So I took the
PATP last weekend, and it was really very straight-forward! I felt very good about it when I left, and it was so short and sweet. I'm posting this so that you can have the same stress-free experience I did.
So the first thing you should do is breath and relax - this is the kind of thing you've been doing for a couple of years now in your dental school clinic! So much of it will come naturally! The format was just like the examples in the Candidate Guide. So to help you prepare, here's the breakdown of this
one hour PATP exam:
- You show up at least 30 min early for the exam to sign in and be seated. You cannot bring anything in with you, but they supplied me with foam earplugs and the usual noise canceling headset. Also: if you bring someone along for moral support/a ride, they cannot wait for you in the waiting room; they must leave/go out in the hallway/whatever until you are done.
- Bring two forms of ID (one must be your driver's license). I used my driver's license and a signed ATM/bank credit card. Make sure it is signed on the back. You can also use a Passport as your second ID.
- They will take your fingerprints electronically and inform you that you must sign in/out this way if you need any bathroom breaks during the exam.
- Once you're seated, do go through the tutorial. It just saves you time and confusion, and the 15 minutes allotted for the tutorial are not taken out of your one hour exam time.
- When you begin the exam, you'll be given all the patient's info in the format shown in the 2011 Candidate Guide (Health History, Dental History, Pictures, Radiographs, etc.). These are arranged into tabs, and at the bottom of the screen are three text boxes just as shown in the 2011 Candidate Guide). This will all be very clear to you if you go through the tutorial before beginning.
- First text box: Treatment modifications (special considerations): This is where you input things like "do not prescribe penicillin", or "avoid latex", or "instruct patient to bring asthma inhaler/nitroglycerin/etc to each appt", or "premedicate with XXX". This is very common sense, just acknowledge any needs you normally would.
- Second text box: Recommended Maintenance Care Interval: Are you recommending 3 month recalls for your patient? Remember: Once an SRP patient, always a perio-maintencance patient. Can the patient get by with the basic 6 month recall?It's a simple two-word answer: "X months".
- Third text box: Sequenced Treatment Plan: This is where you provide a treatment plan, making sure it is in the proper sequence!!!
Quick review of sequencing:
-First: Any emergency care - Pulpotomies, Extractions, etc to get the pt out of
pain. If the patient isn't in pain, then you'll want to try and address their
Chief Concern/Complaint first. This might involve smoothing sharp surfaces of fractured restorations until you can prep a crown/re-restore/etc.
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Second: As with any patient you'd see at your dental school clinic, you want to begin by cleaning the teeth. Specify adult prophy/child prophy + fluoride/SRPs-which quadrants. You do not have to specify OHI (Oral Health Information/Education)- this is assumed. You
do have to specifically mention fluoride as this is not assumed. All of this is in the 2011 Candidate Guide which you will recieve once you register for WREB.
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Now sequence Tx needs: As I am not yet a dentist or educator, you should of course
double check all of the info I offer (I have personally found a good deal of false info posted on these forums, so be aware!).
Information on proper sequencing is not specified in the 2011 Candidate Guide (which is mailed to you once you register for the WREB), but it is obviously beneficial to review and clarify with faculty at your respective dental schools.
Tx is properly (according to me) sequenced as follows:
-Oral Surgery: Extract all non-restorable teeth
-Endo: Complete all RCTs at this point (note that you do not crown these teeth until the very end of tx- this gives you time to be sure that they do not "flare up" in the meantime).
-Operative: For children, Tx plan operative needs
one quadrant at a time, rather than how you would treat adults. This includes extractions and all other needs. Again:
Treat One Quadrant at a Time. If you get a Pedo patient and need to Tx plan a space maintainer post-extractions:
I do not know whether or not you have to specify which type of space maintainer, or simply state "space maintainer". For adults: In general, you want to restore posterior/most decayed teeth first. If you are doing two restorations at once,
do not restore two opposing teeth at the same time! With opposing quadrants numb, how can you ensure correct occlusion?
After all direct and indirect restorations are completed, you can now prep any
crowns (and implant crowns) the patient needs. Makes sense: have you ever prepped a crown on someone with a mouth full of caries? Nope. Do the crowns last. Even if they represent the deepest caries.
- Prosth: Any FPDs/RPDs/Full Dentures as needed. Note: When Tx planning an RPD (as I did), you must specify
three things: which #teeth
are being replaced by the RPD, which #teeth
have rest seats (and where), which #teeth
have clasps (where/what type). Review all of this in the 2011 Candidate Guide. Seriously! It's only a couple pages and you'll feel so much better after you read it for yourself!
-Misc: Note any referals you will need as well: "Refer to Oral Surgeon for extraction of impacted third molar #XX", or "Refer to Oral Surgeon for biopsy of ...", or "Refer to Periodontist for evaluation of cyst-like raised area buccal of implant #XX", or "Refer to Endodontist for RCT of #XX". Put these referrals in your treatment plan at the appropriate times (not at the end just because this is where I mentioned them!).
Above all: Rememer folks: This is just
one of five parts of your WREB Examination. It is possible to fail this portion and still pass the WREB, although I highly doubt you will fail the PATP.
Also: If you reivew
pg 80-81 of the 2011 Candidate Guide, you will note that your treatment plan has to actually
cause harm/overtreat the patient in order for you to fail even a portion.
If you fail any portions,
there's still a (very) good chance you'll pass the rest, and therefore pass the PATP, so don't worry!!
******This exam is meant to weed out candidates who would obviously cause harm to patients! The Examiners recognize that there are multiple ways to approach a treatment plan. Don't obsess over reading the Examiners' minds! Just present a properly sequenced treatment plan that does not harm or over-treat the patient! You are going to pass.