Benchmarks in Oral and Maxillofacial Surgery Education and TrainingBenchmarks in Oral and Maxillofacial Surgery Education and Training
These Benchmarks are offered for use in evaluation of oral and maxillofacial surgery residents in the context of their participation in a residency
training program. These Benchmarks are intended as a basis for the assessment of a resident’s progress in various practice domains specific to thespecialty.
This project was initiated in response to the desire to increase the use of outcomes measurement in assessment of the oral and maxillofacial
surgery residency educational process. There has also been a perceived need, in some institutions, to assess oral and maxillofacial surgery
residents in a manner consistent with other graduate medical education programs.
This document was a collaborative effort between the AAOMS Committee on Residency Education and Training and the OMS Faculty Section
Executive Committee and has been reviewed by the AAOMS Board of Trustees.

Editors

Vincent J. Perciaccante, DDSDavid C. Stanton, DMD, MD, FACS

Authors

Jeffrey D. Bennett, DMD
Larry L. Cunningham, Jr., DDS, MD, FACS
Alan S. Herford, DDS, MD, FACS
D. David Kim, DMD, MD, FACS
Gregory M. Ness, DDS
Vincent J. Perciaccante, DDS
Jon D. Perenack, DDS, MD
Faisal A. Quereshy, DDS, MD, FACSDavid C. Stanton, DMD, MD, FACS
Steven M. Sullivan, DDS
B.D. Tiner, DDS, MD, FACS
Brent B. Ward, DDS, MD, FACSAAOMS Staff
Mary Allaire-Schnitzer
Randi V. Andresen
Penelope Evans2

A general interpretation of each level for oral and maxillofacial surgery is as follows; this may vary by Practice Domain:
Critical Deficiencies: These learner behaviors are not within the spectrum of developing competence. Instead, they demonstrate significant
deficiencies in a resident’s performance.
Level 1: Describes behaviors of an early learner.
Medical Knowledge:
Patient Care:

Basic knowledge
Participates

Level 2: Describes behaviors of a resident who is advancing and demonstrating improvement in performance related to benchmarks.
Medical Knowledge:
Patient Care:

Intermediate knowledge
Provides with supervision or assistanceLevel 3: Describes behaviors of a resident who substantially demonstrates the benchmarks identified for an oral and maxillofacial surgeon who isready for unsupervised, independent practice. This level is designed as the minimal graduation target, but a resident may achieve thesebenchmarks at any point during residency. In addition to the provided language, the OMS Parameters of Care may serve as additional guidelines forthe medical knowledge and patient care outcomes expected of Level 3.
Medical Knowledge:
Patient Care:

Advanced knowledge
Provides independently

Level 4: Describes behaviors of a resident who has advanced beyond the minimal benchmarks that describe unsupervised independent practice.
These benchmarks reflect the competence of a role model. It is expected that exceptional residents will demonstrate these benchmark behaviors.
Medical Knowledge:
Patient Care:

Expert knowledge
Provides complex care independently

Additional Notes
Level 4 is the aspirational goal of training, but does not represent the minimal requirements for graduation.
Decisions about readiness for graduation are the purview of the residency program director.
Some benchmark descriptions include statements about ability to perform independently. These activities must occur in conformity withinstitutional and program supervision policies and guidelines.
3

The diagram below presents an example set of Benchmarks for Practice Domain in the same format as the Benchmark evaluations.
For each reporting period, a resident’s performance on the benchmarks for each Practice Domain will be indicated by:• selecting the benchmark level that best describes the resident’s performanceOr• selecting the “Critical Deficiencies” response option
Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Comments:

The resident demonstrates the knowledge or behavior of the identified
benchmarks of the preceding level and some, but not all, of the knowledge
or behavior of the identified benchmarks of the subsequent Level.

The resident has demonstrated all of theknowledge or behavior of the identified
benchmarks within this Level.

4Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Level 1Anesthesia andMedicine

Medical Knowledge

The resident lacks abasic understandingof medicine andanesthesia beyond
that expected of ageneral dentist.

Demonstrates
intermediateknowledge ofanesthetic
pharmacology
Demonstrates
intermediateknowledge ofcommon medical
conditions
Demonstrates
intermediateknowledge ofdifficult airway
management
Achieves ACLS
certification

Date:

Level 2

Level 3

Level 4

Demonstrates
advanced knowledgeof anesthetic
pharmacology

Demonstrates expert
knowledge ofanesthetic
pharmacology

Engages in outcomesbased research

Demonstrates
advanced knowledgecommon medical
conditions

Demonstrates expert
knowledge ofcommon medical
conditions

Demonstrates
advanced knowledge
difficult airway
management

Demonstrates expert
knowledge ofdifficult airway
management

Demonstrates
intermediateknowledge ofcomplex anduncommon medical
conditions

Demonstrates
advanced knowledgeof complex anduncommon medical
conditions
Achieves PALS
certification

Comments:

5

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4Pre-anesthetic
Assessment of Adult
Patients

Patient Care

The resident obtains
an inaccurate or
incomplete medical
history.

