 Paediatric dentistry 22 2 6 14 11 Orthodontics 22 2 5 15 11 Periodontology 22 2 5 15 11 Oral medicine 14 1 5 8 7 Dental Public Health 10 0 3 7 5 Oral and Maxillofacial Pathology 14 1 4 9 7 Oral Diagnosis and Radiology 10 2 4 4 5 General surgery 10 0 3 7 5 Internal medicine 10 0 3 7 5 Total 200 14 57 129 100

BLUE PRINTING FOR ESSAY QUESTIONS

Candidates will be required to answer 5 out of 6 questions from written paper 1 with each question carrying 20 marks. One question will be asked from each of the subspecialty.

Candidates will also be required to answer 5 out of 6 questions from written paper 2 with each question carrying 20 marks. With at least one question from each of the subspecialty.

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BLUE PRINTING FOR PART 1 OSCE DENTAL SURGERY I

Sub-specialty/units in dental surgery I

Manned stations (10 marks per station)

Unmanned stations (10 marks per station)

Restorative 4 2 Prosthodontics 4 2

Paediatrics 4 2 Periodontology 4 2

Community dentistry 4 2 Orthodontics 3 2

BLUE PRINTING FOR PART 1 OSCE DENTAL SURGERY II

Sub-specialty/units in dental surgery II

Manned (10 marks per station) Unmanned (10 marks per station)

Oral and Maxillofacial surgery 6 4 Oral and maxillofacial pathology 4 3 Oral medicine 2 4 Combined 6 6 Note that the ratio of the manned to unmanned stations will be determined by the number of examiners approved by the College.

BLUE PRINTING FOR PART 1 VIVA

SECTIONS LOGBOOK ORAL EXAMINATION DENTAL SURGERY I 25 Marks 25 Marks (questions from each

subspecialty in the section) DENTAL SURGERY II 25 Marks 25 Marks (questions from each

subspecialty in the section)

EXAMINATION RESULTS (COLLEGE FORMAT)

These shall conform to the following guidelines in scoring out of 100 (using single unit score per item

e.g. in MCQ tests)

1. 70% and above - Very Good Pass (P + 1) A

60% - 69% - Good Pass (P+) B

50% - 59% - Pass (P) C

40% - 49% - Borderline (P-) D

39% and below - Fail, no cross-compensation allowed (P-1) E

2. A score of 49.5% to 49.9% should be approximated to 50%.

3. To be considered as having passed the whole examination a candidate should normally obtain a

minimum of 50% in each of the eight (8) parts of the FMCDS Part I Examinations.

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Options:

Compensation shall be along the followings lines

(a) Any level of performance in other parts cannot compensate for a score of less than 50%

in the clinic/practical examinations. Such a low score means the candidate has failed the

entire examination.

(b) Compensation may be allowed between the 3 written papers i.e. Paper I (Best of four);

Paper II (Essay) and Paper III (Essay). In other words, an average of 50% pass mark may

be allowed in lieu of 50% score in each of the three papers.

(c) Cross compensation may be allowed between the written papers, clinic/practical

examinations and orals provided very good passes are being used to achieve

compensation for borderline scores and provided a very good pass in Orals is not the sole

determinant for compensation.

(d) A score of less than 48% in the written examination and in any of the other five parts

(clinic/practical examinations and orals) shall normally preclude consideration for cross

compensation.

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EXAMINATIONFRAMEWORKFORPARTIEXAMINATION

S/N

Assessment type

Paper What to assess How it will be assessed Time Required

1 THEORY Objective Paper I

Assessment of all the clinical units from a standardized pool of questions.

Two hundred questions with Best of four

3 hours

Written Paper II

Assessment of the knowledge of residents in Prosthodontics, Restorative Dentistry. Paediatric Dentistry, Orthodontics, Periodontics and Community Dentistry.

Five essay question from six questions

3 hours

Written Paper III

Assessment of the Knowledge of Residents in Oral and Maxillofacial Surgery, Oral and Maxillofacial Pathology, Oral medicine, Oral Radiology Internal Medicine and General Surgery.

Five essay question from six questions

3 hours

2 OSCE OSCE I Assessment of Knowledge, skill and attitude of Residents in Prosthodontics, Restorative Dentistry. Paediatric Dentistry, Orthodontics, Periodontics and Community Dentistry.

