Dr. Bruce Baum in his January JADA commentary, "Inadequate Training in the Biological Sciences and Medicine for Dental Students: An Impending Crisis for Dentistry" (
JADA 2007;138 [1]:16–26
), hits the nail squarely on the head. It is my feeling that the bulk of internal medicine training that dental residents get takes place in hospital-based general practice residency (GPR) programs. In my 30-plus years of training dentists in GPRs, they enter our program with very little medical background from dental schools but, through physical diagnosis courses, lectures, case presentations and off-service rotations, they learn some medicine concerning medically compromised patients. It would be nice to have them enter a GPR program with some medical background, and Dr. Baum’s well-thought-out medical training model would certainly accomplish this.
Another model, however, could be to make it mandatory for state licensure, similar to the New York program, for all dental school graduates to participate in a one-year GPR program in which internal medicine could be taught more easily through already established programs and expanded on during this year of training. This would require more GPR programs around the country and would need input from organized dentistry and dental school administrators.
Both models certainly should be discussed, as the present medical training in dental schools is inadequate to treat our medically compromised patients confidently.
