Paediatric General Practice Residency

A general practice residency (GPR) is an additional year of training after graduation from an accredited undergraduate dentistry program. GPRs may be hospital and/or university-based.

A paediatric GPR is an additional year of training at a children's hospital that offers dentists an opportunity to enhance their clinical skills and training in the area of paediatric dentistry. Currently, there are only three accredited paediatric GPR programs in Canada.

Our program is fully accredited by the Commission of Dental Accreditation of Canada and is offered by the IWK Health Centre dental department in conjunction with the Dalhousie University Faculty of Dentistry's division of paediatric dentistry. These two departments consist of six paediatric dental specialists, a staff orthodontist, oral/maxillofacial surgeons, an endodontist, and a periodontist who all provide patient care with our residents. The IWK is a teaching hospital, so our residents also have many opportunities to interact with, and learn from, medical staff in other departments of the hospital.

Program locations

The IWK is a teaching hospital located in Halifax, Nova Scotia. It sits directly across the street from the Dalhousie University Faculty of Dentistry and serves as the paediatric tertiary/quaternary care centre for the Maritime provinces.

The IWK's 2021-22 annual report revealed that the centre saw 33,000 emergency department visits, 261,000 ambulatory/outpatient care visits, 14,000 acute inpatients, 4,000 paediatric surgeries, and hosted 1,000 learners. As the dental department is involved in the care of many of these patients, the IWK provides ample opportunity for residents to gain valuable experience in the management of paediatric patients.

Our residents spend most of their time caring for patients at the IWK. They also have the opportunity to teach and supervise Dalhousie University dentistry students in both preclinical and clinical settings.

Range of treatment provided

Our department cares for a diverse population of patients, many of whom of have difficulty tolerating treatment in a typical dental office setting or have special health-care needs. We regularly treat patients with a wide range of medical conditions, including those of a developmental, cardiac, oncological, rheumatologic, neuromuscular, genetic, craniofacial, and orthopedic nature.

The program has a clinical emphasis and patients are treated using a variety of methods, including basic behaviour guidance, nitrous oxide/oxygen analgesia/anxiolysis, oral sedation, and general anesthesia. Our residents will typically complete 60-75 sedations and 40-60 operating room cases during the year.

When they graduate, residents can apply with confidence for hospital privileges at regional health centres or surgical suites (subject to provincial guidelines).

The advanced training we provide has helped our residents consistently achieve acceptance into full two- or three-year paediatric dentistry specialty programs in Canada and abroad. It is important to note, however, that the desire to pursue paediatric specialty training is NOT a requirement for acceptance into our program.

Dental residents gain in-depth clinical skill in managing paediatric dental emergencies, including trauma and acute odontogenic infection/cellulitis. A dental assistant and attending paediatric dentist are always assigned to be on-call with our residents to help with emergencies that occur outside typical clinic hours.

Residents also provide care to patients as part of our cleft lip and palate and craniofacial team clinics and are given the opportunity to "follow" a family as they are evaluated by other members of the team, including plastic surgery, speech/language pathology, and audiology.

External rotations

External rotations offer valuable opportunities to observe physicians and other medical staff as they diagnose and treat patients. The goal of these experiences is to not only give residents clinical knowledge and experience, but to help them understand the roles different departments play within a collaborative care environment.

An understanding of the specialized treatments other services provide and the many different situations families/patients must navigate will ultimately enhance a dental provider's communications skills and lead to better care for patients. Experiences offered during external rotations depend on patient scheduling and take place at the discretion of departmental staff.

We currently provide the following external rotations:

Developmental medicine - This rotation enhances patient assessment skils and provides an understanding of the diagnosis and management of developmental conditions, such as autism spectrum disorders and cognitive delays.

Oncology/haematology - Residents gain an understanding of the complex management of patients with paediatric cancer and bleeding disorders and the impact these conditions have on the lives of patients and their families.

Cardiology - Observation in the IWK Children's Heart Centre and inpatient areas helps the resident to understand how to evaluate patients with heart problems and identify when pre-, peri-, and post-operative measures need to be taken to minimize adverse outcomes from dental treatment.

Anesthesia - Residents have one-on-one training with paediatric anesthesiologists in airway management, intubations, and IV placement/management. This training will enhance the skills needed to provide care safely to paediatric patients under sedation/general anesthesia and understand the risks involved in these situations.

Oral/maxillofacial surgery - Upon request, and taking the clinical schedule into account, a rotation is available with our oral/maxillofacial colleagues at the QEII Health Sciences Centre, which is next door to the IWK.

