General Practice Residency in Dentistry

The Department of Veterans Affairs is an equal opportunity employer and complies with all applicable employment discrimination laws, including those that prohibit discrimination based on age, race, color, national origin, sex, religious belief, disability, sexual orientation, or any other basis protected by Federal Fair Employment Practice Laws.

Candidates are ranked numerically based on their candid responses to questions the GPR Selection Committee asks. An assignment of a score from 0 to 20, with the highest rating of 20, is given for each candidate's responses. A summation of these scores will determine the final score. Additional documentation supplied by the Pass application process, including class rank and faculty recommendations, is also seriously evaluated.

Requirements For Application:
1. All applicants must be U.S. citizens.
2. All applicants must be enrolled or graduated from ADA Accredited Dental School.
3. All applicants must complete an official application through the Postdoctoral Application Support Service called ADEA PASS. There is no MATCH participation.
4. All applicants must submit VA Form 10-2850d, "Application for Health Professions Trainees," directly to the agency.
5. Dental school graduates must have completed Part I and Part II of the National Board Examination before starting the GPR Program.
6. Applicants must be proficient in the English language.
7. Applicants will be selected by the GPR Director and the Dental Residency Review Board for an interview, which the applicant must attend.
8. Meet licensure requirements to practice in a state or territory of the United States or the District of Columbia.
9. State licensure at the time of application is not required for one-year residents

How To Apply

• All applicants must complete an official application through the Postdoctoral Application Support Service: ADEA PASS
• Complete application form (VA Form10-2850D) and send to:

VANTHCS, Dental Service (160)
Program Director
Attn: Dr. Francisco Garcia-Penna
General Practice Residency
4500 S. Lancaster Road
Dallas, TX 75216
(214) 857-1082

To plan and provide routine and complex dental care for various patients by applying advanced knowledge and developing clinical skills.

• Provide emergency and multidisciplinary comprehensive oral health care.
• Provide patient-focused care.
• Direct health promotion and disease prevention using advanced dental treatment modalities.

To diagnose oral disease and provide care in the context of each veteran patient's health care needs, servicing the VA community of Dallas, Texas.

• Plan and provide multidisciplinary or health care for patients with special needs.
• Understand the oral health needs of communities and engage in community service.

To communicate more effectively with other health care professionals in various settings and understand these professionals' roles.

• To function effectively within interdisciplinary health care teams.

To train residents for both the clinical and hospital-based practice of general dentistry (and to function effectively within the hospital and other health care environments).

To train residents in practice management and behavioral skills for general dentistry.

• Apply scientific principles to learning and oral health care.
• Use of critical thinking.
• Use of outcome-based clinical decision-making.
• Use of technology-based information retrieval systems.
• Utilize the values of professional ethics, lifelong learning, patient-centered care, adaptability, and acceptance of cultural diversity in professional practice.

To understand and practice medical risk assessment and quality assurance concerning hospital administration standards.

• To deliver oral health care by applying concepts of patient and practice management.
• To apply quality improvement

• Training toward clinical competency in general dentistry.
•  Training toward diagnostic competency in general dentistry
• Develop critical thinking among residents.
• Provide residents with a learning environment where they function as part of a health care team.
• Involve residents in continuous quality care assessments of patient care.
• Involve residents in community service efforts through the Vet Outreach Program.

The Dallas VA Medical Center is part of VA North Texas. We also have sites in Bonham, Texas, and Fort Worth, Texas. Bonham is primarily a long-term care facility, and the Fort Worth location is an outpatient clinic. 

All residency training is at the Dallas VAMC, an 853-bed general medical and surgical center with a 40-bed domiciliary. In addition, the University of Texas Southwestern Medical School, the University of North Texas Health Center Science at Ft. Worth, Texas, and the Texas A&M College of Dentistry have affiliation agreements with VA North Texas for didactic training of VA residents.

The group specialist practice atmosphere allows residents to have a close relationship with faculty, consultants, and other dental and medical residents. In addition, our center has many ancillary facilities, including a medical library, computer information systems service, medical media production service, and a research division.

The residency is clinically based, and assignments to other services will be essential to support the goals and objectives.

