Gator Dentist Times July 2011 UFCD ASDA News 6 Dean Dolan Will building new dental schools in Florida improve access to care? 14 Everything You Need to Know to Pass NBDE Part I 13 Dr. Low Licensure and the Examination Process 10 Crossword A New Way to Evaluate Postdoctoral Dental Applicants with a pass-fail NBDE Part I Alexandra Best With these statistics in mind, the decision to make the National Board Dental Examination Part I a pass-fail exam beginning in 2012 has left many dental students wondering how advanced education programs plan to choose their “best” applicants for acceptance. In the past, NBDE Part I scores, dental school grade point average, and class rank were considered of upmost importance, often determining who was even granted an interview. However, the Joint Commission on National Dental Examinations has stated that “there is little measurement error at the minimum passing point [a score of 75], but the error increases slightly as the scores depart from that point. This means for example that there is no guarantee that there is a difference in the knowledge and ability of the candidate who achieves an 89 and the candidate who achieves a 90.” ii At the same time, GPA is difficult to compare between dental schools, and some institutions do not even give letter grades or class rank. Finally, when the ADEA surveyed postdoctoral program directors in April 2010 and asked them to identify what qualities they valued in applicants, it was found that non-cognitive factors such as being a team player, assuming responsibility, and integrity were ranked higher than cognitive factors, yet a further blow to current methods of postgraduate assessment. As a result, students applying to advanced education programs will now be required to submit with their ADEA PASS application Continued on Page 2. According to the ADA, there is an average of fifteen applications for every available spot in postdoctoral dental programs, with specialties such as oral and maxillofacial surgery having numbers as high as 36. At the same time, since 2004, there has been a 10 percent increase in applications, with only a 6 percent increase in enrollment, and nearly half of the graduating 2009 class reported applying to an advanced education program. i
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Gator Dentist Times July 2011 UFCD ASDA News
6 Dean Dolan
Will building new
dental schools in
Florida improve
access to care?
14 Everything
You Need to
Know to Pass
NBDE Part I
13 Dr. Low Licensure and the
Examination Process
10 Crossword
A New Way to Evaluate Postdoctoral Dental
Applicants with a pass-fail NBDE Part I
Alexandra Best
With these statistics in mind, the decision to make the National Board Dental
Examination Part I a pass-fail exam beginning in 2012 has left many dental students
wondering how advanced education programs plan to choose their “best” applicants
for acceptance. In the past, NBDE Part I scores, dental school grade point average,
and class rank were considered of upmost importance, often determining who was
even granted an interview. However, the Joint Commission on National Dental
Examinations has stated that “there is little measurement error at the minimum
passing point [a score of 75], but the error increases slightly as the scores depart from
that point. This means for example that there is no guarantee that there is a
difference in the knowledge and ability of the candidate who achieves an 89 and the
candidate who achieves a 90.”ii At the same time, GPA is difficult to compare
between dental schools, and some institutions do not even give letter grades or class
rank. Finally, when the ADEA surveyed postdoctoral program directors in April
2010 and asked them to identify what qualities they valued in applicants, it was
found that non-cognitive factors such as being a team player, assuming
responsibility, and integrity were ranked higher than cognitive factors, yet a further
blow to current methods of postgraduate assessment.
As a result, students applying to advanced education programs will now be
required to submit with their ADEA PASS application Continued on Page 2.
According to the ADA, there is an average of fifteen
applications for every available spot in postdoctoral dental
programs, with specialties such as oral and maxillofacial
surgery having numbers as high as 36. At the same time, since
2004, there has been a 10 percent increase in applications, with
only a 6 percent increase in enrollment, and nearly half of the
graduating 2009 class reported applying to an advanced
education program.i
score on the first attempt of the
USMLE has been correlated with
successful residency.
Thus, to address the concern
that the transition to a pass-fail
NBDE Part I might jeopardize the
postdoctoral application process,
even with the requirement of the
PPI, several fellows of the American
Dental Education Association
Leadership Institute, representing
various dental schools across the
country, have proposed a National
Postdoctoral Dental Qualifying
Examination (NPDQE). This
examination would evaluate both the
cognitive qualities currently
the previously optional
Personal Potential Index (PPI),
which is “a web-based
evaluation system designed to
provide a more complete
picture of an applicant‟s
potential for success in an
advanced dental education
program- beyond grades, test
scores, and recommendation
letters.”iii
Applicants choose
up to five evaluators to rate
them on six personal attributes:
knowledge and creativity,
communication skills,
teamwork, resilience, planning
and organization, and ethics
and integrity. The resulting
information is considered more
reliable than the optional
professional evaluations
because it is standardized and
incorporates responses from
several evaluators, rather than
just one.
