Patients on clinical board examinations: an examiner's perspective.

I n the interest of fact and reality, ADA Resolution 64H2000, which calls for the elimination of “live, human subjects” (let’s just call them “patients” since we must assume they are both alive and human) from dental clinical licensure examinations by 2005, was rather like the drunk who lost his wristwatch in a dark alley but is looking for it under the street lamp because there is more light there. The issue has never really been patient utilization on examinations. The real issue changes from organizational acronym to acronym. For the American Dental Association (ADA), the issue is membership and demonstrating support for the American Student Dental Association for future membership needs. For the American Dental Education Association (ADEA) the problem is submitting to independent third-party outcome assessment and examination logistics in their schools. For the American Student Dental Association (ASDA), the dispute is the flaming hoop called board exams and being forced to submit to such an indignity. For the testing agencies, the issue is to provide their member states a mechanism for competency assessment. For the state boards, the problem is to protect the consumer from the traveling miscreant or the recent graduate who is not quite ready to enter our profession. If we keep looking under our own self-serving street lamps, we will never find the answer. This resolution, sponsored by ASDA, was supported by the Reference Committee and approved by the 2000 ADA House of Delegates with absolutely no discussion of patients on exams. In both forums, the issue was one of support of ASDA and future membership needs of the ADA. This article, however, will address the actual issue of patient-based clinical examinations and why the entire examining community is polarized on the opposite side of the issue from the other acronym groups. Let’s begin with that and perhaps also address the real issues along the way. History