From the Office of the Provost
Episode 17: Reimagining Dental Education at Pitt and Across the Commonwealth
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Joseph McCarthy: Hello and welcome to "From the Office of the Provost," a podcast that highlights exciting activities and initiatives in the provost's office or University-wide that bolster and enhance our collective vision for growth and transformation. I'm your host, Provost Joe McCarthy, and today I'm joined by Marnie Oakley, Dean of the School of Dental Medicine.
Marnie started her deanship in October of 2023, but she's been with Pitt Dental for over three decades. She received both her bachelor's and DMD from Pitt before serving as a dental officer in the United States Navy. She then returned to Pitt in 1996 as a clinical assistant professor and has since held various leadership roles.
Over the course of her career, Marnie's helped shape Pitt Dental's long-standing commitment to comprehensive community-based care, including the development and implementation of the school's Comprehensive Care Program. Her scholarship has had a national impact on both dental education and leadership development, helping to influence how future providers are trained across the country.
Under her leadership, Pitt Dental Medicine has been recognized among the nation's premier dental schools with a growing focus on expanding access to care, including initiatives that address the unique needs of rural communities which we'll talk a little bit about.
Welcome, Marnie.
Marnie Oakley: Thank you, Joe. I'm happy to be here.
McCarthy: So as I just mentioned, Marnie, you've been in the School of Dental Medicine for a while. It turns out this is actually your second stint as a leader of the school, but now with the role as far as the eye can see here, no end in sight. So, can you tell us a little bit about your vision for the School of Dental Medicine and what really sets apart the school on a national scale?
Oakley: Yeah, I feel like, Joe, at Pitt Dental Medicine, we have a lot to be proud of. Our mission is to improve oral health through our teaching research and our service. When you look at our current outcomes, we are certainly undeniably firing at all cylinders.
If I look at teaching just to start, thanks to the hard work of our faculty, our staff, and our students, our past few years of outcomes have been truly remarkable. We're looking at 99 to 100% first-time pass rates on our written national boards. And our students are not just passing, but they are hitting it out of the park. They are really one to two standard deviations across several of the sections of that exam.
If I look at their clinical outcomes, for two years in a row, we've had a 98 to a 99% first-time pass rate on those clinical exams, which are really tough to prepare for. And that outpaces so many of our schools across the nation. So, it's no surprise to me that they do so well, because at this point, we're looking at about 3,000 applicants for just our 80 spots in our pre-doctoral program. So, we have a lot of ability to pick the best and the brightest, and they show us that.
When I look at our dental hygiene program, this is the fourth year our dental hygiene program has had 100% pass rate as a first-time pass rate on their clinical exams. It's just really amazing when I look at the teaching portion of our mission.
When I look at the research portion, much like Pitt as a parent institution, we're a research powerhouse. We are ranked, right now, number 11 in the country. We have only about a dozen or so active full-time researchers, and that dozen pulls us into that number 11 spot. They're highly, highly funded, so they really are making their mark across all of the areas that they study, and it's really helping our translational research and impacts the care that we give to patients.
When I look at our service, I mean, we provide service to our patients in our community thanks to the Oakland Clinic. We're the only school on campus that has an active clinic that we run. We're looking at about 70,000 patients a year that we serve, and most often, a lot of them come from about three hours away. We are happy to serve as a safety net clinic for so many patients, like patients with special health care needs or patients with complicated specialty needs that have truly nowhere else to go.
So, when I think of our teaching, our research, and our service, boy, it's just a great opportunity to be proud of the work that we do.
McCarthy: Yeah, that sounds amazing. Those pass rates in particular, holy cow.
Oakley: Indeed.
McCarthy: I love it. So, as we both know, dentistry is quickly evolving, especially with advances in digital tools and patient care. How is the school embracing this innovation and preparing our students for the future?
Oakley: Yeah, thankfully, I mean, dentistry for decades has been such an archaic science, if you ask most patients, right? You have all that impression goo running down your throat, making you uncomfortable. And thankfully, we've made a lot of progress when it comes to our ability to incorporate technology into what we do.
So most recently, we had about a $5 million project to expand our digital labs. And we have three new digital labs because of that, which means our patients can now have the ability to come in and instead of having those gooey impressions that are really uncomfortable and then waiting two weeks for a crown or a month for a denture, we can put that into our digital lab, scan them, instead of the gooey impression, scan them, and then tell the printer to print them a new crown or print them a denture.
And it's just so wonderful for our patients to be able to take care or take advantage of that efficiency. And then to have our students as new graduates just come out and lead the conversations about technology out in practice. So that's a really big benefit for us.