Performs
comprehensive
medical history andphysicalexamination ofroutine patientswith assistanceIndependently
performs
comprehensive
medical history andphysicalexamination ofroutine patients

Independently
performs
comprehensive
medical history andphysicalexamination ofcomplex patients

Models and teaches
performance ofcomprehensive
medical history andphysicalexamination

Performs targeted
physical examination
to assess a patient’s
airway with assistanceIndependently
performs targeted
physical examination
to assess a patient’s
airwayIntegrates information
between medical
history and physicalexamination

The resident performs
an inaccurate or
incomplete physicalexamination.
The resident fails torecognize criticalcomponents of the
medical history or key
findings in thephysical examination.
The resident fails torecognize patientsthat are inappropriate
candidates for officebased anesthesia.

Selects appropriate
diagnostic studies andconsultations withassistanceIndependently obtains
appropriate diagnostic
studies andconsultations

Independently
interprets diagnostic
studies
Independently
recognizes need forpre-anesthetic
optimization ofpatients, whenappropriate

Comments:

6

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4Pre-anesthetic
Assessment ofPediatric Patients

Patient Care

The resident obtains
an inaccurate or
incomplete medical
history.

Performs
comprehensive
medical history andphysicalexamination ofroutine patientswith assistanceIndependently
performs
comprehensive
medical history andphysicalexamination ofroutine patients

Independently
performs
comprehensive
medical history andphysicalexamination ofcomplex patients

Models and teaches
performance ofcomprehensive
medical history andphysicalexamination

Performs targeted
physical examination
to assess a patient’s
airway with assistanceIndependently
performs targeted
physical examination
to assess a patient’s
airwayIntegrates information
between medical
history and physicalexamination

The resident performs
an inaccurate or
incomplete physicalexamination.
The resident fails torecognize criticalcomponents of the
medical history or key
findings in thephysical examination.
The resident fails torecognize patientsthat are inappropriate
candidates for officebased anesthesia.

Selects appropriate
diagnostic studies andconsultations withassistanceIndependently obtains
appropriate diagnostic
studies andconsultations

Independently
interprets diagnostic
studies
Independently
recognizes need forpre-anesthetic
optimization ofpatients, whenappropriate

Comments:

7

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2Anesthetic Plan and
Administration for
Adult Patients

Patient Care

The resident fails
to complete a
pre-anesthetic
checklist of
drugs, equipment
or
instrumentation.

Assembles andutilizes appropriate
anestheticarmamentariumwith assistanceIndependently
assembles andutilizes appropriate
anestheticarmamentarium

Formulates
customized
anesthetic plan withassistanceIndependently
formulates
customized
anesthetic plan for
adult patients

The resident fails
to formulate or
implement anappropriate
anesthetic plan.
The resident fails torecognize the need forpre-anesthetic
optimization ofpatients andconsultations, whennecessary.
The resident fails torecognize criticalmonitoring data.

Performs routine
moderate sedation
with supervision

Performs all levelsof routine
anesthetics for adultand pediatricpatients withsupervision
Independently
recognizes
anesthetic
complications

Level 3

Independently
performs
appropriate
anesthetic forcomplex patients

Level 4Engages inoutcomes based
research

Independently
interprets datafrom standard
monitors
Independently
manages routine
anesthetic
complications
Performs
successfully insimulated crisis
management

The resident fails torecognize patientsthat are inappropriate
candidates for officebased anesthesia.

Comments:

8

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Anesthetic Plan and
Administration for
Pediatric Patients

Patient Care

The resident fails
to complete a
pre-anesthetic
checklist of
drugs, equipment
or
instrumentation.

Assembles andutilizes patient
appropriate
anestheticarmamentariumwith assistance inpediatric patients

Independently
assembles andutilizes patient
appropriate
anestheticarmamentarium inpediatric patients

The resident fails
to formulate or
implement anappropriate
anesthetic plan.

Appropriately
customizes monitor
alarm limits forpediatric patients

Formulates
customized
anesthetic plan for
pediatric patientswith assistance

The resident fails torecognize the need forpre-anesthetic
optimization ofpatients andconsultations, whennecessary.
The resident fails torecognize criticalmonitoring data.
The resident fails torecognize patientsthat are inappropriate
candidates for officebased anesthesia.

Level 1

Date:

Determines
appropriate weightbased dosages ofanesthetic agents inpediatric patients

Level 2

Performs routine
moderate sedation
with supervision inpediatric patients

Level 3

Level 4

Independently
formulates
customized
anesthetic plan for
pediatric patients

Independently
performs all levelsof routine
anesthetics forpediatric patients

Independently
interprets datafrom standard
monitors forpediatric patients

Independently
manages routine
anesthetic
complications inpediatric patients

Performs all levelsof routine
anesthetics forpediatric patientswith supervision

Engages inoutcomes based
research

Independently
recognizes
anesthetic
complications in thepediatric patient
Performs
successfully insimulated crisis
management

Comments:

9

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Level 1Anesthesia – Airway
Skills and Parenteral
Access in Patients

Patient Care

The resident fails torecognize airway
obstruction.

