School of Dentistry IDP Report

To: Harold Goodis DMD
Chair, Academic Planning and Budget Committee

From: Richard A. Smith DDS
Chair, Subcommittee

W. Bird, D. Ramos, D. Graham, A. Kahn, L. Jenson, D. Curtis, F. Ramos-Gomez, C. Alexander, M. Ryder, M. Kirkland, B. MacKenzie

RE: Subcommittee Report on Academic Review of a Proposed International DDS Program (IDP)

The Subcommittee has performed an academic review of the proposed International DDS Program as mandated by the California Legislature in Assembly Bill 1116. Special attention was made to the July 17, 1998 charge of the Faculty Council and the August 13, 1998 charge of the Academic Planning and Budget Committee. Our Committee considered the desirability, feasibility, and barriers for implementation of such a program with special attention to assure that the graduate of the IDP would be academically and clinically competent and equivalent to the domestic 4 year graduate. Any plans to develop an IDP program should make provisions and assurances that there would be no negative impact on the domestic DDS Program, the Dental Hygiene Program, or other existent academic programs.

The Academic Review included consideration of the following:

Chronology of events
Faculty interest
Faculty commitment
Faculty incentives
Faculty concerns
Determination if the public interest is being served
Campus and University issues/Tuition and Fees/Suitability of IDP to qualify under the University’s policy on self-supporting high-fee, part-time professional degree program
Admission requirements/process/assessment of basic and clinical science knowledge and clinical skills
Mechanisms for assessing proficiency in English
Resources available to assess quality of foreign universities
Duration of program
Patient supply, Size of Program, Space, Resources
Composition of program of study of existing IDPs at UOP, Loma Linda, & USC
Outcomes assessment to ensure IDP graduate is academically and clinically competent and equivalent to the domestic 4-year graduate
Potential relationship of the IDP to the AEGD Program and Buchanan Dental Center
Impact of IDP on existing educational programs
School of Dentistry curricular revision impact on IDP curriculum
Impact of Clinic Modernization Project on IDP implementation
IDP effect on accreditation
Fiscal impact
Status of UCLA IDP proposal
Role of the Educational Policy Committee
Completion of the process of IDP approval and implementation
Conclusions

1. Chronology of Events for Consideration of IDP by UCSF

1994 UC Task Force on Part-Time Professional Master’s Degree Programs advocates that UC expand opportunities for defined students not served by UC’s regular programs.

1995 Advisory Committee on Policy for High-Fee Part-Time Professional Programs "urges the University to create a climate for encouragement and support for creative new approaches to delivering part-time professional education."

January 1996 At Annual California Dental Association (CDA)/Dean’s Conference, discuss support of IDP by CDA and the "High-Fee" part-time professional programs.

June 1996 President Richard Atkinson distributes Policy on Self-Supporting Part-Time Graduate Professional Degree Programs.

January 1997 At Annual CDA/Dean’s Conference, Executive Director of CDA, (Zakariasen) endorsement of an IDP implying that the "profession would be served."

March 1997 Letter from Vice-Chancellor Dorothy Bainton MD regarding procedural matters related to an IDP:

Faculty review of proposal (work with UCLA on response)
If recommended, send to Vice-Chancellor of Academic Affairs Office and they will coordinate campus review including that of the Academic Senate.
Request review by Chancellor and Cabinet
Review by Office of the President
Presented to the Regents for approval

July 1997 J CDA 25:503-506, 1997 Ethnic Dental Societies back the foreign training bill.

Oct 1997 Assembly Bill No. 1116 signed by Governor "urging the two University of California Dental Schools to offer the two-year International Dental Program.

Oct 1997 J CDA 25:691, 1997 Deans Bertolami and Hume agreed to bring the matter of two-year IDP before their respective faculties.

June 1997 Bird/Ponce Report on IDP Administrative and Fiscal Review after visiting the 3 existing IDP programs in California.

July 1997 Bird/Ponce Report distributed to Faculty Council; further consideration was deferred until after April, 1998 accreditation site visit.

January 1998 Bird/Ponce Report shared with Deans of other Dental Schools and DA.

July 1998 Dr Silverstein of Faculty Council requested Dr Goodis to appoint a Subcommittee of the Academic Planning and Budget Committee to perform an academic review of the proposed IDP.

August 1998 Drs Goodis and Bertolami appoint Subcommittee (Dr Smith/Chair) to perform academic review of IDP.

2. Faculty Interest

No formal assessment of widespread faculty interest has been obtained to date but a formal survey would be beneficial to assure total faculty input and stimulate their interest. However, the faculty at large has been informed of the proposed IDP program through the School Newsletter and e-mail, and at the general faculty meeting, where input was encouraged. Only minimal verbal inquiries were received.

However, among the Subcommittee members, there was a general interest in development of such a program once the potential benefits to the School and Departments were defined. However, there is still some skepticism and concerns that will have to be addressed. Enthusiasm will have to evolve and be generated with assurances and responsiveness to concerns, once the details of the program are elucidated. The faculty must be educated regarding the advantages of an IDP, they must be kept informed of related pertinent developments, and their active participation must be encouraged.

3. Faculty Commitment

At this point, the faculty appears committed to the process of academic review and IDP curricular development. Once the details evolve, and the concerns addressed, a majority of the faculty will likely be committed to development and implementation of an IDP. For certain skeptical faculty, commitment will likely develop only after the IDP has been implemented with documented successful outcomes.

4. Faculty Incentives

Specific faculty incentives would enhance the support and commitment of the IDP.

The School would identify new revenue streams in a period of diminishing resources.
Departments would share in the profitability of the IDP based on participation.
The School will benefit from new patient populations and referrals from IDP students.
Graduates of the IDP would likely to become indebted and loyal to the School and become volunteer faculty and good ambassadors for the School.
The School would be compliant with the State of California Legislature.
The legislative mandate may provide justification for requesting additional funding from the State.
The people of California could be reassured that foreign dentists have received quality education and achieved competencies comparable to domestic DDS programs in the 5 California Dental Schools.
The clinical services would benefit by having a highly productive group of new students
There would be gratifying clinical teaching experiences for faculty.
The marketplace for this program will be expanding with the elimination of the bench test in 2003.
The IDP students historically have performed better on the State Board than domestic four-year students.
The IDP students are mature and motivated.
University of Pacific has a zero drop-out rate for IDP students.
The IDP students provide a rewarding experience for the faculty; they demand high quality education from the Faculty and Institution.
There could be a potential for using the smaller IDP to develop new or alternative teaching strategies potentially applicable to the standard curriculum.
The IDP could be a means of identifying and recruiting new contributors to the School’s Development Program.