Minimum of 30 stations from a pre-standardized set of objectively structured questions

3 hours

OSCE II Assessment of Knowledge, skill and attitude of Residents in Oral and Maxillofacial Surgery, Oral and Maxillofacial Pathology, Oral medicine, Oral Radiology Internal Medicine and General Surgery.

Minimum of 30 stations from a pre-standardized set of objectively structured questions

3 hours

3 VIVA Viva I 5 standardized questions from Prosthodontics, Restorative Dentistry. Paediatric Dentistry, Orthodontics, Periodontics and Community Dentistry.

This may involve the use of slides, clinical pictures

15 min

Viva II 5 standardized questions from Oral and Maxillofacial Surgery, Oral and Maxillofacial Pathology, Oral medicine, Oral Radiology, Internal Medicine and General Surgery.

15 min

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EXAMINATIONFORMATFORPARTIIFMCDSEXAMINATIONThe Part II Fellowship Examinations in FMCDS is designed to complete the assessment and certification

of professional competence in the various subspecialties of Dentistry. Successful performance in these

final examinations confers eligibility for the award of the Fellowship, FMCDS (Subspecialty) of the

National Postgraduate Medical College of Nigeria.

Eligibility

Registration for the Part II FMCDS examination should take place not later than 12 months before the

commencement date of the examination itself. In order to be allowed to sit for the Part II FMCDS

examination, the candidate must

(a) Pass at the Part I Examination of the NPMCN.

(b) Completed 36 months of academic and clinical contact in an accredited institution.

(c) Residents interested in M.D programme will register and submit their research proposal in the first

or second year and defend their dissertation at least six months before the exit of the fellowship

examinations.

(d) The candidate for the MD programme will undergo instructional courses in each of his/her chosen

subspecialty area approved by the faculty board

(e) Completed Dissertation, proposal of which must had been assessed and approved prior to

commencement of the dissertation.

(f) Register the names of two supervisors nominated by his/her training center or institution with due

consultation and agreement with the candidate. One of these two supervisors should be a Fellow of

the College in Dental Surgery.

(g) Submit written attestations by the supervisors indicating their willingness to supervise the project

i.e. designing the project, data collection and analysis as well as the general write-up of the

dissertation itself. Supervisors are not expected to serve merely as proof readers of the dissertation.

(h) Provide a certificate of Clearance by his/her institution’s Ethical Committee in the case of a

research project using human subjects.

(i) Forward a detailed proposal, clearly defining the subject chosen for study, the scope of the study,

and objective(s) to the College. Such a proposal must also contain a critical review of the literature

as well as the materials and method of the study.

The Faculty Secretariat shall nominate assessors (on request by Registrar) after consideration of the

proposal, the Registrar would provide a feedback to the candidate on the suitability or otherwise of his/her

proposal within 3 calendar months of this submission. It is therefore in the Resident’s own interest to plan

80

the submission of his/her research proposal in such a way that this feedback returns to him/her during the

first 12 months of his/her senior residency.

Training Goals

• Advanced competencies in the field of specialization. Also there is more emphasis on

communication, academics, management and leadership skills as well as creative thinking.

• Research capabilities through ability to conceptualize, design, execute report and defend a

Dissertation.

The Dissertation –

Objectives of the dissertation.

The primary goal of the dissertation is to equip the Resident with skills for research and problem solving

situation. It is essential that the candidate must contribute to knowledge through the dissertation however

it is not mandatory that he breaks new ground. However, through this dissertation, each trainee should

demonstrate the ability to:

1. Select and define clearly the research problem chosen for the study.

2. Delineate the scope of the study bearing in mind the resources available thus avoiding the

dangers of unwarranted conclusions.

3. Define the objectives of the study in precise, clear terms leaving no doubt as to the

feasibility of the study.

4. Review critically available literature on the subject.

5. Handle the materials and methods of the study in such a way as to obtain results relevant

to the stated goals of the study.

6. Analyze the results using appropriate statistical tools, and draw logical conclusions from

them.

7. Discuss his findings in relation to the existing body of knowledge on the subject.

8. These should be clearly studied before embarking on the Dissertation Project. The final

dissertation submitted should follow the approved format, namely.

