I. Academic

Affiliation Agreement Policy

Subject: I. Academic – A. Student Affairs

Effective Date: 09/01/2015

Reviewed and/or Revised: 09/01/2017, 02/28/2024, 08/01/2025

Clinical Affairs’ Affiliation Agreements:

The UMSOD Affiliation Agreement Template is to be used for all Affiliation Agreements. Allow 2-3 months when processing new and/or renewed Agreements. The 2-3 months’ time frame allows appropriate time for review and to make changes, if necessary, before the Agreements can be signed and/or approved. 

An Affiliation Agreement needs to be reviewed by the originating Faculty member. The faculty member will then have 3 originals made and sign the 3 originals. The Affiliation Agreement is sent electronically in a Word Document to the Director of Medical Credentialing and Quality Assurance to be reviewed. After the Director of Medical Credentialing and Quality Assurance has reviewed the Agreement, the Affiliation Agreement is sent back to the faculty member with any edits or comments if applicable. If there are no additional edits or comments the faculty provider prints 3 originals of the Agreement and the Faculty’s Department Chairperson. signs the Agreement as originator. The faculty provider will have the 3 originals sent to the Affiliate to obtain the signature and/or approval of the Affiliate. 

The Affiliate would return the 3 signed originals to the faculty member who will forward them to the Director of Medical Credentialing and Quality Assurance for review and to obtain the Associate Dean of Clinic Affairs’ signature/ approval. 

The Director of Medical Credentialing and Quality Assurance will keep one of the originals for SOD files and return the other 2 originals to the faculty member. One original is to be sent to the Affiliate for their files, and one original is to be kept on file by the faculty member’s Department. 

The Director of Medical Credentialing and Quality Assurance will report the Affiliation Agreement to the Carrier for Liability purposes and monitor for renewal dates. If the Agreement is to be renewed, the faculty member would follow the process above for the renewal. 

Clinical and Educational Community Service Events Procedure

Subject: I. Academic – A. Student Affairs

Effective Date: 9/10/15

Reviewed and/or Revised: 09/15/2016, 05/26/2017, 09/01/2017, 07/25/2018, 08/25/2021, 02/29/2024, 01/30/2025, 08/01/2025

1. CLINICAL - For clinical community service outreach activities and health fairs that involve screenings, fluoride varnish, etc., a School of Dentistry Maryland State Licensed Dentist Faculty must oversee this event. The event must be located in Maryland. The following is needed two (2) weeks prior to the event for Liability Insurance reasons:  
   1. Student Activities Information and Guidelines form titled 'Information and Guidelines - Professional Liability Insurance Coverage for Student Volunteer Events with Clinical Activity (PDF)'  – needs to be completed and sent to Elyse Markwitz, the Director of Medical Credentialing and Quality Assurance at least two (2) weeks prior to the outreach clinical event for review and to obtain the Associate Dean of Clinical Affairs’ approval and signature.
   2. Dental Screening Consent form – each patient/participant obtaining a screening is to complete and sign the form. Original forms are kept on file by the overseeing Dentist Faculty’s Department and copies are sent to the Director of Medical Credentialing and Quality Assurance. 
   3. Template Sign in Sheet and Consent - The date on the form will need to be changed and reference the name of the outreach event. Each patient/participant obtaining a screening must sign in. Original sign in sheets and consents are kept on file by the overseeing Dentist Faculty’s Department and copies are sent to the Director of Medical Credentialing and Quality Assurance. 
2. EDUCATIONAL - For educational community service, virtual programs, or outreach activities that do not involve screenings, fluoride varnish, etc. a UMSOD Dentist Faculty or Faculty does not need to be overseeing the event. The following is needed two (2) weeks prior to the event: 
   1. Complete the following Educational Form titled 'Student Education Activities Form: NON- CLINICAL/EDUCATIONAL ONLY (PDF)'. The sponsoring UMSOD Faculty provider and the faculty provider’s Chairperson both sign this form. 
   2. Submit the signed form to Elyse Markwitz, Director of Medical Credentialing and Quality Assurance at emarkwitz@umaryland.edu.
3. A list containing the names of the students’ needs to be submitted to the Director of Medical Credentialing and Quality Assurance two (2) weeks prior to the event stating what the students will be doing at the event. 
4. Faculty is to notify students if they will NOT be assisting at the event and doing other volunteer tasks (such as: setting up, etc.) 

