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DMD PROGRAM: THE CURRICULUM
Overview
The DMD Curriculum is presented in a problem-based approach in which concepts are mastered through group discussion and analysis of real-patient cases. Courses are interdisciplinary, and small group tutorial sessions augment material from lectures, laboratories and independent study. The educational process is designed to encourage students to become responsible for their own learning and to develop the skills to become a competent lifelong learner. A Curriculum Map can be viewed with Adobe Acrobat and shows the sequencing of courses for currently enrolled students in Years 2, 3 and 4 of the DMD program. A similar map for students entering in 2006 and thereafter will be posted shortly.
In the first two years of the DMD program, students study the basic biomedical sciences with faculty at both the Dental School and the Harvard Medical School (HMS). The principles of this curriculum are based on the HSDM philosophy that dentistry is a field of medicine and that oral health is part of overall health. For this reason, the School is committed to the belief that dental students at HSDM should participate wholly in the curriculum at HMS. Curriculum content in the first two years includes parallel dental courses that help make the connections between oral health and general health.
Through a 3-year course sequence, Patient-Doctor I, II and III, students explore interpersonal relationships and the societal and environmental issues affecting patient care. In addition, they become comfortable eliciting patient information to aid in clinical care and learn physical examination skills at a Harvard teaching hospital. The third year course focuses on the practical aspects of providing patient care, including the people and agencies with whom dental professionals interact on a regular basis.
The curriculum is supported by MyCourses, an internet portal developed by the HMS eComputing Team. The MyCourses portal enables registered students as well as faculty to view announcements and events related to courses and community events; access course resources including images, digitized lectures, video clips, handouts, etc.; complete course exams on-line; complete course evalutions on-line; and search for specific information from all resources posted by participating courses. An introduction to MyCourses is presented during Orientation Week.
YEAR 1-The Basic Sciences
The basic biomedical sciences are learned through a sequence of curricular segments extending through the first year and initial part of the second year. These include the morphological sciences (The Human Body); the biochemical and physiologic sciences (The Molecular and Cellular Basis of Medicine and Development and Integraged Human Physiology); developmental and molecular biology (Genetics and Human Development); pathology, microbiology and immunology (Immunology, Microbiology & Pathology); and the neurosciences (Human Nervous System and Behavior).
Connections to oral health are made throughout the first year curriculum in similarly designed oral science courses. While the dental students are completing the Human Body course block, they are also learning in more detail about orofacial structures in a course called Craniofacial Anatomy. The general objectives of this course are to know the detailed anatomy of the head and neck with specific attention to the muscles, nerves, and arteries associated with the mouth and teeth. The student should know what muscles and nerves are located underneath any given surface which would be involved in dental examinations and anesthesia. Radiographic objectives of this course are to be able to identify some simple gross structures on cross-section CT or MR scans, or drawings. Histology objectives are to understand the microscopic anatomy of both the hard and soft tissues which make up the oral cavity.
In courses entitled Clinical Epidemiology and Population Health and Introduction to Research Methodology, again taken with their medical school colleagues, dental students are introduced to clinical research methododology including identifying appropriate study design, assessment of validity, data entry, analysis and interpretation. Students will learn to critically evaluate the published literature as well as design their own research studies.
Oral Physiology focuses on the normal relationships of the craniofacial area and is taught in parallel with Integrated Human Physiology. Students learn about the anatomical components and tissues involved in function including the teeth and their supporting tissues; maxillary, mandibular and temporal bones; the temporomandibular joint system; masticatory muscles, tongue and salivary glands; a complex network of neural components and higher reflex centers.
It is a major undertaking to learn the knowledge and skills relevant to occlusion and oral function. The subject area encompasses anatomy, biochemistry, physiology, psychology, biomaterials, human development and aging, congenital or acquired tissue loss, associated issues with wound healing and tumor biology, and issue of sociology and self esteem. This course introduces students to the fundamentals of the normal oral structures, their functions and complex interactions, with specific emphasis on normal tooth anatomy and occlusal function. In both Craniofacial Genetics and Oral Development, students learn about the development and genetics of the craniofacial complex.
Finally, while the students are enrolled in Immunology, Microbiology & Pathology at the Medical School, they are also discovering concepts pertaining to a) the ecology of the microbiota within the oral cavity, b) mechanisms by which certain members of the oral microflora manifest pathogenicity, and c) pathways by which the host can manage colonization, accumulation and pathogenicity of the multitude of microorganisms to which the oral cavity is exposed in Oral Microbiology and Immunology.
