Charting Progress

The=20 lesson that endures unchanged is the critical need for dental= =20 schools to mesh their priorities with their parent=20 institutions.

A=20 Monthly Newsletter from ADEA Executive Director Richard W. Valachovi= c,=20 D.M.D., M.P.H.

In this month's letter, Dr. Rick Valachovic= ,=20 Executive Director of the American Dental Education Association, loo= ks at=20 the relationship between dental schools and their parent=20 institutions.

Metaphors, Similes, Service, a= nd=20 Survival

This is my month to offer you f= igures=20 of speech. Have you heard these before?

=C2= =B7 =20 "A dental school is the front porch of a university." To many people= , we=20 are the face of the university, because we lead in community service= .=20 Dental school patient care clinics welcome community residents and i= nvite=20 them in=E2=80=94and many times they are among the few parts of the u= niversity that=20 do so.

=C2= =B7 =20 "A university is like a tree." If your dental school allows itself t= o be=20 an isolated branch of that tree, it is easy to lop it off. Embrace t= hat=20 tree trunk! Integrate your school into the university and its=20 mission.

=C2= =B7 =20 "Within the university family, there have been times when the dental= =20 school has resembled a reticent teenager who shuts himself in his ro= om=20 with his computer, pursuing his own interests, rather than joining t= he=20 family picnic."

That last is a quote from The Value o= f the=20 Dental School to the University, a discussion paper written for = the=20 1998 ADEA (then AADS) Leadership Summit that for the first time brou= ght=20 together dental school deans and senior university administrators to= =20 discuss the future of academic dentistry.

During this time period a unive= rsity=20 administrator generally had no trouble affirming the value of the de= ntal=20 school to the parent institution. The dental school was the "front p= orch"=20 that, for instance, gave a university president a way of demonstrati= ng the=20 institution=E2=80=99s public contact and public service to the gover= ning board.=20 The dental school was a source of curriculum innovation that could b= e=20 applied universitywide. It was the home of research that was of inte= rest=20 to many other disciplines and specialties within the=20 institution.

Paradoxically, in this era, the= =20 vulnerability of dental schools was writ large: By 1993 six schools = had=20 closed, and another would close in 2001. The high cost of dental edu= cation=20 was a universal factor, but it was not the whole story behind these= =20 closings. For complex reasons, these schools had become dispensable = to=20 their parent institutions.

A different story was also bein= g=20 written=E2=80=94although we couldn=E2=80=99t have known it at the ti= me. This thought has=20 come to me as the Arizona School of Dentistry and = Oral=20 Health (ASDOH) is about to graduate its first class at a ceremon= y in=20 Mesa. ASDOH, along with Nova Southeastern University Colleg= e of=20 Dental Medicine in Fort Lauderdale, Florida, and the University of Nevada, Las Veg= as=20 School of Dental Medicine have debuted in the past 10=20 years.

There are three more schools on= the=20 way. Midwestern University<= /A> is=20 accepting its first class for fall 2008 at its Glendale, Arizona, ca= mpus.=20 A dental school at East Carolina University in Greenvi= lle,=20 North Carolina, is being planned. And Western Univer= sity of=20 Health Sciences in Pomona, California, announced at the end of 2= 006=20 that it would form a College of Dental Medicine.

So, what is this new story's mo= ral?=20 Some schools vanish, but new schools are born, to be sure. But the l= esson=20 that endures unchanged is the critical need for dental schools to me= sh=20 their priorities with their parent institutions. A dental school nee= ds to=20 resist insularity (the reticent teenager, the isolated tree branch) = and=20 make its value to the university and to the community as highly visi= ble as=20 a welcoming front porch.

One of our contemporary "givens= " is=20 that a dental school belongs in a university setting but, you know, = that=20 wasn=E2=80=99t always the case. In fact, in 1865, only 15 percent of= dentists in=20 the United States were graduates of any kind of school=E2=80=94the r= est had served=20 some kind of apprenticeship. The University of Maryland= Dental=20 School is the direct descendant of the world's first dental coll= ege,=20 the Baltimore College of Dental Surgery, which was chartered by an a= ct of=20 the Maryland General Assembly in 1840. Harvard=E2=80=99s den= tal school=20 became the first university-based U.S. dental education program in 1= 867,=20 and by 1884 there were 10 university-based schools. However, most of= the=20 almost 60 dental schools operating at the turn of the 20th century w= ere=20 freestanding, for profit, and of dubious quality. State legislatures= =20 stepped in to mandate licensing exams and to try to keep graduates o= f=20 proprietary schools from taking them.

