OTHER
J Oral Maxillofac Surg 69:1842-1846, 2011Department of Oral and Maxillofacial
Surgery, University of Puerto Rico
Luis J. Díaz-Cabrero, DMD,* Julio E. Guzmán, DMD,† Atilano León, DMD,‡ and Jerónimo Guzmán, DMD§ The Puerto Rico School of Tropical Medicine (Fig 1),
also known as Escuela de Medicina Tropical, was founded in 1923 at San Juan, Puerto Rico, in affiliation with the Rockefeller Foundation and Columbia Uni-versity. World-renowned research on medications and tropical diseases, such as malaria, tuberculosis, and uncinariasis, among others, was performed until 1946 when Columbia University withdrew as a par-ticipant. Inspired by its legacy, the University of Puerto Rico School of Medicine was inaugurated in 1950 in the same location previously occupied by
Escuela de Medicina Tropical.
The School of Dentistry was founded in 1957 at the University of Puerto Rico School of Medicine. It was accredited by the Puerto Rico’s Superior Council of Education and the American Dental Association. In 1961, Dr Lowell E. McKelvey, a retired Army officer, became the Dean of the School of Dentistry at the University of Puerto Rico. Because of the need for oral surgeons on the island and with the approval of a federal grant, the oral surgery and prosthodontics postgraduate programs were established in July 1963 by Dr McKelvey. In the beginning, 2 residents were admitted to a 36-month oral surgery program.
Dr Lowell E. McKelvey was the oral surgery pro-gram chairman from July 1963 to June 1969. He was also president of the Board of Oral and Maxillofacial Surgery in 1971. Puerto Rico’s geographic location and Dr McKelvey’s fluent English and Spanish were critical in developing relations with Latin America.
Dr Ramón Cabañas, a graduate of the Oral Surgery Program at Millard Fillmore Hospital in New York, became the second program director from 1969 to 1981. Dr Cabañas is known as the father of oral and maxillofacial surgery in Puerto Rico. Before him, oral surgeons were not well respected in the operating room. He broke down barriers and gained respect for the program. During this time, 3 residents were ad-mitted per year, 2 locals and 1 foreign Latin-American resident.
Dr Ramón Cabañas was truly a visionary of the specialty. His educational goals were not limited to training specialists for the Island of Puerto Rico but also to training oral and maxillofacial surgeons from Latin America who would go back to their countries of origin to teach and establish programs that would comply with the American Association of Oral and Maxillofacial Surgeons standards. In 1970, the first foreign resident was admitted to the program. This achievement also increased the respect and prestige of Puerto Rico’s program among the Latin-American countries.
In 1972, the oral surgery program, along with the schools of medicine and dentistry, were transferred to the Puerto Rico Medical Center at Río Piedras (Fig 2). In 1980, the program’s description was changed from oral surgery to oral and maxillofacial surgery.
The third program director was Dr Julio E. Guzmán, from 1981 to 1995, who developed an interest in the treatment of congenital anomalies. A clinic for con-genital anomalies was established at the Pediatric Uni-versity Hospital, where cleft lip and palate, among other anomalies are treated.
In 1990, the residency training period changed to a 4-year program. Since 1994, an agreement of cooper-ation with the Pedro Henrique Ureña University Den-tal School in the Dominican Republic and the US Army Training Program in Fort Gordon, Georgia was established.
The fourth program director was Dr José A. Mo-rales, from 1995 to 1999. As program director, he encouraged the residents to experience new
tech-*Private Practice, San Juan, Puerto Rico.
†Attending, Department of Oral and Maxillofacial Surgery, Uni-versity of Puerto Rico, San Juan, Puerto Rico.
‡Program Director, Department of Oral and Maxillofacial Sur-gery, University of Puerto Rico, San Juan, Puerto Rico.
§Private Practice, Palm Beach, FL.
