My comment on JADA’s January Point/Counterpoint article, "Do Portfolio Assessments Have a Place in Dental Licensure?" (
JADA 2006; 137: 30–4[Medline]
) can be summarized by one word: irrelevant.1 We have here yet another meaningless discussion to validate an antiquated system of licensure. To paraphrase Bill Clinton, "Don’t amend it, just end it."
There is one valid point in this article: that all any examination does is assess ability on one given day, and that is true regardless [of whether] you assess that ability via a patient, a written examination, a mannequin, a computer simulation or a portfolio. The components of a good dental practitioner are education, experience and a commitment to continuing education and ethics, none of which can be adequately measured by any examination method.
What is needed is a good fundamental basic dental education, such as that provided in our dental schools today, followed by a residency system that permits graduates to learn, make mistakes and be mentored into good dentists. That is the system employed successfully by our physician colleagues for decades and, if it works in the life and death situations that present in medicine, there is no reason it cannot work equally as well in dentistry.
What we have is a staid, vested set of systems that try to justify their existence with the notion that they are "protecting the public" when, in fact, absent invasive investigations into daily practice life, these examinations can do no such thing.
It is time we end the charade and cast off the vestiges of a 19th-century system and bring it into the 21st century. We in dentistry, and the ADA in particular, do not serve the public well when we try to continue a system of licensure that is clearly both a failure and a fraud.