NOTE:  When the UMB campus closes due to inclement weather and all in person student activities are cancelled, volunteer student events are also cancelled. Students are not permitted to participate. This policy is required for liability insurance reasons.

Extramural Programs for Operative Dentistry for Students

Subject: I. Academic A. - Student Affairs

Effective Date: July 1, 2017

Reviewed and/or Revised: 09/01/2017, 01/24/2024, 08/01/2025

Extramural Programs - Credit in Restorative Dentistry as part of REST 548A Operative Dentistry: (updated 4/2017)

D4 students are assigned in blocks to participate off-site of the School of Dentistry in extramural programs and externships. Extramural programs are differentiated from externships in that there is faculty supervision at Extramural programs (Perryville, Access Carroll and Frederick). For D4 students there is no credit for procedures accomplished in the externships. For those extramural block assignments assigned by the school of dentistry, e.g., Perryville, Access Carroll, and Frederick (other Access programs are in the process of being established), full credit of Operative Procedures accomplished at these sites will be included in the calculation of student clinical grades. To receive credit at Extramural Sites the student is responsible for following the protocols to keep a daily patient diary for single tooth direct restoration procedures (excluding sealants) and complete the forms with supervising faculty signatures for each day of treatment. Each student must complete the forms to include the summary sheet, and the student will sign the summary sheet. The student also must attach the printout of procedures completed at the extramural site. This format for completion of forms in the Addendum on this Clinic Manual. For the Perryville extramural block assignment, the Axium summary for Perryville will be used in the grade calculation following the guidelines established above, but it is planned that the Axium will not be available after June 30, 2017. Starting July 1, 2017, the protocol for completing the paper forms will be enforced. Forms are to be placed under Dr. Strassler’s door, room 5253 before the last Friday in April 2017.

Mission of Mercy 

During the School of Dentistry’s Mission of Mercy participation, students will receive credit for their Mission of Mercy procedures in restorative dentistry following the same format as used for Extramural Assignments. The diary form for recording treatment must be used and submitted within 30 days after the Mission of Mercy following the protocols for faculty signature and summary for each day of treatment. The student signature is also required. 

All forms are to be placed under Dr. Strassler’s door, room 5253 or Dr. Strassler’s designee.

D3 students can participate in the extramural sites and receive operative credit towards their REST 548A Operative Dentistry (fourth year) grade. Clinical Operative treatment at Extramural sites will not count towards the clinic grade for REST 538A Operative Dentistry but will be included for the dental student in the calculation of the D4 grade for REST 548A Operative as described above. The student must submit the forms that are described above. Forms are to be placed under Dr. Strassler’s door, room 5253, within 30 days after completion of the offsite treatment.

Fourth-Year Service-Learning Externship Program

Subject: I. Academic – A. Student Affairs

Department: Dental Public Health

Origination Date: September 16, 2015 

Reviewed and/or Revised: 02/03/2016, 05/25/2016, 09/01/2017, 01/01/2024, 08/01/2025

Purpose: Defines procedures necessary for students to participate in an externship experience beyond the required Fourth-Year Service-Learning Externship.

Policy and/or Procedure:

NOTE: Additional Externship beyond the Fourth-Year Service-Learning Experiences see Dr. Swank and Dr. Manski. 

The Fourth-Year Service-Learning Externship is a clinical rotation that provides students with the opportunity to experience dental practice in a setting outside of the dental school. This applies to all fourth-year dental students. 

Students wishing to participate in externships service-learning experiences that fall outside of the required, year 4 service-learning experience should adhere to the following protocol to obtain permission from the Dental School. The Dental School wants to support students in these endeavors, when there is no conflict with other academic or clinical responsibilities, and when students make the necessary advance arrangements and secure appropriate authorization in advance. These arrangements and authorizations require coordination with several different entities within the Dental School and are the responsibility of the student seeking the opportunity. The student should: 

