Dental Education in US after BDS

Introduction

The United States has been one of the most favorite destinations for Indian dental students for higher studies and further settlement. Indian graduates cannot get permission to practice in US directly as Indian dental degrees are not recognized by the Commission on Dental Accreditation (CODA).

Indian dental degrees are recognised in the USA as degrees from non-accredited dental schools and Indian dental graduates can sit for NBDE exams.

In order to enter into US dental practice, Indian graduates either have to join Doctor of Dental Science (DDS) or Doctor of Dental Medicine (DDM), which are equal degrees of four years’ time span, or two-year International Dentist Programme (IDP), which will lead to DDS degree; which are accredited by either CODA or the Commission on Dental Accreditation of Canada (CDAC).

Requirements
Based on the student’s merit and performance in BDS exams, NBDE Part-I exam and TOFEL, they would be given admission either in first year of DDS/DDM or IDP. Some schools offer admission into 2nd year of DDS/DDM to those students with very high GPA.

In the US, the licensure for dental practice is granted by the individual states, districts and dependencies. The conditions for licensure vary from state to state and such licence is valid only within the respective geographical confines.

The international dental students shall fulfill three requirements to get the licensure in the United States. They are:

• Obtainment of DDS, DDM degrees, which are accredited by either CODA or the Commission on Dental Accreditation of Canada (CDAC).
• Successful completion of the computer-based National Board Dental Examinations (NBDE) Parts I and II exams, and
• Successful completion of a clinical examination administered by a state or regional testing agency. > In these three qualifications, the dental degrees are granted by different dental schools, which are accredited by the CODA.
  
  The NBDE Part-I and Part-II exams are conducted by the Joint Commission on National Dental Examinations (JCNDE) and they are being accepted by all the states, however with different sets of conditions. For example, some states accept NBDE results only if earned within the last five to 15 years.
  
  And clinical examinations, third requirement, may be conducted by individual state boards of dentistry or by regional or independent dental clinical examination agencies. These exams usually have several components such as written, clinical and the practicals performed on patients. The different boards include the Northeast Regional Board of Dental Examiners (NERB), Western Regional Examining Board (WREB), Central Regional Dental Testing Service (CRDTS) and the Southern Regional Testing Agency (SRTA). Some of the states like California, Connecticut, New York and Minnesota are states which allow candidates to complete a 1-year General Practice Residency (GPR) or an Advanced Education in General Dentistry (AEGD) in lieu of a regional board exam.
  
  Procedure of NBDE Part-I Exam
  The Indian dental graduates those who would like to make it into US shall pass the Part-I exam of the NBDE.
  
  The NBDE conducts two exams for dental graduates namely Part-I and Part-II. Indian students are eligible to sit for Part-I after 2nd year of BDS, however they will get eligibility for Part-II only after getting admitted into American dental degrees. They shall complete both the exams mandatorily by the end of their American degrees, to fulfill the second major requirement for the licensure.
  
  To begin with, only Part-I exam is pertinent for Indian students; hence, this article focuses more that exam. The following are the process, syllabus and evaluation details of the exam.
  
  Process of Part-I Exam
  Indian graduates shall get their dental degrees verified by Educational Credential Evaluators, Inc. (ECE), the agency which prepares evaluation reports that identify U.S. equivalents of educational qualifications earned in other countries. Please find the details of ECE at www.ece.org. The ideal GPA is 3.30 on 4 points GPA scale.
  
  This evaluation process involves the following steps:
  
  1. Student shall contact ECE and request for an ECE evaluation report. The ECE evaluation report request will describe what educational credentials are required, the manner in which to submit them to ECE, and the applicable fee. To request an evaluation report, visit www.ece.org, select Start Your Evaluation Request, and request that a General Report be sent directly to the JCNDE.
  2. Only official reports electronically transmitted from ECE to the JCNDE will be accepted. Personal copies or faxed copies are not acceptable.
  3. The JCNDE will not process the examination application before the ECE Evaluation Report is received.
  4. The name on the ECE report must match the name on your application exactly. Any name changes must be accompanied by legal documentation.
  
  Application process generally takes 60 days and involves the following steps -
  

  Day	Step of Process
  Day 1	Web Based assessment and online registration with American Dental Association (ADA). Obtainment of Dental Personal Identification Number (Dentpin) in registration number from ADA. Process for appearing in NBDE Part-I starts.
  Day 4	Payment process starts with forwarding application to ADA for registration for NBDE part-I.
  Day 5	Apply for eligibility certificate evaluation (E.C.E.) with ADA and Send courier to ADA for ECE.
  Day 15	You will get your confirmation email and application number from ADA within few weeks.
  Day 45	Receive E.C.E. & GPA, courier it to ADA and apply for visa. s.
  Day 60	Sit for the exam in the USA.

  Syllabus of Part-I Exam
  The syllabus for Part-I exam consists of the following topics:
  The NBDE Part I consists of 400 examination items. For each discipline,
  
  approximately 80% of the items are discipline-based and approximately
  20% are interdisciplinary testlet-based items.
  A testlet consists of the patient scenario and a set of items from the various disciplines that are associated with the scenario. One item from each of the disciplines listed below will be designated for the testlets under the topic, Professional Ethics/Patient Management.
  