5. Faculty Concerns

The Subcommittee has expressed certain concerns regarding the IDP that will require a response. These concerns are as follows:

The non-IDP faculty will need assurance that they will not be burdened with any significant additional teaching and administrative responsibilities.
Additional FTE for senior IDP faculty and supportive resources and space will be provided for the program without jeopardizing or diluting existing programs.
There should be no additional taxation, reduction of allocated funding, or other assessments to "indirectly" support this Program.
A business plan should be developed, identifying the source of start-up money and initial funding until this Program becomes truly profitable and self-supporting. The plan should include a fiscal phase-in and impact report.
If the start-up money is borrowed by the School, the increased indebtedness could have an "indirect" cost to the Departments through reduced disbursements from the Dean’s Office.
Additional space for IDP faculty will have to be identified.
The domestic DDS students must be reassured that the IDP will not be a competitor for resources but will enrich their overall educational experience.
There are faculty who have strong nationalistic feelings who may oppose an IDP.
The immigration and naturalization policies are in flux and require close monitoring on its effect on the IDP and students’ ability to obtain visas.
The new California law regarding foreign dentists state that the California State Dental Board evaluate foreign dental schools, and if it is determined to be equivalent to domestic programs, graduates may take the State Board without the 2 year IDP. It appears that The Commission on Dental Accreditation (CODA) will not provide the accrediting services for foreign dental schools and that The California State Dental Board may lack the will or sufficient resources. It remains unclear at this time, whether the law needs revision or how the accreditation mandate in the law can be complied with.
The IDP must be subject to regular academic review.
National Boards, which are used as an admission criteria, may not reflect comprehensive education and can be "prepared for" through old examinations.
There are unavailable and unidentified off campus sites if needed. Also, there are no identified computer or video-based teaching for the IDP.
Assurance must be made that all faculty appointments to IDP are subject to appropriate academic review.
There should be clarification if out-of-state graduates of US dental schools who fail the California State Dental Board 4 times, are eligible to apply to the IDP.
Adequate space for faculty and teaching facilities must be identified prior to implementation.

6. Determination if the public interest is being served

The self-supporting professional program policy requires evidence from the profession that an important public interest is being served before development of programs such as the IDP. The report of the Advisory Committee on Policy for Part-Time Professional Programs states part-time graduate professional degree programs may be undertaken only when a demonstrated need for a part-time program in a specific field of study exists....these programs should be undertaken in partnership with the profession served.

The Subcommittee believes that the public interest will be served:

In a February 18, 1997 letter to Dean Charles Bertolami, Kenneth Zakariasen, Executive Director of the California Dental Association (CDA) expressed the CDA’s support for UCSF and UCLA to develop IDPs. The CDA desired to create a situation that would provide excellent educational opportunities for many foreign graduates and help ensure high quality practice of dentistry in California.
The IDP will ensure that all dentists seeking licensure in California meet a uniform standard of education and training and certify that the graduate is competent to practice.
Under the current public policy, there isn’t appropriate screening to determine the level and competency of graduates of foreign dental students. The IDP would help to correct this deficiency in the system.
The level of training and ability of foreign dental school graduates varies significantly; a two-year IDP would help to standardize the education, training, and competency of the graduates.
An IDP program granting a D.D.S. degree would help to eliminate consumer confusion and assure the public that the competencies of foreign graduates licensed to practice dentistry in California are no different from graduates of domestic institutions.
An IDP could increase the ethnic diversity of the UCSF student body and the dentists serving a diverse population in California.

7. Campus and University Issues/ Tuition and Fees and Suitability of IDP to qualify under the University’s policy on self-supporting high-fee, part-time professional degree program

In a letter to the Chancellors on June 24, 1996, President Richard Atkinson distributed a new policy on Self-Supporting Part-Time Graduate Professional Degree Programs as well as Implementation Guidelines.

The policy states that self-supporting part-time graduate professional degree programs should adhere to the same UC academic standards as do other graduate degree programs. Such programs shall not be undertaken if they strain the resources of the department that sponsors them or have an adverse effect on regular programs on campus. .....such programs should set the goal of becoming fully self-supporting as quickly as possible........self-supporting means that full program costs, student services costs, and overhead, should be covered by student fees or other non-state funds. The sponsors of each proposed self-supporting program should submit a fiscal phase-in plan with their request for approval of proposed fees to the Office of the President. These programs should be undertaken in partnership with the profession served. Self-supporting programs will not be funded from State General Funds and reports of state-funded enrollments will exclude students in self-supporting programs. The Dean of the School offering the program and the Academic Vice Chancellor are responsible for assuring that program publicity and marketing meet the highest standards of quality and accuracy. When the self-supporting fee has been fully implemented, no State General Funds will be provided to the program. When the self-supporting program fee has been fully implemented, the campus may not collect the University Registration fee. Program deficits will be covered by the Campus; however, state funds cannot be used to cover any deficit, except during the start-up years under the approved phase-in plan.

The Implementation Guidelines for the Policy on Self-Supporting Part-Time Graduate Professional Degree programs state:

All faculty must be funded directly from the revenue of self-supporting programs in proportion to the faculty member’s workload commitment to the program. Alternatively, faculty can be paid for overload teaching within tbe 120% salary limitation that governs teaching in University Extension. The Office of the President Budget Office, working with the campuses, has already developed a methodology for establishing the minimum special fee a program should charge to assure that it is self-supporting in 3 years). The Office of the President Budget Office will monitor implementation of the phase-in plan.

Subsequent to the Academic Review and School of Dentistry approval, a combined response with UCLA should be submitted to the Vice-Chancellor, Academic Affairs who will coordinate the campus review process, including Academic Senate review. The request will then be reviewed by the Chancellor and Cabinet. After that, the request would be reviewed by the Office of the President and eventually, presented to The Regents for approval.

8. Admission Requirements/Process and Assessment of Basic and Clinical Science Knowledge and Clinical Skills

The University of California seeks to enroll students who have a demonstrated record of academic excellence. Admission policies require that applicants present evidence of high scholastic achievement in secondary schools and postsecondary institutions consistent with University standards. International applicants must meet the same high academic standards as domestic students.

Transcripts & Records-All applicants are required to submit original, official documents. The records should be sent directly to the University by the institution the applicant attended or the appropriate examining boards. The records must be signed by the proper authorities and bear an official stamp or seal. If only one original record is available, applicants may send a photocopy. If admitted to the University, applicants must present the original document for verification upon arrival. Credentials should be examined carefully for authenticity. Unofficial records may be used to make preliminary admission decisions. Secondary school records normally do not need to be translated unless they are from a country which uses a non-roman alphabet. College or University records must be translated by a certified translator familiar with educational records. Official records in the native language must be submitted as well. A certificate showing results of national, external leaving examinations must show the date of examination, subjects examined, and grades earned.

A transcript should show applicants’ dates of attendance; list individual courses taken; the number of contact hours, credit, or units given; and the grades earned. In order to evaluate properly the content of course work completed at international colleges and universities, course descriptions and/or program curriculum may be required.

Recognition of Institution-Institutions in other countries are acceptable to the University of California when they are recognized by appropriate government ministries and award edges similar to those granted by the University of California or are accredited by US regional associations. Institutions in other countries which are only licensed to operate or are only registered with a government department are not acceptable to the University of California. The D.C.based National Association of Foreign Student Advisors(NAFSA) offers services to evaluate foreign credentials.

Financial Statement & Certificate of Eligibility (INS Form I-20 A-B)
Applicants requiring an I-20 A-B to secure F-1 student visas must present a current, original financial statement showing that required funds are available for the first year of study. The expectation is that such funds will be available for the duration of the students’ status. Admitted students who intend to register at the University will be issued an I-20 A-B when their financial statements have been approved. Issuance of the I-20 A-B indicates that admission and financial requirements have been met.

