Statement of Intent

The Swedish Medical Center GPR program aims to provide residents with an unparalleled education in hospital dentistry, with a particular focus on special needs and medically complex patients. The program involves two main locations: Swedish Medical Center, the largest non-profit hospital system in the greater Seattle area, and Seattle Special Care Dentistry, a private practice designed for medically complex and special needs patients. This unique affiliation between the two allows for residents to learn not only how to best treat medically complex/special needs patients, but also how to incorporate hospital dentistry into a private practice setting. It is our hope that after our program, dentists will seek medical staff privileges at their local hospitals.

Program Goals and Objectives

We have a comprehensive list of overall program goals and objectives. Our focus is caring for patients who present the greatest challenges to the dental profession.


We have curated a list of competencies in compliance with the ADA, that we feel our residents should be able to perform by the time they finish the program. These competency statements form the core of our evaluation process. Note that we have every confidence that a quality resident will be able to complete all of these statements by the end of the program with ease.

Structure of the Program

The majority of our outpatient clinical care is performed at Seattle Special Care Dentistry. The practice is designed to educate residents on the care of medically complex patients, and residents will have the added support and individual mentorship of our pediatric dentists, endodontist, periodontist and medical anesthesiologist. Residents will get a particularly significant amount of IV sedation and General Anesthesia experience in the private practice setting.


  • An anesthesia rotation at Swedish Medical Center (Ballard Campus) where residents spend five weeks learning about anesthetic techniques, airway management, venipuncture, general physiology, fluid balance and emergency preparedness.
  • A twelve-day medicine rotation that includes five days with Swedish's hospitalists, two days with a plastic and a head and neck surgeon, and five days with the cardiothoracic surgery team. This rotation gives the residents ample experience physicals, laboratory studies, cancer considerations, and the opportunity to learn about and view open-heart surgeries.
  • A robust pediatric dental experience, consisting of a rotation to Odessa Brown Children's Clinic (a low-income, healthy child clinic) and weekly GA cases performed at SSCD with our pediatric dentists. This rotation is comprised of four days per week for three months.

On-call Experience

Residents cover the Swedish Medical Center Emergency Department via pager from home. When paged, the resident evaluates the patient with the ED attending. Dental attendings are consulted and go in to meet with the resident as appropriate. Emergent patients include dentoalveolar and maxillofacial trauma, significant infections, and risk management cases within the medical center.

Didactic Program

We feature a very robust didactic program, which includes biweekly lectures and additional treatment planning.

Lecture Series

  • Physical diagnosis (taking/recording a History and Physical examination)
  • Internal Medicine (a comprehensive review of anatomy, physiology, medical treatment and how dentistry may need to be modified as a result)
  • Moderate/Conscious Sedation (oral, nitrous, transmucosal, intravenous)
  • Medical Emergencies and Dental emergencies
  • Pharmacology of medications used in dentistry (Anesthetics, Analgesics, Antimicrobials, etc.)
  • Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS)
  • Advanced dentistry (Restorative, Endo, Perio, OMFS, Pros, Pedo, Ortho, Oral Med, etc.)
  • Business/Legal (Guest lectures by Accountants, Attorneys, Bankers, Office designers, etc.)

Grand Rounds

Grand rounds are held every six weeks on a Tuesday evening. Each resident presents an interesting case via a PowerPoint presentation to their fellow residents and attending doctors. These presentations include a review of pertinent literature and are expected to be about twenty minutes in length. Afterwards, a discussion of the material ensues.

Resident Lectures

Each resident presents an in-depth literature review/lecture (via PowerPoint) on a particular subject related to dentistry. Expected length is 2 hours.

Clinical Experiences

The program has a strong clinical focus in the following areas:

  • Dentoalveolar Surgery (extractions [including impactions], alveoloplasty, pre-prosthetic surgery, tori removal, implant placement)
  • Oral sedation/Nitrous Oxide sedation/IV sedation/General Anesthesia
  • Restorative Dentistry, including crowns and implant restorations
  • Endodontics (Molar endos using rotary instrumentation, microscope, and piezo)
  • Pediatric Dentistry
  • Removable Prosthodontics
  • Business/legal side of dentistry (insurance billing, financial consults, etc.)