However, some specialty
programs are worried that
eliminating Boards scores may
negatively impact their ability
to evaluate applicants. As
ADA President Ronald L.
Tankersley declared,
“Development and
maintenance of standards is
among the most important
things the ADA does, because
those standards are necessary
for us to remain a self-
regulating profession, instead
of a trade.”iv
Along the same
lines, a 2003 study of dual
degree oral and maxillofacial
surgery/M.D. programs
reported that the first-time pass
rate of residents on the
USMLE Part I was seventy-
five times higher for those
scoring between 95 to 99 on
the NBDE Part I than those
scoring below 90. A passing
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measured by the NBDE Parts I and
II, such as clinical knowledge,
clinical decision making, and basic
science background, as well as non-
cognitive and personality traits. The
theoretical test would support the
idea described by Daniel Goleman
in Emotional Intelligence, namely
that “emotional intelligence, defined
as self-awareness, self-management,
social awareness, and the ability to
manage relationships, can matter
more than IQ.”v In conjunction with
the PPI, it would allow advanced
dental program directors to assess
applicants‟ emotional intelligence,
communication skills, empathy,
integrity, critical thinking skills, and
selflessness, traits that currently
are hard to assess or inadequately
assessed during interviews and in
recommendation letters. The
fellows of the ADEA who
developed the suggested criteria
for the NPDQE believe that the
implementation of one
standardized postdoctoral exam
would be more effective than
allowing specialty-specific
assessments such as the Graduate
Record Examination (GRE), as
this would increase costs to the
applicants and still fail to fulfill
the non-cognitive evaluation
component.
To complement the proposal
for a potential postdoctoral
entrance examination, the 2009
House of Delegates passed
Resolution 56H-2009, a
movement that called for the
development of a Task Force that
would evaluate the examination,
referred to as the Advanced
Dental Admission Test (ADAT)
for advanced education
programs. The Task Force was
charged with considering the
validity of examination scores
and incorporating input from
relevant communities, such as
dental specialty organizations,
graduate school educators, and
the American Dental Education
Association. Thus far, the Task
Force has met twice and has sent
a survey to advanced education
program directors regarding
whether they would use results
from the ADAT, and what
characteristics they would like to
see it incorporate. Overall,
qualities such as “ability to
interpret data, clinical
knowledge, clinical judgment,
clinical thinking skills including
Continued on Page 20.
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Angela McNeight ASDA Ethics Chair
“Never let the water run while you are brushing your teeth” is a line that every one of us
heard as a small child, whether it was from our parents or from Barney singing it to us on
TV. But even now as dental students, can we all truly say that we turn the water off for the
entire 2 minutes we are brushing our teeth every day? Conserving water, using sustainable
materials, recycling, and reducing energy usage are just a few of the ways humans help the
environment, but bringing these practices into the dental environment proves to be challenging
and seemingly impossible to some.
The Eco-Dentistry Association, created in June 2010, is an international organization that
bases eco-dentistry on 4 main areas including waste reduction, pollution prevention, and energy
and water conservation. Currently, many dentists are switching to digital radiology and billing,
reducing toxic x-ray chemical release and saving paper. Other ways dental offices can go green
are by using cloth chair barriers, re-washable patient bibs, motion-detector lighting, and non-
chemical steam sterilization. For obvious infection control reasons, many of these suggestions
prove controversial. But where do we draw the line between helping protect our environment
and helping protect ourselves and our patients?
The buzz about dentistry “Going Green” seems to be all around us as dental students. In the
May 2011 ASDA News publication, a Harvard dental student highlighted that even ASDA on a
national level revised its N-1 Policy to recycle materials at all ASDA meetings and events. And
who can forget the wooden USBs that stand was giving out at the ADA Convention vendor
fair? It‟s important for us to know the realizations about how much waste our profession
produces and the specific ways we can help the environment both in the UF clinics and in our
future dental careers. Whether it‟s through lectures or guest speakers, we as 21st century
dentists have a responsibility to learn about our impact on the environment and how to keep both
our planet and patients healthy for years to come.