Prior to initiating an IDP application, the applicant must:

Possess a DDS, DMD, BDS or comparable degree from an accredited foreign dental school
Have an independently certified academic evaluation of their transcripts
Successfully completed Part I of the National Dental Boards with a score of 80 or higher
Proof of proficiency in the English language (minimum scores, paper-based and computer-based, on Test of English as a foreign language (TOEFL)
Evidence of license to practice dentistry in home country
Test of Spoken English (TSE) may be required
Develop test using video presentation followed by written test to evaluate note taking and comprehension of spoken English
Non-refundable application fee
2 letters of recommendation, preferably from home dental school faculty

Applicants who meet the preliminary requirements and whose application indicates potential for success, will be invited for an interview and testing:

Participate in personal interviews by an IDP Admissions Committee
Demonstrate competence in basic dental skills through a technical examination (fixed and removable prosthodontics and operative dentistry)
US citizens and individuals with US permanent residency status may apply for financial aid

Application process

An application packet, a program brochure, and a Web Site will require development
Obtain appropriate visas (F-1 student visa)
Submit a Certificate of Finances to allow the School to provide the Certificate of Eligibility (I-20 A-B), which will allow the student to apply for the student visa which complies with the US Immigration and Naturalization Service (INS)
Foreign nationals must submit a non-refundable enrollment fee of $1000.00

Assessment of Basic Science Knowledge
Part I of the National Board of Dental Examinations tests knowledge in the basic sciences, specifically:

Anatomic Sciences
Biochemistry-Physiology
Microbiology-Pathology
Dental Anatomy and Occlusion

A score of 80 or better on Part I would substantiate satisfactory knowledge in these subjects and should be a requirement for admission to the IDP.

Assessment of Clinical Science Knowledge
Part II of the National Board of Dental Examinations tests knowledge in the clinical sciences, specifically;

Operative Dentistry
Pharmacology
Prosthodontics
Oral and Maxillofacial Surgery-Pain Control
Orthodontics-Pediatric Dentistry
Endodontics-Periodontics
Oral Pathology and Dental Radiology

Passing Part II of the National Board of Dental Examinations would substantiate satisfactory knowledge in these subjects, and would amplify the appeal of the IDP application. However, Part II should not be required as an admission requirement. Since the IDP will include all the subjects in Part II, the examination can be taken subsequent to completing these courses.

Assessment of Clinical Skills
The IDP applicants selected for an interview would be required to take a UCSF-designed, administered, and evaluated bench test in Fixed and Removable Prosthodontics and Operative Dentistry.

9. Mechanisms for Assessing Proficiency in English

Importance
English proficiency is an important predictor of how well foreign trained students will do in a US-based IDP. This was emphasized by David Nielsen, head of IDP at the University of Pacific Dental School. The importance of English proficiency was also shown by a recent publication titled Admissions Test Predictors of Success in a Foreign Trained Dental Program, written by James Simon et al.

What is TOEFL? (Much of this information is available from the website www.toefl.org)
TOEFL stands for Test of English as a Foreign Language. TOEFL, which has been in existence for nearly 35 years and has been used to assess the English language proficiency of many millions of students during that time, was developed to assess English language competency for international students whose native language is not English and who are applying for admission to a two-year, four-year, and graduate schools in the United States and Canada. TOEFL is offered in over 160 countries and is designed to minimize score differences that may result from differences in culture or native language.

In 1998-99, about half of the TOEFL test administrations will be in a computer-based format that allows for a variety of response formats that go well beyond the limitations of the traditional paper-and-pencil, multiple-choice form. TOEFL tests three language skills: reading comprehension, listening comprehension, and language structure and writing. Every computer-based TOEFL test includes an essay writing assignment. The essay is evaluated by two independent readers. The evaluation is figured into the structure and writing score, but the rating is also provided independently so that colleges and universities will have a clear measure of a student’s ability to write in English.

Since TOEFL was developed to assess the English language competency of prospective applicants to North American colleges and universities, the majority of the test is devoted to the assessment of the level and type of language skills necessary for success in an academic environment. Some of the test is devoted to more practical situations, but the clear emphasis of the test is on language usage in academic situations. TOEFL is designed to assess language competency across the spectrum and is, therefore, useful in testing students with low English proficiency all the way up to students with near-native fluency.

A minimum score of 575 paper-based test or 230 computer-based test on the TOEFL is used by the University of Pacific Dental School.

What is TSE?
The primary purpose of the Test of Spoken English (TSE) is to measure the ability of nonnative speakers of English to communicate orally in English.

TSE examinees demonstrate their communicative language ability in English by responding orally under timed conditions to a variety of printed and aural stimuli that are designed to elicit both controlled and spontaneous responses. Because it is a test of general oral language ability, TSE is appropriate for examinees regardless of native language, type of educational training, or field of employment.

TSE has broad applicability because performance on the test indicates how oral language ability might affect the examinee’s ability to communicate successfully in either academic or professional environments. TSE scores are used in many North American institutions of higher education in the selection of international teaching assistants (ITAs). The scores are also used for selection and certification purposes in the health professions.

TSE scores should not be interpreted as predictors of academic or professional success, but only as indicators of nonnative speakers’ ability to communicate in English. The scores should be used in conjunction with other types of information about candidates when making decisions about their ability to perform in an academic or professional situation.

What is SPEAK?
SPEAK was developed to provide institutions with a valid and reliable instrument for assessing the English speaking proficiency of people who are not native speakers of the language. Under this program, test forms are administered and scored by institutions at their convenience, using their own facilities and staff.

Test results can be used to evaluate the speaking proficiency on nonnative English-speaking applicants for teaching assistantships, to measure improvement in speaking proficiency over a period of time, or to identify those who need additional instruction in English. SPEAK is administered with recording equipment and a test book. Audio and visual prompts present 12 contextualized language tasks that are designed to elicit specific language functions. Response times vary from 30 to 90 seconds.

What is a video presentation assessment?
The University of the Pacific Dental School has developed a video presentation on pertinent and relative subjects. IDP applicants take notes and then are asked to complete a written examination. This test simulates real-life dental school lectures, and tests understanding of spoken English, note-taking, and comprehension of the subject matter.

USC uses their own English proficiency test because the security of the TOEFL during these tests internationally, are suspect.

10. Resources Available to Assess Quality of Foreign Universities

UCSF Campus/International Students and Scholars Services
UC Berkeley Campus
American Dental Association/Commission on Dental Accreditation (CODA)
National Association of Foreign Student Advisors (NAFSA)
State of California/State Board of Dental Examiners-Under the law, "The Board may contract with outside consultants or a national professional organization to survey and evaluate foreign dental schools. The consultant or organization shall report to the Board regarding its findings in the survey and evaluation." Assembly Bill 1116 (Keely), "commencing January 1, 2003, requires the Board to be responsible for the approval of foreign dental schools based on prescribed standards, and would establish procedures regarding this approval process. It would require a school to pay a registration fee, not to exceed $1,000.00 at the time of application for approval to pay all reasonable costs and expenses of the Board related to the approval survey and process, and a fee not to exceed $500.00 for renewal of the approval every seven years." The bill also mandates that "any applicant who fails the licensure examination after four attempts......shall not be eligible for further reexamination until he or she successfully completed at least two academic years of education at an approved dental school

11. Duration of IDP Program

The duration of the Program should be 2 years to comply with the Legislative mandate, serve the need of the IDP student, and be competitive in the IDP marketplace.

12. Patient Supply, Size of Program, Space, and Resources

PATIENT SUPPLY
A reasonable supply of patients for the IDP students would be similar to that for the Atraditional@ UCSF D3 and D4 students with an increase in the last two quarters to approximate the numbers treated by a 1st year AEGD resident in quarters 2 and 3 of that program.

This translates into an Aactive@ patient supply (patient assignment list) of 25 patients each for quarters #2 and 3; 40 patients in quarters #4, 55 patients in quarters #5 and 6 and 70 patients in quarters #7 and 8. Thus, for each IDP student, approximately 75 patients will need to be recruited to the pool.

Current new patient visits (NPV) averages approximately 90 per week with for the current D3/D4 students. This number is greatly reduced during the fourth quarter due to the 4th year 4th quarter students completing existing treatment plans and not starting Anew@ cases.