This one-year program consists of approximately 2,000 hours of clinical practice and instruction divided into the following areas:

Over 600 clinic hours are blocked rotation assignments as follows:

• General Medicine - Individual resident rotation with medical service physicians for one week at the Dallas VAMC. In addition to regular interaction with UT Southwestern Oral Surgery MD/DDS residents in the oral surgery clinic and operating room.
• Anesthesiology - Individual resident rotation in anesthesiology for four weeks. Monthly lectures and labs with our staff dental anesthesiologist, including IV placement, sedation in the dental setting, history and physicals, etc.
• Oral and Maxillofacial Surgery - Each resident rotates for three weeks, including clinic and operating room. During this rotation, residents will complete history & physicals for outpatient surgery patients, complete ambulatory surgery, and assist OMFS residents in the OR. During these weeks, each GPR resident is responsible for completing a history & physical on several patients and completing the cases in the operating room under general anesthesia.
• Orofacial Pain/Radiology/Pathology - Individual resident rotation for one week at the Dallas VA Medical Center or Texas A&M College of Dentistry.

Over 1,200 clinic hours are spent on VAMC Dental Clinic patient care for inpatients and outpatients.

The resident performs eight months of comprehensive patient care in their assigned dental operatory with a full-time dental assistant. 

Hospital, domiciliary, and Transitional Care Unit (TCU) patients are considered inpatients. Therefore, it constitutes less than ten percent of resident patient care with treatment similar to private practice but without cost restrictions.

The program's curriculum is divided into 12 major areas of instruction, each with a series of goals and objectives. The educational experience gives residents training and expertise in providing comprehensive oral health care to patients at a level of skill beyond that accomplished in the pre-doctoral training.

To give potential applicants an idea of the experience they may gain, the following is a list of the average number of procedures completed by previous residents.

Procedures may vary with the current patient pool and your clinical interest. However, the opportunity to complete full mouth rehabilitation may be possible under the direct supervision of the attending staff if a case is available.

• Restorations – 150 
• Root Canals – 25
• C&B – 65 units 
• Extractions – 235
• CD – 8 units 
• Perio Surgery – 8 Cases
• RPD – 8 units 
• Implant Placement – 3 to 5
• Pre-prosthetic Surgery – 8 
• Implant Restorations - 10

• Diagnosis: A complete examination of the head, neck and oral cavity is performed. Necessary radiographs and diagnostic mounted casts are made for proper diagnosis. Particular emphasis is placed on soft tissue examination of the oral cavity to detect malignant and premalignant lesions. Occlusion and temporomandibular joint examinations are performed on all patients, and proper treatment is employed when indicated. Periodontal examinations and charting are performed on all patients, and treatment is instituted as indicated. Residents are responsible for obtaining and recording an accurate history and for the correlation of dental treatment planning with the patient's medical status. Residents will be shown a treatment planning and sequencing technique for all the comprehensive care patients following sound practice management principles.
• Restorative Dentistry: The residents will develop their skills and proficiencies in various restorative dental procedures and using chairside assistants. Modern materials and methods will be available for patient care. The attending staff is available for consultation during all patient care sessions. Fixed prosthodontics, including endosseous implants, will be available for residents as a treatment modality.
• Periodontics: Instructions will be given by full-time and consultant faculty in the diagnosis and treatment of periodontal disease. Weekly seminars are conducted throughout the year to discuss current literature and treatment planning of assigned patients. Emphasis is placed on early diagnosis and treatment. Periodontal disease control will be instituted in all patients before corrective periodontal therapy. All restorative dentistry cases will be periodontally stabilized before treatment, including craniomandibular therapy. Opportunity will be given to residents to complete periodontal surgery under direct supervision when available. Periodontal procedures include crown lengthening, osseous surgery, sub-epithelial connective tissue grafts, etc.
• Oral And Maxillofacial Surgery (OMFS): Assignment to the OMFS clinic permits the resident to participate in practically all types of oral surgery under the supervision of the oral surgery staff and consultants. In addition, when assigned to this rotation, residents may alternate on-call duty as an assistant to OMFS residents every other week for emergency/trauma care.
• Prosthodontics: The resident will carry out all phases of prosthetic dentistry. Instructions on actual cases will include diagnosis, mouth preparation, mounted diagnostic casts, and three-dimensional articulation in complete and removable or fixed partial dentures. The resident will perform all clinical steps from the initial impression through the final adjustment of the prosthesis. In addition, the resident will direct the laboratory phases of denture fabrication by technicians in all cases, which include removable (full and partial) dentures and fixed partial dentures. Osseo-integrated implants from surgery through prosthetic replacements, fixed and removable, will be offered as resident cases under direct supervision. Suppose residents are interested in the surgical placement of implants. In that case, they are responsible for treatment planning, presenting the patient's treatment plan to the monthly implant board committee meeting, and fabricating a surgical guide to be used on the day of surgery. The utilization of CAD/CAM digital dentistry is available. Our clinic is equipped with CEREC Primescan Primemill and SpeedFire; residents will be educated in digital workflow and effectively utilizing CAD/CAM in clinical practice.
• Endodontics: Instruction will be given by full-time faculty in the diagnosis and treatment of pulpal and periapical disease. Didactic sessions and clinical rotations are planned throughout the year. Emphasis is placed on treating single and multi-rooted teeth using rotary instrumentation (Pro-Taper Next). Residents are also exposed to indications and techniques of surgical endodontics. The use of a Zeiss surgical microscope is available. Residents may complete more cases with more autonomy as their skill progresses throughout the year.
• Emergency Dentistry: Residents are responsible for covering the same-day emergency clinic for the Dallas VA Medical Center Dental Clinic every Monday. Residents are expected to triage patients, perform limited exams and radiographs, and complete same-day treatment. Procedures include simple/surgical extractions, incision, drainage, pulpectomy, splinting of traumatized dentition, etc. In addition, residents conduct inpatient consults bedside or in the dental operatory.
• Anesthesiology: Under continuous one-on-one supervision by the Anesthesia Section of Surgical Service staff, the residents will deliver general anesthesia and local/conscious sedation anesthesia to the American Association of Anesthesiology Physical Status one, two, and three patients. Emphasis is placed on the following:

