HEY, LICENSURE REPRESENTATIVE! (Yes, I’m talking to you!)

2007…  Board of Trustees passed resolution BOT – 2008:  Resolved, that ASDA supports formation of a Licensure Representative position at the local chapter level, with the responsibilities of the position to include educating their chapter about Licensure issues and acting as an advocate for and educating members, state boards, state governments and local dental societies about ASDA’s Licensure policies. And be it further,  Resolved, that the Representative communicate with the Council Chair on Licensure about issues in his/her community.

2008…  Council on Licensure drafted official Licensure Representative position description:  “The Licensure Representative serves as a source for licensure information. The Licensure Representative will be current on ASDA, local, and statewide licensure policies and relay this information to the local members. The Licensure Representative will also communicate these local issues to the Council Chair of Licensure and direct members to ASDA resources regarding licensure requirements. The second delegate, alternate delegate, or other interested member of each ASDA chapter could serve as its Licensure Representative.

2008…  Specific responsibilities include:  Educating his/her chapter about ASDA’s Licensure policies  Educating his/her chapter about local and statewide licensure policies  Communicates with the Council Chair on Licensure about issues in his/her community  Informs all members as to where they may find ASDA resources on licensure requirements

What did I get myself into?  Happy you asked!  We’re going to hit all the points:  ASDA’s Licensure policies  What to learn/know about your local and state licensure policies (i.e. “Learning the Local Licensure Lingo”)  What to communicate back to the Council Chair on Licensure (i.e. “Critical Communication”)  Where you can find useful resources to do your job! (i.e. “Relevant Resources”)

ASDA’S LICENSURE POLICIES (PAY ATTENTION!!!!!!!!!!!!!!!!)

L-1: Initial Licensure Pathways  “Until a fair and ethical, reliable and reproducible, valid, and clinically relevant national common-content evaluation of minimal competence for initial licensure has been developed, and until all dental licensing jurisdictions of the United States and its territories accept such an examination, the American Student Dental Association supports the universal acceptance of all regional and state clinical licensing examinations.”

L-1 (continued)  “Regardless of the examining authority or the jurisdiction in which the exam is administered, the American Student Dental Association believes that any clinical licensing examination intended to measure technical skill via a sequence of independent clinical tasks should:”  be a non-patient based examination emphasizing the recognition, diagnosis, and treatment planning of disease, in conjunction with the treatment of simulated disease by use of a typodont.  be administered in the final year of dental school.  provide opportunities for remediation, at the candidates’ dental school, prior to graduation.  guarantee anonymity of candidates and examiners.  be administered by examiners who have been calibrated to provide standardized and consistent scoring.  not include a written examination that duplicates the content of the National Dental Board Examination Parts 1 or 2.  be offered to candidates at the lowest reasonable cost possible.

L-1 (continued)  While the American Student Dental Association supports continual improvement of existing examinations and collaborative development of a new examination, the association believes the following alternatives are preferable to the current licensure process:  Initial licensure without an independent clinical licensing examination: Graduates of dental schools accredited by the Commission on Dental Accreditation should be eligible for initial licensure without taking any additional clinical examination.  A portfolio-type clinical examination based on cases compiled during the final year of dental school: Such an examination should require a standardized catalog of required clinical procedures and the portfolio should be evaluated by an examiner independent of the dental school.

L-1 (continued)  A non-traditional patient based clinical licensure examination: Although the American Student Dental Association does not support the use of live patients in traditional clinical licensing examinations, the association recognizes the potential for creation of an ethical, patient based examination.  An Objective Structured Clinical Examination designed to evaluate a candidate’s diagnostic and treatment planning skills.  Completion of a one year post graduate residency program: Completion of a postgraduate residency program that has been accredited by the Commission on Dental Accreditation and has a minimum duration of one year should be sufficient to substitute for the clinical licensure examination requirement in any jurisdiction. However, the American Student Dental Association opposes a mandatory postgraduate residency in any licensing jurisdiction.