Conclusion:
For each group of eight IDP students added to the existing Traditional student clinic enrollment, an increase of approximately 600 patients would be needed to be recruited into the clinic. Depending on the size of the class, assume 16 IDP students per class year for a total of 32. Twenty-four hundred (2,400) (approximately 54 per week) new patients would need to be added. Given the fact that we currently reduce the Spring quarter NPV=s and that by the nature of the IDP group community affiliations, the increase in the patients needed seems to be reasonably possible. Further marketing efforts for all programs is necessary to provide a wide range of clinical experiences for both Traditional and IDP students.

SIZE OF PROGRAM

General Information:
At the beginning of the comprehensive care program traditional class size was changed to 80 students per class based on groups of 8 students per group. This is currently in effect such that all rotation teams, pairings etc. are planned around this group size. Some modifications of this now occurs in several rotations but is workable within this group size. However, the current clinical rotations of Physical Diagnosis D-3, Oral Radiology D-3, Oral Medicine D-3, OMFS D-3 and D-4, Pediatric Dentistry D-3/D-4 would be impacted by any addition of IDP students if they are included in those rotations. Space limits in those rotations, precludes adding more students to each rotation group.

Concerning the pre-clinic laboratory experiences needed by the IDP students, that would seem to present minimal problems especially if their pre-clinical laboratory courses were planned and conducted during the Summer (July through September) quarter. In the summer, the 4th floor student lab is currently not scheduled with the exception of four (4) 2 days for pediatric dentistry lab sessions which these IDP students would also need. The current configuration of the 4th floor lab could accommodate the additional 16 IDP students in those sessions.

Options To Consider:
Year 1 - start with 8 IDP-3 students year 1 = 8
Year 2 - continue 8 - 2nd year IDP-4 and start 8 IDP-3 = 16
Year 3 - continue 8 - year 2 IDP-4 and start 16 IDP-3 = 24
Year 4 - Continue 16 - year 2 IDP-4/start 16 IDP-3 = 32
Year 5 and beyond - 16 IDP-4/16 IDP-3 = 32

Year 1 IDP-3/D3 = 88 D4/IDP-4 = 80
Year 2 - IDP-3/D3 = 88 D4/IDP-4= 88
Year 3 - IDP-3/D3 = 96 D4/IDP-4= 88
Year 4 - IDP-3/D3 = 96 D4/IDP-4= 96
Year 5 and beyond remains as year 4

Assume Tuition at $44,000 @ per year =
Year 1 - $352,000
Year 2 - $704,000
year 3 - $1,056,000
year 4 - $1,408,000

Consideration of increasing beyond 16 IDP students per class would mean reducing traditional student class size proportionately.

SPACE:
Space considerations are three fold; lecture, laboratory and clinic plus students lockers.

Lecture - Room for a class size of 96 (80 traditional and 16 IDP) is available. The greatest impact on lecture/seminar space would be when classes are conducted in Asmall groups@ and might add one or two seminar rooms and facilitator to conduct those sessions.
Laboratory - space is available in the Summer quarter for July through September since the restorative D-2 pre-fall labs have been eliminated by restructuring within the other 3 quarters. Therefore, concentrated lab courses could be held for the incoming IDP-3 students during the Summer. They could also attend the appropriate 8-9 am, 1-2 pm D-3 lectures during the summer and begin (3-5) 2 days of clinic rotations D3/IDP-3 beginning in the Fall. The IDP-3 could also attend required basic science courses during the Fall, Winter, Spring Quarter of their IDP-3 year, with some continuation of basic sciences in their second year/IDP-4.
Clinic - beginning in the Summer of IDP-4, they would begin eight (8) 2 days of clinic rotation. Space is available in AD@ and AC@ clinic for 16 operatories due to the Dental Hygiene classes not being held during the Summer quarter. Fall, Winter, Spring Clinic rotations would be integrated into the current D3/D4 clinic including Night Clinics, SFGH/FDC/Buchanan and out rotations to off-site clinics such as Santa Rosa Jr. College and Clinicia-De-La-Rosa. Other off-campus sites may also become available. Students D4/IDP-4 would be paired for these Non UCSF clinical off-site rotations and faculty appointments would be appropriately arranged (probably WOS).
Infrastructure:
Faculty offices, phones, computers, seminar rooms, etc.
Conclusion:
Clinic, laboratory and lecture/seminar space could be carefully scheduled to accommodate an additional IDP class size of 16 new students per year for a total of 32 IDP students. Possible addition of one more night clinic or a Saturday clinic might be needed.

RESOURCES
The primary resources needed to have an add-on International Dentist Program (IDP) are personnel, both faculty and staff. Some additional lockers would be needed for IDP student instruments and personal/equipment. This will be possible with the addition of 36 wooden clinic lockers during clinic AB@ and AD@ modernization. Additional Instrument mailbox lockers will need to be obtained. Space in the 1st floor corridor for these additions is available.

Basic Sciences:
Additional faculty for the basic sciences, depends on class/seminar configuration (lecture or seminar). One additional faculty may be needed for these classes on a part-time basis. Teaching assistants may be considered for these classes as well.

Clinical Sciences:

Laboratory; if all lab classes are held during the Summer quarter, it is possible that additional general dentistry faculty or staff may be needed and prosthodontics may need an additional faculty.
Clinics - One additional clinical faculty will be needed per 8 students. Therefore if 32 students, 2 full-time and 2 - 50% part-time clinical faculty will be needed. 4-4.5 FTE
For off-site rotations, volunteer WOS faculty will be recruited.
Program Coordinator - due to the complexity of admissions, interviewing, performance tests and scheduling, a full-time Program Director would be needed. 1-FTE
Program Director, staff support = 1 Administrative Assistant
Totals
Faculty FTE = 4-5.5
Staff FTE = 5
Program Dir FTE = 1

Additional resource implications are office space for the IDP program director and administrative assistant, and office space arrangements or additional clinic/basic science faculty. This space for clinic faculty may be alleviated by having more night clinic activities for the IDP students.

Additional possible resource implications would involve pediatric and OMFS faculty and staff if those program were to have extended hours clinical programs such as evening clinic or Saturday clinics.

Overall Conclusions:

Faculty/staff resources can be balanced by additional tuition and increased clinic revenue.
Clinical and laboratory space can be carefully scheduled to incorporate a class size of 16 for IDP - 3 and 16 for IDP - 4.
Office space will need to be assigned by the Associate Dean for Administration. Some existing space may need to be reclaimed to do this.
Patient supply should be able to be increased appropriately through marketing and increased NPV=s.
Class size per year of 16 could be accommodated into existing programs with increase in faculty/staff. Any larger IDP class would need a reduction of the Traditional student class sizes.
It may be best to wait to begin this program until after clinics AB@, AC@ and AD@ are modernized. This is due to the need during modernization to have surge space available while each clinic is being modernized.

