GPR vs. AEGD
Historically, postdoctoral training programs in general dentistry were first considered Dental Internships and were strictly hospital based. Over time the terminology changed to General Practice Residency Programs (GPRs). Eventually, these postdoctoral programs evolved to include training programs that were typically dental school based and not just hospital based. These programs were called Advanced Education in General Dentistry (AEGDs) programs. Today, AEGDs can be hospital based (as seen in most of the VA Hospital programs), dental school based or free standing programs. Some GPR programs do provide the same training as AEGDs. There is also nothing that precludes AEGDs from offering training that is required of GPRs such as medical rotations or treatment of more medically complex patients. In recent years the ADA has continued to revise the accreditation standards of the two types of programs so that the differences between the two are relatively limited. Below I have included the ADA definitions of the two types of programs as well as the exact Commission on Dental Accreditation Standards that point out the unique program requirements. Ultimately, the dental student applicant needs to evaluate each and every program in depth to determine if it meets their specific learning objectives.
What Type of Advanced Education Programs are Available?
Source: https://coda.ada.org/en/find-a-program/program-options-and-descriptions
General Practice Residency Programs
The General Practice Residency (GPR) program is designed for advanced clinical and didactic training in general dentistry with intensive hospital experience at the postdoctoral level. GPR programs provide instruction and experience in the delivery of care to a wide range of ambulatory and hospitalized patients. This training and exposure prepares dentists to obtain privileges at local hospitals once in private practice. Most GPR programs are sponsored by either a hospital or a hospital affiliated institution such as a dental school.
Like the AEGD programs, the demand for GPRs has increased. GPR programs can be one or two years in length, the majority being one year. Both AEGD and GPR award a post-graduate certificate upon completion. Fellowships are sometimes available to serve as a third non-accredited year of training in a specific field of interest. GPR residents rotate through a variety of services including general medicine, general surgery and anesthesiology. Each program also includes advanced training and clinical experience in preventive dentistry, periodontics, restorative dentistry, endodontics, and oral surgery. Training in orthodontics and pediatric dentistry is desirable but not mandatory for GPR programs. The majority of the resident’s experience is gained in the direct delivery of oral health care to ambulatory patients. The remaining time may be spent in the operating room involved with inpatient services, as well as the emergency room. Time is also devoted to non-dental services, such as lectures, conferences, and seminars.
Advanced Education in General Dentistry Programs
The Advanced Education in General Dentistry (AEGD) program provides advanced training in clinical dentistry and applied basic sciences. It is a planned, sequential postdoctoral training program specifically designed to meet the needs of recent graduates who want to enhance their skills as general practitioners. The program is an advanced supplement to the predoctoral dental curriculum, not a continuation of that training. The majority of AEGD programs are one year. Several programs offer two-year positions.
The major distinction between the AEGD and GPR programs is the emphasis that the AEGD program places on clinical dentistry in contrast to the emphasis on medical management in the GPR program.
The specific objectives of the program are to enhance competence and confidence in the various clinical disciplines that are integral components of dentistry. AEGD graduates should have a broader base of knowledge and experience to facilitate judgments in diagnosis, treatment planning, and decision making during treatment. Completion of an AEGD program can help to better prepare the dentist to evaluate patients’ total oral health needs, provide a full range of general dental care, and refer patients, when indicated, to appropriate specialists. The AEGD program also increases the understanding of practice administration through hands-on experience in this area.
A Comparison of the Differences in Accreditations Standards Between GPRs and AEGDs
(as implemented by the A.D.A. Commission on Dental Accreditation, July 1, 2013)
Goals
GPR:
– Function effectively within the hospital and other health care environments.
– Function effectively within interdisciplinary health care teams.
AEGD:
– Function effectively and efficiently in multiple health care environments within interdisciplinary health care teams.
Standard 1 – Institutional Program Effectiveness
GPR Standard #1-1:
The program must be sponsored or co-sponsored by either a United States-based hospital, or an educational institution or health care organization that is affiliated with an accredited hospital. Sponsoring and co-sponsoring institutions must be accredited by an agency recognized by the United States Department of Education or accredited by an accreditation organization recognized by the Centers for Medicare and Medicaid Services (CMS).
AEGD Standard #1-1:
The program must be sponsored or co-sponsored by a United States-based educational institution, hospital or health care organization accredited by an agency recognized by the United States Department of Education or accredited by an accreditation organization recognized by the Centers for Medicare and Medicaid Services (CMS).
GPR Standard #1-6:
1-6 The medical staff bylaws, rules, and regulations of the sponsoring, co-sponsoring, or affiliated hospital must ensure that dental staff members are eligible for medical staff membership and privileges including the right to:
- vote and hold office;
- serve on medical staff committees; and
- admit, manage and discharge patients.
GPR Standard #1-7:
1-7 Dental students/residents must be appointed to the house staff of the sponsoring, co-sponsoring, or affiliated hospital and enjoy the same privileges and responsibilities provided student/residents in other professional education programs.
AEGD Standard #1-6:
1-6 There must be opportunities for program faculty to participate in institution-wide committee activities.
AEGD Standard #1-7:
1-7 Dental students/residents must have the same privileges and responsibilities provided students/residents in other professional education programs.
Standard 2 – Educational Program
GPR Standard #2-6:
2-6 Students/Residents must be assigned to an anesthesia rotation with supervised practical experience in the following:
- preoperative evaluation;
- assessment of the effects of behavioral and pharmacologic techniques;
- venipuncture technique;
- patient monitoring;
- airway management and intubation;
- administration of pharmacologic agents;
- prevention and treatment of anesthetic emergencies; and
- assessment of patient recovery from anesthesia.
**THERE IS NO COMPARABLE STANDARD FOR AEGDs.
GPR Standard #2-7:
2-7 Students/Residents must be assigned to a rotation in medicine that has supervised practical experiences, to include:
- obtaining and interpreting the patient’s chief complaint, medical, and social history, and review of systems;
- obtaining and interpreting clinical and other diagnostic data from other health care providers;
- using the services of clinical, medical, and pathology laboratories; and
- performing a history and physical evaluation and collect other data in order to establish a medical assessment.
**THERE IS NO COMPARABLE STANDARD FOR AEGDs.
GPR Standard #2-11:
2-11 The program must provide student/residents with an understanding of hospital organization, functioning, and credentialing process.
**THERE IS NO COMPARABLE STANDARD FOR AEGDs.
GPR Standard #2-12:
2-12 Students/Residents must receive training and experience in the management of inpatients or same-day surgery patients, including:
- reviewing medical histories and physical examinations;
- prescribing treatment and medication;
- providing care in the operating room; and
- preparing the patient record, including notation of medical history, review of physical examination, pre- and post-operative orders, and description of surgical procedures.
**THERE IS NO COMPARABLE STANDARD FOR AEGDs.
Standard 3 – Faculty and Staff
**GPR & AEGD STANDARDS ARE IDENTICAL
Standard 4 – Educational Support Services
**GPR & AEGD STANDARDS ARE IDENTICAL
Standard 5 – Patient Care Services
**GPR & AEGD STANDARDS ARE IDENTICAL
