The Future of Licensure
Licensure by Credentials
The ADA supports licensure by credentials. The ADA House of Delegates strongly supports freedom of movement through licensure by credentials. Review the ADA Guidelines for Licensure (PDF) for details. The number of licensing jurisdictions that offer licensure by credentials has increased dramatically in the last decade.
Alternative models to the clinical licensure exam
While the clinical licensure examination continues to be the pathway to licensure for many dental graduates, there are several emerging alternative platforms in discussion.
Post-Graduate Year Residency
Completion of a residency program at least one year in length (PGY-1) in an accredited postdoctoral program in lieu of the clinical licensure examination as a pathway to licensure in the state.
As of March 2010, the PGY-1 is offered by New York (mandated), Washington, Minnesota, California and Connecticut.
Canadian Examination—Non-Patient Based OSCE
On June 26, 2009, the Minnesota Board of Dentistry voted unanimously to accept the results of Canada’s non-patient based two-part exam, known officially as the objective structured clinical examination (OSCE). The OSCE is a station-type exam where candidates answer extended match questions based on models, X-rays, casts and case histories. The University of Minnesota’s School of Dentistry began administering the OSCE exam to eligible students in 2010. When CRDTs withdrew from ADEX in 2009, the University saw an opportunity to explore licensure examinations. The school worked closely with the Minnesota State Board of Dentistry, which formed a task force to study the feasibility of non-patient based exam options.
To learn more about the OSCE exam, visit the National Dental Examining Board of Canada web site at www.ndeb.ca.
California signed Assembly Bill 1524 to allow a dental school-based portfolio examination process. Once regulations are adopted, students will have the option to take a school-based licensure exam that allows them to build a portfolio of completed clinical experiences and competency exams in seven subject areas over the entire course of their final year of dental school. The portfolio licensure exam process in California replaces the clinical exam administered by the dental board. The Dental Board of California, the California Dental Association and the six California dental schools all supported the measure which is effective January 1, 2011.
The ADA News article California OKs nation's first portfolio exam for licensure highlights the legislation.
The hybrid portfolio model is designed to use the structure for student evaluation that currently exists within the schools to assess minimum competence. The model is considered a performance examination that assesses skills in commonly encountered situations, which includes components of the clinical examination administered by the traditional testing agency. Performance is measured during competency evaluations conducted in the schools by calibrated examiners who are members of the dental school faculty. Thus, the hybrid portfolio examination involves hands-on performance evaluations of clinical skills as evaluated within the candidates' program of dental education.
Learn more about the Hybrid Portfolio model at www.dbc.ca.gov (search: hybrid portfolio).
National Board Part III
An ADA Board of Trustees’ workgroup is studying the current licensure issue, including the potential development of a Part III National Boards Dental Examination. The 2009 ADA House of Delegates considered a resolution (26S-1) to study the development of NBDE Part III that will evaluate clinical competency, ethics and professionalism. Because of conflicts with the Bylaws duties of CDEL and the Joint Commission on National Dental Examinations, the House referred the activity to an ADA Board of Trustees workgroup.
Future Changes in NBDE Scoring
The National Board Dental Examinations will be moving from a scored exam to a pass/fail. Beginning January 1, 2012, candidate performance on Part I and Part II will be reported to candidates, state boards, and dental schools only as pass or fail. The decision to move to pass/fail was made at the Joint Commission on National Dental Examinations' meeting on March 11-12, 2008 and an extension was approved in 2009. Further, they will continue to report raw score performance information in the disciplines covered on the examinations for failing candidates only. The information on failing candidates will be provided to candidates and dental schools. For more information on the changes in scoring, visit their Web site at www.ada.org/JCNDE.aspx. The concept of a Part III National Boards Dental Examination was discussed at the 2009 ADA House of Delegates.