13. Composition of program of study of existing IDPs
In a June 17, 1997 memorandum, Dr William Bird and Dean Julian Ponce reported on their visit to the international programs at The University of Southern California, Loma Linda University, and the University of the Pacific. This report, plus the review of literature from the 3 Universities with international programs and selected interviews educated our Subcommittee on the composition of their programs of study as well as other features. The comparisons are tabulated as follows:

Overview of Curriculum

UOP	Loma Linda	USCS
First Quarter Radiology and Radiographic Technique Radiographic Interpretation Dental Materials Periodontal disease Preclinical periodontia Pediatric Dentistry Preclinical Fixed prosthodontics Preclinical operative dentistry Preclinical removable prosthodontics	First Quarter Technical procedures Endodontics General clinic	First Trimester Oral Radiology Dental Materials Preclinical Endodontics Preclinical Fixed prosthodontics Behavioral Issues Preclinical Operative Periodontics Clinic Preclinical Rem. Prosth & Implants
Second Quarter Comprehensive patient care Pharmacology Orientation to clinic seminar Dental materials Pediatric dentistry Fixed prosthodontics Periodontology Preclinical operative dentistry Elimination of Pain Local Anesthesia	Second Quarter Conjoint dental seminar Christian belief and life General clinic	Second Trimester Endodontic Clinic Preclin. Fixed Prosth.Occlusion Emergency Dental Rx Chronic Orofacial Pain Oral Medicine Preclinical Operative Preclinical Orthodontics Periodontal Diseases Periodontia Clinic Clinical Restorative Dent. Preclinical Remov. Prosth & Implants
Third Quarter Preclinical endodontics Pharmacology Human growth and development Ethics Clinical Practice Clinical applications basic sciences Preclinical fixed prosthodontics Periodontology Occlusion Removable prosthodontics Oral and Maxillofacial Surgery	Third Quarter Conjoint dental seminar Removable partial denture design General clinic	Third Trimester Local Anesthesia Pharmacosedation Pharmacology Endodontic Clinic Fixed Prosth. Clinic Diagnosis/Treatment Planning Clinic/Semin. Emergency Dental Clinic Operative Clinic Preclinical Pediatric Dentistry Periodontia Clinic Remov. Compl. Prosth. Cl
Fourth Quarter Selective Clinical practice Basic Mgt. Science Oral Pathology Removable prosthodontics Pharmacology Endodontics Preclinical pediatric dentistry Orthodontics Oral and Maxillofacial Surgery Dental implants	Fourth Quarter Conjoint dental seminar Clinical oral pathology Pain control and psychosedation SDA belief and life General clinic	Fourth Trimester Emergency Medicine Ethical Issues Endodontics Fixed Prosth.Clinic Endo. Clinic Dx and Treatment Plan Clinic Emergency Dent Treat. Clinic Operative Clinic Orthodontic Seminar Orthodontic Clinic Pediatric Dent. Cl Periodontal Surgery Oral Pathol Rem Prosth Comp Cl Rem Prosth Partial Cl Oral Surgery Oral Surgery Clinic
Fifth Quarter Clinical sciences Oral pathology Special patients Clinical practice Clinical practice rotations - supplementals, selectives - clinical case presentations - extramural practice - emergency and screening - oral and maxillofacial surgery - pediatric dentistry - dental auxiliary utilization - applied orthodontics - facial pain clinic - oral medicine clinic	Fifth Quarter Conjoint dental seminar Scientific investigation General clinic	Fifth Trimester Ethical Issues Endodontic Clinic Fixed Prosth Clinic Geriatric Dent Clin Special Pt. Care Clin Dx & Treat. Plan. Clin Physical Evaluation Emergency Dent Rx Operative Clinic Orthodontic Clinic Dent for Children Clin Periodontics Periodontia Clinic Review of Literature Sem. Rem Prosth. Compl. Clin Rem Prosth. Partial Clin Oral Surgery Clinic
Sixth Quarter Special patients Management science Jurisprudence Differential diagnosis of oral disease Clinical practice Clinical sciences Clinical practice rotations - supplementals, selectives - clinical case presentations - extramural practice - emergency and screening - oral and maxillofacial surgery pediatric dentistry dental auxiliary utilization applied orthodontics facial pain clinic oral medicine clinic	Sixth Quarter Conjoint dental seminar General clinic	Sixth Trimester Ethical Issues Endodontic Clinic Fixed Prosth. Clinic Geriatric and Special Pts. Special Patient Clinic Dx & Treat. Plan. Clin. Physical Evaluation Clin. Emerg. Dent. Clinic Operative Clinic Orthodontic Clinic Dent. for Children Clin. Periodontia Clinic Rem Prosth Complete Implant Dentistry Rem Prosth Comp. Clinic Rem Prosth Partial Clinic
Seventh Quarter Special Patients Management science Basic science review Clinical practice Clinical science Clinical practice rotations - supplementals, selectives - clinical case presentations - extramural practice - emergency and screening - oral and maxillofacial surgery - pediatric dentistry - dental auxiliary utilization - applied orthodontics - facial pain clinic - oral medicine clinic	none	none
Eighth Quarter Preparation for State licensure Clinical Sciences Clinical practice rotations - supplementals, selectives - clinical case presentations - extramural practice - emergency and screening - oral and maxillofacial surgery - pediatric dentistry - dental auxiliary utilization - applied orthodontics - facial pain clinic - oral medicine clinic	none	none

International D.D.S. Program (IDP)

Program Features	UOP	USC	Loma Linda
Program Profitability	+	+	+
Program contributes to School financial resources	+	+	+
High fees utilized	+	+	+
Clinically productive students	+	+	+
Maturity of students	+	+	+
Motivation of students	+	+	+
Rewarding experience for faculty	+	+	+
Students demand for high quality education from Faculty and Institution	+	+	+
Satisfactory academic preparation (ranges from adequate to excellent)	+	+	+
Satisfactory clinical preparation (ranges from adequate to excellent)	+	+	+
Adequate pool of qualified applicants	+	+	+
Available clinical space is main limiting factor limiting program size	+	+	+
Reliance on tests administered by Schools for admission evaluation	+	+	+
Home country credentials play only a minor roll for selection for admission	+	+	+
Most students live in geographic proximity to campus	+	+	+
Program initiated	1987	1967	1985
# FTE	10	3 + 40 part-time & volunteer	2.6

Program Features	UOP	USC	Loma Linda
English proficiency a major concern/problem	+	+	+
Initial faculty resistance to the program based on concern about qualifications	+	+	+
Alumni resistance based on concerns related to qualifications, competition, & nationalism	+	+	+
Quality of students making it easier to attract without salary faculty coverage	+	+	+
IDP Alumni having strong affiliation to Program and support it as without salary faculty	+	+	+
Greater clinical productivity than domestic DDS students, requiring less staff coverage	+	+	+
Length of Program	2 years	2 years	18 months
National Boards best indicator of student qualifications	not reported	+	not reported
Rare for IDP student to fail to finish Program	+	+	not reported
Rare for IDP student to fail to obtain California Dental License	+	+	not reported
Most graduates practice in California	+	+	not reported
Most graduates practice in high earning practice areas rather than underserved areas	not reported	+	not reported
Students coming from countries where a dental degree requires no more than a high school education have difficulty due to insufficiency of training in basic science	+	+	not reported
Specially designed orientation program necessary	+	+	+
# students/class	16	30	20

Program Features	UOP	USC	Loma Linda
# applicants/year	120	70-100	120
Fee schedule for IDP dental services same as domestic DDS	+	+	+
Tuition *	$86,700/2 yrs	$67,546/2 yrs	$53,00/18 mo.
Financial Aid	95 % of students	not reported	not reported
Concern of Program Director re: UCSF/UCLA lower tuition/ fee structure	+	+	+
WEB Site for IDP Program	+	+	not reported
Average age of applicant	28 years (range 22-48)	not reported	not reported
IDP students bring new patient population to clinics	+	+	not reported

