Minnesota Board of Dentistry

The Wonderful World of Dentistry:

License to DrillMarshall Shragg, MPH

March 4th, 2011

Minnesota Board of Dentistry

BOARDS of DENTISTRY

• Mission- Protect the Public

Minnesota Board of Dentistry

PROTECTING the PUBLIC

LicensingProfessional Development

Complaint Resolution

Minnesota Board of Dentistry

LICENSURE

Determination of Minimum Standards

• Application (fitness to practice)–Education–National Boards–Clinical Examination

Minnesota Board of Dentistry

PATHWAYS to LICENSURE(MINNESOTA)

CLINICAL EXAM

• CRDTS• WREB• NERB• SRTA• CITA

PGY-1

Completion of a Minnesota-based AEGD/GPR program

CREDENTIALS

Review of experience in other jurisdiction(s)

LIMITED GEN’L LICENSE

Foreign-trained (non-CODA) dentists

NDEB EXAMS

Limited to Canadian grads and recent Minnesota grads

Minnesota Board of Dentistry

• Years of trust established– Attendance at one another’s meetings– Reliance upon UofM faculty for licensee remediation– Mutual respect

• Proximity to UofM• Board history/experience with NDEBs• Formal agreement for Board to participate in

critical UofM meetings/processes–Admissions– Education Policy (Curriculum)–Competency Review– Scholastic Standing–Calibration

UNIQUE RELATIONSHIP

Minnesota Board of Dentistry

• Recent review of regional clinical examining agencies/setting priorities [June 2008]

• Commitment to shared NDEB goal of meeting a minimum established standard and ensuring the competency of initial licensees

• Board approached by Dean Lloyd to consider options

TIMING

Minnesota Board of Dentistry

• Ensuring competence and fitness to practice of individuals being issued licenses

• Clinical objective patient-based examinations meet the Board’s standard; may consider equivalent alternatives

• Active Board involvement in the appropriate communities… including CRDTS, AADB, NDEB, and the University of Minnesota

MINNESOTA’S COMMITMENT

Minnesota Board of Dentistry

CRDTS• Minnesota a founding member state• Defensibility--- support of

psychometricians• Board members participate as

examiners

• Critical failures noted on recent patient-based examinations @ various CRDTS sites…

Minnesota Board of Dentistry

COMMENT FROM AN ED• “If you have ever attended an

examination session, you would understand the public’s concern – it raises legitimate questions about the capacity of dental schools to ensure competence without a third-party evaluation.”

--- Executive Director, East Coast State

Minnesota Board of Dentistry

ADJACENT TOOTH DAMAGE

Minnesota Board of Dentistry

SUBSTANDARD AMALGAM RESTORATION

Minnesota Board of Dentistry

WRONG TOOTH SURFACE TREATED

TOOTH #9

Minnesota Board of Dentistry

PERIODONTAL LACERATION 4 mm

(Improper Instrumentation)

Minnesota Board of Dentistry

COMMENT FROM AN ED• “[Our state] will consider non-

patient based exams when dentists agree to only practice on manikins”

--- Executive Director, Southern State

Minnesota Board of Dentistry

LIMITATIONS• State-by-state determination of

licensure requirements• Available only to recent UofM grads • Limited portability• Resistance from licensing &

examining communities

Minnesota Board of Dentistry

AADB EDITORIALNumber of Complaints Received by type for CURRENT fiscal year:

Apparently, through their university and dental board, the citizens of Minnesota have essentially thumbed their noses at the “examination community” and embraced the Canadian National Dental Examining Board’s Objective Structured Clinical Examination (OSCE) which includes written and non patient-based modules. This will satisfy the state’s requirements for initial licensure in Minnesota. The school was excited about it and the board voted unanimously to accept the examination.

Not that this instance from Minnesota is going to run rampant over the rest of the states, but I would suspect that other state agencies are looking at embracing this process.

Minnesota Board of Dentistry

OTHER BOARDS’ COMMENTS• “The boards issue licenses to dental school graduates to enter

private practice where, unlike in dental school, there is NO SUPERVISION.”

• “Examiners typically are practicing dentists – not the teachers of the candidates.”

• “Third party examination is impartial, and not subject to teacher bias or dental school desire to retain students.”

• “Bottom line:  The State, through its board, must guarantee the public that the dental school graduate has passed a complete and standard examination of competency to practice on the public.”

• “The ------ Dental Board has zero use for anything other than a patient-based exam.”

Minnesota Board of Dentistry

Minnesota Board of Dentistry

BOARD MISSION

PROTECTthe

PUBLIC!