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Oral Medicine

PROGRAM OVERVIEW

ORAL MEDICINE APPLICATION DEADLINE EXTENDED UNTIL APRIL 15, 2014, please see "Application Procedures" paragraph below for details!!

Program Director: Caroline Shiboski, DDS, MPH, PhD
University of California, San Francisco
Box 0422, C-647
San Francisco, CA 94143-0422
email: caroline.shiboski@ucsf.edu
phone: (415) 476-5976

The Division of Oral Medicine, Oral Pathology and Oral Radiology is pleased to offer a new 3 year residency program which leads to a Certificate in Oral Medicine and a Master in Oral and Craniofacial Sciences. Our program has been carefully designed to offer residents a broad based training in oral medicine and oral and craniofacial sciences, and to prepare them for an academic career in the field of Oral Medicine.

UCSF School of Dentistry is a recognized partner on the UCSF Health Sciences Campus. Its close relationship to world-recognized schools of medicine, nursing and pharmacy gives the School access to health professionals from a variety of disciplines when dealing with the prevention, diagnosis, evaluation, and treatment of oral disease. The University of California, San Francisco has a wide range of training experiences in patient care and research. The Comprehensive Cancer Center, HIV clinics, and transplant services at UCSF are among the best in country and offer oral medicine residents a unique opportunity to be exposed to care of medically complex patients. The Oral Medicine Center, with its diverse patient population, offers an excellent training ground for residents to gain and increase their knowledge on a wide range of oral diseases and conditions.

There are also many opportunities for interdisciplinary research collaborations. The UCSF campus has one of the richest environments anywhere for a student to do research, whether it is clinical or basic science. A broad selection of courses is available within the School of Dentistry and the other Schools on campus (Medicine, Pharmacy and Nursing). In addition, the broad range of research interests among the faculty throughout the Department of Orofacial Sciences and the campus affords students the opportunity to choose among a wide variety of research projects.

The Division of Oral Medicine, Oral Pathology and Oral Radiology annually accepts two postgraduate students into the Oral Medicine Program.  Applicants must be U.S. citizens or hold permanent resident status, and must have graduated from an ADA-accredited dental school. GME Funding is available for these applicants if accepted into the program.

CURRICULUM

The Postgraduate Program in Oral Medicine at the University of California, San Francisco is a full-time 36 month course of study leading to a certificate in Oral Medicine and an M.S. degree in Oral and Craniofacial Sciences. Our three year program is aimed at preparing dentists to diagnose and treat complex oral problems, manage oral conditions and diseases that occur in medically complex patients, recognize and manage oral manifestations of primary and acquired immunodeficiency, and manage oral diseases, salivary gland dysfunction, facial pain and chemosensory disorders. The program's main goal is to train applicants for either a full-time or part-time career in academia.

Instruction in all areas of Oral Medicine is provided through lectures, seminars, conferences, and clinical training in outpatient and inpatient settings.

DIDACTIC TRAINING

Residents will spend much of their first year attending core courses required by the American Board of Oral Medicine and the UCSF graduate division. All residents will complete a specially tailored core curriculum that includes courses in biostatistics, oral biology, developmental biology, oral medicine, oral pathology, immunology, behavioral sciences, and medical ethics. Residents also will participate in medical grand round/primary care grand rounds lectures offered by UCSF School of Medicine on the UCSF campus. In addition, students will attend a course on how to conduct clinical research during the summer of the first year. Elective courses depend on the student's area of interest.

The didactic component of the residency program also includes weekly oral medicine seminars, oral biology seminars, journal club and patient management conferences throughout the length of the program which review teaching cases from the Oral Medicine Clinical center and the UCSF Oral Pathology Service. Residents also attend Head and Neck Tumor Board. Students will take a 20 hour course on Physical Diagnosis for instruction in physical exam and assessment which will provide a foundation for their clinical rotation in internal medicine and other clinical rotations taken during the second year.

This fundamental and didactic instruction provides background for and complements clinical rotations taken in the second year.

CLINICAL TRAINING

Development of clinical skills is a strong component of the entire program, with increasing time and responsibilities as the student advances.