Address correspondence and reprints to Dr Díaz-Cabrero: De-partment of Oral and Maxillofacial Surgery, University of Puerto Rico, P.O. Box 365067, San Juan, Puerto Rico 00936-5067, Puerto Rico; e-mail:luijodiaz@gmail.com
©2011 American Association of Oral and Maxillofacial Surgeons
0278-2391/11/6906-0093$36.00/0 doi:10.1016/j.joms.2006.07.022
FIGURE 1. School of Tropical Medicine.
Díaz-Cabrero et al. Oral and Maxillofacial Surgery Department, University of Puerto Rico. J Oral Maxillofac Surg 2011.
FIGURE 2. Puerto Rico Medical Center.
niques in dental implant surgeries. A total of 300 implants surgeries are performed every year by resi-dents.
The fifth program director was José F. Lázaro, from 1999 to 2005 (Fig 3). He developed a keen interest in plastic surgery. A full scope of facial plastic surgery is now performed in the program, with a total of 130 cases annually performed by residents.
The current program director is Dr Atilano Léon, from 2005 to the present. His main goal has been to continue working toward the excellence of the pro-gram, bringing in all the updates in terms of the academics and clinical aspects of oral and maxillofa-cial surgery (Fig 4).
Since the program began in 1963, a total of 89 surgeons have graduated from the program. Of these individuals, 58 were from Puerto Rico and the United States, 12 from Venezuela, 10 from Mexico, 1 from El Salvador, 2 from the Dominican Republic, 2 from Colombia, 1 from Panama, 1 from Costa Rica, 1 from Curacao, and 1 from Chile. The program has been accredited by the Council on Dental Education of the American Dental Association and the American Board
of Oral and Maxillofacial Surgery. Since 1972, a total of 35 graduates from the program have successfully completed the American Board of Oral and Maxillofa-cial Surgery. In 2003, the program was reaccredited with several commendations and no recommenda-tions by the American Association of Oral and Maxil-lofacial Surgeons. This achievement has brought pres-tige to Puerto Rico’s program.
The program consists of 48 consecutive months of full-time study. The first year of the program exposes the residents to the fundamental knowledge related to the evaluation of patients in the hospital environ-ment. With on-call duty every third night at the emer-gency room, the residents work with medically com-promised patients at the outpatient clinic. A physical diagnosis course with second-year medical students, seminars, published data reviews and case presenta-tions, and an advanced pathology course provide ba-sic knowledge and skills for oral and maxillofacial surgery diagnosis and treatment. The residents are also introduced to basic research concepts, biostatis-tics, and scientific methods, so they can apply them in future situations during their professional lives. FIGURE 3. Faculty and residents of Department of Oral and Maxillofacial Surgery in December 2005. (Top row from left to right) Dr Andrés
Guerra, Dr Edgar Echevarría, Dr José Lázaro, Dr Lidia Guerrero, Dr Julio Guzmán, Dr Atilano León, Dr Angel Otero, Dr Yilda Rivera, Dr Francisco Bermudez, Dr José Morales, Dr Gerardo Guillén, and Dr César Talavera. (Seated from left to right) Dr Jerónimo Guzmán, Dr Anabela Herrera, Dr Elizabeth Orsini, Dr Luis Díaz, and Dr Ricardo Jiménez.
Díaz-Cabrero et al. Oral and Maxillofacial Surgery Department, University of Puerto Rico. J Oral Maxillofac Surg 2011.
The second year consists of rotations in the medical departments of anesthesiology (4 mo), internal med-icine (2 mo), and neurosurgery (2 mo). During the second year, the residents also participate in the out-patient clinic and in seminars, published data reviews, and a case presentation course.
The third year includes rotations in tumor service (1 mo), trauma service (2 mo), and the surgical inten-sive care unit (1 mo) of the general surgery depart-ment. The residents also have elective rotations in the oto-head and neck surgery department (1 mo) and dermatology (1 mo). In the third year, the residents work toward the improvement of all the acquired basic oral and maxillofacial surgery principles, evalu-ation of the medically compromised patient, treat-ment of complicated odontectomies, periodontal sur-gery, dental implants, benign tumors of the oral cavity, fractures of the facial skeleton, debridement and suturing of oral and facial lacerations, and mas-tering intravenous sedation techniques.
