Introduction/Background The coincidental simultaneous development of a new in hospital one year general dental residency program and a medical simulation center at St. Joseph’s Mercy Oakland Hospital in Pontiac, Michigan provided an opportunity to develop and implement fully integrated and objectively driven simulation based educational experiences to enhance and supplement the larger clinical curriculum of the residency program. Methods A needs assessment interview was conducted with the director of the dental residency. Two themes emerged as gaps in training or areas where the curriculum could be enhanced with simulation based education given the current equipment and capabilities of the developing simulation lab: 1) In Hospital Medical Skills (i.e., Intubation, and I.V. Starts); 2) Management and Identification of Medical Emergencies. Four initial simulation sessions (standardized patients, task training and high fidelity) were developed and planned for quarterly delivery. The initial sessions included training on: intubation and peripheral lines, as well as the management of some medical emergencies such as syncope, airway obstruction, chest pain and cardiac arrest. Immediately after the delivery of the first session, feedback from the residents made it clear that while they had enjoyed participating and found some value in the session, some of the content was beyond the residents scope of practice, lacked the fidelity of the dental clinical environment, was far above or below their skills and abilities, or was poorly timed in the academic year. The curriculum was re-evaluated and modified to more closely match the knowledge base, skills and needs of the dental residents. The timing of task training sessions were moved to coincide with relevant department rotations and scenario based simulations were created for the most common emergencies and then delivered in a simulated hospital setting, as well as a simulated dental office (clinical and administrative settings). Dental residents receive simulation based education on peripheral IV starts, basic airway management, vital sign assessment near the beginning of the academic year; intubation training prior to rotating through the anesthesia department. Throughout the course of the year residents participate in high fidelity simulation cases covering the most common dental office emergences.1 These cases include: 1) Foreign body airway obstruction; 2) Asthma attack; 3) Mild allergic reaction; 4) Angina; 5) Hypoglycemic; 6) Anaphylactic reaction; 7) Syncope or postural hypotension; 8) Cardiac arrest (BLS and supported ACLS); 9) Stroke; 10) Tachycardia; 11) Hyperventilation; 12) Sedation complications. Conclusion Since the redesign of the simulation based curriculum, residents have self-reported increased comfort and performance with the procedural skills and emergency recognition and management, pharmacology and pathophysiology covered in simulation cases. Additionally attending faculty members from the hospital’s dental clinic have expressed interest in using the curriculum as an interdisciplinary training exercise for the staff in the hospital’s dental clinic and their private practices. Research to evaluate knowledge acquisition and retention are currently under development and the next stage of evaluation for this curriculum. Reference 1. Malamed S: Knowing Your Patients. Journal Of The American Dental Association 2010; 141;3SS-7S. Disclosures Adams, Associate Director - DeVry Center of Excellence in Simulation.