L-2: Licensure for Graduates of Foreign Dental Schools  “ASDA is opposed to licensure by any mechanism of graduates from schools not accredited by the ADA Commission on Dental Accreditation. Graduation from a dental program accredited by the ADA Commission on Dental Accreditation, regardless of its geographic location, should be required for eligibility for initial licensure in any jurisdiction in the United States, given that all other jurisdictional requirements are also fulfilled.”

L-3: Definition of Curriculum Integrated Format  “An initial clinical licensure process that requires candidates to successfully complete an independent clinical assessment prior to graduation from a dental education program accredited by the ADA Commission on Dental Accreditation.  If such a process includes patient care as part of the assessment, it should be performed by candidates on patients of record whenever possible, within an appropriately sequenced treatment plan. In order to be integrated into the curriculum, the competencies assessed must be mutually accepted between the dental education program and the examining agency.  All portions of this assessment must be available three or more times during dental school. This ensures that patient care is accomplished within an appropriate treatment plan and allows candidates to remediate and retake any portions of the assessment, which were not successfully completed. There must also be a defined mechanism within the dental education program curricula for remediation of students who fail any section of the assessment.”

L-4: Policy on Dental Examinations (i.e. the newest member of the family)  “Resolved, that in regards to National Board Dental Examinations (NBDE), the American Student Dental Association supports a secure examination process, and be it further, Resolved, that in regards to an examination for advanced post graduate education in dentistry, the American Student Dental Association supports a single exam that is secure and valid for quantitative scoring.”

Learning the Local Licensure Lingo  What kinds of information you should be picking up:  Where your state stands on universal exam acceptance  Which exams are accepted  Maybe why they choose not to accept certain exams So we know what to fight for!

Critical Communication  Tell the Council Chair…  When you attend a state dental association or dental society meeting So we can show our members how we are functioning to serve them!  Any changes in licensure policy in your state So we can keep our members updated and post information to our website  Acceptance of alternative exams  Any communication you have after meetings (letter- writing, lobbying, etc)

Relevant Resources  For info related to licensure exams…  Exam websites (NERB, WREB, etc)  For info related to state licensure policies…  State dental association/dental society websites  State dental association/dental society meetings  For info related to ASDA’s licensure policies…  asdanet.org!.... duh.  Its more fun than textsfromlastnight.com anyway.

IN AN IDEAL LR WORLD…. (An example of how YOU should approach LR!)

To review… What should the LR try to do?  The LR should update the chapter on events pertaining to licensure  Ex. Minnesota is the first dental board to accept the Canadian exam which is patient-free.  The LR should represent ASDA to the State Dental Association when possible.  The LR should represent ASDA’s policies to the State Dental Board when possible.

Jonah Goes to Plainville  HCOL is the Connecticut State Dental Association licensure committee.  To protect student interest, Jonah reviews CT’s policy on licensure and the policy of ASDA.  He contacts the CSDA and expresses interest in representing the student voice on their committee.  He respectfully entertains discussion on possible changes and speaks intelligently to the policy ASDA supports.

Representation at the State Dental Board  The hearing of the State Dental Board are often open to the community  Contacting the State Board about ASDA’s licensure policy can be done over the phone and our representation will vary based on the above policy within each state.  If necessary, letter-writing campaigns can be organized by the LR for the chapter directed at the board.

How do I know what to say?  ASDA would like you to voice the policies as they pertain to licensure and trusts you to represent your fellow members.  When asked about PGY-1, it is appropriate to say ASDA supports the idea of a one year residency equating to a licensure exam, but does not support this as a mandatory requirement for licensure.  When asked about the current examination process it is important to know what testing agency and what test is administered by that agency.

Common Questions of Students  What specific procedures should an ideal exam contain?  What are ASDA’s current problems with the exam?  What alternatives to the traditional patient based exam are feasible?