*Does not include fees, books/supplies or living expenses

USC

Selection Criteria for Admission to International D.D.S. Program

selection by IDP Faculty
Part I National Boards (75 or better)
Part II National Boards (some have on admission, required for graduation)
evaluation of home country credentials
immigration status verified
technical skills testing
English competency
Graduate Record Examination
ADA Science Achievement Test
performance on a bench test in clinical skills (fixed and removable prosthodontics, operative dentistry, spatial coordination)
performance on a comprehensive language exam administered by the American Language Institute (verbal and written)
interview with IDP Faculty
provide documentary proof in independently certified English translation of their dental degree, School record of academic achievement, and license to practice dentistry to practice dentistry from home country
2 letters of recommendation from former teachers re: clinical experience
Integration with 4 year DDS Program
separate faculty
separate clinic
partially separated curriculum
separate laboratory
clinical faculty to student ratio 1:6

UOP

Selection Criteria for Admission to International D.D.S. Program

selection by School Committee, headed by Program Director
National Board, Part I (75 or higher)
National Board, Part II (some have on admission, required for graduation)
TOEFL (585 or better)
TSE (Test of spoken language) (50 or higher)
bench test administered by School
provide documentary proof, in independently certified English translation of their dental diploma and academic record from their home Institution
use of D.C.-based National Association of Foreign Advisors: International Educators to evaluate foreign credentials
developed test using video presentation followed by written test to evaluate note taking and comprehension of spoken English
Integration with 4 Year DDS Program
separate preclinical laboratory
separate curriculum for first part of first year
integrated curriculum in remainder of first year and second year
fully integrated curriculum and clinic in second year
clinical faculty to student ratio is same as domestic DDS Program

Loma Linda

Selection Criteria for Admission to International D.D.S. Program

selection by School Committee, headed by Program Director
National Board, Part I (80 or better)
National Board, Part II recommended, but required for graduation
TOEFL
provide documentary proof, in independently certified English translation, of their dental degree, class standing, and license to practice dentistry in their home country
2 letters of recommendation from former teachers
2 day interview (including psychiatrist)
bench test
Integration with 4 Year DDS Program
separate clinic
separate curriculum
separate faculty
separate laboratory
clinical faculty to student ratio 1:6

14. Outcomes Assessment to ensure IDP graduate is academically and clinically competent and equivalent to the domestic 4-year graduate

The IDP student must pass Part I and II of the National Dental Boards
All separate and integrated courses in the IDP curriculum must be passed
All academic standards must be maintained
The IDP student will be assessed by criteria on a series of defined clinical competencies which have been developed for the School of Dentistry
Quality of Care Assessments will be performed
Productivity will be assessed
Students will take Clinical Qualifying Examinations
Performance on the California State Dental Board Examination is another outcomes assessment tool

15. Potential Relationship of the IDP to the Advanced Education in General Dentistry Program (AEGD) and to the Buchanan Dental Center

Consideration was given to the concept of linking the IDP to the AEGD Program as well as to the Buchanan Dental Center.

Linking the IDP to the AEGD Program

This idea was initially entertained because it could provide an additional clinical year to the IDP, thus broadening their opportunity to gain clinical experience and perhaps increasing the Program appeal. The additional year could be tied to a stipend (possibly through Graduate Medical Education [GME] monies). This concept of incorporating an additional mandatory year to the IDP linked to the AEGD Program was dismissed because:
it introduced potential visa problems
it would make the Program longer than the State Legislature mandate of 2 years
it would diminish UCSF’s capacity to be competitive in the IDP marketplace
it could require high fees for those individuals only desiring an AEGD program if there was total linkage
would be unpopular with UCSF 4 year graduates if admission from the IDP to AEGD was “automatic”
a required third year in an AEGD Residency linked to a 2-year IDP would not be consistent with the objectives of IDP applicants which are to learn current techniques and materials, make them competitive with domestic graduates for associateships, partnerships, or postgraduate education, pass the California licensing examination, all in the shortest possible time
in recent years, The AEGD Program has had the following number of foreign trained dentists: 1998-1; 1997-4; 1996-3.
It may be an advantage to have an extra year of training in the AEGD Program as an option rather than a requirement for IDP.

Linking the Buchanan Dental Center to the IDP
The Buchanan Dental Center has 16 chairs on the main clinic floor which is insufficient to accommodate the current number of AEGD Residents. Since there are approximately 30 AEGD Residents, off-site rotations were created to accommodate daily placement of Residents.

The laboratory space at the Buchanan Dental Center consists of 16 work benches which the AEGD Program utilizes for both didactic “hand-on” courses and patient care activities requiring laboratory procedures. This laboratory space could accommodate a limited number of additional students. However, careful attention to planning would be necessary in order to avoid adversely impacting patient care activities of the AEGD Program.

Any co-shared use of the Buchanan Dental Center for IDP clinical activities would likely require a proportionate reduction in AEGD positions. Use of this off-campus site would create logistical problems during the first year of the IDP due to didactic and laboratory course requirements on the Parnassus Campus. With the exception of the adverse impact on the AEGD Program, there would be less of a logistical problem in the second year of the IDP.

16. Impact of IDP on existing educational programs

A. Impact on pre-doctoral basic science curriculum
The traditional basic science curriculum would not be necessary to be part of the IDP. Specifically designed IDP courses in Pharmacology, Local Anesthesia, and Anatomy of the oral and maxillofacial regions should be considered. The Oral Pathology Course in year 2 of the four year curriculum (in the revised curriculum is the Biomedical Stream: Organ Systems and Human Pathophysiology) should be required for the IDP. A potential conflict exists if a first year IDP student is required to take oral pathology (required of 2nd year dental students) and certain clinical science courses (required of 3rd year dental students) as these courses are given simultaneously.

B. Impact on pre-doctoral specialty rotations
IDP students should be required to take all third year clinical rotations in the domestic 4-year program including: Periodontics, Oral Medicine, Oral and Maxillofacial Surgery and Physical Diagnosis, Orthodontics, and Pedodontics. Provisions will have to be made and resources provided to support these additional students without diluting experiences of the 4-year domestic students.

C. Impact on DI-DII predoctoral curriculum
The following major considerations need to be taken into account when assessing the impact on the DI and DII curriculum:

Physical Space
The 4th floor preclinical laboratory is presently in the planning stages for a major redesign to accommodate both a traditional lab bench and a clinical simulation delivery system for each student workplace. This new scheme will necessarily result in a downsizing of available spaces from 108 to 86 workstations for a traditional class size of 84 DI and DII students. Locker space is already minimal and lecture hall seating (N-225 & S-214) is maximized.
Faculty
Existing preclinical faculty are predominantly 50% FTE who spend 2 or 3 days per week on campus. These restorative faculty traditionally are only here on Wednesdays, Thursdays, and Fridays and spend the other days in their private practices. This group of faculty is relied upon to teach preclinical restorative and is maximally utilized in student contact teaching hours and are asked to serve on various school committees from 12-1pm and 5-6pm. They have no available time to teach in a new program. Vacation schedules for faculty must be considered.
Integration
Due to varying educational backgrounds and technical abilities of incoming international student, their immediate integration into the traditional DI or DII restorative lab courses is doubtful. The three existing programs in California start their international students in a separate laboratory course tailored to their specific needs.