1. Submit a written request to Dr. Patricia Meehan, Associate Dean for Academic Affairs. This request should include the dates that the student is proposing for the experience, the site, and the specific activities that the student wishes to undertake. If the student misses any regularly scheduled academic assignments, or clinical activities those should be delineated, and the strategies for addressing those responsibilities should be outlined. If clinical activities are affected, the student will need the approval of their GP Director and Dr. Louis DePaola, Associate Dean of Clinical Affairs. Dr. Meehan will make the decision regarding whether the student’s absence can be approved.
2. The student should consult with Dr. Scott Swank, Externship Program Coordinator, to determine whether the Dental School has a current Affiliation Agreement with the proposed site. Affiliation Agreements are required in order for the Dental School’s liability insurance carrier to cover the student’s activities at the site. 
3. If there is no current Affiliation Agreement with the site:
   1. The student may request that an institutional Affiliation Agreement be established. This request must be submitted in writing to Dr. Scott Swank, Externship Program Coordinator. Institutional Affiliation Agreements generally take two to three months to complete.
   2. If an institutional Affiliation Agreement cannot be established, then it will be the student’s responsibility to obtain their own liability insurance. 
4. The extramural site documents requiring signature by the Dental School will be signed by Dr. Manski and Dr. DePaola, Associate Dean of Clinical Affairs. 

SAMPLE LETTER TO EXTRAMURAL SITE:

Dear _____:

I am writing regarding an externship for one of our students ____(name)____ who wants to do an externship at your (location name and Department).

The externship has not yet been scheduled.

I have attached the Agreement Template that we normally use for our student externships. Please let me know if this would be an acceptable Agreement for ______________.

If you are not the correct person to contact regarding this, please advise me who would be the person I should contact.

Thank you for your assistance.

Sincerely,

International Travel Requirements/Information

Subject: I. Academic – A. Student Affairs

Effective Date: July 1, 2016

Reviewed and/or Revised: 09/01/2017, 11/23/2025, 2/13/2026

Resources for University International Travel. UMB’s International Operations department provides safety and security services to all UMB personnel conducting international business or academic travel on behalf of the University. The UMB Global Hub is the mandatory point of contact for all UMB-sponsored international travel. For guidance on travel-related matters or to schedule a pre-departure safety and security briefing, please contact International Operations via the UMB Global Hub. 

For reference, the UMB Global Hub provides information regarding: 

• Emergencies abroad  
• FAQs for international travel 
• International SOS and how it benefits UMB travelers 
• UMB travel alerts 
• Travel planning and safety & security abroad 
• Travel policies and procedures 
• Other topics and resources  

Memorandum of Understanding (MOU)

Subject: I. Academic – A. Student Affairs

Department: Clinical Affairs

Reviewed and/or Revised: 09/01/2017, 02/28/2024, 08/01/2025, 3/27/2026

Policy and/or Procedure:

The MOU Template is to be used for all MOUs. Allow 2-3 months when processing new and/or renewed MOU Agreements. The 2-3 months’ time frame allows appropriate time for review and to make changes, if necessary, before the Agreements can be signed and/or approved. 

A MOU Agreement needs to be reviewed by the originating Faculty member. The MOU Agreement is sent electronically in a Word Document to the Director of Medical Credentialing and Quality Assurance to be reviewed. If appropriate, the Director of Medical Credentialing and Quality Assurance will send the Agreement to UMB Legal for review. 

After the Director of Medical Credentialing and Quality Assurance has reviewed the Agreement, the MOU Agreement is sent back to the faculty member with any edits or comments if applicable. The faculty provider will have 3 originals made of the Agreement and have their Department Chairperson sign the Agreement as originator. The faculty provider will send the 3 originals to the Affiliate to obtain the signature and/or approval of the Affiliate. 

If the Affiliate wants any changes made, they need to send them to the faculty member who will send them to the Director of Medical Credentialing and Quality Assurance to determine if the changes can be made. If no changes are to be made, the Affiliate would return the 3 signed originals to the faculty member who will forward them to the Director of Medical Credentialing and Quality Assurance for review and obtain the Associate or Assistant Dean of Clinical Affairs’ signature/approval. 

The Director of Medical Credentialing and Quality Assurance will keep one of the originals for SOD files and return the other 2 originals to the faculty member. One original is to be sent to the Affiliate for their files, and one original is to be kept on file with the faculty provider’s department.  

The Director of Medical Credentialing and Quality Assurance will report the MOU Agreement to the Carrier for Liability purposes and monitor for renewal dates. 

If the MOU is for an event or recurring events a list of the names of the students and UMSOD personnel need to be submitted to the Director of Medical Credentialing and Quality Assurance and to the Associate or Assistant Dean of Clinical Affairs 2 weeks prior to the event stating what the students will be doing at the event. Faculty is to notify students if they will NOT be assisting at the event and doing other volunteer tasks (such as setting up, etc.) 