9. A title page featuring. “The title of the work

i. Submitted by

81

ii. Name of author.

iii “The National Postgraduate Medical College of Nigeria in part fulfillment of the

requirements for the award of the Final Fellowship of the Medical College in

Dental Surgery, FMCDS ( Paediatric Dentistry), August 1989”

10. The Declaration Page – Here the candidate declares that the work presented has been

done by him/her under appropriate supervision and that it has not been submitted in part

or in full for any other examination.

11. A Dedication Page – This is optional.

12. The Attestation Page – On this page the supervisors attest to the fact that the work has been done and the dissertation written under their close supervision.

13. The Attestation page by Head of Department 14. The Acknowledgement Page – Candidate specifically acknowledges all the assistance

he/she has received in the course of the work, including copyright permissions.

15. The Summary – The main work begins with a summary of the dissertation featuring the

key points, in about 200 words. Nothing should feature in the summary that has not been

included in greater detail in the main body of the work.

16. Introduction – The introductory chapter should :

a. Define clearly the problem for study

b. Provide justification for the study

c. Explain briefly the scope of the study.

17. Literature Review

18. Objectives of the study

19. Materials and Method – This should describe the study design including the statistical

analysis planned for processing the results.

20. The Results

21. The Discussion

22. Conclusions and Recommendations

23. References, using the system proposed by the International Committee of Medical

Journal Editors, Uniform requirements for manuscripts – submitted to biomedical

journals. Br. Med. J. 1988, 296, 401 – 405. This is also reproduced in the College’s

Research Methodology Handbook. Candidates are advised to acquire a copy of this

Handbook in addition to making special effort to attend at least one of the yearly

intensive courses in Research Methodology mounted by the College. When a candidate is

to appear for the oral examination on his/her dissertation, he/she is required to bring a

82

copy of the dissertation identical to the 4 copies previously submitted for the

examination.

The Examination

The Part II FMCDS examination shall consist of

• A comprehensive oral examination on the candidate’s dissertation. This “Dissertation Orals”

shall focus on the candidate’s accomplishment of those objectives for the dissertation stated

above.

• A second orals (viva voce) examination on the subspecialty in which the candidate has been

trained during the senior residency.

Each candidate for the Part II FMCDS examination must submit his/her dissertation at the same time

he/she submits his/her application for the examination. The Residents Logbook must reach the Faculty

Secretary at least two months before the date of commencement of the examination. The approve

proposal for the dissertation would be made available during the examination. Where applicable the file

containing the resume of their operation evidence should also be brought with them to the venue of the

Dissertation Orals.

Examination Results.

1. Pass: shall apply to candidates who have satisfied the examiners in all parts of the examination.

This shall include candidates who need to correct only typographical errors or errors of English

syntax in their dissertation. Such errors would need to be corrected in the final bound copies

which are to be prepared after the candidates receive their pass result.

2. Provisional Pass: shall apply to candidates who have clearly satisfied the examiners in the Viva

Voce part of the examinations and would have passed but for the necessity to make significant

corrections in the dissertation.

3. Reference: shall apply to candidates who have successfully presented and defended their

dissertation, but are found wanting in Viva Voce part of the examination. Such candidates must

reapply and appear for a subsequent examination, in the Viva Voce part only.

4. When a candidate passes his/her Viva Voce but commits errors of conceptualization,

methodology or interpretation of the original research, he/she shall be referred in the Dissertation.

He/she shall reapply, represent and defend a corrected version of the dissertation at a subsequent

examination.

83

5. Fail: shall apply to candidates who have failed to satisfy the examiners in the whole

examination and need to reapply and appear for a subsequent dental examination.

A candidate who fails the Viva Voce, and whose dissertation is not accepted on account of significant

errors i.e. such as to rate Provisional Pass must be classified as Fail, and be required to retake the whole

examination, with the provision that the dissertation be re-examined by the same set of examiners.

A candidate cannot get a reference in Viva Voce as well as a Provisional Pass in dissertation in one and

the same examination.