Students are expected to spend a significant amount of time in the Oral Medicine Clinical Center learning to evaluate and manage patients with a variety of systemic diseases, and head and neck complaints. During the three year residency, residents will spend approximately 14 months (at least 3 days per week in Year 1, and 1 and ½ day per week in years 2 and 3) in the UCSF Oral Medicine Clinical Center. The Oral Medicine Clinical Center is a referral center for the Bay Area and follows over 5,000 patients a year. This diverse patient population provides our residents with a unique opportunity to learn clinical oral medicine, including in the medically complex patient. The Oral Medicine Clinical Center patient population includes but is not limited to patients with head and neck cancer, HIV/AIDS, Sjögren’ syndrome, and mucocutaneous inflammatory diseases. Stem cell and solid organ transplant recipients are also commonly treated in the Oral Medicine Clinical Center since they often develop oral complications (e.g., GVHD for stem transplant recipients, and opportunistic oral infections for solid organ transplant recipients). In the Oral Medicine Clinical Center residents gain expertise in the management of patients with inflammatory oral mucosal disease (such as lichen planus, pemphigoid, pemphigus, and erythema multiforme), infectious diseases affecting the oral mucosa, salivary gland disorders, oral cancer (diagnosis of oral cancer, pre-radiation work-up and follow-up during and following radiation for patients with head & neck cancer), and chronic orofacial pain syndromes. Our residents have the advantage of being able to follow patients over time, which provides them with a better understanding of the natural history of the disease as well as the outcome of therapy.

The second year of oral medicine residency PGY-2 includes a number of hospital-based training rotations in the UCSF Medical Center. Residents will complete a full time 4 week rotation in the Internal Medicine in-patient service in the UCSF Division of Hospital Medicine where they perform physical examinations and work up patients, and attend rotation-related lectures and seminars. Additional rotations in several medical subspecialties throughout the year in inpatient and outpatient settings are structured to provide an in-depth varied experience wherein the resident gains a deeper understanding of etiology, pathophysiology, and differential diagnosis and medical management of the medically complex patients and oral medicine conditions. Rotations include Oral Pathology/Radiology, Diabetes, Radiation Oncology, Medical Oncology , Infectious Disease/HIV, Transplant Nephrology and Hepatology, Viral Hepatology, Sjögren’s syndrome/Rheumatology, and Dermatology.

ROTATION DESCRIPTION

Internal Medicine Rotation

Site: Inpatient Hospital Service, UCSF Medical Center
Faculty: Bradley Sharpe, M.D.

Residents learn to perform a complete admission history and physical exam, select and interpret appropriate diagnostic tests, develop an assessment, including differential diagnosis, based on information gathered from the history, physical examination and laboratory tests and present patients to the attending. This rotation provides the resident with an excellent opportunity to learn to manage, diagnose and treat (or refer for treatment) general medicine cases. The rotation includes a daily 1 hour conference where residents and fellows from the School of Medicine (who also rotate through this service) get to discuss cases seen that day with attending physicians.

Diabetes Rotation

Site: Diabetes Outpatient Clinic, UCSF Medical Center
Faculty: Dr. Umesh Masharani

Residents shadow the attending physician during consultations. Residents are expected to collect patient history and to present it to the attending. This rotation provides the opportunity to observe a physician manage diabetes, but also diagnose and treat (or refer for treatment) various diabetes-associated diseases (e.g., disorders of the kidney, heart, thyroid, pancreas, and neuropathy). They also learn to monitor laboratory values relevant to the management of diabetes. Residents perform oral soft tissue examination on patients visiting the diabetes clinic, and treat patients who are found to have oral candidiasis.