Independently
placesoropharyngeal andnasopharyngeal
airways

The resident fails to
successfully ventilate
the routine airway.
The resident fails toassemble theappropriate airway
armamentarium.
The resident fails torecognize an
infiltrated intravenousline

Performs laryngeal
mask airway
placement withsupervision
Performs placementof intravenous
catheters in routine
patients withsupervision
Independently
preparesintravenous fluids
for administration

Date:

Level 2

Level 3

Performs
endotracheal
intubation withsupervision

Independently
performs
endotracheal
intubation

Independently
performs laryngeal
mask airway
placement

Performs advanced
airway techniques(e.g., fiberoptic
intubation, awake
intubation) withsupervision

Independently
performs
placement of
intravenous
catheters

Level 4
Independently
performs advanced
airway techniques(e.g., fiberoptic
intubation, awake
intubation)

Independently
performs prolonged
mask ventilation
Performs advanced
techniques to secureaccess to administer
drugs (e.g.,
intraosseous)Comments:

10

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Level 1Anesthesia – Airway
Skills and Parenteral
Access in PediatricPatients

Patient Care

The resident fails torecognize anatomical
airway differences in apediatric patient.

Independently
placesoropharyngeal andnasopharyngeal
airways

The resident fails torecognize airway
obstruction.
The resident fails to
successfully ventilate
the routine airway.
The resident fails toassemble the patient
appropriate airway
armamentarium inthe pediatric patient.
The resident fails torecognize an
infiltrated intravenousline

Performs laryngeal
mask airway
placement withsupervision
Performs placementof intravenous
catheters in routine
patients withsupervision
Independently
preparesintravenous fluids
for administration

Date:
Level 2

Level 3

Performs
endotracheal
intubation withsupervision

Independently
performs
endotracheal
intubation

Independently
performs laryngeal
mask airway
placement

Performs advanced
airway techniques(e.g., fiberoptic
intubation, awake
intubation) withsupervision

Independently
performs
placement of
intravenous
catheters
Performs
intramuscular
injections withsupervision

Level 4
Independently
performs advanced
airway techniques(e.g., fiberoptic
intubation, awake
intubation)

Independently
performs prolonged
mask ventilation
Independently
performs
intramuscular
injections
Performs advanced
techniques to secureaccess to administer
drugs (e.g.,
intraosseous)Comments:

11

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Pain Management

Medical Knowledge

The resident lacks alevel of understandingof opioid and nonopioid analgesic
pharmacology beyond
that expected of ageneral dentist.

Demonstrates
intermediateknowledge of opioidand non-opioid
analgesic
pharmacology

Demonstrates
advanced knowledgeof opioid and nonopioid analgesic
pharmacology

Demonstrates expert
knowledge of opioidand non-opioid
analgesic
pharmacology

Demonstrates expert
knowledge of medical
and pharmacologicalmanagement ofchronic facial pain

Demonstrates
advanced knowledgeof thepathophysiology ofacute and chronicpain

Demonstrates expert
knowledge of thepathophysiology ofacute and chronicpain

Demonstrates
intermediateknowledge of thepathophysiology ofacute and chronicpainComments:

12

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Level 1Pain Management

Patient Care

The resident fails torecognize or treat
procedural pain.

Independently
manages
uncomplicatedprocedural pain.

The resident fails torecognize impact ofprescribing practices
and substance use
disorders.

Recognizes substanceseeking behavior

Date:

Level 2

Level 3

Manages complex
procedural painwith assistanceIndependently
manages complex
procedural pain

Recognizes chronic
pain conditions

Independently
manages
uncomplicatedchronic pain
conditions

Level 4
Independently
manages complicatedchronic pain
conditions

Recognizes the needfor consultation withpain management
specialist

Comments:

13

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Dentoalveolar and
Pre-Prosthetic
Surgery

Medical Knowledge

The resident lacks
the level ofunderstanding ofdentoalveolar
surgery, local
anesthetics orradiographic
interpretation
beyond that
expected of a general
dentist.

Demonstrates basic
knowledge of thepertinent head and neckanatomyDemonstrates
advanced knowledgeof the common
complications
associated with
dentoalveolar/preprosthetic surgery
and the appropriate
treatment options

Demonstrates expert
knowledge of bone healing
and complications
associated with radiation
and anti-resorptive
medications

Educates colleagues
and other
professionals

Demonstrates basic
knowledge ofappropriate indications
for antibiotic
prophylaxis
Demonstrates basic
knowledge of normal
radiographic
anatomy (e.g.,
panoramic views,
periapical views)
Demonstrates basic
knowledge of thepathophysiology of
periapical pathology
Demonstrates
advanced knowledgeof the use of local
hemostatic
techniques (e.g.,cellulose, fibrin
sprays)Demonstrates
advanced knowledgeof pathologic
radiographic
anatomy (e.g.,
panoramic andperiapical views)
Demonstrates
advancedknowledge of the
management of
impacted teeth(including
orthodontic
management)

Engages in outcomesbased research

Demonstrates expert
knowledge of care ofpatients receiving
radiation/chemotherapy
Demonstrates advanced
knowledge of advanced
hemostatic techniques(e.g., transfusion
products)
Demonstrates expert
knowledge ofprovision of surgicalcare in patients withcomplex medical
conditions
Demonstrates expert
knowledge of hardand soft tissue
grafting techniques
and wound healing

Comments:

14

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Dentoalveolar and
Pre-Prosthetic
Surgery

Patient Care

The resident lacks thelevel of skill in
dentoalveolar surgery
beyond that expectedof a general dentist.

