Mandatory Residency for New York Licensure in 2007

[gryffindor]

The legislation has already gone through in Albany that starting in 2007, a 1-year GPR/AEGD or multi-year specialty program must be completed in order to be licensed to practice in New York state.

Below is the article from the NYSDA website. It doesn't mention anything about having the option to take the NERB or not.

http://www.nysdental.org/whats_new.cfm?ID=204

Licensure reform passes in New York State Legislature
April 30, 2004
Both the New York State Senate and Assembly have passed NYSDA-supported legislation that, beginning in 2007, will require dental students to complete a clinically based CODA-approved postdoctoral general practice or specialty dental residency program of at least one year's duration as a prerequisite for initial licensure in New York State.
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Since 2003, New York was the only state to offer dental students the option to complete an accredited postgraduate dental training program in lieu of Part III of the dental licensing examination in order to obtain a dental license. This new legislation, expected to be signed in to law by the Governor in the coming weeks, will eliminate the clinical exam as a requirement for licensure in New York.
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NYSDA President Brian Kennedy notes that New York is the only state to adopt legislation with such sweeping reform to dental licensure.
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?Due to the bipartisan support this bill received, it is apparent that our elected officials understand our goal?to elevate the level of training of the profession to protect dentists and the public,? said Dr. Kennedy. ?This follows the medical model for licensure, and treating dentists the same as physicians seemed logical to both the Senate and Assembly.?
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NYSDA asserted that the one-shot examination performed on a volunteer patient, is fraught with difficulties which, through no fault of the dental student and bearing no relation to his or her skills as a dentist, can cause the student to fail the examination. Often the patient is nervous or otherwise uneasy about being the subject of a student?s licensing examination and this can have a negative effect on the dental student?s performance, again without any relation or bearing as to the student?s competency.
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NYSDA Executive Director Roy Lasky is confident a full year of post-graduate dental training provides a better evaluation of a student?s aptitude, abilities, education, practice skills, and demeanor. ?A year residency is certainly fairer and more likely to ascertain a student?s fitness and ability to be granted a dental license than an all-or-nothing one-shot examination that tests a very limited number of dental skills,? said Lasky.
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Unlike the previous New York PGY-1 bill passed in 2002 that gave students the option to take part in a residency program in lieu of a clinical exam, this bill will carry no sunset provision or follow up evaluation period.

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[Meggs]

The legislation has already gone through in Albany that starting in 2007, a 1-year GPR/AEGD or multi-year specialty program must be completed in order to be licensed to practice in New York state.

What's the reason behind this? Do they think that 4 year school isn't good enough to practice dentistry?

 

[gryffindor]

meggs, this quote from the second to last paragraph, is their reason as to why:

?A year residency is certainly fairer and more likely to ascertain a student?s fitness and ability to be granted a dental license than an all-or-nothing one-shot examination that tests a very limited number of dental skills,? said Lasky.

So they basically feel doing a residency is a better indication of your clinical abilities in order to give you a license rather than the results of the NERB.

 

[spooky42]

I hope other states follow with the same type of legislation. I would much rather complete a one year residency then go through the bull **** involved with the nerbs and other one day licensure exams.

 

[River13]

Not me. I think that legislation sucks. I took WREB last month and passed fine. Sure it cost me a little over a grand and a big headache...but that's better than a whole year of lost income. Dental school is the place to "ascertain a student?s fitness and ability to be granted a dental license". I feel plenty confident in my abilities to practice general dentistry as of graduation in two days. Having to spin my wheels for a whole year is far worse than taking a board exam. I think both avenues should be options.

 

[Dr.BadVibes]

Not me. I think that legislation sucks. I took WREB last month and passed fine. Sure it cost me a little over a grand and a big headache...but that's better than a whole year of lost income. Dental school is the place to "ascertain a student's fitness and ability to be granted a dental license". I feel plenty confident in my abilities to practice general dentistry as of graduation in two days. Having to spin my wheels for a whole year is far worse than taking a board exam. I think both avenues should be options.

I agree with River13.....My goal will be to pass the NERBS and go right into practice and start paying off my debt...hopefully Temple will give me a lot of practice so I can pass the NERBS with ease...the option should be there, and because of this law, I have no plans to practice in NY now.

 

[Dr.SpongeBobDDS]

What's the reason behind this?