Heptalogy Rotation

Site(s): Liver Disease and Viral Hepatitis Outpatient Clinic, UCSF Medical Center; Liver Transplant Outpatient Clinic, UCSF Medical Center
Faculty: Dr. Norah Terrault (Liver disease and viral hepatitis); Dr. Philip Rosenthal (Liver transplant)

These rotations take place in three outpatient clinics at UCSF:

  1. Liver Disease: This clinic offers diagnosis and treatment of all forms of liver disease and evaluation of patients with severe liver diseases for whom liver transplantation is being considered, as well as consultation on patients with complex hepatic problems. Residents shadow Dr. Norah Terrault during her Tuesday morning clinic. Specialized procedures available include TIPS shunt placement for management of ascites or variceal bleeding and genetic liver disease (hemochromatosis, porphyria, Wilson Disease, and others).
  2. Viral Liver Disease: This clinic specializes in the diagnosis and management of patients with chronic viral hepatitis. Residents shadow Dr. Norah Terrault whose Monday clinic focuses mainly on hepatitis C patients. They learn how to interpret laboratory values of patients with chronic hepatitis C. They also learn about the criteria used to determine eligibility for hepatitis C therapy (mainly with pegylated interferon), and about the responses to, and side-effects of, therapy.
  3. The Liver Transplantation Program at UCSF is one of the most active in the country, both in terms of volume and clinical research. Programs exist for both adult and pediatric liver transplantation. The pediatric program is headed by Dr. Philip Rosenthal (Pediatric Medical Director). Survival statistics for the Liver Transplantation Program are among the very best in the United States. The program also has performed pioneering research in a number of different areas, including post-transplant viral hepatitis, the use of new immunosuppressive agents, transplantation for fulminant hepatic failure, and the use of live donors for liver transplantation. Residents rotate through the pediatric liver transplant outpatient unit where they shadow Dr. Rosenthal and get to learn about the main causes for liver failure in children, medical management of pediatric liver transplant recipients, and the potential effects of immunosuppressive therapy on the oral cavity.
Nephrology Rotation

Site(s): Inpatient Kidney Transplant Unit, UCSF Medical Center; Outpatient Kidney Transplant Unit, UCSF Medical Center
Faculty: Stephen Tomlanovich, MD

The Nephrology rotation has two components: a rotation in the hospital Kidney Transplant Unit, and a rotation in the outpatient KTU. During the hospital rotation, the residents go on morning and afternoon rounds with the transplant team, and they get to follow patients from intake (pre-transplant) to 5 days post-transplant when patients are discharged. They learn about various kidney function tests, and the complex immunosuppressive regimens, antiviral, antifungal, and antibiotic regimen that are administered after transplant. They also learn about the various causes of renal failure. Then they spend 6 weeks shadowing Dr. Tomalnovich in the outpatient KTU every Thursday morning. Here they learn about the long term follow-up of renal transplant recipients, and how the various drug regiments are tapered to leave only a maintenance immunosuppressive regimen. They also get to learn about the various stages of renal failure, and they can observe patients on dialysis who are also followed in the outpatient KTU.

Infectious Disease Rotation/HIV

Site(s): Outpatient HIV Clinic, UCSF Medical Center; Urgent Care Infectious Disease, UCSF Medical Center
Faculty: Dr. Marc Jacobsen

  1. Continuity Clinic. This first site is a clinic for HIV-infected patients. Residents observe a broad spectrum of medication issues, and chronic condition issues other than HIV (hyperlipidemia, diabetes, hypertension, chronic hepatitis B or C) and behavioral issues.
  2. Urgent Care Infectious Disease Clinic. Residents get to participate in the work-up of a wide spectrum of disease pathology and differential diagnosis in urgent care.
Oncology Rotation

Site(s): Oncology Outpatient Clinic,UCSF Medical Center; Pediatric Bone Marrow Transplant Clinic, UCSF Medical Center
Faculty: Dr. Alan Kramer (Medical Oncology), Drs. Biljana Horn and Morten Cowan (Hematology/Oncology)