If the Agreement is to be renewed, the faculty member will follow the process above for renewal. 

Non-UMSOD Student and/or International Scholars Shadowing Resident in Post Grad And PreDoc Clinics

Subject: I. Academic – A. Student Affairs

Department: Clinical Affairs

Origination Date: July 2016

Reviewed and/or Revised: 09/01/2017, 09/30/18, 2/28/2024, 8/1/2025

NON-UMSOD Students and/or International Scholars who are shadowing Faculty, Residents and/or Students on the Clinic Floor in the Post Grad Programs or Predoc Program can chairside assist in providing patient care if they have taken and have the following on file with UMSOD:

• CPR
• Bloodborne Pathogens (BBP - via Blackboard Clinic Essentials) - pass at 100%
• Start of Day Video & Assessment for STUDENTS & RESIDENTS ONLY (SODA/S - Via Blackboard Clinic Essentials) - pass at 100%
• HIPAA (via Blackboard Clinic Essentials) - pass at 100%
• Copy of COVID-19 vaccine
• Complete and Submit OSHA Questionnaire and submit to Director of Medical Credentialing and Quality Assurance;
  • Depending on current mask policy: once medically approved and cleared, a mask fit test is scheduled.

If they are here to ONLY observe and have no patient contact, they need to have the following on file with UMSOD:

• HIPAA (via Blackboard) - pass at 100%

Note: In addition, they need to complete and sign and have the Department Chairperson sign the Student Volunteers form and Confidentiality Agreement and send it to the Director of Medical Credentialing and Quality Assurance prior to being in the clinics. 

NOTE: The following appropriate forms need to be completed and signed by the appropriate people before visiting the clinic and submitted to the Director of Medical Credentialing and Quality Assurance prior to the visit.

1. Observation Form for Visitors 
2. Confidentiality Agreement
3. Visitor/Volunteer Agreement (School retains original. Volunteer retains a copy.)
4. Visiting Scientist Agreement/Intellectual Property Agreement

Office of Admissions Process:

The application process and requirements can be found on our website https://www.dental.umaryland.edu/ce under Advanced Programs for Internationally Trained Dentists. Listed below are the requirements.

Observation Form for Visitors

The University of Maryland School of Dentistry must abide by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This act sets standards for national electronic health data systems, simplifies submission of electronic insurance claims. In addition, it contains comprehensive regulations safeguarding the privacy of patients.

Before you will be allowed to observe the treatment of patients in the Dental School, you will need to sign a Confidentiality Agreement. By signing this agreement, you agree to abide by the privacy regulations of HIPAA. Briefly, you cannot disclose any of the following patient information:

Examples of violations

• Telling a friend that someone is a patient at the Dental School.
• Talking about the patient in an identifiable manner in the hallway or elevator.
• Disclosing that someone is a patient in a situation that is not related to the patient’s treatment (i.e., telling others about famous people you saw treated at the Dental School).

There are stiff fines for the violation of these regulations, 

$50,000 fine + one year in prison for improper disclosure of health information. 

$100,000 fine + five years in prison for obtaining health information under false pretenses. 

$250,000 fine + ten years in prison for using health information for personal gain.

Additional Forms

Foreign National Visiting Scientist Questionnaire

Student Acting as Patients Policy and Procedure

Subject: I. Academic – A. Student Affairs

Department: Clinical Affairs

Reviewed and/or Revised: 09/01/2017, 05/01/2017, 2/28/2024, 8/1/2025

Policy Statement

To ensure student safety and inform prospective students of participation expectations.

Procedure

Each Student must be screened and have a chart made except as noted below.

Faculty specifies parameters for partner/classmate exercise.

Student to follow Faculty instructions.

Note: State and Federal Laws specifically prohibit Radiography as being a part of the classroom activity or clinical demonstration. (See COMAR 26.12.01.01 page 41 Section F.3 – “General Requirements” subheading: (a) “Administrative Controls”:

Note: As part of the education process, students in all of the School’s clinical programs are required to provide treatment for patients and practice techniques with student-partners. Students are required to serve as patients for their classmates in performing  diagnostic and reversible procedures such as local anesthesia administration, sealant placement, and oral prophylaxis. The Dental School is responsible for ensuring timely and safe treatment of all patients during these processes. Individuals have the option of electing not to service as patients during such clinical exercises. These instances will be managed on a case-by-case basis by the faculty. 

