The Licensure Equation:
Where YOU Fit
Adam C Shisler, DDS, Texas- Houston ’12
Immediate Past President
Ben Youel, Illinois ’13
Vice President
Keri Jamison, Louisville ’13
Chair, Council on Education and Licensure
Agenda
• The Nitty Gritty
• The Controversy
• Where are we on improving the situation?
We all want to get here?
Where do we start?
• Timeline:
– NBDE Part 1 & 2
– Awarded/On-track diploma
– Clinical licensure exam
– Application for licensure
– License
– Practice dentistry and love every minute
Slow it down
• First, where do you want to live?
• Find that state boards’ website
Can’t sit here?
• Only certain clinical exams are accepted
by certain state boards of dentistry.
– CITA (24)
– CRDTS (16)
– NERB ADEX (17)
– SRTA (30)
– WREB (34)
Say hello to my little friends
• Council on Interstate Testing Agencies
– CITA
• Central Regional Dental Testing Services
– CRDTS
• North East Regional Board
– NERB
• Southern Regional Testing Agency
– SRTA
• Western Regional Examining Board
– WREB
Collective Mission of the
Regional Board Exams
•
AADB Mission Statement:
– To serve as a resource by providing a national forum for exchange,
development and dissemination of information to assist dental
regulatory boards with their obligation to protect the public.
•
AADB Values Held Statement
– AADB values protection of the public whenever it seeks dental health
care.
– AADB values collaborative relationships within organized dentistry
among educators, accreditors, examiners and regulators.
– AADB values meeting the needs of all its members.
Fine Lines of Differences
ENDO –
Manikin
PROSTH –
Manikin
PROSTH –
Comp /
CSW
PERIO –
Live Pt
PERIO –
Comp /
CSW
REST Manikin
REST –
Live Pt
DIAG
Comp Ex
COST*
CITA
X
X
X
X
$2500$3000
CRDTS
X
X
X
X
$2095
NERB
X
X
X
X
SRTA
X
X
WREB
X
X
X
X
X
X
X
X
*Fees do not include Prometric/Pearson site fees or school
specific instrument fees.
X
$2085
$2300$2800
X
$1760$2360
Documents to Organize
•
•
•
•
•
•
Notarized Copy of Diploma
Certified Clinical Licensure Exam Results
Nitrous Certification from Dental School
AHA BLS Certification
DL / SSN Card
Part 1 / Part 2 Notarized Copies
Is this really the way it has
to be?
• The Controversy
ASDA Policy (L1: Interim)
The American Student Dental Association believes that any clinical licensing examination
intended to measure technical skill via a sequence of independent clinical tasks should:
A)be a non-patient based examination emphasizing the recognition, diagnosis, and treatment
planning of disease, in conjunction with the treatment of simulated disease by use of a
typodont.
B)be administered in the final year of dental school.
C)provide opportunities for remediation, at the candidates‘ dental school, prior to graduation.
D)guarantee anonymity of candidates and examiners.
E)be administered by examiners who have been calibrated to provide standardized and
consistent scoring.
F)not include a written examination that duplicates the content of the National Dental Board
Examination Parts 1 or 2.
G)be offered to candidates at the lowest reasonable cost possible.
H)be universally accepted by all state boards of dentistry.
I)be psychometrically sound.
ASDA Policy (L1: Interim)
While the American Student Dental Association supports continual improvement of existing
examinations and collaborative development of a new examination, the association believes
the following alternatives are preferable to the current licensure process:
A)Initial licensure without an independent clinical licensing examination. Graduates of a U.S.
CODA-accredited dental school should be eligible for initial licensure without taking any
additional clinical examination.
B)A portfolio-type clinical examination based on cases compiled during the final year of dental
school. Such an examination should require a standardized catalog of required clinical
procedures and the portfolio should be evaluated by an examiner independent of the dental
school.
C)A non-traditional patient based clinical licensure examination. Although the American
Student Dental Association does not support the use of live patients in traditional clinical
licensing examinations, the association recognizes the potential for creation of an ethical,
patient based examination.
D)An Objective Structured Clinical Examination designed to evaluate a candidate’s diagnostic
and treatment planning skills.
E)Completion of a one year post graduate residency program. Completion of a U.S. CODAaccredited post graduate program that has a minimum duration of one year should be
sufficient to substitute for the clinical licensure examination requirement in any jurisdiction.
ADA policy (2005:3351)
•
Resolved, that the Association supports the elimination
of human subjects/patients in the clinical licensure
examination process with the exception of the
curriculum integrated format within dental schools, and
be it further,
Resolved, that the Association encourages all states to
adopt methodologies for licensure that are consistent
with this policy.
The Controversy:
Ethics
1. ADA Principles of Ethics and Code of Professional
Conduct (Nonmaleficence & Beneficence)
2. Comprehensive care
3. Delaying treatment
4. Patient compensation
5. Price of the exam
6. Manipulating radiographs
The Controversy:
Accuracy
1. Subjective nature
2. One-day one-shot mentality
The Controversy:
Best Practices
1.
2.
3.
4.
Unnecessary treatment of incipient caries
Invasiveness
Redundancy of content
Reciprocity
What’s Happened:
• 2000: ADA favors the elimination of live
patients in clinical licensure exams
• 2003: NY option to do PGY-1
• 2004: ADA supports Universal Licensure
• 2007: NY mandate to do PGY-1
• 2007: CA, CT & MN option to do PGY-1
• 2007: ASDA & ADA Define CIF
• 2008: WA option to do PGY-1
What’s Happened:
• 2009: MN option to take Canadian OSCE
• 2010: CA option to submit Portfolio
• 2010: ADA directed to develop Portfolio
Exam
ADA Policy (Resolution 29-2012)
What’s Happening:
Eliminating Use of Human Subjects in Board Examinations
Resolved, that dental students providing patient care under the direct and/or
indirect supervision of qualified faculty is an essential method of learning clinical
skills including the ability to manage the anxieties, fears, reflexes and other
emotions related to dental treatment, and be it further
1. ADA Task Force on Portfolio Exam
2. Refining ASDA and ADA Policy on
Resolved, that although the use of human subjects in licensure examinations
raises certain
Patient-Based
ethical concerns, the
Exams
practice is not in and of itself unethical as
determined by the ADA Council on Ethics, Bylaws and Judicial Affairs
(Trans.1993:109),
and be it further
3. ASDA/ADEA/ADA
Strategy
4. State-Level
Advocacy
Resolved,
that the Association
supports the elimination of human subjects/patients
in the clinical licensure examination process with the exception of the curriculum
integrated format within dental schools, and be it further
Resolved, that the Association encourages all states to adopt methodologies for
licensure that are consistent with this policy
Questions?