  1. Medical Oncology Faculty: Dr. Alan Kramer This rotation takes place on Mondays in an outpatient clinic at UCSF where Dr. Kramer manages patients undergoing chemotherapy as treatment of various types of head & neck cancer, lymphoma, breast cancer, prostate cancer, and leukemia. The chemotherapy is often administered in parallel to radiation therapy (RT). This provides residents the opportunity to understand the mechanism of action of various chemotherapeutic agents, their risks, benefits, and side-effects when these agents are administered alone or in conjunction with RT. Residents also perform oral examinations on patients and manage salivary hypofunction, candidiasis, and ulcerations when these conditions occur.
  2. Hematology / Oncology Faculty: Drs. Biljana Horn and Morten Cowan This rotation takes place on Wednesday morning in the Pediatric Bone Marrow Transplant clinic at UCSF. Patients (from birth to age 18 years) who have received a hematopoietic stem cell graft (from various sources such as peripheral blood, bone marrow, or umbilical chord) as treatment of recurrent leukemia or other blood dyscrasia are managed until complete immune reconstitution. Residents shadow the attending physician and learn about the various forms of both acute and chronic graft-versus-host-disease (GvHD) that may occur in this patient population. They specifically learn how to recognize the clinical signs of oral GvHD, and various management approaches ranging from topical steroid applications, if GvHD is mild and limited to the oral cavity, to systemic therapy if GvHD is more severe and affects other organs (e.g., lung, skin, eyes, liver, GI tract)
Head & Neck Radiation Oncology Rotation

Site: Mt. Zion Radiation Oncology Unit, UCSF Mt. Zion
Faculty: Drs. Jeanne Quivey and Sue Yom

Intensity Modulated Radiation Therapy (IMRT) has been used to treat head & neck cancers at UCSF since 1997. The residents shadow Dr. Quivey during pre-radiation consultations, treatment planning sessions, and consultations that occur at regular time-intervals as patients are undergoing radiation therapy. They also get to observe the simulation phase that precedes IMRT.

Auto-Immune Dermatology Rotation

Site: Auto-Immune Dermatology Clinic, UCSF Medical Center
Faculty: Dr. Kari Connolly

The clinical rotation takes place in the Auto-immune Dermatology clinic, an outpatient clinic that focuses on the management of patient with muco-cutaneous disorders thought to be of auto-immune etiology (e.g., lichen planus, pemphigus, pemphigoid, lupus). Residents get to collect patient history and work up cases with Dr. Connolly. They perform oral examinations when relevant, and learn how to collect a skin biopsy. This rotation is very complementary to the Oral Medicine clinical rotation as residents get to work-up diseases they have encountered in the Oral Medicine clinic among patients with extensive skin involvement.

Orofacial Pain/TMD Rotation

Site(s): The Center for Orofacial Pain, Department of Oral and Maxillofacial Surgery, UCSF
Faculty: Dr. Charles McNeill, (Center for Orafacial Pain), Dr. David Lee UCSF Pain Management Center

  1. The Center For Orofacial Pain. Residents learn how to perform a comprehensive work up of patients with temporo-mandibular disorders and other orofacial pain related disorders. They learn about the most up-to-date pharmacologic agents used in pain management, occlusal appliances, and the use of physical therapy in the management of myofacial dysfunction.
  2. UCSF Pain Management Center, UCSF Department of Anesthesia. The UCSF Pain Management Center (PMC) has been in existence since 1987, treating patients from all over the world with complicated and chronic medical, surgical, and neurological pain problems. The staff, based in the Dept of Anesthesia, consists of a variety of doctors and therapists with specialties in anesthesia, neurology, psychology, nursing, and PT. Patients consult the PMC because of various types of back pain, neuropathic (nerve) pain, cancer pain, musculoskeletal/rheumatologic pain, post-injury or surgical pain, and many others. A wide variety of treatment modalities are available, and each patient's case is personally reviewed by the multidisciplinary staff so that the best combination of therapies is offered to each person. Oral Medicine residents get to shadow faculty at the PMC and observe the process of making a differential diagnosis on a chronic pain patient, and develop an appropriate treatment plan.
Sjögren’s Syndrome/Rheumatology Rotation

Site: UCSF Sjögren’s syndrome clinic
Faculty: Dr. Ava Wu

Residents shadow Dr Wu as she performs the oral and salivary evaluation of patients with suspected Sjögren’s syndrome. Residents learn to perform the parotid saliva collection and the labial salivary gland biopsy. They also shadow the Ophthalmologist who performs Schirmer test, tear break-up time, and ocular staining to evaluate patients for kera-conjunctivitis sicca. The residents shadow the Rheumatologist who performs a comprehensive review of systems among all patients with suspected Sjögren’s syndrome.