Note: The Dental School recognizes that health issues that are not disabilities may arise during the course of a student’s enrollment. These situations may require the student to be absent from the academic program for a period of time or may limit the student’s participation in certain educational experiences. In certain instances, modification of a student’s educational program may be necessary. Possible modifications may include short-term leaves of absence or customization of the student’s schedule of course work. The impact of these adjustments may be a delay in the student’s progress toward graduation. While reasonable efforts will be made to support the student, an extension of the educational program may be necessary.

Student Externship Agreements Learning Experiences

Subject: I. Academic – A. Student Affairs

Effective Date: September 16, 2015

Reviewed and/or Revised: 10/6/2016, 09/01/2017, 08/01/2025

Definitions: The Fourth-Year Service Learning Externship is a clinical rotation that provides students with the opportunity to experience dental practice in a setting outside of the dental school

Policy and/or Procedure:

Student Externship Agreements Learning Experiences

Student Externship is a clinical rotation that provides students with the opportunity to experience dental practice in a setting outside of the dental school. This applies to all fourth-year dental students.

Students wishing to participate in externships service-learning experiences that fall outside of the required, year 4 service-learning experience should adhere to the following protocol to obtain permission from the Dental School. The Dental School wants to support students in these endeavors, when there is no conflict with other academic or clinical responsibilities, and when students make the necessary advance arrangements and secure appropriate authorization in advance. These arrangements and authorizations require coordination with several different entities within the Dental School and are the responsibility of the student seeking the opportunity. The student should:

1. The student should consult with Dr. Scott Swank, Externship Program Coordinator, to determine whether the Dental School has a current Affiliation Agreement with the proposed site. Affiliation Agreements are required in order for the Dental School’s liability insurance carrier to cover the student’s activities at the site.
2. If there is no current Affiliation Agreement with the site: 
   1. The student may request that an institutional Affiliation Agreement be established. This request must be submitted in writing to Dr. Scott Swank, Externship Program Coordinator. Institutional Affiliation Agreements may take up to two to three months to complete.
   2. If an institutional Affiliation Agreement cannot be established then it will be the student’s responsibility to obtain their own liability insurance.
3. The extramural site documents requiring signature by the Dental School will be signed by Dr. Manski and Dr. DePaola, Associate Dean of Clinical Affairs or Dr. Alkhubaizi, Assistant Dean of Clinical Affairs.

Student Judicial Policy

Subject: I. Academic – A. Student Affairs

Effective Date: July 2016

Reviewed and/or Revised: 09/01/2017

The Student Judicial Policy applies to students in the Dental School DDS program, Bachelor of Dental Hygiene program, and students in Advanced Dental Education certificate programs: Advanced Education in General Dentistry (AEGD), Endodontics, Orthodontics, Pediatric Dentistry, Periodontics, and Prosthodontics. Students are obliged to carry out his or her designated responsibilities within the rules and governance structure adopted and agreed to by the community as a whole. Accordingly, student actions and behavior in the clinic are subject to review as described in the Student Judicial Policy.

This academic community has interrelated responsibilities of producing and disseminating new scientific knowledge, teaching, caring for patients, and educating individuals to carry on these same functions. In carrying out these responsibilities, the academic community needs rules to guide the maintenance of high standards.

Student Responsibility Statement

Subject: I. Academic - A. Student Affairs

Department: Clinical Affairs

Reviewed and/or Revised: 09/01/2017, 02/24/2024, 08/01/2025

UMSOD Student Responsibility Statement (Updated 10/09/20)

OVERALL GUIDELINES

• The primary goal of all UMSOD clinics is to ensure that patient-centered care is the priority.
  • Patients should expect to be treated with high ethical standards, and students should exhibit qualities such as honesty, compassion, kindness, courtesy, integrity, fairness, and charity.
  • Students must always strive to do what is right and in the best interests of the patient.
• Students must provide patient-centered treatment at ALL times.
  • Students will provide timely and high-quality dental treatment to ALL assigned patients.
    • This includes dental care provided to same day “emergency” patients.
  • Students must attend ALL block assignments, clinical rotations, and assigned externships.
  • Students must arrive on time to their designated clinic sessions or block assignments and must be dismissed by faculty before leaving.
  • If students are not treating patients for a session, they must be reachable via cell phone or email and be able to return to the clinic floor ASAP.
    • The PCC for each GP will maintain a current list of phone number/emails.
  • Students MUST ask faculty to intervene if they are unable to complete a treatment in a reasonable amount of time.