I think of that when I think of technology and opportunities, and I would have to say that we are all embracing AI as well. We just actually had a faculty retreat all morning, yesterday morning, and had our staff in some sessions, too, about AI and what impact that would have. Not just on our curriculum and how we teach and how we approach our students, but really what kind of platforms should we be looking for in the healthcare setting to make sure that our patients have the advantage of the technology and the advancement, but then also are secure and comfortable with the fact that as humans, we're always going to put our minds on the data that comes out and not blindly just accept it.
But it's really exciting to think about how AI would pull into some of the diagnostic tools that we would have to predict disease. I think not just dentistry, but across medicine. I think that's having the biggest splash. It's really exciting.
McCarthy: You mentioned the goo. For me, it's that, chewing on the cardboard that makes you gag for x-rays that I want to get away from.
Oakley: No, nobody likes that.
McCarthy: So, turning to Pennsylvania for a second, we have one of the largest rural populations in the nation, and we've seen a workforce shortage in recent years in your field. How are you working to shape the way Pitt Dental is approaching this education and care delivery in these regions?
Oakley: Yeah, I think this topic is probably the one that I get most excited about after hearing you say 30 years, over 30 years or three decades at Pitt. This is something that excites me more than anything I think I've ever done or been in charge of or been adjacent to.
We have an amazing team of folks who really understand what is happening in Pennsylvania. I recently got to hear some of the American Dental Association's Health Policy Institute leaders, I never thought I'd be as interested as I am in healthcare economics. If you would have told me that in my past life, I would have been like, no way. But it's understanding this data that really helps us produce solutions that are going to matter and going to have a really big impact.
So, what I'm learning and what we're all seeing across Pennsylvania, like you said, it's the third most rural state in the nation. So, it's incredibly rural. And adjacent to that is, of course, rural access to care is not something that we've never heard of before. It's a nut we've been all trying to crack for forever.
In Pennsylvania, in particular related to dentistry, is that dentists, I found out dentists are leaving, exiting Pennsylvania more than any other state in the nation. So not only do we have a small percentage of dentists, but they actually leave to go to other states to practice.
And on top of that, we're really looking at what kind of impact we can have on the one, about 1.5 million people who don't have this care and the 50 plus counties out of the 67 counties that are considered health profession shortage areas.
So for us, we wanted to create something that would provide, increase our providers, get more access to care for our neighbors in Pennsylvania, but also do it in such a thoughtful way that it could be affordable, it could be scalable, and it could be sustainable.
And to me, that's what really defines our regional training centers. And that's what we've been calling our solution, if you will. And when I think about them, there's three sections or pillars of providers.
One is what we call a general practice resident. And that's someone who's graduated from dental school. They're a licensed dentist, and they really just want, they have a goal to be a more comprehensively trained provider. What we give them in dental school is, you know, certainly enough to get you competent, but they really want to work on their skill and their speed and their confidence. So, a general practice residency program that's one year long is exactly what they look for. And what's wonderful is if we go and develop a general practice residency program in a rural region, there's nothing but comprehensive dental needs. So those goals align really, really well.
The second piece of our regional training center is to really address the workforce issues of what we call the dental auxiliaries. And those are your dental hygienists, your dental assistants. And although those have been declining for about 8% currently, the same organization, the American Dental Association's Health Policy Institute, suggests that they're going to decline another third by the end of five to six years. So if you put that adjacent to losing providers, already having an access to care problem.
And one of the things I didn't mention about our dentists is that, second to only Hawaii, we have more dentists who are 55 years and older, which means in the next 5 to 10 years, they're going to retire or look at retiring. So, you can see that Pennsylvania is not seeing the worst of this.
So, we're going to build not only our providers, but, in dentists, but build them in dental assistants and dental hygienists. And the way to do it for us, as we see it in dental assisting and dental hygiene, is to go and recruit them from where they live.
A lot of data will tell us that if you pull someone out to the big city for college, I'm a good example of that, the likelihood for them to go back to the rural area is really low. So, we feel that if we provide what we call hybrid teaching, so the didactic classes for all three of these providers, the residents, the dental assistants, the dental hygienists, all of those classroom courses will be given online in an online format. And then all of their clinical training will happen in the region right there with one of our partners, either a federally qualified health center who has a bunch of dental needs and dental patients that come there, or with a rural or regional hospital in the area.
So, it's the hybrid teaching, train where you live, and strong partnerships that I think really make the model very unique and very, very different than what we've seen before.
McCarthy: Yeah, that's great. Sounds like a powerful combination. I, for one, really love that idea of educating the workforce in situ. That's why Pitt's really been committed to our regional campuses, and so I love that that's a hallmark of what your focus is in dental medicine.
When we think about that and training in the communities where people live, can you talk about how that impacts the student experience and their success post-graduation?