Application Requirements

We accept five residents per year for this one-year program. Applicants must have graduated from a US or Canadian Dental School by the start of the residency. They must have passed Parts I and II of the National Board exam. In making our decisions, we evaluate dental school performance, letters of recommendation, demonstrated motivation and how well-rounded the applicant is. We are looking for applicants who will flourish in our area of dentistry and incorporate it into their careers. We recognize that while high academic performance is desirable, some candidates excel in other ways, and we consider the complete application. Interviews are mandatory for those whose paper applications meet our standards. Take a look at the Swedish GPR Admission Criteria and Policies pdf.

Application process

We participate in PASS.

Our PASS program number is GPR548.

The PASS applications are due by October 1, 2019 with no additional materials required other than a quality photograph of yourself. You may either send a 2x2 printed image via traditional mail to our office, or Email a 300 DPI JPEG image to

Earlier submission is encouraged due to the heavy backload at PASS in late September.

Our interview dates are scheduled for November 4, 2019 and November 8, 2019.

Visiting the Program

Applicants visiting Seattle are more than welcome to come and spend a few hours with us to see the program first hand. Because our normal daytime operation is busy, we can only host visitors at specific times. If you are interested in a visit, please Email us at and our staff will help find a time that is mutually acceptable. Note that whether or not you come to visit the program has no bearing on our application process.

About the Director, Assistant Director, and Faculty

Dr. Noah Letwin is the Director of the program. He has been on the GPR faculty ever since he completed his own, serving as Assistant Director for years prior to becoming Director. Dr. Letwin has a PhD in Pharmacology, is both the primary resource and principal didactic lecturer for the residents, and is available for dental counsel. Dr. Letwin additionally oversees the transition of residents through their rotations, with attending coverage for on-call residents. He has been instrumental in making this program exciting and full of rich experiences.

Dr. Aarika Mitchell serves as the Assistant director to the GPR program. She completed her GPR in this program, and rejoined our faculty as Assistant Director. Dr. Mitchell works in conjunction with Dr. Letwin to provide all residents with any resource they need, including attending coverage for on-call residents.

All our faculty members are trained and quality educators who have been involved in both the academic and private community. They have agreed to work in this program because they love to teach, are committed to residency training, and believe in the mission of the program. Please see their short bios on our faculty page.

Salary and Benefits

Expected salary is $57,600 plus benefits. Each resident is provided three weeks of vacation per year; residents expecting to apply for specialty programs must conserve their vacation time for interviews and transfer time at the end of the year.

Our Strengths and Details to Consider

Our Strengths

  • Our greatest asset is the quality of the faculty members who work with us--they comprise some of the finest experts we have ever found in their fields.
  • Swedish Medical Center is a well-established hospital system, providing exceptional support and resources to this residency program. We are very pleased to be able to work with them.
  • Seattle Special Care Dentistry is furnished with new digital radiography technology and electronic records. Residents become comfortable in a near-paperless office and learn volumes about how a private practice is managed from the business end, including how to open and build a practice.
  • We are fully accredited by the ADA Commission on Dental Accreditation, and are recognized by the Washington State Dental Quality Assurance Commission.
  • Our training in GA/IV sedation, pediatric dentistry, dentoalveolar surgery, implants, special needs, and medically complex patient care is among the finest in the nation.
  • The most important thing we want to emphasize is that we have had wonderful careers working with patients the average dentist is unwilling or unable to treat. We work with underserved/underfunded patients and enjoy doing so. Our goal is to never have to refuse care to someone who requires our expertise based upon their financial situation. We hope to pass these ideals on to our residents, and have them find similar ways to be civically minded in their careers.

Details to Consider

  • Our focus is on medically complex/special needs patients. Ample complex dentistry of all varieties is available throughout the year, but this is not a program that has a primary focus on luxury dentistry.
  • Residents are issued limited licenses that apply to their duties while working in our program. A full Washington State license is not required. Residents must obtain a personal NPI number and DEA registration.
  • Assistants are available at all clinical treatment sites. Residents only do labwork that would normally be expected of any general dentist in a private practice setting.
  • We treat our residents like professional colleagues and associates in our practice. We expect a lot of them, but give a lot in return. Residents work hard and put in long hours because we believe this is the best way to learn!
  • Questions are welcome. Please feel free to contact us!

Thank you for considering our residency. GPRs/AEGDs provide wonderful opportunities for career enhancement, and you are to be congratulated for pursuing a postdoctoral program!

Lecture Files