i Okwuje, Ifie, Anderson, Eugene, Valachovic, Richard W. Annual ADEA Survey of Dental School Seniors: 2009
Graduating Class. J Dent Educ. 2010 74: 1024-1045. ii Hawley, Nate. (2008). NBDE Part I: A Meaningful Score or A Score without Meaning [Powerpoint slides]. Retrieved from
http://www.adea.org/. iii
American Dental Education Association. Introducing the Personal Potential Index: A New Resource for Presenting and
Evaluating Applicants for Advanced Dental Education Programs. Retrieved from http://www.adea.org/. iv Fox, Karen. Postgraduate Exam Under Study. Nov 12 2009. Retrieved from http://www.ada.org/.
v Brodie, Abby J., Crow, Heidi C., Eber, Robert M., Handysides, Robert, Holexa, Roy, Kiat-amnuay, Sudarat, Spallek, Heiko.
Evaluating Postdoctoral Dental Candidates: Assessing the Need and Recommendations for a National Qualifying
Examination. J Dent Educ. 2011 75: 719-725. vi Task Force on Developing an Advanced Dental Admission Test. Reference Committee: Dental Education, Science and
Related Matters. Report of the Task Force on an Advanced Dental Admission Test. Rep. Sept. 2010: 4198-4215.
amended language would now move the current dental licensure exam to the American
Dental Licensing Examination (ADLEX).
Another issue of importance pertained to
prohibiting maximum allowable charges for non-
covered services. This legislation stops insurance
companies from dictating allowable charges for
services not even covered in their policy. These
bills will stop artificial price controls and bring
fairness back to the contract negotiation process.
This legislation passed unanimously in the Senate
Committee on Wednesday, April 13, 2011.
The final legislation supported by the
FDA aimed to increase access to care with
supervision level changes for hygienists. The
FDA and the Florida Dental Hygiene Association
have joint legislation to improve access to dental
care in health access settings. Without dentist
supervision, hygienists will be able to apply
fluoride and dental sealants. A medical clearance is
needed for hygienists to clean teeth in these settings.
This legislation passed Senate Committee and
House Committee and then was passed to Senate
Floor.
The one issue strongly opposed by the FDA
was a legislation aiming to bypass supplemental
education requirement. This legislation would
allow internationally-trained dentists from non-
accredited dental schools to bypass the two-year
supplemental education requirement and sit directly
for the Florida licensure exam. This legislation, and
any attempt to create a “back-door” pathway to
licensure, would threaten Florida‟s minimum
standard of care for all patients, according to the
FDA. This legislation did not pass.
F
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4
Nicholas Mann
ASDA Co-Legislative Liaison
The Student National Dental
Association‟s (SNDA) mission is to promote and
encourage the increase of minority enrollment
and retention in dental schools in order to
improve the delivery of dental health to all
people, with an emphasis on minorities and the
underserved. The University of Florida Chapter
of SNDA hosts and participates in a number of
activities throughout the year. The Chapter ran a
highly successful Impressions Program in the
summer of 2010. Thirty-five undergraduate
students from various universities got a view of
what dental school is like during the event.
Dental students, faculty and staff assisted as the
participants learned to take alginate impressions
and wax teeth. The participants had a great time
and expressed that they would have liked to stay
longer at a feedback session at the end of the
event!
The UF SNDA Chapter also organized an
event at a local Boys and Girls Club. Oral
hygiene instructions were given to a group of
kids at the Club using a gator puppet. Treats such
as toothbrushes and toothpaste were provided to
every child. Additional SNDA highlights include
Relay for Life, dinner at Ronald McDonald
house and an annual Christmas fundraiser that is
held to benefit children in need. In December
2010, the proceeds from the Chapter‟s Christmas
Candy Gram fundraiser were used to purchase
Christmas gifts for a child in the Partnership for
Strong Families “Wish Upon A Star” program.
At the 97th
NDA/SNDA Annual
Convention held in July 2010, UF SNDA was
awarded Chapter of the
Year and First Place in
the Scrapbook
Competition! This year,
UF SNDA will continue
to work hard to be a
benefit to the
community. The Chapter
is excited to be working
on plans for a “Mini”
Impressions program
that will be provided to
introduce high school
students to the field of
dentistry!
5
Will building new
dental schools in
Florida improve
access to dental
care?
someone‟s ability to obtain dental care
would probably be helpful. And finally,
we can think about how increasing the
number of dental schools and students
in Florida may or may not be part of the
solution.