Level 1
Independently
performs routine
dental extractions
Independently
performs routine
intraoral suturing
Provides routine
post-operative
care
Performs surgicalextractions withassistance whenindicated
Obtains appropriate
routine radiographs
Recognizes
common surgicalcomplications

Date:

Level 2

Level 3

Level 4

Independently
performs routine
procedures (e.g.,
biopsy, incision anddrainage ofabscess)

Independently
formulates
treatment plansand performs preprosthetic surgeries

Models and teaches
dentoalveolar
surgical skills.

Independently
performs hardtissue procedures(e.g., alveoloplasty,
tori removal)
Independently
performs surgicalextractions
Manages surgicalcomplications withassistanceManages surgicalcomplications

Engages inoutcomes based
research

Formulates atreatment plan forpatients withcomplex medical
issues andcollaborates carewith other providers
Independently
performs complex
procedures (e.g.,
vestibuloplasty,
gingival grafts)

Comments:

15

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Maxillofacial
Infection

Medical Knowledge

The resident lacks anunderstanding of thepertinent anatomy,
microbiology,
immunology andpharmacology.

Demonstrates basic
knowledge of thesigns and symptomsof serious
maxillofacial infection

Demonstrates
intermediateknowledge of the
postoperative
progress of patientswith maxillofacial
infection

Demonstrates
advanced knowledgeof the management of
the critically ill
infection patient

Demonstrates
expert knowledgeof the managementof the critically ill
infection patient

Demonstrates basic
knowledge of theprinciples of airway
management inpatients with serious
odontogenic
infections
Appropriatelyinterprets laboratory
valuesDemonstrates
intermediateknowledge of the
management ofserious maxillofacial
infection

Demonstrates
advanced knowledgeof the criteria for
extubation of patientswith serious
maxillofacial infection
Demonstrates
advanced knowledgeof thepathophysiology ofsepsisComments:

16

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Maxillofacial
Infection

Patient Care

The resident is unable
to recognize apotentiallycompromised airway
or life threatening
infection.

Independently
recognizes apotentiallycompromised airway
or life threatening
infection

Manages acute airway
compromise withassistanceIndependently
manages orcoordinatesinterdisciplinary careof acute airway
compromise

The resident fails toseek higher level
management, whenindicated, in a timely
manner.

Selects appropriate
antibiotic therapy

Manages thecritically ill
maxillofacial
infection patient(e.g., sepsis,
ventilatory support,
nutrition)

Independently
manages patientswith simple infections
Participates in theinitial managementof patients withserious maxillofacial
infection

Utilizes anatomic
knowledge andimaging to plan
appropriate surgery
Provides routine
inpatient andoutpatient carefollowing incision anddrainage procedures
Independently andaccurately assesses
infection severity
and initiates
necessary level ofcare

Coordinatescomprehensive
multidisciplinary
management of theserious maxillofacial
infection
Independently
performs surgery forserious maxillofacial
infections

Comments:

17

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Maxillofacial Trauma

Medical Knowledge

The resident lacks abasic understandingof pertinent anatomy.

Demonstrates basic
knowledge ofcommon facial
fracture patterns
and classification
systems

Demonstrates
intermediateknowledge ofappropriate use ofimaging modalities inmaxillofacial trauma

Demonstrates
advanced knowledgeof the principles oftreatment sequencing
in panfacial trauma

Demonstrates basic
knowledge of theincidence andmanagement
implications ofother concomitant
injuries

Demonstrates
intermediateknowledge of the
etiology andincidence of the lateeffects ofmaxillofacial injury

Demonstrates basic
knowledge of theroutine use of
maxillomandibular
fixation devices

Demonstrates
intermediateknowledge of thetrauma survey

The resident lacks anunderstanding ofbasic surgicalprinciples of hard andsoft tissue
management.
The resident lacks abasic understandingof wound healing.

Demonstrates basic
knowledge of theprinciples of thesurgical treatmentof hard and soft
tissue injuries andosteosynthesis

Demonstrates
advancedknowledge of thesurgical principles
of complex
procedures

Level 4
Demonstrates
advancedknowledge of the
management oflate sequelae andcomplications offacial trauma

Achieves ATLS
certification

Demonstrates
intermediateknowledge of therelevant anatomyof common
approaches to thefacial skeleton

Comments:

18

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Maxillofacial Trauma

Patient Care

The resident isunable toperform anadequate history
and physicalexamination.

Orders appropriate
diagnostic andimaging studies

Manages acute airway
compromise withassistanceAccurately interprets
imaging studies forminor maxillofacial
traumaAccurately interprets
imaging studies

Independently
manages orcoordinatesinterdisciplinary careof acute airway
compromise

The resident fails
to recognize
concomitant
injuries.
The resident isunable to treat
dentoalveolar orminor soft tissue
injuries.
The resident isunable torecognize airway
compromise.

Requests appropriate
consultation forconcomitant injuries
Provides routine
post-operative care
Participates in thesurgical managementof the complex
maxillofacial trauma
patient

Independently
formulates atreatment plan forroutine facial trauma
Independently
performs routine
procedures (e.g.,closed reduction)
Manages
complications withassistanceLevel 4
Independently
manages complex
secondarydeformities

Independently
performs complex
procedures
Independently
manages
complications
Independently
formulates atreatment plan forpatients withcomplex injuries,
polytrauma andcomorbidities

The resident is unable
to recognize common
postoperative
problems.

