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Dental Resident Reflects On Training That Fueled Her Passion for Dentistry

Capt. Rachel Duval in the operating room during oral maxillofacial surgery rotation.  [Photo credit: Courtesy of Capt. Rachel Duval]

By Vivian Mason

 

Army Capt. Rachel Duval, a Uniformed Services University Postgraduate Dental College student and second-year periodontal resident in the U.S. Army Advanced Education Program in Periodontics, at Fort Gordon, Georgia, distinctly remembers whirling through five hospital rotations that included four weeks in internal medicine, four weeks in oral maxillofacial surgery, two weeks in otolaryngology, three weeks in plastic surgery, and eight weeks in anesthesia. After completing clinical rotations throughout the week, Fridays were dedicated to academics; residents would attend lectures, review literature pertaining to periodontics, and present patient case reviews. 

By the end of Duval’s first year of residency (known as the “R1 year”), in addition to working on research, she also completed more than 261 hours of didactic coursework, took 22 exams, and attended several annual meetings. Furthermore, first- and second-year residents were required to attend Master’s-level courses at Augusta University as they worked toward attaining their Master’s degree in Oral Biology from USU.

Despite the whirlwind, Duval was inspired by the challenges.  “What I enjoyed most about the program,” she explains, “is that there is hardly any limitation to the types of procedures we can tackle. We are privileged to have the latest technology and treatment modalities at our disposal. The staff is amazing, as are our mentors. Everyone here wants you to succeed, which continues to fuel my passion for dentistry.”

Duval, pictured first row, fourth from the left, poses for the 2021 class photo. (Photo credit: Capt. Rachel Duval)
Duval, pictured first row, fourth from the left, poses for the 2021 class photo. (Photo credit: Capt. Rachel Duval)

Duval likens her first year in the program to “drinking out of a fire hose.”  

“There’s an enormous amount of information to absorb, and there’s a lot going on. You need to keep up with everything―your hospital rotations, your patients, your academic modules, and your courses at Augusta University, all while trying to balance familial and personal responsibilities.”  

During her R1 year, much of Duval’s focus was on evidence-based approaches to preventing, diagnosing, and treating periodontal disease. She gained experience in preserving sites after tooth extractions and placing dental implants. 

“Periodontology is not only about placing implants, but we also specialize in a lot of soft tissue procedures,” she notes. Periodontists specialize in a variety of both surgical and nonsurgical procedures, however, Duval is partial to the surgical components of the specialty. “I really enjoy surgery. There’s an art to it. In my opinion, periodontics is like the plastic surgery of dentistry. Like most of my co-residents, having a strong conceptual understanding of a procedure is crucial. Periodontics bridges the gap between what I can do clinically and what I understand theoretically.” 

Army Capt. Rachel Duval, a resident in the U.S. Army's  Advanced Education Program in Periodontics, Tingay Dental Clinic, Army Postgraduate Dental College (PDC) at Fort Georgia. (Photo credit: Capt. Rachel Duval)
Army Capt. Rachel Duval, a resident in the U.S. Army's 
Advanced Education Program in Periodontics, Tingay Dental
Clinic, Army Postgraduate Dental College (PDC) at Fort
Georgia. (Photo credit: Capt. Rachel Duval)
Among her experiences, Duval recalls assisting a fellow resident who was performing a crown-lengthening periodontal procedure that embodied more of the plastic surgery aspect of periodontology. She also planned treatment for cases of severe periodontal disease. Duval says all of this exposed her to a wide diversity of patients and conditions, as well as to advanced technologies and treatments. 

Fort Gordon houses three residency programs at Tingay Dental Clinic: periodontics, prosthodontics, and endodontics. While oral and maxillofacial surgery is just next door at Dwight D. Eisenhower Army Medical Center (DDEAMC), periodontic residents work closely and often network with their oral surgery colleagues.  

The five to six months spent at DDEAMC was not only necessary to solidify medical knowledge and gain experience, but it also ultimately gave the residents an opportunity to network with their medical colleagues. She believes that one of the most overlooked aspects of professional training is networking. 

“Having mentors and advisers both within and outside of your specialty during your R1 year is incredibly valuable,” Duval adds.

There were a few rotations that Duval says she enjoyed most. “The anesthesia rotation prepared me for administering and monitoring moderate IV sedation cases.”  She continues, “It was an incredible experience. We learned how to place IVs, manage airways, and intubate patients in the operating room (OR). We also learned how to manage potential medical emergencies that we may encounter chairside.

“I also enjoyed my oral surgery rotation because I became more proficient at surgical third molar extractions, which is not something periodontists routinely do. In addition, we were able to scrub in on a lot of fascinating cases in the OR.”

Duval recalls that they had a week in between rotations to assist second- and third-year residents. Sometimes, the R1 residents helped with running sedations or taking photographs during surgeries. 

“We were assigned to a third-year resident, who helped orient us to the clinic. The third-years showed us how to properly set up for surgeries. Being paired with a third-year resident gave us the opportunity to learn from them and become familiar with our surgical armamentarium.”

(Left to right): Army Lt. Col. Munoz, Capt. Duval, Maj. Retrum, and Capt. Colamamarino conduct rounds as first-year dental residents. (Photo credit: Capt. Rachel Duval)
(Left to right): Army Lt. Col. Munoz, Capt. Duval, Maj. Retrum, and Capt. Colamamarino conduct rounds as first-year dental residents.
(Photo credit: Capt. Rachel Duval)

Duval admits that, while sitting through her many lectures, she was eager to jump into surgery, but needed the strong foundation of information to understand what was truly going on before she could take the plunge.

“Now, as a second-year resident doing my own surgeries,” Duval adds, “I’ve been able to connect the dots and make sense of what I learned last year.” 

In addition to being in the clinic, as well as the didactics, a periodontal research project in partial fulfillment of the Master’s degree (leading to a thesis and manuscript suitable for publishing in a periodontal, medical, or basic sciences journal) is initiated during this year. This three-year program is filled to the brim with much to learn.

Duval advises R1 residents to “make the most of the year,” taking advantage of every moment and using the time to stay abreast of all the assigned readings. 

“It’ll be difficult. But just remember that you’ll revisit topics in second year, then again in third year, and eventually it will start to stick. Residency is the perfect time to fail, make mistakes, and learn from them.”  

Duval admits that her R1 year was not easy. “There’ll be another two years of more challenges, but that’s what I signed up for. The support of my family, co-residents, and mentors keeps me going. I’ve only begun my second year, and I've already acquired so much knowledge. That’s why I embrace this once-in-a-lifetime learning opportunity.”