The Pew-funded study used eight
policy benchmarks to assess childrens‟
dental health. The benchmarks included
having sealant programs in at least 25
percent of high-risk schools; allowing a
hygienist to place sealants in a school-
based program without requiring a
dentist‟s exam; providing optimally
fluoridated water to at least 75 percent
of residents who are served by public
systems; meeting or exceeding the 2007
national average of 38.1 percent of
Medicaid-enrolled children receiving
dental services; paying dentists who
serve Medicaid-enrolled children at
least the 2008 national average of
median retail fees; reimbursing medical
care providers for preventive dental
health services; authorizing a new type
of primary care dental provider; and
submitting basic screening data to the
national database that tracks oral health
conditions. The dentist workforce is a
consideration in these “access to care”
issues, but expanding the dentist
workforce, particularly by enrolling
students in a very expensive academic
program resulting in large debt loads at
graduation, is unlikely to make a dent
in Florida‟s “F” grade. Additionally, it
is unlikely to impact access to care for
adults, older adults, and vulnerable
populations such as individuals with
disabilities or living in long-term care
facilities.
What could make a difference?
A recent report from the Florida
Department of Health ii proposed
several excellent recommendations in
an effort to allow all persons in Florida
access to quality dental care. The
Workforce Task Force studied these
Teresa A. Dolan, DDS, MPH
Professor and Dean
University of Florida
College of Dentistry
Florida‟s “F” grade
two years in a row from the
Pew Foundation report on the
“State of Children‟s Dental
Health” i has captured the
attention of many local and
state leaders and has made
access to dental care,
particularly for children, a front
page news story throughout
Florida. But will a rapid
expansion of dental schools in
Florida improve access to care?
In order to answer that
question, it would be helpful to
first understand why Florida
received an “F” grade. Second,
a quick review of the many
factors that influence
issues for more than a year, and
concluded that there is a need for
innovative approaches in order to
deliver appropriate and high
quality dental care services to
underserved populations.
Recommendations included
expanding public health education
and prevention services, improving
the Medicaid dental program,
using incentives to attract dentists
to work in safety net clinics, and
allowing expanded duties and
reduced supervision levels for
allied dental providers who
practice in health access settings.
Expanding the number of dental
schools was discussed by the
committee, who ultimately did not
include this in the list of
recommendations. Rather, the
Task Force recommended the
expansion of learning experiences
through dental school externship
or residency programs in safety net
facilities, and the establishment of
short-term training programs in
pediatric dentistry. UFCD has
been a national leader in both of
these activities for many years, and
is open to the opportunity to
expand these programs.
High quality, affordable,
science- and evidence-based dental
education is an important public
good, and UFCD is grateful for the
public investment in dental
education. Rapid expansion of
high-cost, and potentially lower
quality and non-research intensive
dental education in a state that is
strapped for cash and is currently
having difficulty supporting the
higher education programs
currently in existence requires
much more thoughtful
consideration. And adding dental
graduates, particularly those with
large educational debts, will not
6
The Future of Dental
Education in Florida Phil Bell, ASDA Co-Legislative Liaison
UFCD Class of 2014
Dental
School
Notes Next Step Accreditation
Status
Seats Tuition and
Fees Annually
Anticipated
Opening
University of
Florida
Established in
1972
Expand Class
Size
Approval
without
Reporting
Requirements
Approximately
80
Residents-
$30,936
Non-residents-
$57,416
-
Nova
Southeastern
University
Established in
1997
- Approval
without
Reporting
Requirements
Approximately
120
Residents-
$48,450
Non-residents-
$50,950
-
Lake Erie
College of
Medicine
Now
Accepting
AADSAS
Applications
Accept Class
of 2016
Initial
Accreditation
100 $48,900 Fall 2012
University of
Central
Florida
UCF Board of
Trustees
Unanimously
Approved on
May 26th
,
2011
Board of
Governors
- 100 Estimated
$50,000-
$60,000
Fall 2014
Florida
A&M
University
Requested but
have not yet
received state
funding
Board of
Governors
- - - -
equate to improvements in access to dental care,
particularly for vulnerable Floridians. A more
thoughtful, comprehensive view of public policy
issues affecting access to dental care, and state-wide
dentist workforce planning to ensure high quality
and affordable dental education in our state will
yield a much more positive impact on the oral
health in Florida. i http://www.pewcenteronthestates.org/uploadedFile s/The_State_of_Children's_Dental_health.pdf , accessed June 5, 2011. ii http://www.doh.state.fl.us/Family/dental/OralHeal hcareWorkforce/200903Dental_Workforce_Report.pdf, accessed June 5, 2011.
