Licensure 101
Christian Piers, MFA
Editor-in-chief
Colorado ‘16
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et
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The three types of
compensation
• Mastery  Meaning
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Agenda
•Status quo
•The controversy
•What’s happened
•What’s happening
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Three requirements
requirements
1. Educational
- CODA
2. Written exam
- NBDE I and II (JCNDE)
3. Clinical exam
- Today’s topic!
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Where do I start?
• First, where do you want to live?
• Find that state boards’ website
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Oh, you thought this was a
costume party?
• Only certain clinical exams are
accepted by certain state boards of
dentistry.
•
•
•
•
•
CITA
CRDTS
NERB
SRTA
WREB
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Subtle Differences
ENDO –
Manikin
PROSTH
–
Manikin
PROSTH
– Comp /
CSW
PERIO –
Live Pt
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
PERIO –
Comp /
CSW
REST Manikin
REST –
Live Pt
X
X
X
X
DIAG
Comp Ex
X
COST*
$2085
$2300$2800
X
$1760$2360
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Is this really the way it has
to be?
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ASDA Policy (L1: 2013)
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.
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ASDA Policy (L1: 2013)
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.
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The controversy
Ethics
1. ADA Principles of Ethics and Code of Professional
Conduct
2. IRB
3. Proper informed consent
4. Recruitment of individuals
5. Patient compensation
6. Price of the exam
7. Manipulating radiographs
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The controversy
Accuracy
1. Subjective nature
2. One-day one-shot mentality
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The controversy
“Best Practices”
1.Unnecessary treatment of incipient caries
2.Invasiveness
3.Comprehensive care
4.Delaying treatment
5.Redundancy of content
6.Reciprocity
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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
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What’s happened
•
•
•
•
2007: CA, CT & MN option to do PGY-1
2008: WA option to do PGY-1
2009: MN option to take Canadian OSCE
2010: CA option to submit hybrid portfolio
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Hybrid Portfolio
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Hybrid Portfolio
• Advantages
–
–
–
–
–
–
Psychometric elements of clinical exam
Conducted with patients of record
Longitudinal not cross-sectional
License upon graduation
Reduced stress
Reduced cost
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Hybrid Portfolio
• Disadvantages
– California only
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OSCE
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OSCE
• Advantages
– Non-patient based
– Reproducible and objective
– Less competition to get board patients
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OSCE
• Disadvantages
– License for Minnesota (and Canada)
only
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ASDA’s PGY-1 Policy: A-1 Additional Year of
Dental Education (1983, revised 2002, 2012)
• “The American Student Dental Association strongly
supports high quality dental education, and favors
voluntary postgraduate training and the creation of
additional postgraduate opportunities. The
American Student Dental Association is opposed to
a mandatory one-year postgraduate program or the
addition of an additional year to the present dental
curriculum. The American Student Dental
Association supports students having the option to
complete an ADA accredited postgraduate
residency program in lieu of a clinical licensure
exam for the purpose of initial licensure.”
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PGY-1
• Advantages
– Addresses ethical issues of live patient
clinical exam
– Residency may be paid
• Disadvantages
– Extra year before beginning practice
– Not honored in most states
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Quiz:
Which states offer PGY-1? Select all that apply.
A. Michigan
B. Arkansas
C. Connecticut
D. Delaware
E. Wisconsin
F. New Jersey
G. New York
H. Washington
I. California
J. Missouri
K. Minnesota
L. Ukraine
M. Rhode Island
N. Ohio
O. Utah
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Quiz:
Which states offer PGY-1? Select all that apply.
A. Michigan
B. Arkansas
C. Connecticut
D. Delaware
E. Wisconsin
F. New Jersey
G. New York
H. Washington
I. California
J. Missouri
K. Minnesota
L. Ukraine
M. Rhode Island
N. Ohio
O. Utah
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Quiz:
Bonus: Which state mandates PGY-1?
A. Michigan
B. Arkansas
C. Connecticut
D. Delaware
E. Wisconsin
F. New Jersey
G. New York
H. Washington
I. California
J. Missouri
K. Minnesota
L. Ukraine
M. Rhode Island
N. Ohio
O. Utah
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Quiz:
Bonus: Which state mandates PGY-1?
A. Michigan
B. Arkansas
C. Connecticut
D. Delaware
E. Wisconsin
F. New Jersey
G. New York
H. Washington
I. California
J. Missouri
K. Minnesota
L. Ukraine
M. Rhode Island
N. Ohio
O. Utah
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What’s happening
ADEA Task Force (Res:5H-2014)
 Report ADEA HoD 2015 with
recommendations to advocate for
transition to validated OSCE.
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What’s happening
State-Level Advocacy by ASDA
Pillar 1: Reform State Dental Licensure Policies
• State Dental Associations
• State Dental Boards
• State Legislators
• National Dental Organizations
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What’s happening
State-Level Advocacy by ASDA
Pillar 2: Awareness and Education
• Educational resources (presentations,
website, articles, programming)
• White Paper
• Work Plan
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Questions?
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Contact:
Email: Christian.piers@gmail.com
LinkedIn:https://www.linkedin.com/pub/christ
ian-piers/78/605/b5
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