GPRs and AEGDs: Making the Match

By Michelle Pisano-Marsh, DMD, GPR Program Director, Lehigh Valley Health Network

Michelle Pisano-Marsh, DMD

Next steps are always confusing and as you reach the end of your predoctoral career, you are faced with many choices. If you are certain you are interested in specialty training, the path is clear. But what if you want to pursue further education in the field of general dentistry? Or if you would just like more information as to what you can expect from a general dentistry program? I hope I can offer you some answers to those questions.

First, let’s discuss why you might want to do a program of advanced education in general dentistry. There are many great reasons, but first and foremost to me is that we are all privileged to be in a field of healthcare that is always growing and expanding the services we are able to provide to our patients. This means that the pre-doctoral curriculum must also expand but there are still only four years to complete it. Our colleagues in medicine have bridged that gap by requiring post-doctoral residencies to better prepare providers. Doing a post-doctoral year can expand your career options and scope of practice. It will also:

  • Make you more comfortable in your patient management skills
  • Teach you advanced clinical skills
  • Help you to better understand how to manage medically complex patients
  • Allow you to offer more complex care to your patients as well as to understand in detail what specialty care can and cannot do so you are better able to explain treatment options to your patients
  • Aid you in development of your treatment planning skills
  • Facilitate decreasing your time per procedure
  • Will give you valuable insight to decide whether specialty training is right for you
  • Will make you more desirable to prospective employers

Now let’s discuss the two types of programs in general dentistry, Advanced Education in General Dentistry (AEGD) and General Practice Residency (GPR). The major difference between the two is that a GPR must be hospital-based or hospital-affiliated. In the past, AEGDs were almost always affiliated with dental schools, but currently we are seeing more AEGDs that are part of Federally Qualified Health Centers (FQHCs). As someone who did a GPR and has been associated with a program for 31 years, I feel I can speak in most depth to the GPR side of this equation. Practically what the AEGD/GPR difference will mean to you as a candidate is that in a GPR, you will see more medically complex cases as you will be providing clearances for patients requiring cardiac surgeries, orthopedic surgeries, transplant surgeries, as well as oncology patients prior to chemotherapy or head and neck radiation therapy. Many of these patients are too medically fragile to be discharged from the hospital to seek this care as outpatients. You will also provide dental care in an OR setting and will have a much wider exposure to trauma cases.

So what should you look for in a program? This should be a very individualized answer. Are you interested in lots of pediatric patients? Oral surgery? Comprehensive care? Mentoring? Each program is unique and there is definitely one out there that would be the right fit for you. First, give careful thought to the areas you are looking for a greater depth of experience—make a list! As a CODA site visitor for Advanced Dental Education Programs, I would be remiss if I didn’t say that you want a CODA accredited program. CODA accreditation is there to assure that educational standards are being met: Chiefly, that the programs are providing you with didactic and clinical training to ensure that upon completion of training, the resident is able to provide care at an advanced level of skill and/or case complexity beyond that accomplished in pre-doctoral training.

Next, research programs. Start with the ADEA/Pass search engine. This is a powerful tool to help you find as much information as possible. It will also usually include a link to any website the program maintains with more in-depth descriptions and, most valuable of all, contact information. Do not hesitate to reach out to programs to ask questions or to set up a visit. I know the best years are when we not only find the right resident for our program, but when our residents are in the right program for them.