BLUEPRINTFORPARTIIEXAMINATION

S/N

Assessment type

What to assess How it will be assessed Marks to be allocated

Time Required

1 Dissertation Defense

The overview of the dissertation, the relevance of the work/contribution to knowledge. The research question, Aims and Objectives. The appropriateness of the study design and data collection tools and methods. The appropriateness of the methods of analysis/statistical tools. The interpretation of the results, the discussion, conclusion and recommendation. The conclusion must answer the research question.

By interview. The assessors must have gone through the dissertation for a period of two months before the examination.

100 2 hours

2 General Viva Candidates will be expected to answer a minimum of 10 questions from a preset standard pool of questions made up of : six clinical problems, two leadership questions, one ethical issue, one management issue

This may involve the use of slides and clinical pictures

30 30 mins

3 Subspecialty viva

Candidates will be expected to answer a minimum of six clinical questions from a preset standard pool of questions in his/her subspecialty.

This may involve the use of slides and clinical pictures

70 30 min

4 Logbook assessment

The competencies acquired from the performed procedures will be assessed

100

• Residents interested in M.D programme will register and submit their research proposal in the

first or second year and defend their dissertation at least six months before their final fellowship

examinations. For such residents, their final fellowship examination will include logbook

assessment, general and subspecialty oral examinations only.

• Whereas, residents who do not register for M.D. will present themselves for all the 4 stages of the

part II final fellowship examinations.

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CHAPTERVII:THEPOSTGRADUATEDOCTOROFMEDICINE(MD)DEGREEPROGRAMME

PreambleThe postgraduate MD programme is a pre-fellowship doctorate degree programme equivalent to Ph.D.

that is awarded by universities.

PhilosophyThe philosophy of the MD program is to develop highly knowledgeable and skilled manpower for

teaching and research for the public, private and international organizations in the field of medicine and

related sciences

AimsandObjectivesa) Providing interested individuals with the necessary knowledge, skills and competencies to function

effectively as teachers, researchers and professionals in the health and medically related industry.

b) Acquisition of teaching, research and professional skills for imparting knowledge in Nigeria and

internationally

c) Producing graduates who are capable of applying scientific knowledge and principles to solve human

and environmental problems

d) To produce scientists who are socially responsible and mindful of accepted norms and ethics

EntryrequirementforMDProgramThe entry requirement for the MD program will be

1. Associate fellows of the college who have registered with the residency training

programme in the faculty they intend to pursue the postgraduate M.D.

2. Candidate must have completed the Junior Residency programme in Faculty of Dental

surgery

3. Candidate must submit a research proposal to the college at the time of application for the

programme

4. Candidate must be sponsored by two supervisors who are willing to supervise the

research work of the candidate

5. Fellowship of National Postgraduate Medical College of Nigeria

6. Fellows of other Postgraduate Colleges in Nigeria will also be considered

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7. Any other qualifications acceptable to the senate of National Postgraduate Medical

College of Nigeria

MethodofapplicationInterested residents should indicate their intention by obtaining application form from the college in the

first year of Senior residency training. The completed application form must be accompanied by a

research proposal at the time of submission.

ProgrammeDurationThe duration of the programme shall be a minimum of six semesters of fifteen weeks each after

registration. At the beginning of each semester subsequent to initial registration, each MD candidate shall

be required to submit a satisfactory 100-word report duly endorsed by the supervisory committee as a

condition for the renewal of registration.

ResearchproposalA research proposal submitted by the candidate shall be subjected to formative assessment within 8 weeks

and the resident shall be informed of its acceptability, modification or rejection.

FinalassessmentofdissertationThe course is for Six (6) continuous semesters. The examination is scheduled during regular College

examinations with Examiners appointed by the college. The supervisors among others may be invited to

witness the examination.

• No candidate is eligible to sit for the examination before passing the part 1 fellowship examination

• The examination shall take place at least 6 months before the resident is due for the final fellowship

examinations

• Each candidate shall be examined by two examiners: at least one of whom must be an assessor of the

proposal.