..............

$$

 

[Dr.SpongeBobDDS]

There are so many problems with this idea I don't even know where to start. For one thing the facilities to have every dental school grad in NY in a GPR simply don't exist. The idea of a residency for everyone like we have in medicine just can't work in dentistry. If they try to expand the current GPRs to deal with the demand, they are going to get so watered down trying to spread the work around that residents are probably going to get less experience than if they had just stumbled into an HMO almalgam mill after graduation. Procedures are going to become even more scarce for predoctoral students than they are now.

Sure grads can go to out of state residencies but these spots are limited and admission is competitive; what is the bottom of the class going to do? Are these kids just out of luck? "Sorry, you just spent $300,000 on an education, but I'm afraid the state of NY isn't going to grant you a license because you were unable to complete a GPR."

Of course, I can see the dental corporations coming in to save the day offering to run their own "GPR"s in their clinics. They'll be getting the same the level of skill they've always hired, but now they only have to pay $20,000/yr instead of $100,000. I'm sure the corporations have had their hands in this from the beginning along with the schools. They're the only two groups who stand to profit from this - not the new dentists and not the people of NY.

What a crock!!!!

 

[gryffindor]

Not me. I think that legislation sucks. I took WREB last month and passed fine. Sure it cost me a little over a grand and a big headache...but that's better than a whole year of lost income. Dental school is the place to "ascertain a student?s fitness and ability to be granted a dental license". I feel plenty confident in my abilities to practice general dentistry as of graduation in two days. Having to spin my wheels for a whole year is far worse than taking a board exam. I think both avenues should be options.

River, I agree that dental school should be where your competency is decided. So why make us jump through hoops and take the NERB to get a license - why not let the NBDE I & II and a DDS from a dental school be enough?

On the other hand, I've heard the WREB is a slightly easier clinical board compared to the rest of them. In your experience in taking them, after you finished, did you feel anything like UBTom & I did over on Tom's "*#&$@ NERB" thread? I have yet to talk to any of my classmates who feel confident about having passed the NERB. Everyone seems to have no confidence in their performance and is basically leaving it to the hands of fate as to whether or not we passed. I mean, I feel like my mannequin bridge is good, but who knows if it will break between shipping it from Buffalo to Maryland? That's not my fault, but it's probably an automatic fail.

SpongeBobDDS - New York claims that there are enough GPR spots in New York state to accomodate every graduate of the 4 New York dental schools. I never added up the number of spots in New York (maybe next week) but there are a lot of spots in the New York City area, so maybe it's true. But there definitely are not 4000 post-grad spots - specialty & GPR combined - in the USA to make this a possibility nationwide (there are approx 4000 dental graduates each year). And anyone at the bottom of any dental class in the USA can get a residency if they want one. There are lots of programs every year after match day that don't fill their spots and will take anyone who wants to go there.

avingupta - The problem with the NERB isn't that you don't get enough practice with the procedures in dental school. It's the grading (retired oral surgeons grading amalgam preps) and overall subjective nature of the exam that everyone complains about. In the past it's been viewed as a hazing ritual to get your license, but now I think more dental students and dentists are starting to question its validity.

And for those of you who think this is a terrible idea, in my graduating class of 90, 30 students opted not to take the NERB. Probably about 5 of them were Canadian or planning to move and never practice in a NERB state, but the other 25 are doing residencies and opted not to take the NERB b/c they never forsee themselves leaving New York. So for these students, this option wasn't such a bad idea since they were going to do a specialty/GPR anyways, and now they didn't have to deal with the NERB.

I'm sure there will be unexpected consequences as a result of this decision, but it might be too early to know what those are yet.

 

[Dr.BadVibes]

griffin.....ive always agreed with you about the subjective nature of the NERB, however, schools such as Temple and Tufts shows a very promising statistic on their graduates passing the NERB on their first try. Why should these graduates be forced into doing a GPR when they completed 4 years in dental school and passed a very "subjective" exam? If I use your class numbers as you've given, 25/85 people are gonna do residencies, and assuming in a hypothetical way that everyone passed their NERB, only 29% of your class benefits from this new law if it were already passed. The other 71% will most likely NOT practice in NY assuming they all pass. Tell me, how is this good?

I think your solution to just award people a license if they pass Part 1 and 2 and get their DDS is proposterous. Dentistry is a clinical profession and testing of these clinical skills is crucial. We all know that not all dental schools are the same. Going back to the infamous Columbia thread, we know that Columbia (and other schools Im sure) has never put primary focus on its clinical education (although this seems to be changing, please dont flame me), and previous Columbia grads have said that they are not ready for private practice and opt for a GPR....why should these people be allowed to practice right away when even they themselves dont think they are ready.