Two turning points in the 1920s= =20 encouraged a rapid shift toward university-based dental education. T= he=20 first was the formation in 1923 of the American Association of Denta= l=20 Schools (AADS), ADEA's predecessor organization. The second was the = 1926=20 publication of the Gies report on dental education, written for the= =20 Carnegie Foundation for Teaching by Dr. William J. Gies, whose name = may=20 also be familiar to you from the ADEAGies Foundation.

A Columbia University biochemis= t with a=20 strong interest in dental research, Dr. Gies made such a compelling = case=20 for university-based dental education that the point became virtuall= y=20 indisputable. As The Value of the Dental School to the University pu= ts it,=20 "the university is the best place for schools of dental medicine, fo= r the=20 sake of both the school and the university, as it is the key place i= n=20 American life and culture that supports both learning and research,= =20 bestows credibility on individuals, and valorizes=20 pursuits."

Interestingly, four of the six = new=20 dental schools, including ASDOH, are associated with schools of=20 osteopathic medicine. This is as good a juncture as any to dispel an= y=20 lingering doubts about the credibility of that connection. Suffice i= t to=20 say, U.S. medical schools that grant the D.O. degree and those that = give=20 the M.D. degree have similar curricula. The degrees are equivalent, = and=20 the recipients of the degrees are almost universally licensed by the= same=20 state boards of medicine. D.O. graduates compete equally with M.D. graduates for the most prestigious residency slots in hospitals thro= ughout=20 the country. Osteopathic medicine=E2=80=99s emphasis on treating the= whole=20 person=E2=80=94body, mind, and spirit=E2=80=94fits well with dentist= ry. We in dental=20 education have long been pointing out the holistic concept that oral= =20 health is a key to systemic health. The mouth is a part of that whol= e=20 person, and it matters!

What matters most to ASDOH=E2= =80=99s parent=20 institution, the A.T. Still University of Health Sciences, is establ= ishing=20 and nurturing programs to fill substantial unmet health care needs i= n=20 Arizona. At ASDOH, fourth-year dental students have been rotating th= rough=20 community clinics, including those that serve Native Americans. They= will=20 graduate with both a D.M.D. degree and a certificate in public healt= h=20 management. If they wish, they can use the certificate credits to wo= rk=20 toward a master=E2=80=99s degree in public health from the Universit= y of North=20 Carolina at Chapel Hill. So, the presence of a school of dentistry n= ot=20 only lends prestige to the A. T. Still campus but also reinforces it= s=20 public health mission.

"Centrality of mission" was a t= heme=20 that ran through our landmark 1998 summit meeting of dental school d= eans=20 and university administrators. Looking back, I am struck by the cont= inuing=20 relevance of the issues and advice. "How can the deans tell what the= =20 university executives are thinking about in terms of centrality of=20 mission?" one participant asked, and another immediately responded, = "The=20 first thing is to open up the dialogue." (The Summit=20 Proceedings, by the way, are interesting reading.)

And here are more ideas=E2=80= =94some for deans=20 and senior administrators, some also for others=E2=80=94for improvin= g and=20 strengthening your school's relationship with the rest of the univer= sity,=20 gleaned from the summit and from more recent reflection.<= /P>

=C2= =B7 =20 Give thought to how the dental school can be integrated into univers= ity=20 life through teaching, research, and public service. As a former=20 university president advised, integrate and, if necessary, "infiltra= te and=20 even ingratiate."

=C2= =B7 =20 Become involved in university governance. Put your best people forwa= rd for=20 committee assignments, particularly for committees to select vice=20 presidents and other deans.

=C2= =B7 =20 Blow your own horn, inside and outside the university. Take every=20 opportunity you can to let people know the importance of oral health= and=20 oral health research, the role your school is playing, and the value= of=20 your work to society. And don=E2=80=99t be afraid to state the obvio= us=E2=80=94it may not=20 be obvious to others. The authors of a Journal of Dental Education=20 article, "Perce= ptions=20 of Dental Schools from Within and Outside the University," inter= viewed=20 a state legislator who "was indignant when informed about the link b= etween=20 periodontal disease and systemic disease and demanded to know why th= is=20 information had not previously been made available to his=20 office."

=C2= =B7 =20 Participate in national organizations and specialty associations. Na= tional=20 exposure brings prominence back to the parent institution.

=C2= =B7 =20 Think of yourself not only as part of the dental education community= but=20 also as part of the higher education community and the academic heal= th=20 community.

And may your school live long a= nd=20 prosper=E2=80=94on the front porch of your university.

Richard=20 W. Valachovic, D.M.D., M.P.H.
Executive Director
valachovicr@adea.org=20

American Dental Education=20 Association

1400 K Street, NW, Suite 1100, Washington, DC= =20 20005
For member service questions, call toll free 888-ADEA OPEN= =20 (888-233-2673)
Phone: 202-289-7201 Fax: 202-289-7204
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