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whohave【日本語要旨】

ノース・カロライナ大学は1794年に設立され、現在、学部、大学院合わせて28，000名を超える学生が学んでいます。歯学部は大学病院、公衆衛生学部や癌研究センターに隣接し、PhDプログラム、大学院教育プログラム、歯科衛生学やデンタルアシスタントの教育プログラムを含む多種の専門教育を行っています。

小児歯科学部門では、3年間の大学院教育プログラムに入学したレジデントは修士号を取ることが求められます。レジデントの診療は、乳幼児から青年期までの患者を対象とした一般歯科治療が主体です。患者には、神経障害、血液凝固障害、がん、唇顎口蓋裂、各種症候群、臓器移植など、多様な有病児も含まれます。その他、精神鎮静法は年間約150例、全身麻酔法は年間400例以上実施しています。
救急部門では外傷歯の治療、週に1日は矯正治療も行います。
小児歯科学部門では、学生・レジデントともに多職種間の医療連携についても学びます。
トの場合、麻酔科、救急部、小児科、血液腫瘍科およびCraniofacial

レジデン

teamにそれぞれ1か月間ローテーションします。そこで、多職種間で緊密に医療連携を取りながら診療する基礎訓練を受けます。また、Craniofacial

teamは、心理学、聴覚学、耳鼻咽喉学、形成外科学、口腔外科学、矯正歯科学、小児歯科学などの専門医で構成されており、部分的無歯症、エナメル質形成不全症などの歯の発生異常を有する患児に対する複合的な治療を学ぶことができます。歯科診療部門には、10名のデンタルアシスタ
ントが勤務しているため、部門内のデンタルアシスタントとの連携を学ぶ機会にもなります。その他、3年目のレジデントはティーチングアシスタントとして学生の臨床教育にも参加します。
また、3年目のレジデントには、地域の歯科クリニックで勤務する機会も与えられます。そこでは、個人クリニックの医院経営や医療技術について学ぶことができます。また、米国におけるさまざまな医療保険制度を理解する機会にもなります。米国では、こどもの約50％が何らかの公的医療保険制度に加入しています。Medicaidは、アメリカ最大の公的医療保険制度で、州と連邦政府が共同出資しています。その他、アメリカには公的社会保障制度であるSocial Securityがあり、障がい者は通常、MedicaidかSocial Securityのいずれかに加入しています。これらの公的医療保険制度の他、数多くの私的医療保険制度もあり、それぞれに特徴があります。これらの保健制度を学ぶことはレジデントにとって貴重な経験です。

学部教育では、2年目に学生一人に数名の小児患者を配当します。各学生は、卒業するまで配当された小児患者の口腔管理を担当します。治療が必要な場合は、指導教官とともに治療計画を立案します。

そこでは、生活習慣、成長発育、予防なども考慮した包括的な治療計画を立案する能力を獲得するよう教育されます。その他、エックス線写真の撮影と読影、シーラント、レジン修復などの技能習得も必修です。手術室、スペシャルニーズ歯科診療室、地域の保健所、乳児の口腔衛生教育プログラムなどにも参加し、そこでも口腔管理に関する基礎知識と技能を習得します。

このように、ノース・カロライナ大学の小児歯科学教育プログラムは、包括的で多様な内容で構成されています。学生は、小児患者の歯科口腔衛生管理全般に関する専門教育を受け、レジデントは、小児歯科専門医を目指しより複雑で多様な疾患にも対応できるよう訓練を受けます。

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