The following suggestions concerning the above may be considered:

Space:
1. Laboratory space available for international DDS program:
  1. The 4th floor lab (or new sim lab) is not presently used in:
    a) Fall Quarter - Tues am, Thurs am & pm
    b) Winter Quarter - Tues am & Thurs am
    c) Spring Quarter - Mon pm,Tues am,Wed am & Fri am
  2. Prefall D-2 (Sept) is being terminated in 1999 leaving the 4th floor lab unused during the months of July, August, and September.
  3. Buchanan clinic has 16 lab stations available every Thursday am. AEGD students are in seminar at this time.
2. Locker space for international DDS program - With the remodernization of clinics B and D, additional 20 lockers will be available. In addition, 30 more could be installed along the walls at the ends of the 2nd and 3rd floor clinics. This has been cleared through the fire marshal. Doing this would be an expense, congest an already busy area, and alter the cosmetic appearance of these clinics.
3. Lecture seating space for international program
  1) With proper scheduling an international student class could be integrated with current DI or DII classes and seated in the larger lecture halls.
  2) Modernization of the 4th floor preclinical lab could/should include making this room lecture friendly – a raised lectern, audio visual VCR and slide projectors, retractable screen and room darkening curtains. This would provide additional lecture space and maximize student/faculty time – end walking back and forth from lab to lecture.
4. Consideration could be given to using evening and Saturday hours for the international dentist program.
Faculty
A separate faculty would need to be hired for the preclinical/clinical instruction of the international students because current faculty are maximally utilized and are not on campus the days the lab is available. Some clinical sciences lecture courses could absorb the additional students.
Integration into the existing DI and DII lecture and lab courses could be accomplished by decreasing the traditional class size by the number of international students. While this might be an unpopular notion, it may be a sound idea from a fiscal, space, and faculty support standpoint.

D. Impact on Predoctoral Clinical Science Curriculum and Clinical Courses (DIII-DIV)

Assumptions

The International DDS Program would be a two-year (eight academic quarters) curriculum.
Each IDP class would be a maximum of 16 students.
attend the existing D-III lecture courses.
IDP students would begin clinic courses in the Fall of the first year.
There would be no decrease in lecture, laboratory and/or clinical space for the traditional DIII and DIV curriculum as presented in Dr. Bird’s report.
There would be no decrease in faculty resources for the traditional DIII and DIV as presented in Dr. Bird’s report.
The existing DIII and DIV curriculum is adequate for the training of traditional dental students.

Possible impact on the traditional DIII and DIV curriculum
I. COURSES
a. DIII
1. Comprehensive Dental Care 139
CDC 139 is a four-quarter course beginning in the Summer of the third year. It is unlikely that IDP students would be able to take this course without preparatory work that demonstrated their suitability for clinical training. Therefore, a modified version of CDC 139 would need to be created that covered 3 (possibly 2) quarters. It is assumed that IDP students have sufficient clinical experience prior to their admission to the program to obviate the Summer (possibly the Fall) clinical quarter expected of the traditional DIII students. CDC 139 and its modified IDP version would have to be treated as equivalent courses.

Students in CDC 139 are divided into clinical teams of eight and assigned a faculty member as a “mentor”. The addition of 8 or 16 IDP students could be incorporated into the existing structure of the course provided that adequate faculty and staff are assigned to the course. At present, this course has an inadequate number of both. It is not clear what effect combining IDP students with DIII students within teams would have. It may be that IDP students would require less supervision by the attending faculty, thus freeing them up to attend to the traditional DIII students. It may be that IDP students would require more supervision and would frustrate the traditional DIII students. It would be a simple matter to assign all IDP students to the same team(s), until the faculty became familiar with the unique academic needs of the IDP students.

Currently, DIII students are paired in their clinical training; one student operates while the other assists. This arrangement has been criticized as providing insufficient operative experience for the DIII students. As the school moves towards a competency-based curriculum design, we will know if this criticism is justified. If so, future plans to “un-pair” the students would be thwarted by the addition of IDP students given the limitations of the school’s clinical space.

2. Clinical rotations:
Periodontology 139
Oral Medicine 139
Oral Surgery 137
Orthodontics 139
Pedodontics 106

It is not clear if the IDP students would have these rotations as part of their curriculum. According to Dr. Bird’s report, careful scheduling and/or expanded clinic operating hours could accommodate 8 or 16 additional IDP students.

3. Simulation laboratory:
Restorative Dentistry 136

It is not clear if the IDP students would have this laboratory class as part of their curriculum. Careful scheduling and/or expanded laboratory class hours could accommodate an additional 8 or 16 IDP students.

a. DIV
1. Comprehensive Dental Care 149
CDC 149 is a four-quarter course beginning in the Summer of the fourth year. The prerequisite to this course is successful completion of CDC 139. The prerequisite to this course would need to be amended to include the modified version of CDC 139 for the IDP students. We would need to determine if the IDP students are as competent after three quarters of clinical training as the traditional DIII students are after four quarters.

Students in CDC 149 are also grouped into teams of eight and assigned a faculty member as a “coach”. The addition of 8 or 16 IDP students could be incorporated into the existing course structure provided that adequate faculty and staff are assigned to the course. At present, this course has an inadequate number of both.

2. Interdisciplinary Studies 149
IDS 149 currently serves as additional clinical training in comprehensive dental care at the Family Dental Center at SFGH. At the present time, additional space for IDP students is not available. Blending IDP students with traditional DIV students would require a decrease in the present clinical experience of DIV students.

3. Elective Courses
Traditional students are required to take 8 elective units in the course of their 4-year curriculum. It is not clear if this same requirement would be made for the IDP students. If so, competition for available space in elective courses could increase, diminishing opportunities for the domestic students.

II. Faculty
DIII and DIV clinical faculty must be confident that all students are adequately prepared, both academically and technically, to treat patients. IDP students would have to demonstrate this preparation in one academic quarter if they are to start treating patients in the Fall of their first year. Otherwise, IDP students would have to be limited in the types of clinical care they could provide to patients until their preparatory work is complete. This poses potential problems for the existing CDC 139 course structure and faculty. It may necessitate having faculty that are designated to teach only IDP students in a customized clinical course.

III. CURRICULUM REVISION
The forgoing assessment is based upon the existing curriculum. The School’s Educational Policy Committee is currently considering a major curriculum revision. It is impossible to say at this time what impact an IDP program could have on this process or its outcome.

IV. CONCLUSIONS
Until an IDP two-year curriculum is proposed it is difficult to assess its consequences for the traditional DIII and DIV curriculum. It is unlikely that the two curricula will be identical unless it is determined that the IDP students are at the same competency level at the beginning of their program that the traditional DIII students are at the beginning of their third year. Managing two different curricula will present challenges for course and clinic directors to order to avoid diminishing the current educational experience of the traditional students. A customized curriculum for the IDP students will also require staff and faculty resources that may not be currently available.

17. School of Dentistry curricularrevision impact on IDP curriculum

Since the final curricular revision has not been completed or implementation approved, analysis of the impact is limited. However, it is likely that the curricular revision will impact the IDP. The specific curriculum for the IDP will be developed by the Educational Policy Committee (EPC) in the School of Dentistry, but potential conflicts and issues are foreseeable. For example, in the Biomedical Stream, which integrates the basic sciences with clinical applications, there are portions of the Stream that should be required for the IDP (e.g. Oral and Maxillofacial Pathology) and others that should not be required (e.g. Cell Structure and Function etc). Therefore, provisions should be made for IDP students to take selected portions of existing courses. The Office of the Registrar will need to be consulted.

There would be variable impact of curricular revision on the IDP: Five streams have been designed for the new curriculum. They are as follows:
1. The Foundations of Biomedical Science
2. Foundations of Dental Science
3. Patient-Centered Care
4. Scientific Method and Clinical Dentistry
5. Foundations of Restorative Care
Classrooms will have to be selected to accommodate larger class size. Ideally, implementation of the revised curriculum should be accomplished prior to implementation of the IDP to avoid significant alterations of the IDP, once the students are matriculating.

18. Impact of the Clinic Modernization Project on IDP implementation
The Clinic Modernization Project could have an impact on the IDP depending on the dates of completion of the Project and implementation of the Program. During the Modernization Project, “swing space” will be required to accommodate existing clinical program requirements that would preclude the possibility of integrating additional IDP students. Therefore, completion of the Modernization Project is recommended prior to complete IDP implementation.

