The Faculty of Dental Medicine and Oral Health Sciences鈥� General Practice Residency (GPR) program provides dental medicine residents with hands-on experience across three main sites: the Jewish General Hospital (JGH), the Montreal General Hospital (MGH), and the Montreal Children鈥檚 Hospital (MCH). A new sub-speciality within the GPR program was introduced in 2023, allowing one resident to focus their training on geriatric and special care dentistry. We interviewed the first resident to take part, Dr. Bishoy Yacoub, on his experience of the one-year program so far, including the two 鈥榰nderserved鈥� populations it鈥檚 training him to treat, the importance of research, and the roles of his two mentors: Dr. Melvin Schwartz, Chief of Dentistry for the CIUSSS West-Central Montreal network of which the JGH is a member establishment, for Gerodontology and Dr. Chantal Czerednikow, Director of the Oral Health Clinic for the Neurodivergent Community at the MGH, for Special Care Dentistry.
A Dual Focus: Elderly and Neurodivergent Patients
What sets this program apart is its dual focus. It provides a comprehensive approach to dentistry for two often underserved populations: the elderly and the neurodiverse. 鈥淭reating them with equal importance, with equal amount of care, and with a tailored, adapted approach,鈥� Dr. Yacoub explains.
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Personalized Care: No 'One-Size-Fits-All' Approach
One of the program's key values is its emphasis on personalized care. Dr. Yacoub highlights that the residency teaches technical dental skills, fosters research, and also trains residents in behavioral management techniques. 鈥淲hat's essential to understand is that a one-size-fits-all approach doesn't work. Each person is unique in their needs and how they express themselves.鈥�
In a typical week, Dr. Yacoub spends two days in CIUSSS West-Central Montreal affiliated long-term care facilities treating elderly patients, and two days seeing patients from the neurodivergent population at the MGH (Fridays are reserved for reading and research). Each treatment day starts with a 鈥榤orning huddle鈥� to review upcoming cases and discuss plans as a team. 鈥淎nd when we sit as a team, we complete each other! Each one of us, if we know something extra 鈥� tips and tricks 鈥� we share it with each other.鈥� Based on careful examination of medical history and any previous knowledge of each patient, Dr. Yacoub鈥檚 team decides how to provide the best personalized care. 鈥淓very day is a learning experience,鈥� he says, 鈥渁nd every patient is a school.鈥�
Empathy, Communication, and Medical History: Crucial to Patient Care
The General Practice Residency program not only teaches residents how to treat patients, but how to truly care for them: understanding their needs, health conditions, and personal histories. Its holistic approach highlights the importance of empathy, communication and thorough knowledge to any dentist, but especially those dealing with these populations.
Engaging with patients and those close to them is critical to bridging communication gaps and enabling personalized treatment 鈥� after all, 鈥渇amilies and caregivers know their loved ones better than you, right?鈥� This level of communication also ensures the empathy key to properly caring for special needs patients, many of whom may have difficulty expressing themselves or need more time to process information. Thoroughly understanding a patient鈥檚 medical background is the final part of providing the personalized care the program instructs residents in. It helps prepare for potential emergencies and guarantees safe and appropriate treatments.
Interdisciplinary Collaboration for Holistic Care
Collaboration with other healthcare professionals is integral to the GPR program. It operates within an interdisciplinary framework, working closely with dental hygienists and assistants, physicians, nurses, pharmacists, social workers, nutritionists, and beneficiary attendants. 鈥淚t's one team and we are working in harmony with each other鈥� explains Dr. Yacoub, 鈥渢his multidisciplinary teamwork ensures that we address all aspects of a patient鈥檚 health, providing them with the best possible care.鈥�
Balancing Care with Research
According to Dr. Yacoub, 鈥渞esearch plays a pivotal role in the GPR program, especially when it comes to special needs.鈥� The GPR program doesn鈥檛 just focus on clinical skills but also encourages residents to engage in impactful research, with the aim of enhancing oral health and access to care for the elderly and the neurodivergent.
As resident, Dr. Yacoub is involved in several research projects, including a study with Dr. Schwartz focused on modulating oral bacteria to help prevent caries and inflammation. They hope this could help maintain tooth integrity in individuals less able to brush their own teeth, or those whose teeth it is difficult for others to brush.
The program also emphasizes the importance of improving access to care. Dr. Yacoub is working with Dr. Czerednikow to compile a list of dentists and specialists who are willing to provide care to individuals with special needs, a crucial part of ensuring that underserved populations have access to appropriate dental services.
"Hero" Mentors
According to Dr. Yacoub, the dedication of Doctors Schwartz and Czerednikow is what allowed the GPR program to exist. They created opportunities for residents to work in real-world settings, with the right tools and support. They designed the curriculum, recruited and trained support staff, secured resources, and have done everything in their power to make the program the success Dr. Yacoub sees it as. Their passion for teaching and their desire to see the next generation of professionals succeed makes them 鈥渉eroes鈥� in Dr. Yacoub鈥檚 eyes, inspiring him to aim for the same level of commitment in his career. They have shown him that being a mentor is about more than just sharing knowledge; it鈥檚 about being a model for passion, persistence, and the kind of empathy that makes a lasting impact.
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After the Program
Dr. Yacoub plans to continue his research, particularly in refining minimally invasive treatments 鈥� an idea he said he already vaguely had in mind but that 鈥渋ntegrating the program gave me the opportunity to realize it.鈥� He also aims to engage more deeply with the Canadian Society of Disability and Oral Health, an organization he became a member of thanks to the GPR program. Finally, the program has deepened Dr. Yacoub鈥檚 desire to pursue his passion for teaching: he hopes to pass on his zeal and knowledge to students and future residents, inspiring others to provide care to underserved populations.
Candidate Considerations
In Dr. Yacoub鈥檚 own words, candidates need 鈥渞esiliency, adaptability, openness to an interdisciplinary approach, empathy, and communication skills.鈥� The General Practice Residency program is no small undertaking, but it is an immensely rewarding one; Dr. Yacoub shared a story about an elderly patient he recently saw. She needed much dental work done, so he asked her what her chief complaint was. She pointed out a broken tooth which Dr. Yacoub set about repairing. When he was done, he handed her a mirror: 鈥淪he was so happy! I was happy and rewarded by the delight I saw in her eyes and of her companion and caregiver. We all were happy, and I went home happy!鈥