Comments:

19

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Skeletofacial
Deformities andObstructive Sleep
Apnea

Medical Knowledge

The resident lacks abasic understandingof skeletofacial
deformities orobstructive sleep
apnea.

Demonstrates basic
knowledge of thegrowth anddevelopment of the
craniofacial skeleton

Demonstrates
intermediateknowledge ofcephalometric analysis

Demonstrates
advanced knowledgeof the vascularsupply to themaxillofacial region
and its implications
for surgicaltreatment

Demonstrates
advanced knowledgeof maxillofacial
anatomy and its
implications forcomplex surgicaltreatment

The resident lacks abasic understandingof the pertinent
anatomy.

Demonstrates basic
knowledge of theclassification ofskeletofacial
deformities
Demonstrates basic
knowledge of the roleof multidisciplinary
treatment ofskeletofacial
deformities
Demonstrates basic
knowledge ofessential
cephalometriclandmarks
Demonstrates
intermediateknowledge of thepathophysiology of
obstructive sleep
apnea

Demonstrates
intermediateknowledge of surgicalconcepts used to treat
skeletofacial
deformities
Demonstrates
intermediateknowledge of theprinciples of occlusion
and treatment planning
Demonstrates
intermediateknowledge of common
complications of thesurgical correction ofskeletofacial
deformities

Demonstrates
advancedknowledge ofthemanagement ofcomplications ofsurgicalcorrection ofskeletofacial
deformities

Demonstrates
advancedknowledge of therole ofmultidisciplinary
treatment ofskeletofacial
deformities andobstructive sleep
apnea

Demonstrates
expert knowledge ofthe pathophysiologyof obstructive sleep
apnea

Demonstrates
advanced knowledge ofthe pathophysiology of
obstructive sleep apnea

Comments:

20

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Level 1

Skeletofacial
Deformities andObstructive Sleep
Apnea

Patient Care

The resident is unable
to perform basic datagathering techniques.

Performs an accurate
facial analysis andevaluation

The resident is unable
to perform an
accurate history andphysical.

Performs basic
cephalometricanalysis

The resident is unable
to recognize common
postoperative
problems.

Performs model
surgery or virtual
surgical planningtechniques withassistance
Performs adequate
clinical photography

Date:

Level 2

Level 3

Level 4

Independently
performs model
surgery or virtual
surgical planningtechniques

Integrates
cephalometric andclinical analysis toformulate treatment
plans

Formulates andimplements surgicaltreatment plans forcomplex skeletofacial
deformities

Performs surgicalprocedures withassistance

Actively participatesin multidisciplinary
treatment planning ofskeletofacial
deformities andobstructive sleep
apnea patients

Independently
manages andperforms complex
orthognathic
procedures

Prescribes or refers
for non-surgicalmanagement,
obstructive sleep
apnea patients, whenappropriate

Independently
manages andperforms routine
orthognathic
procedures
Independently
managespostoperativecomplications

Comments:

21

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Cleft and Craniofacial
Deformities

Medical Knowledge

The resident lacks abasic understandingof cleft andcraniofacial
syndromes.

Demonstrates basic
knowledge of
craniofacial genetics
and the growth anddevelopment of the
craniofacial skeleton

Demonstrates basic
knowledge of thebroad rationale oftreatment sequencing
for cleft/craniofacial
deformities

Demonstrates basic
knowledge of theclassification of cleft
deformities

Demonstrates
intermediateknowledge ofcharacteristics ofcommoncleft/craniofacial
syndromes

Demonstrates
advanced knowledgeof vascular supply tothe maxillofacial
region and its
implications for
surgical treatment

Demonstrates
advanced knowledgeof maxillofacial
anatomy and its
implications forcomplex surgicaltreatment

Demonstrates
advancedknowledge ofsurgical concepts
and procedures
used to treat
cleft/craniofacial
deformities

Models and teaches
the rationale oftreatment sequencing
for cleft/craniofacial
deformities

The resident lacks abasic understandingof the pertinent
anatomy.

Demonstrates basic
knowledge of the roleof multidisciplinary
treatment of cleft andcraniofacial
deformities

Demonstrates
advancedknowledge of therole ofmultidisciplinary
treatment ofcleft/craniofacial
deformities

Comments:

22

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Level 1

Cleft and Craniofacial
Deformities

Patient Care

The resident is unable
to perform basic datagathering techniques.

Performs an accuratecraniofacial analysis
and evaluation

The resident is unable
to perform an
accurate history andphysical.

Performs adequate
clinical photography

The resident is unable
to recognize common
postoperative
problems.

Date:

Level 2

Level 3

Level 4

Independently
performs model
surgery or virtual
surgical planningtechniques

Integrates
cephalometric andclinical analysis toformulate treatment
plans

Formulates andimplements surgicaltreatment plans for
craniofacial
deformities

Performs alveolar
cleft grafting withassistanceIndependently
manages common
postoperativecomplications

Independently
manages patients andperforms surgery forprimary cleft andcraniofacial
proceduresManages
complications
with supervision
Ensures
multidisciplinary
care of thecleft/craniofacial
patient from birth
to maturity

Manages complex
postoperativecomplications withassistance
Actively participatesin multidisciplinary
treatment planning

Independently
manages complex
postoperativecomplications

Independently
performs alveolar
cleft grafting

Comments:

23

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Level 1

Facial Cosmetic
Surgery

Medical Knowledge

The resident lacks abasic understandingof facial aging andcommon facial
cosmetic deformities.