The process of discovery will involve discussion and investigation of concepts that are highlighted in relevant case material, textual material, and lectures. Through these media
of exposure and discovery, the student should develop an understanding of the disease processes that they will encounter in the clinic and thus have a stronger biological foundation on which to base his/her clinical therapy
YEAR 2-Pathophysiology
The second year begins with a brief introductory course, Principles of Pharmacology. This foundation is reinforced throughout the remainder of the year, most of which is comprised of the Human Systems course series which is generally organized by organ systems. Human Systems is designed to provide close correlation between structural and functional changes in disease and the ways in which these changes become manifest at the clinical level. Two dental basic science courses parallel these courses in the second year:
Orofacial Pain - deals with temporomandibular disorders and facial pain.
Oral Pathology and Radiology - designed to familiarize students with the etiology, radiology and pathogenesis of major oral diseases. Students learn to recognize clinical and radiographic manifestations, associated laboratory findings and microscopic features of oral disease. In addition, they are expected to acquire a working classification of disease and apply this to the task of recognition or abnormalities and the development of differential diagnoses and strategies for initial case management. Students gain an understanding of and appreciation for viral, fungal and bacterial infectious diseases of the mouth. The etiologic factors of caries, pulp and periapical disease, as well as periodontal diseases are covered. In addition, neoplasia, hereditary disorders, autoimmune disorders, oral manifestations of systemic disorders, salivary and sinus pathoses, and fibroosseous diseases are addressed.
YEAR 3- Core Clinical Dentistry
Six dental courses in the third year (Diagnosis and Prevention (DxP), Treatment of Active Disease (TxAD), Restorative Treatment (RTx), Treatment of the Child and Adolescent (TxCA), Advanced Surgical Treatment, (ASTx) and Outcomes of Treatment (OTx), form a basis for dental students to understand abnormal dental biological conditions. Students are expected to understand the etiology, epidemiology, differential diagnosis, prevention, treatment and prognosis of oral and oral related disorders. In addition they learn the preclinical and clinical skills to treat simple and then more complex dental cases in the Teaching Clinics at HSDM. Didactic dental courses continue to be taught in a PBL-hybrid interdisciplinary fashion. Clinical care of patients is delivered in a treatment team structure, in comprehensive care clinics at HSDM.
YEAR 4-Advanced Dental Rotations
In the fourth year, dental students spend time in the HSDM clinics providing ongoing care for patients and learning advanced dental techniques (for example advances in esthetics, implant therapy, advanced pain management techniques). In addition, students rotate through various externships, spending three months at a Community Health Center or Veterans Administration Hospital, and one month on an Oral Surgery rotation at a Harvard teaching hospital. Many students continue doing research, spend time at other dental schools completing selectives in a specialty area, or travel overseas to participate in community health projects.
RESEARCH PROGRAM
HSDM considers the generation of new knowledge to be an integral part of the education of future leaders in the field of dentistry. In recognition of this goal, predoctoral students are required to explore and develop interest in a special field, resulting in the completion of a research project and defense of a thesis prior to the awarding of the DMD degree. Students are introduced to the research program during Introduction to Research Methods in Year 1 and receive guidance from the Office for Research in the selection of a research mentor and the identification of a project of manageable scope. More specific information about the research program can be found in the Student Research Handbook.
Curricular Options
In addition to the 4-year PBL curriculum, HSDM offers several optional curricula.
Five Year DMD Program
Designed for individuals who wish to take time to explore individual areas of interest, the Five Year DMD Program facilitates opportunities for DMD students to conduct in-depth research, pursue other educational degrees, or become involved in international oral health projects.
Health Sciences and Technology (HST) Program
The HST curriculum is oriented toward students with a declared interest in a biomedical research career or a strong interest and background in quantitative or molecular science. It is particularly appropriate for students who are planning interdisciplinary research careers in academic medicine or dentistry. The approach is quantitative and rigorous and emphasizes modern biology, biotechnology, engineering, and physical sciences.
Applicants with strong backgrounds in math, physics, or the engineering sciences may be potential candidates for the HST/DMD program. Please contact the HSDM Office of Dental Education for additional information.
DMD/MBA Program
Approved in fall, 2005, the DMD/MBA Program is designed to enable students to pursue both the DMD degree at the Dental School and the Master of Business Administration (MBA) degree at Harvard Business School, most often completing requirements for both degrees in five years. Application to and acceptance at both schools is required.
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