Other learning experiences

Grand Rounds - Residents attend weekly paediatric Grand Rounds, during which paediatric subspecialists present up-to-date reviews and research on a wide range of paediatric health-related topics.

Journal club - Several journal clubs are held throughout the year with the attending dentists. Research articles are assigned to residents, who will present a brief summary and lead a discussion on the topic. These clubs provide an opportunity for residents and attending dentists alike to learn and stay up-to-date with current research.

Case presentations - Our residents meet regularly with residents from the Dalhousie periodontic, adult GPR, and oral/maxillofacial surgery programs to present and discuss interesting cases. Residents are expected to document a case, including intra/extraoral photos and radiographs (if indicated/taken), and be prepared to present/discuss the history, management plan, and treatment progress of the patient.

Tumour Board - Residents attend weekly Tumour Board meetings. These meetings bring together physicians/staff from various departments and are meant to determine and provide updates on the course of treatment for patients with childhood cancers, the majority of whom are patients of the dental department.

Research - Residents are expected to complete a research project or presentation on a topic of special interest, which will be presented at IWK Grand Rounds. Paediatric attending dentists will approve the topics, help with topic/project planning, and supervise progress throughout the year.

Orientation sessions - Paediatric attending dentists provide a two-day orientation on a range of pertinent topics, including (but not limited to) infant oral healthare, pulp therapy, behaviour management, management of patients with haematology/oncology diagnoses, and dental trauma. In late June/early July, Dalhousie faculty present a range of didactic and hands-on sessions, including intra/extraoral photography, endodontic treatment techniques, medical emergencies, nitrous oxide/oxygen sedation, pharmacology, and feedback/evaluation in teaching.

Learning objectives

At the end of the program residents will:

• Be able to diagnose and treat paediatric oral pathological conditions using enhanced skills in paediatric dentistry, including sedation/general anesthesia when indicated.
• Treat children and adolescents with and without special health-care needs in an appropriate setting with a multidisciplinary approach using evidence-based protocols.
• Be competent to apply for privileges to practise dentistry in a hospital/clinical/operating room setting.
• Recognize complex medical conditions, co-operative challenges, and oral pathological needs that require the expertise of a paediatric dental specialist and initiate an appropriate referral.
• Gain skills required to work as a dental educator in a faculty of dentistry and participate in research.
• Have enhanced eligibility for advanced training as a specialist in paediatric dentistry or other dental specialty.

Other useful information

• Two resident positions are available each year.
• This program is one year in length, from mid-June to June 30 the following year.
• Residents are paid a stipend of $65,000.
  
• Three weeks of paid vacation are included (dates subject to faculty approval, taking into account the clinic/external rotation schedule).
• Residents are required to pay Nova Scotia student dental license fees, Nova Scotia Dental Association fees, and CDSPI malpractice insurance.
• Paediatric advanced life support certification is required and is paid for/reimbursed by the program.
  

Admission requirements

Admission requirements are outlined in the Faculty of Dentistry section of the Dalhousie University academic calendar. They include:

• $70 CAD application fee
• Registration/participation in the National Match Program process (a receipt/screen capture will suffice)
  
• Completed application form [PDF 607 kB]
  
• A DDS or DMD degree from a CDAC-accredited program or reciprocal degree from an accredited institution.
  
• Eligibility for student licensure in Nova Scotia. 
  
• NDEB certificate is preferred, but not required.
  
• Two letters of reference regarding your character and suitability for the residency program, submitted directly by the referees.
  
• Official academic transcripts from all colleges and universities that you have attended, forwarded directly from the institutions to Dr. Evan Shaw at the IWK Health Centre dental department.
  
• A current curriculum vitae
  
• A letter of intent
• Foreign-trained dentists, other than US-trained applicants, must possess a certificate issued by the National Dental Examining Board of Canada and must meet immigration requirements
• US-trained applicants must possess and send proof of successful completion of the Integrated National Board Dental Examination or National Board Dental Examination parts I and II.
• Completed Dalhousie University immunization record form [PDF 372 kB] - to be sent once you are matched to a program. All applicants must be fully vaccinated for COVID-19 in accordance with IWK Health Centre policy.
• NOTE: All application materials must be submitted in English.
  

How to apply

Application materials (including all supporting material) and the application form must be submitted by September 30.

Applications, supporting materials, and the application fee should be sent to the IWK dental department:

Dr. Evan Shaw
Dental Department, IWK Health Centre
5850/5980 University Avenue
PO Box 9700
Halifax, NS
B3K 6R8
Canada

Contact information:
Tel: 902.470.6678
Email: evan.shaw@iwk.nshealth.ca

Please feel free to contact us with any inquiries regarding the program.