1. The Buffalo Model Joseph E. Gambacorta, DDS
Assistant Dean for Clinical Affairs
University at Buffalo School of Dental Medicine

2. Background In 2012 applications for licensure
decreased in New York State and
NYSDA forms PGY1 Task Force.
November 2014 first planning
session at UB with CDCA & NYSDA.

3. PGY1 Task Force Pilot Exam
To assure that patient care is
protected.
Care on patients of record
in a normal course of treatment.
Integrated exam to be offered
continuously throughout the D3
and D4 year.

4. Establishing a Process
PGY1 Task Force Report used as
a basis to formulate exam model.
Advisory Group formed
UB Clinical Staff
D3/D4 Group Directors
Student Leadership
CDCA
NYSDA

5. Curriculum Integrated Format - CIF
In 2007 ADA House defined CIF as:
Treatment performed on patients of
record with sequenced treatment plan.
Exam assessment integrated into
dental school curriculum.
Multiple exams scheduled during
the academic year.

6. The Buffalo Model Is a modification of the traditional
licensure exam format which enables
the focus of the exam to shift from
the candidate to the patient.

7. Exam Modifications Faculty & Curriculum integration
Patient eligibility restricted
Multiple exam dates available
Exam part of normal clinic day

8. Faculty/Curriculum Integration
CDCA faculty calibration session
Revised faculty role includes:
Prior to Exam
- lesion/case approval
Exam Day
- competency assessment
- documentation
- supervise definitive treatment

9. Patient Eligibility Treatment MUST be rendered on
patients of record as part of
an appropriately sequenced
treatment plan.

10. Exam Schedule Six exams were scheduled every 3 weeks January – May.
Manikin Exam – one session
Retakes offered at all exams.
Eligible candidates were allowed to
register with only two sections of the
clinical exam approved.

11. Normal Clinic Day Seamless integration of the exam
was achieved as a result of:
Control in populating exam
UB faculty, staff and student support
Available clinic space
Flexibility of CDCA
CDCA and UB faculty interaction on
the clinic floor.

12. Intended Consequence
The Buffalo Model is the Curriculum Integrated Format in action.

13. Orientation Before each exam UB and CDCA held
a joint orientation session to:
Schedule exam patients into database.
Review parameters of ADEX exam.
Discuss faculty role.
Outline documentation requirements.

14. Exam Day CDCA established a Buffalo exam team.
UB staff coordinate clinical activities.
Prescheduled clinical assignments
continue uninterrupted.
Continuous interaction between
Examiners and UB faculty/staff.
Definitive treatment model established.

15. Results Case Approval Competency Exams Class of 2015 Results
WREB/ADEX Comparison

16. Case Approval
RESTORATIVE
PERIODONTICS
EXAM DATE
ACCEPTED
REJECTED
JANUARY 20 15 9
FEBRUARY 10 31 14
MARCH 24 40 2 16
APRIL 14 37 23 1
MAY 12 10 5
98.5% of the restorative lesions and periodontal cases pre-approved by UB faculty were accepted by
CDCA examiners.

17. Competency Exams
EXAM DATE
Total
D4’s
OPER
PERIO UB
PASS
FAIL
ADEX
ADEX FAIL
JANUARY 20 9 8 4
FEBRUARY 10 17 3 12
MARCH 24 25 11 2 13
APRIL 14 27 7 15
TOTAL 78 26 16 46 6 48
- NO COMPENCIES OFFERED DURING MAY 12th EXAM.
- NO FAILURES IN PERIO.
- TWO CANDIDATES PASSED ADEX BUT NOT UB COMPETENCY.
- COMPETENCY OPTION WELL UTILIZED BY STUDENTS.

18. 66.6% of UB candidates passed the ADEX exam on their first attempt.
Class of 2015 Results
EXAM DATE
# D4 s
2-SECTION
REGISTRATION
3-SECTION
TOTAL
PASS
FAIL
JANUARY 20 9 3 6 5 4
FEBRUARY 10 17 11
MARCH 24 25 10 23 2
MARCH 28 61
N/A 49 12
APRIL 14 27 8 24
MAY 11
MAY 12 1
66.6% of UB candidates passed the ADEX exam on their first attempt.

19. WREB/ADEX Nine candidates challenged both exams.
# D4s
RESTOR.
PERIO.
ENDO.
WREB 39 9 7
ADEX 61
Nine candidates challenged both exams.
Only first attempts were considered.
Prosthodontic manikin only part of ADEX.
Student comments most important result in this
comparison.

20. Student Perspective Presence of faculty helped establish trust
between students and examiners.
No need to search for “ideal” lesions.
Flexible scheduling reduced the stress of “all
or nothing weekend exam”.
No extracted teeth to mount and radiographs
to take.
It felt like a regular day at school.

21. UB Next Steps Establish faculty, da, and runner coverage schedule.
Pre-exam chart review.
Treatment plan submitted as part of
patient intake.
Move manikin exam to fall semester.
Certify D3 candidates to challenge at
the end of the spring semester.

22. Next Steps Nationally Educate the dental community
– 2016 ADEA Annual Session
– seminars/publications
Pilot The Buffalo Model at other
dental schools – CDCA survey.
Standardization of the process to
facilitate ease in implementation.

23. Thank You Dr. Michael Glick UB faculty, staff and students
CDCA examiners and staff
ADEX
NYSDA – PGY1 Task Force
Mr. Michael Zeder
Dr. David Perkins
Dr. Guy Shampaine

24. questions