Live Patient Licensure Exams

ASDA has taken a firm and definite stance on its licensure policy which calls for the creation of a nationalized dental licensure that does NOT involve the use of live patients during the examination process. There several reasons that ASDA has taken action to pursue this revised licensure exam. Among those reasons are:

  • The inconvenience and inconsistency with finding board qualified patients and the reliability placed on these patients.
  • The cost involved, particularly for students testing away from their place of residence.
  • The idea that a student can spend two years passing clinical competency exams and are deemed competent by their school and that competency is not recognized by the state.

However, the biggest reason ASDA has called for a patient free licensure exam is the issue of ethics. Students begin looking for their licensure patients in their third and fourth year. Instead of restoring the small lesions when they are found, they are asking patients to wait and have their treatment done for the exam. In dentistry, we are taught to promote preventative care. Asking a patient to wait on treatment, and risk the development of an even larger lesion, goes against the principles of care we should be practicing. Similarly, many patients have a preference as to which dental material they would like to be used. For those patients wishing to have composite, often times students will prepare an amalgam restoration for the purpose of the licensure exam and have the patient return at a later date to have the amalgam replaced with composite. This not only subjects the patients to two appointments and multiple injections and dental surgeries but also removes more tooth structure than would have been removed had the preparation been made for a composite restoration. All of this for the purpose of taking a licensure exam and none in the best interest of the patient.

There has also been the exposure of organizations who screen patients for the purpose of finding board lesions and then selling them to students for thousands of dollars. This not only puts students who are less financially sound at a disadvantage but, again, goes against the principle of comprehensive care that we are all striving to achieve. Selling a patient for a licensure exam violates several basic ethical principles but if a student is without a board patient, what else can they do?

For the first time in 2009, Minnesota accepted a patient free exam and it is now available for Minnesota graduates. During the ADA House of Delegate, there was continued discussion on this topic, and the House agreed that our nation needs to move in this direction. The House called for a task force to create an exam that is fair, ethical, and measures competence without live patient testing.

It is critically important that we continue to press this issue. Complaining without action is merely making noise. One way students can take action is get involved with a state and national lobby days and express our concerns to our state representatives. For more information on how to get involved, email our Legislative Liason.

Dental Licensure