1. Airway management, intravenous infusions, and primary pharmacological agents.
2. Performance of preoperative assessment and evaluation of assigned patients.
3. Post-anesthetic review of patients with whom they have been associated during rotation.

Learning activities will include the assignment of a patient from the next-day operative schedule, preoperative assessment and evaluation under the supervision of a physician, administration of general anesthesia and local/conscious sedation anesthesia under the continuous supervision of a nurse anesthetist or anesthesiologist, and assigned reading by a staff anesthesiologist.

• General Surgery Operating Rooms: Assignment of residents to Surgical Service for instructions and training in operating room (OR) procedures, techniques, and draping will be carried out in the General Practice Residency Program. Lectures by the faculty in Oral and Maxillofacial Surgery (OMFS) will be given on control of shock, bleeding, instrumentation, and pre/post-operative care for patients undergoing oral surgical procedures in the hospital's operating rooms. In addition, the resident will assist the OMFS staff on cases requiring a general anesthetic in the surgical suite during the OMFS rotation. This is a one-day-per-week rotation that lasts for three consecutive weeks. Each resident will admit two dental patients for surgery in the OR, complete a history and physical examination, intubate, perform a dental surgical procedure, and prepare a discharge summary.
• Pathology and Laboratory Service: Instruction will be given in both general and oral pathology, including diagnostic laboratory tests, biopsy techniques, and lectures. Staff pathologists and consultants will cover routine pathology and laboratory procedures. Oral pathology rotation will be covered online in collaboration with TAMCOD Pathology Department.
• Oro-Facial Pain: This one-week rotation at Texas A&M College of Dentistry exposes residents to techniques for treating and diagnosing orofacial pain with Dr. Steven Bender. Residents will observe neurologic examination techniques, fabrication and adjustment of occlusal orthotics, and management of OSA patients with TAP appliances. Lectures include diagnosis and management of TMD, such as local injection techniques to manage symptoms.
• Radiology: During the Radiology Department rotation, the residents will be given a general orientation on using radiographic techniques and interpretation of head and neck structures. In addition, GPR residents will have access to a CBCT for the diagnosis and treatment of comprehensive care patients, currently in the process of including Simplant software for guided dental implant surgery in conjunction with Azento implant protocol.
• General Medicine: This is a one-week rotation. Residents report to the Ambulatory Care Department for assignment to a physician and medical unit. They will be expected to handle medical history and physical diagnosis under the direction of a staff physician.
• Conscious Sedation Techniques: Intravenous (IV) conscious sedation is used by Oral Surgery department. GPR residents will be exposed to these techniques but will not gain an IV sedation permit due to recent changes in Texas Dental Board Anesthesia requirements. However, residents can provide conscious oral sedation to select patients at the VA under the direct supervision of the staff dental anesthesiologist, Dr. Zydnia Marrero. Residents will take and pass an ACLS course at the VAMC and a Conscious Oral Sedation course in the fall semester at Texas A&M College of Dentistry.
• Continuing Education Series: Residents will have the opportunity to select and attend continuing education courses offered throughout the year. Past residents have taken classes on Conscious Oral Sedation, Digital Dentures, Prosthetically Driven Implant Placement, Dental Sleep Medicine, etc. Funding for these courses is dependent on approval by the VA.
• Clinical Asepsis and Infection Control: The VANTHCS safety protocol for asepsis, infection control, and hazard control is practiced and monitored by a VAMC OSHA unit.
• Resident Assignments and Policies: A written examination (Outcome Assessment Exam) prepared by the American Association of Hospital Dentists and the Special Care Dentistry Association will be given to all residents at the beginning and end of the academic year. This educational and outcome assessment tool permits the teaching staff to gauge the success of the training and identify those areas which may need improvement.