field of dentistry. Of particular interest, we were
able to see a machine that generated a 3-D
image of a tooth and then shaped a crown within
6 minutes. Our group was able to sit in on the
House of Delegates meeting that discussed new
issues that would affect dentistry in Florida. In addition, it was a great
experience networking with Florida dental students, as well as, a variety of
professionals in the field of dentistry. Overall, it was a great experience and
would recommend it to anyone with an interest in dentistry. Our Pre-Dental
ASDA group and I had a great time and hope to attend another Florida
National Dental Convention in the future.
Kyle J. Losin
President, UF Pre-Dental ASDA
11
The 2010-2011 school year has been full of events for HSDA. What follows
is a small list.
Fall semester began with a Spanish teaching session for those students going
on mission trips. Some of our members went to Chicago for the national Hispanic
Dental Association meeting during October. Thanksgiving dinner was graciously
made by our members, and served at one of our own member‟s house. Finally, the
Christmas mood was set when we made over 150 pancakes to feed the families
staying at Ronald McDonald House.
Equally eventful, spring semester began with a celebration of “Dia del
dentista” at a local restaurant. Later, many students headed off to the Puerto Rico Dental Convention; the trip was facilitated by the efforts of one of our members. As the semester neared an end, a
lot of migrant workers benefitted from the screenings that we performed at a Migrant Fair event—overlooked by
Dr. Shaddox and Dr. Sposetti. Also, who can forget the lunch n‟ learns decorated by the many colors found in our
delicious Hispanic food.
Many events are planned for the coming months. If any of the above sounds interesting and you would like
to get involved, we would love your help.
An Update
from our
ASDA
President Dustin Pfundheller
In June, the State
Dental Convention was held
in Orlando, Florida. The
University of Florida
encouraged attendance and
worked hard to make the
conference meaningful for
dental students. University of
Florida brought over 60
dental students along with Nova bringing another 30
students. In addition, the UF ASDA chapter contacted
numerous undergraduate institutions and encouraged the
attendance of an additional 100 pre-dental students.
University of Florida also hosted an information
session specifically for dental students. The meeting
simplified and summarized the workings of the
complicated house of delegates so that all dental
students were able to understand and actively engage in
the convention. Also, the most current hot topics were
presented along with future events in the state.
Dental students contacted the Florida Dental
Convention numerous times, gaining permission for
dental students to attend meetings of the reference
committees, various districts, and councils. As a result,
the dental students were able to fully participate with
the dentists. Having dental students on the committees
was logical since most of the topics were student
centered -- such as the dramatic increase of dental
schools in the state.
At the convention, The Florida Dental
Association House of Delegates passed two
resolutions that were written by students. First,
Resolution 2010H-092 allows two dental students to
be on three sub councils: the Sub Council of a New
Dentist, the Council on Membership, and the Council
on Education and Licensure. Secondly, 2010H-068
gives money to the Council on Membership and to
Sub-council on a new Dentist to provide several
educational opportunities such as "Lunch and Learns"
and to increase student recruitment to the Florida
Dental Association. Previously, there was no student
representation on the committees.
As a result of the hard work of our UF ASDA,
there were many positive results for both the students
and the Florida Dental Association.
Jorge del Valle, HSDA Vice President
12
Samuel Low, DDS, MS
Assoc. Dean & Professor
Department of Periodontology
Just when the 4th
year dental student sees
light at the end of the
proverbial dental
academic tunnel, a cloud
emerges threatening to
squash well intended
efforts to finally be a
dentist. This unavoidable
consequence of the
journey is noted as the
licensure examination.
Historical documentation demonstrates that the
controversy over licensure examinations began in
1905 and had not ceased since. We have regional
exams, state exams, PGY-1, the imported Canadian
OSCE exam, and the “new kid on the block”
California portfolio exam.
Debate continues over patient based exams
versus non patient exams, third party evaluation versus
“in house” evaluations. And is a class II amalgam
performed in Washington evaluated to a different
standard than one in Nebraska? And why do we have
the exam anyway?? If I graduated from an ADA
CODA accredited dental school with honors, should
that be enough to prove I am worthy? Well yes and no
to all!
A defined objective of the licensure exam
process is to ensure that citizens of each respective
state receive competent safe dental care. This is
achieved through an independent third party process