School has resumed once again, so we thought that it would be appropriate to take a moment and reflect on the gross inadequacies of dental licensure in its current state. Likely the most heated topic in dental education today, there still remains no clear consensus on what educators and policymakers would like to see. Sure, most would say that they would like some sort of change, but what type?
If all dentistry were to be polled, were certain that the attitude toward dental licensure would be that the current system is not right. Take, for example, the many thousands of dollars spent to take an exam in another part of the country, just to prove what has been done many times over in an ADA-accredited school. What is the point of accrediting schools when an independent testing agency has the final say in how competent a student is?
How about the time that is spent screening potential patients? This could be better utilized learning more about dentistry, not recruiting and bartering for patients.
The fact that treatment is continually delayed for these patients over the course of a number of months seems absolutely absurd. We are the last holdout in the health professional community to still use live patients for board exams. All other medical professions have left this behind for good reason. Why, then, havent we?
The disparities even extend to our professions specialties. If an individual decides to specialize and does not take the clinical board exam at the time of dental school graduation, or has a dental license and decides to relocate to a state that does not recognize licensure by credentials or reciprocity, he or she must take another general dental exam. Thus, a recently graduated or practicing oral and maxillofacial pathologist is required to prepare a Class II amalgam, Class III composite and other procedures that he or she likely has not completed in many years.
Where is the ethical reasoning in this situation? And how does performing general dental procedures ensure competency for specialists who do not utilize those procedures in their practice? Does their taking a state or regional dental board indeed protect the public as is maintained by many state boards of dentistry? We maintain that this is, instead, harmful to the public and serves no purpose other than to act as an obstacle to entering the region or state.
We all realize the shortcomings of clinical dental licensure. It is our duty to our profession to make sure that competent dentists are serving the public. However, requiring licensed dentists to retake an examination is divisive, restrictive and may even be harmful to the public. It most certainly is harmful to us as a profession.