Im not debating the issue of whether a GPR is valid or not....all that Im saying is that a choice should remain. Otherwise, future graduates like myself will take the NERB, pass it and NOT practice in NY state. Im gonna graduate with about 140K in debt and that is on the low side of what the average is these days....once I graduate, my primary goal is to pay this back.....residency salaries just aint gonna cut it for me and Im sure this is the common conception among dental school graduates since the ADA claims that 70% enter private practice right away.....Tom is right...NY is gonna lose a lot of future dentists by bullying them into doing a residency.

The solution should be to keep the NERB, but to take criticisms of it such as the ones you have given and reform it in a way to make it more a more effective tool to test and regulate dental practitioners. That is my opinion.

 

[River13]

Well said Griff. I think both should remain options. I've heard WREB is easier than NERB as well. When I was done I felt like I 'most likely' passed. Still had a few doubts, but small ones. There were no catastrophes or anything like that for me, and knowing the pass rate is in the 70-80 something percent, I wasn't too worried. Just glad it all worked out. I waited over a month for my score...that was the worst part.

 

[Dr.SpongeBobDDS]

I would never have guessed there were that many GPR spots in NY state, griffin. Amazing. I still say it's all about the money though. GPR programs are a cash cow for the schools. I mean, where else can you get a fully trained and degreed dentist working in your clinic for $20,000/yr? I'm sure some practicing dentists think it's a good idea because it means less competition from new dentists. The program is absolutely going to drive new grads away from practicing in NY.

But for the people they claim it will help, students and the people of NY, it's just bad, bad, bad. What a fetid pile of steaming kimchi.

 

[ItsGavinC]

Aving,

Student loans are deferred during residency so there isn't anything to pay back during that period. You aren't expected to pay back loans during residency. So if you're only gripe with doing a residency is that you won't make enough to pay back loans, then don't worry about it. You aren't expected to pay back loans yet.

 

[Dr.BadVibes]

Aving,

Student loans are deferred during residency so there isn't anything to pay back during that period. You aren't expected to pay back loans during residency. So if you're only gripe with doing a residency is that you won't make enough to pay back loans, then don't worry about it. You aren't expected to pay back loans yet.

No I knew that Gavin, but I just want to start paying off the debt ASAP.....Ill be 27 when I graduate, and getting rid of my debt will be my priority.....I just hate debt.

 

[groundhog]

The GPR's, because they can be located away from the dental schools, will become the means by which more of the underserved populations will be provided access to dental care at a subsidized price. GPR's are a political slam dunk and are the wave of the future in all states. In fact, I predict an eventual 2 year GPR as technological advances make justifications for the existance of dental specialities outside of the academic/university health center arena less compelling. My personal advice...unless you are attracted to academics and research, go with a GPR and continuing education vs a speciality program.

 

[drPheta]

This legislation does have a good side to it, and it seems like it could open a very big door to the reciprocity of licensure between states of different regions (i.e Cali, WREBS, NERBS, et al.)

But I still agree with you guys that there should be an option.

 

[gryffindor]

I think your solution to just award people a license if they pass Part 1 and 2 and get their DDS is proposterous. Dentistry is a clinical profession and testing of these clinical skills is crucial. We all know that not all dental schools are the same. Going back to the infamous Columbia thread, we know that Columbia (and other schools Im sure) has never put primary focus on its clinical education (although this seems to be changing, please dont flame me), and previous Columbia grads have said that they are not ready for private practice and opt for a GPR....why should these people be allowed to practice right away when even they themselves dont think they are ready.

badvibes, Wait till you've picked up and used a high speed handpiece and used it in someone's mouth before you start calling me preposterous.

Tufts & Temple may report 95% passing on the NERB. But here is a little fact you might not have known about that "pass" rate. The NERB agency considers a "pass" to be the following: Student takes NERB in May, passes restorative, perio, computer exam, but fails the typodont. The student retakes the typodont in August and passes it. This is a NERB "pass" - failing on the first attempt, but passing in the first retake. If the student had failed again in August, that would be considered a "fail" at that point, not back in May when he originally failed. 100 students take the exam in May, 50 of them pass the whole thing. The other 50 fail 1 or more sections and retake it in August. In August, 45 of the 50 pass the parts they fail. 45 (August) + 50 (May) = 95. 95/100 = 95% pass rate according to the NERB.

