By Dan Fost
In an effort to stay ahead of trends in modern dental practices and to ensure equity and diversity in its offerings, the UCSF School of Dentistry has been working to evolve and strengthen its education programs.
Michael Reddy, DMD, DMSc, dean of UCSF School of Dentistry, teaching in the predoctoral dental clinic.The improvements are part of a multiyear strategy to reimagine dental education and ensure that UCSF stays at the forefront in producing top-notch clinicians. In the first two years of the effort, the school has focused on making strategic investments and modifications to support its continuous progress and ensure its students’ experience readies them for any career in dentistry.
“My goal is to prepare people for practice in the year 2050,” said Michael Reddy, DMD, DMSc, dean of the School of Dentistry.
In part, Reddy said, that means anticipating trends. “We know certain things are going to happen,” he said. “We know that we’re going to have an influx of the use of data and technology in all of health care. And we know we’re going to see an increase in the diversity of our population. I also expect to see more integration and coordination between health care disciplines.”
Focus on Clinical Excellence
To meet those changes, UCSF — which already teaches a competency-based curriculum — has focused on strengthening its students’ clinical experience.
One of the first improvements implemented involved changing the clinical teaching model to one based on “group practices,” in which a team of students work with a full-time clinical teaching faculty to care for patients.
The new model helps students learn how to work as part of a team, reflecting a shifting landscape in which more and more graduates wind up in group practices instead of their own private practice. It also provides a more consistent learning experience.
Ana Casal, DDS, associate professor and one of UCSF Dentistry's group practice leaders, works with two students to care for a patient.“Instead of having a large number of part-time and volunteer faculty who come in to check the students and see how they’re doing, we have now augmented our teaching with group practice leaders who are there practically full time,” Reddy said. “It’s their practice. Students work in their group. They know the patients. They work with their associates to deliver care.
“It’s better care for patients, and putting the patient first is the right way to do it,” Reddy said. “Second, it’s better for our learners. Students have a consistent person they’re learning from. It’s a more efficient and consistent model that both improves patient care and education quality.”
Smaller Cohort, Higher Quality
In addition, UCSF has decreased the number of dental students it admits to provide a more meaningful experience for those who do attend.
While so many entities emphasize growth and many facilities are expanding at UCSF’s Parnassus campus, where the dental school is based, school leadership felt it could increase quality by shrinking the student body by one-third.
“There’s room in the range of dental schools in North America to have one that’s a little bit smaller and more sophisticated,” Reddy said. “That fits with UCSF’s approach to everything.”
The decision was also “data-driven,” said Jennifer Perkins, MD, DDS, the School of Dentistry’s executive director of clinical education. “Having a cohort of 80 is what our building and institution can support to produce really proficient dentists at graduation. That bucks the trend of everywhere. I like that.
“It’s easy to accept more people and figure out how to squeeze them in. But this is a thoughtful, intentional, future-forward way to look at it, to say: We could do a better job if we had fewer students,” Perkins said. “We could also attract even more high-quality applicants. As an educator, there isn’t anything more exciting to me than getting the best students and giving them the best experience.”
Reddy acknowledges that the move has “some consequences we’ll have to overcome.
“If you’re not going to use increased enrollment as your business model, you’ve got to do something else,” he said. “You’ve got to see more patients, do more research and be more entrepreneurial in the way you approach running the school as a business.”
Despite the financial hit, Reddy believes it’s the right thing to do to for students. He considers it an investment that will ensure UCSF maintains its reputation for excellence in dental education. The school is also hiring more faculty who will teach in the dental clinics, giving students more attention and instructional support.
Core Degree Programs Aligned
Another change aimed at bolstering clinical training involves integrating the Doctor of Dental Surgery (DDS) program with the International Dentist Pathway (IDP) program. By weaving these programs together more tightly, students in the DDS program will have more clinical opportunities, IDP students will have more research opportunities, and UCSF can ensure equity in student experience by giving everyone more of the same experience before they graduate.
Students in the International Dentist Pathway (IDP) program practice their skills in the Flemming Pre-Clinical Simulation Lab.IDP students are foreign-trained dentists pursuing a U.S. dental degree and license. The change means instead of a two-year path to a DDS degree, they will spend three years, giving them more time to hone their clinical skills and greater freedom to pursue research.
DDS students will likely mourn the summer off that they enjoyed after their first year — time that gave them the chance to participate in some of UCSF’s cutting-edge research — but UCSF was among the only schools that offered that time. A top priority for the implementation committee was figuring out how to maintain access to the rich research opportunities UCSF is known for.
“We are nationally known for having high-quality research for dental students, and we didn’t want to lose that,” said Perkins.
The UCSF School of Dentistry routinely ranks among the top dental schools in the world, and last year it again led all U.S. dental schools in research grants from the National Institutes of Health (NIH). Preliminary numbers for 2021 again put UCSF in the number one spot in NIH funding.
The school is now providing two pathways for students to pursue research. They can apply to participate in research projects the summer before they begin dental school, and they can also do a research fellowship in their second year, with extra time dedicated to a capstone project in the spring.
Those programs mean “we’ll have equity for the international students,” Perkins said, noting that they didn’t have the time to participate in research projects under the two-year pathway. And many of them are coming to UCSF with research experience gained abroad. “We’re really excited about it,” she said.
A Tech-Forward Future
Reddy, who joined UCSF in 2018, is also leading a push to use new technology.
The school started a seed fund so that students can gain experience in integrating the latest technologies with evidence-based dentistry. A fundraising campaign has already launched with great success, and the UCSF chancellor’s office will match all funds dollar for dollar. In addition, the school has begun exploring partnerships with suppliers to bring in new technological tools.
Technology is also being integrated to improve the school’s education processes. The latest technology was used to build the Student Clinical Experience Dashboard, which is updated in real time with each student's progress in meeting program requirements. The dashboard tracks students' competency exams and skills assessments so both students and faculty can gauge if students are on track, ahead of the game or need extra support.
That information had been hard to track, update and report on consistently. The dashboard will replace a clumsy system of tracking reports, providing students and faculty with a real-time view of student progress through useful data visualizations.
Reddy says the school is now ready to move into the next phase of its education strategy — reimagining, defining and implementing a new curriculum. Associate Dean for Education Sara Hughes, MA, EdD, who started the process toward these changes, retired last year, and the school will soon appoint a new associate dean to lead what will be the biggest overhaul to UCSF’s dental curriculum in 30 years.