  These items will require a basic understanding of professional ethical principles in patient management. The items for the NBDE Part I are drawn from the following disciplines:
  
  Anatomic Sciences [100 M]
  
  1. Gross Anatomy [49 M] The following topics will also be considered under each category of gross anatomy:
     • Bone Muscles
     • Fascia Nerves (peripheral and autonomic)
     • Arteries, veins, and lymphatics Spaces and cavities
     • Joints and ligaments Endocrines and exocrines
  2. Histology [23 M]
  3. Oral Histology [16 M]
  4. Developmental Biology [11 M]
  5. Professional Ethics/Patient Management [1 M]
     
  Biochemistry & Physiology [100 M]
  1. Biological Compounds [10 M]
  2. Metabolism [17 M]
  3. Molecular and Cellular Biology [9 M]
  4. Connective Tissues [8 M]
  5. Membranes [4 M]
  6. Nervous System [7 M]
  7. Muscle [6 M]
  8. Circulation [9 M]
  9. Respiration [6 M]
  10. Mechanical aspects
  11. Renal [8 M]
  12. Oral Physiology [3 M]
  13. Digestion [5 M]
  14. Endocrines [8 M]
  15. Professional Ethics/Patient Management [1 M]
      
  Microbiology-Pathology [100]
  1. General Microbiology [20]
  2. Reactions of Tissue to Injury [10]
  3. Immunology and Immunopathology (at least 3 on oral immunology) [13]
  4. Microbiology, Immunology, and Pathology of Special Infectious Diseases (at least 8 on oral diseases) [22]
  5. Systemic Pathology [22]
  6. Growth Disturbances [12]
  7. Professional Ethics/Patient Management [1]
     
  Dental Anatomy and Occlusion [100]
  1. Tooth Morphology [43]
  2. Pulp Cavity Morphology [5]
  3. Calcification and Eruption [6]
  4. Principles of Occlusion and Function [37]
  5. Clinical Considerations—Tooth Morphology and Anomalies [8]
  6. Professional Ethics/Patient Management [1]
  
  
  Exam pattern of Part-I Exam
  The NBDE Part-I is comprised of 00 multiple-choice items, which are evenly distributed across Anatomic Sciences, Biochemistry and Physiology, Microbiology and Pathology, and Dental Anatomy and Occlusion. Approximately 20% of the items are grouped in testlets with interdisciplinary focus and clinical application. The time of examination is 7 hours, excluding one hour lunch break.
  
  About 80% questions will be in multiple choice format and 20% questions are being asked in a new format called testlets. A testlet consists of a patient scenario/history and a set of items from the various disciplines that are associated with the scenario, and 6 to 10 questions will be asked on the given case sheet.
  
  One testlet from each of the disciplines listed above will be asked in the exam under the topics of Professional Ethics/ Patient Management. These testlets will test the basic understanding of professional ethical principles in patient management of the candidates.
  
  Evaluation of Part-I Exam
  According to the new test pattern, candidates can get to whether he/she is passed or failed and the numerical scores are no more available. The minimum pass percentile is 75, and averages percentile is 88.
  
  Admission into Dental Schools
  The aspiring graduates shall apply to obtaining good average percentile in the Part-I exam for admission into DDS, DDM or International Dentist Programme. The Indian students generally apply for admission into four-year DDS, DDM courses or two-year IDP.
  
  Those who have very high GPA can apply for direct entry into second year of DDS, DDM degrees and the IDPs. However, competition for these seats is very high.
  
  For successful admission into schools, one should do well in the following variables:
  
  1. NBDE Part-I score
  2. TOEFL iBT score
  3. GPA (Grade Point Average)
  4. 3 Letters of Recommendation
  5. A solid and professional Career Statement or Statement of Purpose
  6. Original Transcripts signed by Dean/Principal of your college/university
  7. Application submission
  8. Personal Interviews
  9. Resume
  10. Paper/Poster presentation
  
  
  There are a few institutes in the country are offering coaching and mentoring for American dental education. Their assistance is a useful source for the aspiring candidates.
  
  Students can apply for dental programmes in two ways; they can apply to schools directly or send single online application to different dental schools through
  the Associated American Dental Schools Application Service (AADSAS).
  For more details on admission, process please log on to the following websites of American Dental Association and the AADSAS - https://www.ada.org/3219.aspx and
  https://www.adea.org/Landingpage.aspx?id=16878 - respectively.
  
  Finances
  The NBDE Part-I exam would be around US $ 1,200, excluding exam coaching costs and airfares. Student shall read the relevant literature available at ADA website (i.e. www.ada.org) and related blogs so that they don’t have to incur extra costs during the exam and admission application process.
  The tuition fees of dental programmes for the first year would be somewhere between US $ 8,000 and US $ 35,000 and annual average expenses would be around US $ 11,000. Those who have opted for three year and four-year dental degrees have to spend more than those could get seat in IDPs.
  
  Note of Caution
  Dental education in US is an expensive proposition and only few scholarships are available. The dental practice is US is presently in doldrums due to economic slowdown as well as increasing number of dental graduates. Similar situation is prevailing in neighbouring Canada.
  Hence, students shall make detailed enquires and estimates before they opt for an US dental degree. The final decision made shall be a thoroughly informed one.
  

Published date : 03 Jun 2013 05:14PM