Demonstrates basic
knowledge of thepertinent anatomy
Demonstrates basic
knowledge of theeffects of aging on theface
Demonstrates basic
knowledge of the useof clinicalphotography

Date:
Level 2Demonstrates
intermediateknowledge of theconcepts of facial
aging and basic
surgical and nonsurgicaltreatments for the
aging face
Demonstrates
intermediateknowledge of thenormalrelationships, andproportions infacial analysis
Demonstrates
intermediateknowledge of the
impact ofpsychologicalfactors and patient
expectations on
outcomes in facial
cosmetic surgery

Level 3
Demonstrates
advancedknowledge of theindications forvarious treatment
options foraddressing theaging face

Level 4
Demonstrates
expert knowledgeof the anatomy
and principles ofcomplex facial
cosmetic
procedures

Demonstrates
advancedknowledge of the
anatomy andprinciples of basic
surgical and nonsurgical facial
cosmetic
procedures
Demonstrates
advanced knowledgeof the complicationsof facial cosmetic
surgery

Comments:

24

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Facial Cosmetic
Surgery

Patient Care

The resident is unable
to perform a focusedcosmetic evaluation of
the face or identify
complications of facial
cosmetic procedures.

Performs adequate
clinical photography

Formulates treatment
plans with assistance

Performs a focusedcosmetic evaluation of
the face withassistanceManages common
complications of facial
cosmetic procedureswith appropriate
supervision

Performs minimallyinvasive procedureswith supervision

Identifies
complications offacial cosmetic
procedures withassistance

Assists with facial
cosmetic
procedures

Independently
assesses,diagnoses, andformulates
treatment plans

Level 4
Independently
performs
procedures andmanages complex
complications offacial cosmetic
procedures

Comments:

25

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Facial Pain andTemporomandibular
Disorders

Medical Knowledge

The resident lacks abasic understandingof the pertinent
anatomy.

Demonstrates basic
knowledge of thepathophysiology ofcommon facial pain
disorders

Demonstrates basic
knowledge of theindications for surgicaland nonsurgicaltreatment

Demonstrates expert
knowledge of medical
and pharmacologicalmanagement ofchronic facial pain

Demonstrates basic
knowledge of theimportance ofmultidisciplinary
treatment of facial
pain andtemporomandibular
disorders

Demonstrates
intermediateknowledge of therelevant anatomy ofcommon approaches
to the TMJ

Demonstrates basic
knowledge of thebroad rationale oftreatment planningand sequencing of
TMJ total joint
replacement

The resident lacks anunderstanding of thespectrum of
temporomandibular
disorders and facialpain.

Demonstrates
intermediateknowledge of surgicaland non-surgicalmanagement of facialpain

Demonstrates basic
knowledge ofcontraindications tosurgical management
and make appropriate
referrals for further
care

Demonstrates
advanced knowledgeof non-surgical andsurgical managementoftemporomandibular
disorders and facialpain

Demonstrates expert
knowledge of nonsurgical and surgicalmanagement of
temporomandibular
disorders and facialpain

Demonstrates expert
knowledge ofmaxillofacial anatomy
and its implications
for surgical treatmentof
temporomandibular
disorders and facial
pain

Comments:

26

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Facial Pain andTemporomandibular
DisordersPatient Care

The resident is unable
to perform basic datagathering techniques.

Performs
temporomandibular
joint evaluation andmanagement withassistance

Performs
temporomandibular
joint surgery withassistanceIndependently
performs routine TMJ
arthrotomy

Independently
performs
arthroplasties incomplex cases (e.g.,
total joint
replacement,
ankylosis)

The resident is unable
to perform an
accurate history andphysical.
The resident is unable
to recognize common
postoperative
problems.

Independently
performs anddocuments sensory
and motor
examinations of thehead, neck and face
Independently
performs anddocuments detailed
TMD examination

Interprets sensory,
motor and TMD
examination of thehead, neck and facewith assistanceOrders and interprets
advanced imaging
with assistanceIndependently
interprets sensory,
motor and TMD
examination of thehead, neck and face
Refers facial pain
patients for nonsurgical management
when appropriate

Independently
performs
neuroablative
procedures for facial
pain

Independently orders
and interprets
advanced imaging

Comments:

27

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Pathology

Medical Knowledge

The resident lacks abasic understandingof common pathologic
conditions of the headand neck.

Demonstrates basic
knowledge ofcommon benign
and malignant
diseases andassociatedcomplications

Demonstrates
intermediateknowledge ofadvanced diagnostic
and imaging studies

Demonstrates
advanced knowledgeof the indications for
surgical and nonsurgical treatments ofbenign and malignant
diseaseDemonstrates expert
knowledge of the
management ofcomplex disease andregional and distantmetastases

The resident lacks
an adequate
understanding of
the anatomy of thehead and neck.

Demonstrates basic
knowledge of thestaging of head andneck cancer
Demonstrates basic
knowledge of basic
diagnostic andimaging studies

Demonstrates
intermediateknowledge of surgicalprinciples of ablative
surgery
Demonstrates
intermediateknowledge of the roleof adjunctive
therapies

Demonstrates basic
knowledge of the
management ofregional metastases
Demonstrates
advancedknowledge ofcomplexcomplications ofbenign disease

Demonstrates
advancedknowledge ofcomplexcomplications ofmalignant disease

Comments:

28

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Pathology

Patient Care

The resident is unable
to perform an
accurate history andphysical.