Collegebasedcourses30 credit units are deemed to have been obtained in faculty based pre-part 1 courses in line with NUC

BMAS

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Pre-part 1 courses

• PMC 901 Advanced Trauma Life Support 2 Credit Units

• PMC 902 Advanced Cardiac Life Support 2 Credit Units

Post-part 1 courses

• PMC 951 Research methodology 2 Credit Units

• PMC 952 Health resources management 2 credit Units

• PMC 953 Ethics in clinical practice 2 credit Units

MD courses

• PMC 994 Medical Education 2 Credit Units

• PMC 995 Advanced Research Methodology

• PMC 996 Advanced Health Resource Management

• PMC 997 Assessments and Examination Methods

Faculty Course codes

• 2 credit units for lectures to include any of the following:

o DEN 941 Advanced Community Dentistry 2 Credit units

o DEN 942 Advanced Oral and Maxillofacial Pathology 2 Credit units

o DEN 943 Advanced Oral and Maxillofacial Surgery 2 Credit units

o DEN 944 Advanced Oral Medicine 2 Credit units

o DEN 945 Advanced Prosthodontics 2 Credit units

o DEN 946 Advanced Restorative Dentistry 2 Credit units

o DEN 947 Advanced Periodontology 2 Credit units

o DEN 948 Advanced Paediatric Dentistry 2 Credit units

o DEN 949 Advanced Orthodontics 2 Credit units

o DEN 998 Seminars 6 credit units

o DEN 999 Thesis/ Dissertation 12 credit units

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DentalSurgeryCourseSynopsesDEN 941 ADVANCED COMMUNITY DENTISTRY (2 CREDIT UNITS)

Community Oral Health Promotion and Disease Prevention, Oral Health Services Delivery System, Law

and Ethical Issues in Dentistry

DEN 942 ADVANCED ORAL AND MAXILLOFACIAL PATHOLOGY

Surgical Aspect of Oral and Maxillofacial Pathology (Biopsy Services, Cytology), Clinical Aspect of Oral

and Maxillofacial Pathology, Oral Microbiology and Oral Immunology, Molecular Aspect of Oral and

Maxillofacial Pathology, Advanced Pathology Laboratory and Imaging in Diagnosis of Oral and

Maxillofacial Diseases.

DEN 943 ADVANCED ORAL AND MAXILLOFACIAL SURGERY

Principles of Oro-facial Management of Trauma – 1, Principles of Oro-facial Management of Trauma - 2

Hard Tissues (Fractures), Principles of Reconstructive surgery, Surgical Implantology, Principles of Oro-

facial Oncology Management

DEN 944 ADVANCED ORAL MEDICINE

The course will cover the following: Oral Mucosal and Salivary Gland Diseases, Temporomandibular

Disorders and Orofacial Pain, Oral Complications of Systemic Diseases, Dental Management of

Medically Complex Patients, Dental Therapeutics and Pharmacology.

DEN 945 ADVANCED PROSTHODONTICS (2 CREDIT UNITS)

This course will cover fixed and removable (partial, complete) prosthodontics including geriatrics

prosthodontics. Advanced aspect of maxillofacial and cranial prosthodontics and implant prosthodontics

including science of materials and fabrication of implant prosthesis will be covered. Temporomandibular

Disorders, Sports and Special Prosthodontics will be covered in details.

DEN 946 ADVANCED RESTORATIVE DENTISTRY

This course will cover Cariology, Endodontics, Aesthetics Dentistry, Advanced Fixed Prosthodontics,

Dental Traumatology.

DEN 947 ADVANCED PERIODONTOLOGY

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The course will cover the following: Periodontal Management Principles, Periodontal Pathology, Non-

Surgical Periodontal Therapy, Periodontal Surgery, Perioceutics

DEN 948 ADVANCED PAEDIATRIC DENTISTRY (2 CREDIT UNITS)

The course will cover the following: Cariology and Endodontics in Children, Behavior Management in

Children, Orofacial and Dental Traumatology in Children, Principles of Management of Tumours and

Soft Tissue Injuries in Children, Interceptive Orthodontics.

DEN 949 ADVANCED ORTHODONTICS (2 CREDIT UNITS)

This course covers study of normal and abnormal craniofacial and occlusal development/Tooth eruption,

Orthodontics Treatment Methods for variety of malocclusion including special Handicapping

Malocclusion. Orthognatic Surgery Orthodontics. Implant Orthodontics course will cover the anatomical

and clinical basis of implantation and the science of the materials used in the fabrication of implant.

Candidates are strongly advised to visit the college website for detailed information about the MD

programme.

dr owoidoho udofia, fmcpsych college registrar

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