Nikko Lee, DDS, Columbia, Class 2010
Leading up to the NERB exam, I had everything in order. Filling out the application was relatively simple. The application form came in the candidate guide. I wasn’t too worried about the dentistry part of the exam. I knew how to do a class II. I knew how to do a class III. I knew how to remove calculus. The part that stressed me out the most in the weeks leading up to the test was finding reliable patients that had lesions that fulfilled the NERB criteria.
I heard that I could save myself a lot of stress by reading the manual thoroughly. I heard that the test wasn’t so much about whether you can fill a cavity as it was about whether you can follow directions in a stressful situation. For example, proper patient selection, managing the required paperwork (consent forms, medical history, recent radiographs, perio worksheets, evaluation forms), properly requesting modifications, and so on. I got to clinic around 7 a.m. to set up my area for the operative portion of the test. I got lucky and had a class II and III to do on the same patient. It wasn’t perfect, but things went relatively smoothly. On both preps my patient returned from evaluation with an “Instructions to Candidate” form. This meant I had to make a few changes before proceeding, but it was nothing major and I finished on time. Then, I got to the perio part of the test….
We had from 2 - 5 p.m. for the perio section. I told my patient to arrive at 1:30 p.m. so that I could have him seated, get forms signed, and ready to start the test at 2. It was 2 p.m. and still no patient. Of course, by this time I had called the patient repeatedly, checked the waiting room, even went down to the lobby to see if she got lost. 2:45 rolls around, still no patient. Since I didn’t have a back-up, it was looking like I was going to fail and have to retake a few months later. Needless to say, I was frustrated, especially since I had met with the patient two days prior and we talked about the importance of showing up.
I was hanging out near the waiting room venting to a friend about what had happened when I catch word that a patient of my classmate brought her father along (he was interested in getting treated at Columbia in the future). Another classmate of mine had already taken radiographs on the individual and I thought he may qualify to be a patient for the exam. I spoke with the patient through a translator (he only spoke Spanish) about the testing process and he agreed to let me screen him to see if he met the criteria. By this time it was after 3, and while two hours seems like a long time to scale a quadrant of teeth, the paperwork for getting a patient qualified is VERY cumbersome. It was going to be close…
Before candidates can start scaling, an evaluator will review the patient to determine if he or she is acceptable for the exam – and this must happen at least 45 minutes before the end of the test. I had about an hour to take a medical history, blood pressure, and obtain consent (in Spanish), make him a chart, examine the patient, fill out a worksheet with probing depths/calculus detection, and if he qualifies, take a full-mouth series, followed by approximately an hour for scaling.
It was 2 p.m. and still no patient… Since I didn’t have a back up, it was looking like I was going to fail and have to retake a few months later.
Thankfully I had awesome classmates and clinic staff who helped me with the radiographs and paperwork and I was able to get everything done in time. It was a frantic couple of hours that I never want to do again! Thankfully, it all worked out in the end. I got really, really lucky — not only was there an extra patient that happened to be in the waiting room, but he actually was qualified to be a patient. I screened a lot of patients prior to the exam and for one reason or another there was always something that made them not ideal for the test. And it’s no wonder considering the requirements were something like: 12 surfaces with detectable calculus, at least three sites with pockets of at least 5mm, no more than two-three canines/incisors, at least three premolars and molars, all of which needed an approximating surface within 2mm. I really lucked out that there was someone in the waiting room that fulfilled all the criteria.
The fact that I knew exactly what needed to get done when I finally found a patient went a long way in helping me finish everything in time. This is why it is so important to read the manual. Time is limited as it is, so when things don’t go your way, you don’t want to waste time familiarizing yourself with paperwork you’ve had for months but never bothered to look over.
Of course, if I could go back and do something differently, I would have found a more reliable patient! But honestly, some of those things are out of your control. My advice is to take care of the things you can control…in other words, be prepared! Even if you think your patient is reliable, things happen. Patients are still people, and anything can happen in a person’s life to prevent him or her from making it to an appointment. Despite the circumstances, in the end it’s still up to the student to pass the exam.
Where is Dr. Lee today?
After graduating from Columbia in 2010, Dr. Lee enrolled in a residency program at New York University, and is now practicing in Texas.