What do clinical boards really do?

[iowa1525]

I just finally passed my WREB exam after having to retake the op. section. I was in the top 15 in my class in terms of GPA, and was told by several faculty that I had some of the best clinical skills in the class. Well, I failed my first attempt at operative. Caries remaining. Had a stellar score on the other tooth and then nearly perfect on my retake of the op. section.

The boards is just a game. I could have easily failed the second time around due to some random incident that happens at every exam. The problem is that your dental school degree is worthless without the boards. This makes no sense because it really does not assess your clinical abilities or weed out the poor clinicians. If you look at your own class, I would bet my last dollar that this is the truth across the board.

When the test is set up in such a manner that the best can easily fail and a monkey with the right patients can easily pass, something is wrong.

I understand that the board is there to simply keep the schools in check in what they are teaching, and no so much to weed out the bad ones. I am sure they do catch bad ones from time to time but I think the opposite is more true. We have dental school accreditation, but I often wonder what they are really accrediting? I dont believe that a school that watches you perform for 4 years has more credibility that a couple of class 2's on a given Saturday.

To make the situation worse, is the fact that most schools only take the exam once, so to retake a section is very, very difficult.

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[Motormouth]

part 1 and 2 are realistically a waste of time....what makes part 2 even worsen is that it's unethical. To think about how many Pt get treatment done that is delayed, unnecessary, and could be done in a less invasive manner then a classic amalgam etc is scarry. GV black dentistry went out the door many years ago with modern dental materials for the most part...

part 1 boards are a sick case of the tail wagging the dog.... i can say that my dental education has been less focused on dental-applicable medicine/science/operative then it should have been, instead it almost feels like a 2 year Boards-Prep-Courseto the tune of $6XXXX+ per year..... That is not to say that I haven't made the best of it to my ability but you really have to have the realization that dental school (especially inthe US) is beurocratic.

Here is how I see it..... If you get into dental school and have a clear focus of what is required of you to become a dentist you will become a dentist despite dental school!

congrats on passing!

 

[staroceanX]

I agree, the clinical exams are unethical and a gamble. Currently there are four states that allow residencies to acquire licenses and I hope more states follow this pathway because besides the 4 years in dental school, 1 year of full time clinical experience really DOES beat 1 weekend on "the smallest cavity we can find" (you know what I mean). Anybody know any news or rumors on any other states following the residency licensure pathway? So far, Cali, New York, Conn, and Minnesota allows this pathway.

 

[puncho]

I just finally passed my WREB exam after having to retake the op. section. I was in the top 15 in my class in terms of GPA, and was told by several faculty that I had some of the best clinical skills in the class. Well, I failed my first attempt at operative. Caries remaining. Had a stellar score on the other tooth and then nearly perfect on my retake of the op. section.

The boards is just a game. I could have easily failed the second time around due to some random incident that happens at every exam. The problem is that your dental school degree is worthless without the boards. This makes no sense because it really does not assess your clinical abilities or weed out the poor clinicians. If you look at your own class, I would bet my last dollar that this is the truth across the board.

When the test is set up in such a manner that the best can easily fail and a monkey with the right patients can easily pass, something is wrong.

I understand that the board is there to simply keep the schools in check in what they are teaching, and no so much to weed out the bad ones. I am sure they do catch bad ones from time to time but I think the opposite is more true. We have dental school accreditation, but I often wonder what they are really accrediting? I dont believe that a school that watches you perform for 4 years has more credibility that a couple of class 2's on a given Saturday.

To make the situation worse, is the fact that most schools only take the exam once, so to retake a section is very, very difficult.

While I do agree with most of what you said, there should be no excuse for leaving caries. With the amount of training over the 4 years, a "bad day" should not, and is no reason for having caries remain in any prep.

 

[iowa1525]

While I do agree with most of what you said, there should be no excuse for leaving caries. With the amount of training over the 4 years, a "bad day" should not, and is no reason for having caries remain in any prep.

I take it you have not taken a clinical board exam?
-On the exam, you do the opposite to what you do in a normal setting. You prep an ideal cavity first. Normally, you remove caries, then idealize your prep.
-What you are taught to leave behind in dental school can lead you to a "caries remaining" in the clinical boards.
-What they think could be caries in some groove,99.9% of dentist would not remove could leave you with a "caries remaining".
-Some examiners press as hard as they can to get a "stick." When it happens you get "caries remaining."
-Some have preped a slot and got caught with caries remaining on the occlusal(me), when several of your faculty looked a week before and they all thought that there was no caries other than in the interproximal (slot).
-Some have been denied modifications and still dinged for "caries remaining" on the same wall/surface.
-Some have asked for modifications for caries that could be penetrated with a ball burninsher, yet it was denied.
-****The most important thing to remember, there is so much on the line that errors and oversights are most likely to occur during this exam.

So the real answer is this: It is what the board thinks is caries remaining, not you or I. What you would leave in a day-to-day setting is often caries in the clinical boards definition. Any little corner or groove could be the death of you. To say "there is no reason for caries" is just scratching the surface. Read on here long enough and you will find professors and the tops in the class getting hit with caries remaining.

My advice is this: Be aggressive on boards. I know it sounds unethical, but that is how the game is set up. In the 3 years that my school has offered WREB, NOBODY has failed operative for anything but caries remaining. Even with bad preps and pink slips, nobody failed. So, if you want to pass, make sure you take out every groove and anything remotely suspicious. Being conservative and ethical like we are all taught is what makes you fail.

I am a dentist now with my license in hand. That is all that matters.
Good luck on your clinical exam.

 

[puncho]

I have taken the WREB. You do bring up some good advice tho 👍

I do agree that you have to be aggressive. If YOU believe there is caries remaining, take it out. If you're denied mods, take it out anyways. You're the one that will be graded, not the floor examiners. I'd rather get points taken off for overprepping than the possibility of an auto failure by leaving caries (people who took NERB did this because many just didn't have time to get multiple mods). It really is similar to playing a game, calculating the different possibilities to garner the most points given different scenarios.
I was going to prep a slot as well but opted to do a conventional design just to be "safe". I'd advise people to be sure to read the candidate guide several times and know the rules well. They do have 3 examiners check it if the two examiners disagree, but if you suspect occlusal caries, I would prep it just so no doubt exists.

Good luck to you, iowa1525...at least it's over. 😎