Performs anaccurate history andphysical of an
uncomplicatedpatient with headand neck pathologic
conditions

Recognizes common
complications

Recognizes common
lesions of the hardand soft tissues of
the head and neck

Independently
performs minor
procedures (e.g.,
biopsy, fine needle
aspiration)

The resident is unable
to recognize common
postoperative
sequelae orcomplications.

Provides routine
postoperative care

Appropriately
prescribes
postoperative
rehabilitation

Independently
interprets
diagnostic studies

Level 3
Independently
formulates atreatment plan
Independently
performs excisionand reconstructionof benign disease
Manages complex
complications

Level 4
Independently
manages patientswith malignant
diseaseIndependently
performs excisionand reconstructionof malignant disease
Actively participatesin amultidisciplinary
head and neckcancer teamComments:

29

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Reconstructive
Surgery

Medical Knowledge

The resident lacks abasic understandingof common
reconstructive
surgery.

Demonstrates basic
knowledge of thesurgical anatomy ofdonor sites for hardand soft tissue flaps
and grafts

Demonstrates
intermediateknowledge of thesurgical treatments
for hard and soft
tissue defects

Demonstrates
advanced knowledgeof the surgicalprinciples of hard andsoft tissuereconstruction

Demonstrates basic
knowledge of hardand soft tissue
wound and graft
healing

Demonstrates
intermediateknowledge of theclinical and imaging
assessment ofpatients forreconstructive surgery

Demonstrates
advancedknowledge of theeffects of priortreatment
modalities onreconstructive
options

Demonstrates
advancedknowledge of the
management ofcomplex head andneck defects withadvanced
techniques in hardand soft tissue flaps
and grafts

The resident lacks
an understandingof head and neckanatomy.

Demonstrates
intermediateknowledge of
prosthetic
reconstructive options
Demonstrates
intermediateknowledge of thepathophysiology ofnerve injury andregeneration

Demonstrates
advancedknowledge of theclassification of
nerve injuries

Comments:

30

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Reconstructive
Surgery

Patient Care

The resident is unable
to perform an
accurate history andphysical.
The resident is unable
to recognize common
postoperative
problems.

Level 1
Provides routine
postoperative care
Requests andinterprets appropriate
imaging
Able to discuss theindications, risks,benefits andalternatives ofreconstructive
surgical procedures

Date:

Level 2

Level 3

Level 4

Performs routine
reconstructive
procedures withassistance

Formulates atreatment plan forcomplexreconstructive surgery

Manages common
postoperativecomplications ofreconstructive surgery
with assistanceIndependently
performs routine
reconstructive
procedures

Independently
formulates complex
treatment plans forreconstructive
patients withcomorbidities andprior treatments

Independently
performs a focusedneurologic
examination todiagnose nerve injury

Performs complex
reconstructive
procedures withassistanceIndependently
manages common
complications

Independently
performs complex
reconstructive
procedures
Independently
manages complex
complications
Independently
performs nerve
repair surgery

Comments:

31

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Dental and
Craniomaxillofacial
Implant Surgery

Medical Knowledge

The resident lacks thelevel of understandingof implant surgery andanatomy beyond that
expected of a general
dentist.

Demonstrates basic
knowledge of hardand soft tissue site
preparation

Demonstrates
intermediateknowledge of clinicaland imaging
assessment ofpatients for implant
surgery

Demonstrates expert
knowledge of theprinciples of implant
surgery (e.g.,
immediate placement,
immediate load andsoft tissue
management)

Demonstrates basic
knowledge of hardand soft tissue
wound healing
Demonstrates basic
knowledge offundamentals of
osseointegration,
osteoinduction,
osteoconduction
and osteogenesis

Demonstrates
intermediateknowledge ofrestorative options
Demonstrates
intermediateknowledge of the risk
factors andcomplications
associated withimplant surgery

Level 4Engages inoutcomes based
research

Demonstrates expert
knowledge of esthetic
principles as they
relate to implant
surgery

Comments:

32

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Dental and
Craniomaxillofacial
Implant Surgery

Patient Care

The resident lacks thelevel of skill in implant
surgery beyond that
expected of a general
dentist.

Level 1
Performs history
and focusedevaluation of theimplant candidate
Participates inroutine implant
procedures
Recognizes
commonpostoperative
problems

Date:

Level 2

Level 3

Performs routine
implant procedureswith supervision

Independently
performs complex
implant procedures

Recognizes and treats
commonpostoperativecomplications ofimplant surgery withsupervision.

Independently
performs hard andsoft tissue site
preparation
procedures

Level 4
Independently
performs
craniomaxillofacial
implant surgery
Engages inoutcomes based
research

Independently
manages hard andsoft tissuecomplications
including periimplantitis andfailures

Comments:

33

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Quality Improvement

Practice-Based
Learning and
Improvement

The resident lacks
interest or the ability
to learn from theresults of his or herpractice.
The resident fails torecognize the impactof errors and adverse
events in patient care.
The resident does not
accept constructive
criticism.

