Changes afoot in U.S. dental education

Aug 10, 2009

Editor's note: Helaine Smith's column, The Mouth Physician, appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.

“Dental education needs an overhaul. The system is broken, and schools need to revamp their curriculums. ...”

The news that Minnesota has become the first state in the U.S. to offer candidates for dental licensure the opportunity to take a nonpatient-based clinical licensure examination is a promising and positive advance for dentistry.

For more than 50 years, every state in the U.S. has enforced the same barbaric patient-based exam -- even after the ADA passed a resolution in 2000 that supported eliminating human subjects from the clinical licensure exam. (By the way, they are people, not "subjects.")

We all have horror stories from our board exams, such as my friends across the aisle "pulping out" during the class II amalgam prep -- cause for immediate failure. When I took my boards in 1991, the pressure to pass was intense for another reason as well: I had $150,000 in student loans and needed to begin working as soon as possible to repay the loans. (Luckily, I passed on the first try.) Today the average student leaves dental school with even more debt, often close to $250,000.

Teaching dental students everything they need to know in four years is difficult. I firmly believe all graduating dental students should do a one- to two-year general practice residency. Needless time spent in preparing for the live patient exam could be replaced with useful lectures and more clinical exposure to real-life situations. Additionally, these residency programs could offset the need to serve the underprivileged while exposing new grads to the latest techniques as they increase their clinical skills.

In fact, two years ago, New York began offering an alternative to the Northeast Regional Board exam: a one-year postgraduate residency. This is another commendable example of our industry's efforts to modernize the way dental students are tested.

Dental education needs an overhaul. The system is broken, and schools need to revamp their curriculums to include modern dental procedures and create a general practice residency program. There is a better way to educate and mentor our new graduates for them to be true mouth physicians, and Minnesota's decision to adopt the Canadian exam approach is a step in the right direction. It is time for the rest of the U.S. to follow suit and change the antiquated clinical board exams.

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