Oakley: Yeah, just, you know, trailing off of if you go to the big city, you're likely not to go back. We knew that, and we knew we had to create something very, very different that would be different than what we've tried in the past. And when you talk about access to care and medicine or dentistry in any way, a lot of times what you hear is folks from the rural communities will say, "We just need to convince people to come live here. This is a great place, right? You can raise your families here. The cost of living is awesome. You know, your money will go further. It's beautiful."
And you know, all those things are true. But the reality is that approach has not worked. And I think once you realize that you can't continue to do the same thing over and over again and expect a different outcome, right? You have to make something different.
And to me, that's why developing the strongest force of the dentist providing the care to be that one-year experience and have the goals align. So if their goal aligns with my goal, they want all that experience. If they leave after a year, that system doesn't break. And if I train the people from where they live, hopefully they train there and they stay there. And there's nothing but opportunity for a job right when they graduate.
So, our dental assistants can get their certificate right out of high school. And our dental hygienists, they can get their degree. Actually, what we offer for them is an accelerated bachelor's degree. So great opportunity for them to have a job right out of the gate and stay and serve in the communities that they really, really, you know, where their hearts are.
I mean, for me, the best stories and the outcomes that we've had when we started our dental assisting program back in right after COVID in ‘21, ‘22 was hearing folks say, you know, ‘my parents said I really wasn't good at sciences. So, I thought maybe I just have to get, kind of like a tech job or something like that. I really didn't think I could get anywhere near health care. But now I can see I can have a career in health care’.
And that was just so fulfilling for us to know that there they are. They're going to just train in a few short months, have a sustainable wage and a career.
McCarthy: This is all very exciting. Sounds like a win, win, win.
Oakley: We think so.
McCarthy: As you just described. As you continue to lead dental medicine, what's on the horizon? What comes next?
Oakley: There's always something next, right? You can't just stop there. So, you know, one of the important things I've learned as a leader is you can look ahead, but you got to make sure that you're keeping your eye on the mission. So, what's going well needs to continue to go well. And that's one thing that we're going to watch very closely. So, all those metrics that I started with, they better stick or even get better.
So, I feel like we're so fortunate right now that we've had such a longstanding time of success in our program that, we were able to lean on that success and leverage it to do this amazing, amazing work out in our regions. But yeah, we'll keep our eyes there on the home base. Part of that is really looking to expand our research and advance our research. Like I was alluding to before, that research is what changes how we treat our patients and advances our profession. So, it's-
McCarthy: One more cardboard.
Oakley: Right? right? We got to get past that, right? Somebody's working on that, I assure you.
McCarthy: Thank you.
Oakley: I'll put you in touch with them. But yeah, so we want to increase that footprint, maybe look at the possibilities of having brand new centers for our research and make sure that we're making the impact that Pitt is accustomed to and that the University and our school deserves.
We're really looking to leverage our regional training centers and the success of that and really thinking about how we can make them truly scalable.
So, we are in a nice position to lobby for some funding, especially now that the Rural Health Transformation Program is out and all that money is available. And we certainly are going to go after that.
And if we do, we're looking at really being across the state. And in my eyes, there's no reason why that model couldn't be scalable beyond our state. If it's working for us, I would love to sit down with my dean partners in other states and say, "Let me show you the blueprint. Here's how we can really make a difference for folks across our country."
As that model grows and as I continue to talk to my colleagues who are also deans in the health sciences here at Pitt, I think we have something very unique here at Pitt, which, when I talk to deans at other dental schools, they don't share with me that they have the same kind of collaborative relationships with the deans at their health science schools, at their institutions. And from day one, when I started talking about these regional training centers, those other deans were all in from day one. You know, tell us when you get there. Tell us when we can come. So, I think that is the goal.
And if Pitt does what we're capable of doing, we're really looking at changing the model of healthcare in rural areas and really looking at how we could integrate all sciences across those regions who are in terrible, terrible need. I mean, they talk to me about labor and delivery all the time and other services like orthopedics that they wish they had. And I would very much look forward to bringing that to the Pitt name, to all of these communities that are in need.
McCarthy: Yeah, well, I'm sold for sure. I'm sure you've also piqued the interest of a lot of our listeners.
So can you tell me how folks can stay connected and keep track of what you're up to?
Oakley: Yeah, the best way, right? Who would guess it, right? Just go to the internet. You can find us there. We're dental.pitt.edu. We have Instagram, Facebook, LinkedIn, but reach out, let us know what you're thinking.
Certainly let us know if you want to be part of some of the work that we're doing. We'd really welcome that.
McCarthy: Outstanding. Well, thank you, Marnie, for joining me today and sharing the great work that you and your team are doing.
And thank you, listeners, as usual, for tuning in. I am Provost Joe McCarthy, and this has been "From the Office of the Provost."
Oakley: Thank you.
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