I am quite sure that publishing the "Two Views of Licensure" letters to the editor (November JADA) will provoke many letters. I thought I would offer my view.
I do not wish to insult Dr. Tonsi for his many years of service as a dental board examiner. However, it is unfortunate that Dr. Tonsi misses the point. The issue is not whether dental students should be trained and tested on live patients. The question is whether a separate test should be required on a state-by-state or region-by-region basis.
I am sure that all dental students repeatedly are given clinical examinations on live patients and also have clinical requirements. As a consequence, the dental school faculty has many opportunities to assess a student’s clinical and academic skills.
I would suggest that having a separate test subsequently administered by board examiners is, at best, repetitious and, at worst, fraught with the myriad difficulties that examinees face (the patient does not show up, the opening and closing of burn-out ovens and so on). These are real problems that examinees encounter that have nothing to do with competence.
This is to say nothing of those students who test in a school or a site remote from their home school. The unfamiliarity alone often is overwhelming and leads to excessive amounts of stress. Is the public really protected because you administer a test that the student fails due to a casting failure or because the patient does not show up? Leave it to the schools to assess competency over a four-year period, not to an arbitrary series of examinations.
Lastly, Dr. Tonsi claims he has never seen prejudice or discrimination by a board examiner. Perhaps Dr. Tonsi’s statement is true. However, discrimination takes many forms in that certain preparations or wax setups are done uniquely from school to school. When examiners see differences, they may view those differences as inadequacies and, consequently, result in failure.
Finally, I pose this question to Dr. Tonsi and any other supporter of our current system: "Does a student who passes your carefully constructed regional or state examination really need to take another regional or state examination just to practice in that state or region?"
In other words, if your examination is so well-constructed to protect your citizens, then shouldn’t it be good enough for all citizens across this country?