The fourth year seeks to refine the surgical tech-niques. The residents are expected to treat condi-tions such as congenital and acquired anomalies of
the mouth and face, develop expertise in recon-structive procedures of the maxillofacial area, and understand and apply the principles of bone graft-ing, orthognathic surgery, skin transplantation, and the use of alloplastic implants, as well the evalua-tion and treatment of facial plastic surgical proce-dures (cosmetic surgery). Each resident must also complete a significant publishable research project on a clinical subject related to oral and maxillofacial surgery.
The students who complete all the requisites of the 48-month program and have their course thesis ap-proved will obtain the MSD degree. The residents enrolled in this course have a maximum of 5 years to complete the research project and have the thesis approved by the thesis committee.
In addition to the 4-year postdoctoral program in oral and maxillofacial surgery, the School of Den-tistry offers a 6-month to 1-year special program that is not conducive to a degree, certificate, or diploma. The students receive a letter of comple-tion of the program. The program provides inter-ested foreign dentists with the basic didactic and
FIGURE 4. Faculty and residents of Department of Oral and Maxillofacial Surgery in December 2009. (Top row from left to right) Dr Edwin
Rosa, Dr José Morales, Dr Angel Otero, Dr Francisco Bermudez, Dr Edgar Belardo, Dr Lidia Guerrero, Dr Jaime Suárez, Dr Atilano León, Dr Julio Guzmán, Dr Edgar Echevarría, Dr Yilda Rivera, Dr César Talavera, and Dr Andrés Guerra. (Seated from left to right) Dr Mauricio Herrero, Dr Anabela Herrera, Dr Elizabeth Orsini, Dr Liz Arocho, Dr Uzkelia Uzkategui, and Dr Gerardo Guillén.
clinical experiences related to the latest concepts, diagnostic methods, modalities of treatment, and surgical techniques in the field of oral and maxillo-facial surgery.
Every year, the program has more than 350 hospital admissions, 300 cases performed in the operating room, 7,000 outpatient visits, and more than 1,000 patients seen in the emergency room. The program is affiliated with the University District Hospital, Trauma Center, Pediatric University Hospital, Oncology Hos-pital, Cardiovascular HosHos-pital, Industrial HosHos-pital, and San Juan Municipal Hospital, all of which are located at the Puerto Rico Medical Center. This medical cen-ter is a multidisciplinary level I trauma cencen-ter in which patients from Puerto Rico and the Caribbean are treated.
Currently, the oral and maxillofacial surgery pro-gram consists of 4 full-time, 4 part-time, and 6 volun-teer faculty members. The faculty of the program are
as follows: Dr Atilano León (program director), Dr José Morales, Dr Edgar Echevarría, Dr Julio Guzmán, Dr Bonifacio Rivera, Dr Lidia Guerrero, Dr Francisco Bermudez, Dr Angel Otero, Dr Jaime Suárez, Dr José Lázaro, Dr Iván Marrero, Dr Josué Castillo, Dr Héctor Ramos, Dr Nelson Mercado, and Dr Edgar Belardo.
The Puerto Rico Oral and Maxillofacial Surgery pro-gram is an outstanding propro-gram with a complete scope in all aspects of oral and maxillofacial surgery, including trauma surgery (⬎200 cases/year), dentoal-veolar surgery, cosmetic surgery (130 cases/year), dental implants and reconstructive surgery (300 cases/year), temporomandibular joint surgery, cleft lip and palate surgery (⬎20 cases/year), oral and facial pathology surgery (⬎20 cases/year), and or-thognathic surgery (⬎115 cases/year). These char-acteristics make the program an excellent training center that develops competent, responsible, and dedicated surgeons.
