Letters: Boards no place for patients
March 21, 2016
The issue in Iowa of banning live patients from board exams ("Using Patients in Board Exams Under Debate in Iowa
," Feb. 15 ADA News) is not new. In 1993, the Journal of the American College of Dentists published an editorial "Time to Take the Teeth Out of the Boards." The ADA House of Delegates passed a resolution sponsored by ASDA in 2000 that called for the elimination of human subjects in board exams by 2005.
This is 2016, the era of modern dentistry.
We don't practice the way we did in 1916, so why do we still test board candidates the same way we did back then?
Your article quotes Dr. Kaaren Vargas of the Iowa Dental Board: "We are here to protect the public from incompetent professionals." Using human beings to search for incompetence is not only unethical, it is archaic.
Dental schools are best at evaluating students' patient care talents in a safe, controlled environment over four years. The board's job is to monitor the educational system with a broad-based exit exam that is commensurate with the academic achievements of the high-caliber graduate students that dentistry attracts.
Eliminating the narrow skills, patient-based exam removes the costs of paying patients, assistants and labs; prevents overtreatment and stops the wasted time in searching for board cases. Just like in pilots' training, simulators are the appropriate means for finding red flags. After all, the board examiners are looking only for the worst not the best; which, in the testing crucible, cannot avoid turning some patients into victims of bad outcomes.
Dr. Vargas' further comments defending the status quo are the same old school, retreaded arguments that have kept our learned profession in the embarrassing light of being the only surgical discipline which still uses live human subjects in a testing environment.
The debate should not be complicated: a comprehensive, fair exit exam run by the state should not utilize live patients in determining minimum competence to be consistent with our profession's high ethical standards.
In 2116, no one will believe that real patients were once used for testing dental students back in 2016. The time for change is long past.
Victor J. Barry, D.D.S.