1. Residents will follow all operating room protocols and aseptic techniques according to established policies of The Joint Commission.
2. Residents must attend all scheduled lectures, courses, conferences, rotations, and seminars as requested by the GPR director.
3. Residents must maintain accurate medical/dental records with acceptable documentation of treatment as mandated in ADA Guidelines for General Practice Residency programs.
4. After the residency program, each resident will present one of their completed comprehensive cases to the faculty for evaluation and review.

• The GPR program begins on July 1 and ends on June 30 each calendar year. 
• One-year residents receive a stipend per annum every two weeks. 
• The current compensation for the 2021-2022 residents is approximately $64,861. 
• Dental uniforms (VA scrubs) may be requested. 
• Regular working hours are from 7:30 a.m. to 4:00 p.m., Monday through Friday. 
• We observe all federal holidays and ten days of paid time off (PTO) are granted. 
• Sick leave for medical treatment or illness may be granted. 
• Administrative leave may be granted for attending state and regional dental meetings and taking a state board examination. Resident training includes on-call duty, which is limited to Dallas VAMC. 
• Upon completing the GPR program, residents will receive an official Department of Veterans Affairs certificate.
• Participation in government group life and medical/dental insurance is also available. 
• The Federal Tort Claim Act covers residents, and malpractice insurance is not required. 
• Practice privileges outside the GPR program and for professional activities not associated with the Department of Veterans Affairs are not covered by the Federal Tort Claim Act. 
• Activities such as moonlighting and working outside VA are NOT permitted.

• Clinic Facilities: Our 14-operatory clinic with hygiene and radiology sections has a complement of 20 ancillary staff, including four hygienists. All units and equipment are of modern design. In-house laboratory technicians complete daily laboratory tasks such as pouring impressions and repairing prostheses. The Central Dental Laboratory (CDL) services the entire country and is on campus. The CDL is responsible for the fabrication of fixed and removable restorations. Complete audiovisual and dental videotape libraries are part of the medical center.
• Local Area: Dallas VA Medical Center is in the southeast Dallas area. It is approximately 15 miles from downtown and 40 miles from Fort Worth. The DFW International Airport and Love Field Airport are centrally located for travel. The DART light rail system has a station at the VA Medical Center campus entrance.
• Orientation: The first week of the residency is the orientation and assignment of an operatory and dental assistant. A review of standard procedures in hospital patient care and general policies and practices of the medical center and service will be covered. Proper documentation of dental records and medical charts will be reviewed. Residents will be assigned personal access codes and instructed to navigate the VAMC's Computerized Patient Record System (CPRS, DRM Plus, and Vista).
• The General Practice Residency Director: The GPR Director is responsible for program administration, oversight of resident selection, monitoring the development of curriculum, and coordination of resident and faculty evaluation.
• Teaching Staff: The faculty includes staff dentists, physicians, and consultants. Most specialties of dentistry are represented in addition to generalists, all of whom have a significant role in program development and instruction. Specialties not represented include pediatrics and orthodontics.

Dallas VA Medical Center – Dental Clinical Faculty

• Dr. Ramirez – Endodontics [Chief]
• Dr. Glasgow – General Dentistry [Assistant Chief]
• Dr. Garcia-Penna – General Dentistry/Periodontics [GPR Director]
• Dr. Bagtas- General Dentist (former GPR resident)
• Dr. Finn – Oral and Maxillofacial Surgery
• Dr. Marrero – Dental Anesthesiology (former GPR resident)
• Dr. Mucha – General Dentistry (former GPR resident)
• Dr. Naik – Maxillofacial Prosthodontics
• Dr. Perez – Prosthodontics
• Dr. Tran – Prosthodontics
• Dr. Venkatachalam – Board Certified Maxillofacial Prosthodontics/General Dentistry
• Dr. Villafane – General Dentistry

Clinical Affiliates of Dallas VAMC GPR – Faculty

• Dr. Ahmed, Dallas VAMC – Anesthesiology
• Dr. Bapna, Dallas VAMC – General Medicine
• Dr. Bender, Texas A&M College of Dentistry – Orofacial Pain
• PA Samuels, UNT Health Science Center – History & Physicals
• Dr. Woo, Dr. John Wright Texas A&M College of Dentistry – Oral Pathology & Radiology