19. IDP effect on Dental School accreditation
The American Dental Association (ADA) currently accredits conventional DDS and IDPs simultaneously within the regular accrediting cycle. This policy could change with a proliferation of IDPs. However, at the next accreditation site visit, additional preparation to include the IDP, can be anticipated.

20. Fiscal Impact
The following estimated IDP staff costs were prepared by Julian Ponce 3/18/99:
Program Head: Design of the program structure, design of curriculum, supervision of faculty, supervision of clinical training, and coordination with domestic pre-doctoral program

1.0 FTE x $100,000 per year + 20% benefits = $120,000

Dental Faculty: Teaching shall be provided by clinical faculty. They will be assisted by dental auxiliary staff and clinic administrative support staff.

Dental Faculty 4.50 FTE x $74,000 per year + 20% benefits = $399,600

Staff Support:Clinic Assistants, reception, billing, chart room

Clinic Assistants
2.00 FTE x $35,000 per year + 20 % benefits = $84,000
Support Staff
3.00 FTE x $30,000 per year + 20% benefits = $108,000
Central Services
$2,300 per student x 32 students = $73,600

Dental Supplies: Consumable supplies used in treatment. Estimated at $12,000 per student per year. Estimate based on present supply usage in UCSF Dentistry D4 Clinic ‘97/’98.

32 students x $12,000 = $384,000

Total Estimated Costs = $1,169,200

Projected Income:
- Total income presuming tuition of $44,000 per year x 32 students = $1,408,000
- Total clinic income at ‘97/’98 D4 level = $14,400 per student x 32 students = $460,800

Total Projected Income = $1,868,800

NET TO SCHOOL = $699,600 PER YEAR

The Subcommittee concurs with the above anticipated revenues and costs but also recognizes that there probably will be unanticipated costs. The above report is at full enrollment which does not reflect the probability that there will be an escalating enrollment. If the IDP is responsible for repayment of the start-up and phase-in costs plus interest, then the net to the School would not be realized until an undefined number of years later. The School should work with the Office of the President’s Budget Office who has developed a methodology for establishing fees to assure the Program is self-supporting in 3 years. Budgetary considerations must be given to infrastructure expenses, such as computers and phones. These type of expenses were not included in the above estimated fiscal impact analysis. Tuition structure should be flexible, re-evaluated yearly, and adjusted as needed to reflect potential increased costs of the IDP operation.

21. Status of UCLA IDP proposal
Dean No-Hee Park of UCLA School of Dentistry, on September 23, 1998, appointed Associate Dean for Clinical Dental Services, Dr Ron Mito, to Chair an Ad Hoc Committee on an International DDS program. His charge was to produce a broad assessment of the feasibility of establishing an International DDS Program. The Dean did not request a specific curriculum, but rather that the Committee consider issues and make recommendations in the area of: developing such a Program under the auspices of the University’s “high-fee professional programs” criteria; admission requirements; English proficiency: faculty commitment; program size; space requirements; resource implications (including tuition requirements); and the potential implications for the current pre-doctoral program.

Their Committee reviewed the other dental schools in California, currently having IDPs. They proceeded to look at feasibility and identify barriers. The specific curriculum design will be the charge of the School’s Curriculum Committee. They are planning to have a two-year program and have a high tuition fee. They plan to start with 8-12 students and then go up to 20-25 per year.

They are trying to identify a stand-alone facility to house the Program and have identified 3 potential sites. They will have some integration with the current DDS domestic program, but they want to limit the impact on the program as much as possible. They plan to have Part I of the National Dental Board as a requirement with a score of 80% or higher and a TOEFL score of 600 or more.

The start-up costs will be absorbed UCLA School of Dentistry. They also considered accreditation standards of the schools from which the students will be applying. They are also unclear whether the California State Board of Dental Examiners or some other agency will perform the accreditation review of foreign dental schools.

In general, the UCLA task force was in favor of implementing this Program and they are moving in this direction and have submitted their report to the Dean. They plan to form an Implementation Committee and are looking at the year 2001 or 2002 for Program initiation.

UCSF Vice Chancellor of Academic Affairs, Dorothy Bainton, recommended that UCSF and UCLA work together on a proposal.

Although there will likely be specific curricular differences between UCLA and UCSF, the Admissions requirements, Program goals and objectives, length of study, and tuition should be similar.

22. Role of the Educational Policy Committee
The IDP curriculum will require development of certain separate, specifically designed courses, given by additional, designated Senior Faculty, or by existing Faculty through special arrangement and compensation, or a combination thereof. The EPC, in consultation with the faculty, will determine the degree of integration with the domestic 4-year program. Provided there is School of Dentistry approval for the IDP, continuance of the process of curricular development should be the responsibility of the EPC. The information provided by this Subcommittee’s Academic Review should facilitate the next phase.

Completion of the Process of IDP Approval and Implementation

April 1999: Complete academic review of IDP program by Subcommittee of Academic Planning and Budget Committee
Refer to Academic Planning and Budget Committee
Present to Faculty Council and Dean
Present to Faculty
Refer to Educational Policy Committee
Present UCSF and UCLA proposals to UCSF Vice-Chancellor for Academic Affairs
UCSF campus and Academic Senate Review
Review by Chancellor and Cabinet
Review by the Office of the President
Present to Regents for approval
Identify new faculty and initiate curricular development and fiscal plan
Announce and publicize IDP program and begin accepting applications.
July 2002, admit first IDP class.

Conclusion
The Subcommittee’s Academic Review, which included interviews, document review and individual investigations, provided its members with knowledge of the issues surrounding development of an International DDS Program at UCSF. It is our collective conclusion that the Program would be desirable, feasible, and beneficial to the School of Dentistry. However, there are faculty concerns, expressed in this document, which must be addressed. The predominant concerns were that the IDP must not impact negatively any of the existent academic programs, including financially, and that the IDP graduate would be academically and clinically competent and equivalent to the domestic 4 year graduate. It is recommended that the process of an International Dental Program development and implementation proceed.

APPENDICES

Assembly Bill No. 1116
Policy on Self-Supporting Part-Time Graduate Professional Degree Program (including Implementation Guidelines)
Bird/Ponce Report on IDPs at other California Dental Schools
Defined Clinical Competencies for the School of Dentistry
Pertinent Correspondence:
January 13, 1997 Dean Bertolami letter to Kenneth L. Zakariasen DDS, PhD., Executive Director, CDA
February 18, 1997 Kenneth Zakariasen letter to Dean Bertolami
February 25, 1997 Dean Bertolami letter to Vice-Chancellor,Dorothy Bainton
February 26, 1997 Dean Bertolami letter to Department Chairs
March 6, 1997 Vice-Chancellor Dorothy Bainton letter to Dean Bertolami
Guidelines for Evaluation of International Applicants and Applicants with International and Domestic Records
CDA, Ethnic Societies Back Foreign Training Bill. July, 1997.vol.25.No.7.CDA Journal, 503-5-6
Bulletins, Catalogues, and Webpages from UOP, USC, and Loma Linda regarding their IDPs

Appendices are available by request from the Dean’s office.

Last Webpage Update: 4/25/13

University of California, San Francisco
San Francisco, CA 94143, (415) 476-9000
The Regents of the University of California

Last Webpage Update: 4/25/13

University of California, San Francisco San Francisco, CA 94143, (415) 476-9000 The Regents of the University of California

University of California, San Francisco
San Francisco, CA 94143, (415) 476-9000
The Regents of the University of California