RESEARCH

Research is an integral component of the mission and goals of the program. Early on in their training, oral medicine residents will identify one or more areas of clinical research to pursue over the course of the program with faculty supervision. Research training includes courses in clinical research protocol development, Biostatistics, and Bioethics. Faculty members represent a broad array of scientific fields using, clinical, epidemiological and basic science approaches in their investigations. This diversity of scope establishes a broad base for research programs and training available to the residents. Students are required to complete a master's level research project under the supervision of a thesis advisor and committee, in accordance with the guidelines of the University of California Graduate School.

It is expected that the outcome of this work will be presented at a national meeting and published in the scientific literature.

PROGRAM FACULTY

Our faculty are nationally and internationally recognized for their contributions to the fields of Oral Medicine and Oral Pathology.

Oral Medicine Faculty
Caroline Shiboski, DDS, MH, PhD
Deborah Greenspan, BDS, DSc
Sol Silverman, DDS, M.S.
Ava Wu, DDS
John Robinson, DDS
Piri Veluppillai, DDS, M.S.                                                                                                          Daniel Ramos, DDS, PhD

Oral Pathology Faculty
John Greenspan, DDS, PhD
Richard Jordan, DDS, PhD
Troy Daniels, DDS, MS.
 

ADMISSION REQUIREMENTS

The Division of Oral Medicine, Oral Pathology and Oral Radiology annually accepts two postgraduate students into the Oral Medicine Program who must be U.S. citizens or hold permanent resident status, and must have graduated from an ADA-accredited dental school. GME Funding is available for these applicants.

  • DDS or DMD degree
  • GRE (Graduate Record Examination) scores. PLEASE NOTE: GRE scores can be submitted after the application and interview process, however, if accepted into the program, you are required to apply to the MS in Oral and Craniofacial Sciences program, as a Master’s Degree is part of the curriculum. Please submit a Statement of Purpose which describes your interest in both oral medicine and oral and craniofacial science. In order to be accepted into the MS program you will need to submit the GRE score report no later than March 15th to the start of the program. The minimum requirement to be accepted into the MS program is to obtain 30% in each category (Verbal, Quantitative, Writing) of the general test. Institutional Code: 4840; Departmental Code: 0604.

APPLICATION PROCEDURES

  1. Applicants must first submit an application to PASS (Postdoctoral Application Support Service) by the deadline posted on the PASS website. They must include with their PASS application, dental school transcript, 3 PPI evaluation forms; 3 PEFs (including a Dean's institution evaluation form), and a personal essay.  
  2. Applicants must submit the following items directly to UCSF by April 15, 2014 (application deadline extended!):

University of California, San Francisco
Dental Admissions Office
513 Parnassus Avenue, S-630
San Francisco, CA 94143-0430

Supporting documentation includes:

  • An official copy of transcripts from any college or university attended, (including transcripts from foreign universities and Canadian institutions where English was not the official language of instruction) Please note: Xerox or notarized copies are not acceptable.
  • Curriculum Vitae
  • Course-by-Course evaluation from Educational Credential Evaluators, Inc. or World Education Services for ALL foreign transcripts received outside of the US including Canadian schools where English was not the official language of instruction
  • Official GRE scores (Graduate Record Examination). If accepted into the program, GRE scores must be submitted. This may take place after the application and interview process.

Postgraduate Application Fee Form with non-refundable $60 fee to:

UCSF Office of Admissions and Registrar
P.O. Box 742908
Los Angeles, CA 90074-2908

Do not send any transcripts, letters of recommendation, other documents or correspondence to this address.

CONTACT FOR APPLICATION MATERIALS

For questions regarding admissions and application procedure, please contact:

Daliah Williams
Admissions Coordinator
Office of Admissions
513 Parnassus Avenue, S-630
San Francisco, CA. 94143-0430
(415) 476-2737 (voice)
(415) 476-4226 (fax)
E-mail: daliah.williams@ucsf.edu