Level 1
Participates in
Morbidity andMortality and/or
other Quality
Improvement
conferences

Date:

Level 2

Level 3

Continually seeks andincorporates feedback
to improve
performance

Accurately assesses
areas of competencies
and deficiencies andidentifies areas forcontinued
improvement

Level 4
Applies selfassessment andlife-long learning
behaviors forpractice
improvement

Acknowledges gaps
in personal
knowledge andexpertise andfrequently asks for
feedback fromteachers andcolleagues
Appropriately
responds tofeedback

Comments:

34

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Research andTeaching

Practice-Based
Learning and
Improvement

The resident is unable
to critically evaluate
the literature.
The resident does notcommunicate
effectively as ateacher (e.g., isdisorganized, isinattentive, uses
language unsuitable
for the level of thelearner, discourages
and disregards
questions).

Level 1
Describes basic
concepts in clinicalepidemiology,
biostatistics, andclinical reasoning
Accurately
categorizes researchstudy design
Participates in the
education ofpatients, families,
residents and/or
students

Date:

Level 2
Critically evaluates
research outcomes
Teaches patients,
families, residents
and/or students

Level 3

Level 4Formulates a valid
research question anddescribes a plan toinvestigate it

Executes a research
project

Teaches colleagues
and other healthprofessionals in bothformal and informal
settings

Develops andorganizes
educational
activities at the
programmatic level

Assesses and provides
feedback to residents
and/or students
Demonstrates
evidence of other
scholarly activity

Comments:

35

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Level 1

Communication with
Patients and Families

Interpersonal andCommunication Skills

The resident is notable to clearly,
accurately andrespectfullycommunicate basic
healthcare information
with patients andfamilies.

Ensures that
communication withpatients, families andother healthcare
providers isunderstandable andrespectful

The resident is unable
to communicate
effectively with other
healthcare providers.

Date:

Level 2Customizes
communication toindividual patientcharacteristics
Provides timely
updates to patientsand families duringhospitalizations andoffice visits

Level 3

Level 4

Demonstrates
sensitivity towards
patients and families

Capable ofnegotiating andmanaging conflictamong patients andfamilies

Discusses
complications anduntoward events withpatients and families
Actively participates ininterdisciplinary
conferences

Organizes,
coordinates andfacilitatesfamily/healthcare
team conferences

Comments:

36

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Level 1

Personal and EthicalBehavior

Professionalism

The resident displays
undesirable orunethical behaviors,
including being
impolite or
disrespectful,breaching patient
confidentiality andprivacy.

Demonstrates polite
and respectful
behavior toward
patients, theirfamilies, and other
health care
professionals

The resident lacks
integrity or fails totake responsibility forpatient care activities
or his or her actions.

Responds to pages
and consultation
requests promptly
Honest andtrustworthy
Respects patient
confidentiality andprivacy

Date:

Level 2
Maintains
composure inaccordance withethical principles
even in stressful
situations
Demonstrates acommitment tocontinuity of care bytaking personal
responsibility forpatient careoutcomes
Exhibits compassion
and empathy
toward patients andtheir families

Level 3

Level 4

Ensures patient care
responsibilities are
performed andcontinuity of care ismaintainedServes as a role modelfor ethical behavior

Accepts
responsibility forerrors in patient careand initiates
corrective actions

Consistently places
the interests ofpatients ahead ofself-interests

Consistently
demonstrates
integrity in all
aspects of careand professional
relationships

Recognizes thelimits of his or her
knowledge andseeks assistance asappropriate

Comments:

37

Name:PGY Level:

Date:

Practice Domain

Competency

Critical Deficiencies

Level 1

Level 2

Level 3

Level 4

Coordination of Care

Systems Based
Practice

The resident lacks abasic understanding of
the resources
available forcoordinating patientcare.

Demonstrates
intermediateknowledge of theresources available forcoordinating patientcare within thehealthcare system

Actively participatesin the coordination ofcare acrossmultidisciplinary
teams

Arranges, consistently
and efficiently,
disposition planningand interdisciplinarycare

Utilizes the necessary
resources to provide
optimal patient care

Coordinates postdischarge ambulatory
care

Coordinates complex
disposition planning,(e.g., homehealthcare, skilled
nursing facility care
etc.)

Comments:

38

Name:PGY Level:

Practice Domain

Competency

Critical Deficiencies

Level 1

Patient Safety

Systems Based
Practice

The resident lacks
understanding ofpatient safety
protocols.

Demonstrates
intermediateknowledge of patient
safety protocols

The resident fails torecognize adverse
events.

Demonstrates basic
knowledge ofcommon causes of
medical errors

The resident fails tointervene in the
management or
prevention of an
adverse event.

Complies withdepartment andinstitutional safety
policies

Date:

Level 2

Level 3

Level 4Uses protocols toprevent adverse
events (e.g.,checklists,
huddles andbriefings)

Reports problematic
behaviors,
processes, anddevices (including
errors and nearmisses)Describes thecommon systemcauses for errors

Actively
participates inmorbidity andmortality
conferences toimprove patient
safetyFormally analyzes
shared teamexperiences toprevent future errors
using proven analysis
techniques (e.g., root
cause analysis, failuremode effects
analysis)
Leads team bypromoting situationalawareness and input
by all team members

Demonstrates basic
knowledge of teamapproach inpreventing adverse
eventsComments:

39