GENERAL RULES

• Clinic Policies and Procedures
  • Students must follow all UMSOD policies and procedures contained in the clinic manual.
  • All dental treatment must be performed in designated clinical spaces under the direct supervision of a licensed faculty member. 
  • No patient dental care may be performed in Dental laboratory and/or Simulation spaces. 
  • Patients/visitors may not enter non-clinical spaces unless they are approved by Clinical Affairs.
• Health Insurance Portability and Accountability Act (HIPAA)
  • Students must understand and follow all rules related to HIPAA.
  • Students must remember that all patient information is the explicit property of the patient and the SOD.
  • Patient images may NOT be published on social media.
  • All mobile devices must be registered with the UMSOD Office of Information Technology
  • All laptops and mobile devices must be encrypted and password-protected
  • All patient images must be uploaded into the patient management system.
  • No patient information is publicly accessible.
  • Any HIPAA infraction is considered very serious and may result in a loss of clinical privileges.

• CPR status
  • Students must maintain a current CPR status (required recertification every 2 years) to work in the clinic.
    • Note: this CPR certification will be maintained on file with the UMSOD Director of Credentialing and Quality Assurance.
• Swipe cards
• Students CANNOT use faculty swipe cards, and faculty should NOT give their swipe cards to students to be used.
  • This is considered fraud and is a legal matter of “impersonation.”
• Clinic missteps
  • Students must be familiar with the Clinic Missteps document and fully understand the consequences for the various missteps.
• Chart documentation
  • ALL clinical documentation must be maintained in the patient’s Electronic Health Record (EHR), which includes:
    • All treatment notes,
    • Any relevant patient conversations/comments related to treatment, including, but not limited to:
      • Restoration shade approvals,
      • Verbal consents,
      • Specific questions.
    • The patient’s medical history/medications must be updated and approved at each visit (including BP).
• Adverse incidents
  • Students must immediately report any adverse incidents to the covering faculty.
  • Students must complete all documentation and report any adverse incidence to the Emergency Response Team, which includes:
    • Incident Report Form,
    • A relevant note in the patient’s EHR
• Infection Control
  • Students must wear appropriate Personal Protective Equipment (PPE) that is compliant with Occupational Safety and Health Administration (OSHA), Centers for Disease Control and Prevention (CDC), and UMSOD Policies and Procedures:
    • Appropriate school-issued scrubs and closed-toed footwear,
    • Disposable blue jacket/coat,
    • Eye protection with side shields,
    • Properly fitting gloves
    • A mask that covers the nose.
  • Scrubs approved by the UMSOD must be worn for all clinical, preclinical and lecture activity.
    • The proper color for each class should be worn.
  • In addition, all hair should be properly contained (hair should be pulled back and off the face), and men should be neatly groomed.
  • Students must properly disinfect the patient’s chair and all necessary equipment and apply all required barriers prior to seating the patient.
    • Students must properly remove all barriers and then properly disinfect the patient’s chair and all equipment after dismissing the patient.
  • Disposable blue gowns/coats
    • UMSOD provided disposable blue gowns/coats must be worn during all patient contact/treatment.
    • Gowns must be worn ONLY in the clinical areas!
    • Gowns must NOT be worn in restrooms, in eating areas, or outside of clinic.
    • Gowns must be disposed of in the white cloth bins.
      • DO NOT place them in the trash OR in the red biohazard waste bags.
  • Biohazard waste (RED bags)
    • Biohazard bags must be used for disposal of single-use items having come into contact with a patient.
      • Ex: GLOVES, gauze, cotton rolls, suction tips
    • Note: anesthetic carpules and syringe needles, scalpels, scalpel blades and other recognizable sharps should be placed in the RED SHARPS container.

BEFORE SEATING THE PATIENT

• Students must ensure that their patient has been “checked in” at the front desk.
• Patients are responsible for paying any past-due balance prior to being seated.
  • If an outstanding balance cannot be paid, the patient should be escorted to the business manager to make financial arrangements.
• If there is a problem with payment and/or collection of an outstanding balance, students must discuss this with their GP director/assistant director before providing any additional treatment, unless the treatment is of an emergency/urgent nature.
• Ideally, all financial transactions will have been satisfied by the front desk staff prior to the patient being seated for treatment, however, it is ultimately the student’s responsibility to verify that the patient’s account balance is current.

