Hamilton AI (1977), State Board Examinations: Are They Needed?, Operative Dentistry, 2(2) 49.
State Board Examinations: Are They Needed?
State examinations for dental licensure are coming increasingly under adverse criticism. Pressure to condemn the examinations as unnecessary and to have them discontinued is mounting.
A major complaint leveled at state board examinations is that they are not as effective in evaluating the competence of dental graduates as are the dental schools from which the students graduate and in which they have been under the tutelage and supervision of the faculty for about four years. The faculty, it is said, is in the best position to assess the knowledge and skill possessed by the students when they graduate. Be that as it may, we must recognize that standards vary widely among teachers when it comes to examining their own students. Some teachers, with a misplaced sense of compassion and a misinterpretation of their responsibility to the public, are overly sympathetic to students. These teachers tend, on the one hand, to give advice and help during examinations and, on the other, to overlook inadequacies. The result is that students not competent to practice are graduated nevertheless. Even more alarming is the fact that some state boards-under pressure from candidates, politicians, and dental schools, and reluctant to subject patients to inept operating-have had to lower their requirements.
Examination of students by external examiners is a common practice among universities in many parts of the world, the University of London being an example. Under this arrangement members of the faculty of one university participate in the examination of students of another university. The rationale behind the use of external examiners is to ensure that the fundamentals of any particular discipline are being taught adequately. A further beneficial effect of the arrangement is to stimulate the faculty of each university so involved to bring the knowledge and skill of its own students up to the highest level possible.
State board examinations can have a similar influence on the teaching of dental schools and sometimes have forced them to raise their standards. Some may object that this system does not allow the university freedom to innovate but the fact remains that beyond the fundamentals there is plenty of scope for innovation.
In any event innovations are not always successful, and on this score the record of dental schools in the recent past has been anything but encouraging. Witness the example of the three-year curriculum, which is now being discontinued by most schools that adopted it; but not until after several classes of students, through no fault of their own, had graduated with less than the best education and training. Apparently the urge to institute new programs without adequate testing is irresistible, and the results are now evident in the decline in the clinical competence of dental graduates. And this from the very institutions that are charged with scientific leadership!
In too many instances, however, the leadership of dental schools is, unfortunately, in the hands of deans and faculty that have had little experience with restorative dentistry and little or no experience of dental practice. Astonishing though it may be, some universities have appointed deans that are not even dentists! The danger of the direction of dental education falling into the hands of such people is ever present and thus there is a need for dental graduates to be examined by dentists that are actively engaged in treating patients and so have first-hand knowledge and experience of dental practice-the profession, after all, for which dental students are supposed to be educated.
Criticism of the conduct of some state board examinations may be justified but, if this is so, it is more a reason to improve and strengthen than to abandon them. External examiners are essential because the education of dental students is much too important to be left to the academics.