However, with the introduction of the "year long NERB" where you take parts of the exam throughout your senior year and have a chance to remediate any part you fail before graduation (Tufts & Temple are a part of this I believe), I don't know how the statistics have changed. If they're not gonna get rid of the NERB yet (the old examiners all have to die off first), then the year long thing is a better compromise I think. But be wary of any stats they give you, because the NERB is known for fooling with its stats to look comparable to the other testing agencies. That's why River can walk out of the WREB being 70 - 80% sure he passed b/c thats how many do actually pass. My classmates don't feel quite the same way because there have been years at our school where upto 50% failed the mannequin section on the NERB because their bridges broke or shrank during shipping and grading weeks after the exam, not because they were faulty bridges if they were in someone's mouth during that time.

Again, if you had read what I wrote at the end of the Columbia thread, then you wouldn't be saying ridiculous stuff. Even if a school doesn't place emphasis on the clinical part of dentistry, you can't say "Graduates of school X should do a residency while graduates of school Y can go straight to practice." And the NERB exam will not do anything to make the distinction clearer, b/c the clinical skills it tests are miniscule compared to the procedures you will be doing as a practicing dentist. Again, it is up to the STUDENT to decide if a residency is valuable to him or not. Read below and refresh your brain, b/c I don't feel like typing it all over again.

The NERB testing agency is not a "regulatory" agency. They offer an exam that tests clinical competence on placing 1 ideal amalgam, 1 resin, and cleaning 6 teeth on real patients. Then you do a bridge and endo on a mannequin - these mannequin excercises (especially the endo) are so far removed from what you would do clinically on a real patient. Any denal student can probably pass the NERB after second year; you will have the basic skills you need after finishing all your pre-clinical operative, fixed, endo. You can't compare the NERB to the DAT like in your analogy. A student from a school that doesn't prioritize clinical education can pass the NERB and get a license; it's not a difficult exam. The problem with passing the NERB is the subjectivity of it, not the actual dentistry part.

The NERB tests nothing on clinical competence on removable prosthodontics (dentures), oral surgery, pediatric dentistry, or orthodontics. NOTHING. You can pass the NERB knowing nothing about 4 major clinical disciplines in dentistry. Even if ortho and pedo are mainly referral disciplines, there isn't a GPR in the USA where you can get away without making dentures or pulling teeth. But you could potentially get away without doing those things in dental school (I used to pawn off pulling teeth to everyone else and no one ever stopped me) and still get a license.

The NERB will also not test whether you know how to place a foundation (core-buildup) restoration, if you know how to manage a medically compromised patient (b/c you screen the medically complicated ones out and only use the healthy ones for the exam), if you can do other aspects of operative and fixed, perio surgery, implants, and I can go on with this. So its results are meaningless. Everyone knows this; the NERB is basically another piece of red tape to go through before being allowed to practice. Go ask the practicing dentists on dentaltown and they will all tell you what a worthless exam the NERB is.

 

[gryffindor]

I was unclear in my earlier post and meant to say that the choice between residency or NERB is a good thing, and 25 of my classmates are not taking the NERB because the choice exists. Many more took the NERB and doing a residency and still planning to stay in NY, they took it "just in case" or with hopes of moonlighting during residency.

I don't know if I feel mandatory residency is a good thing. Like spongebob said, maybe it is about the $$$ because there are lots of GPR spots in New York City that are unfilled, so the hospitals are losing out on $$$. Maybe this a way to try and fill them, who knows.

At one of my GPR interviews they asked me "What do you think of PGY1 (mandatory residency)?" I said I thought the choice should remain and they further questioned me by saying "Would you let one of your classmates who is going straight to practice work on your mother?" What would you say?

 

[datu]

Aving,

Student loans are deferred during residency so there isn't anything to pay back during that period. You aren't expected to pay back loans during residency. So if you're only gripe with doing a residency is that you won't make enough to pay back loans, then don't worry about it. You aren't expected to pay back loans yet.

Yeah, that's the big myth surrounding loans. Sure, you don't have to pay it back but it's still accruing interest during that period. I'd rather pay it off sooner.

 

[ecdoesit]

I am just curious, how are they going to generate the stipend paying for all those residents.

 

[aboo-ali-sina]

New york State requires MD's to do one year of residency before they have a license (in fact many states do) why shouldn't they require that of DMD's?