GETTING A “START”

• Students must review the chief complaint, current radiographs, medical history, and take a current BP before requesting a “start” from faculty.
  • Once the “start” has been granted, the student may begin clinical examination and/or treatment of the patient.
• All dental treatment planned for the day must be reviewed and approved by the covering faculty before treatment is started.

PATIENT CONSENT AND COMMUNICATION

• Students must obtain all appropriate patient AND faculty consents before rendering treatment.
• Students should constantly be working to improve their patient communication skills, including:
  • Active listening skills,
  • Explaining procedures appropriately to ensure that patient comprehension,
  • Giving patients the opportunity to ask questions.

BEFORE DISMISSING THE PATIENT

• Students must ensure that all treatment is entered/swiped in Axium and approved/completed by faculty prior to the patient being dismissed.
• Students must walk their patient to the front desk to check out.

I have reviewed and understand the above clinic Student Responsibility Statement and agree to accept the above referenced responsibilities while working under the supervision of faculty in clinic.

Print name: _____________________________________________ GP: ______________

Student signature: ________________________________________ Date: ____________

Visitors in UMSOD Clinics, Clinical Laboratories, Simulation Laboratories, and Classrooms

Subject: I. Academic – A. Student Affairs

Department: Clinical Affairs - Clinics

Origination Date: 01/01/16

Effective Date: 01/01/16

Reviewed and/or Revised: 09/01/2017, 11/16/2020, 10/04/2021, 2/13/2024, 4/9/2024, 8/5/2024, 6/11/2025

Policy and/or Procedure:

Visitors, including family and children, are NOT permitted in any UMSOD Clinics, Clinical Laboratories and Simulation Laboratories unless they are a patient receiving care or a Visitor Form has been submitted and approved by the Office of Clinical Affairs prior to the visit.

This policy applies to all clinical students (residents), faculty, and staff. 

The following is needed for visitors to be in the clinic and needs to be submitted to the Director of Medical Credentialing and Quality Assurance prior to the scheduled visit. The following forms must be completed and signed by the visitor and sponsoring UMSOD department chairperson at least two weeks prior to being onsite: 

• The Visitor/Volunteer Agreement Form PDF (completed and signed by the visitor and chairperson of sponsoring UMSOD department)
• The Confidentiality Agreement Form (completed and signed by the visitor and chairperson of sponsoring UMSOD department)
• If the visitor is in the clinical laboratories, simulation laboratories or in the clinics outside of the splash zone (outside of the cubicles) the following is needed:
  • A KN95 mask and face shield need to be worn by the visitor while in clinical areas.
• If the visitor is in the clinic and within the splash zone (inside the cubicles), the following is also needed:
  • A copy of their current signed CPR copy.
  • Clinic Essentials training and assessments in Blackboard are required upon arrival at UMSOD. The visitor’s information needs to be added to the UMB Community Directory by the sponsoring department administrative person, so the visitor has access to Blackboard to review the Clinic Essentials requirements and take and pass the associated assessments in the VISITORS & OBSERVERS FOLDER at least one week prior to being onsite.
• For those in the clinic and within the splash zone: An OSHA Respiratory Questionnaire needs to be completed and signed and sent to the Director of Medical Credentialing and Quality Assurance. The person completes the OSHA Questionnaire form [regarding page 1 respirator section, please check off both a and b (half face)], sign and date page 3, print and email as a PDF file to: emarkwitz@umaryland.edu. Once the form has received medical review/clearance, the person is scheduled for a mask fit test.  NOTE: if the current UMSOD masking policy requires an N95 mask, the person will be scheduled for a mask fit test. Otherwise, a KN95 mask and face shield will need to be used while in the clinic. Note: High school and college student visitors who will be within the splash zone are not required to have CPR certification.
• The current Face Mask Policy will determine if an KN95 face mask will need to be worn in clinical areas (not chairside) of the UMSOD building.
• Social distancing guidelines are to be performed.

Clinical Competency Exam List

Subject: I. Academic – B. Competencies

Effective Date: 9/2/16

Reviewed and/or Revised: 09/01/2017, 2/13/2026

Click the following link to access the School of Dentistry Competency Statements and Competency Examinations.