"Above the Line, Below the Line":
A Selective Look at the State-Constructed
Dental Licensing Examination
If the dental licensing examination was scored using a conjunctive model rather than a compensatory model, then the pass rate for United States dental school graduates would be less than or equal to 25.56 percent instead of 53.66 percent. A conjunctive scoring model places substantial demands on foreign dental school graduates taking the restorative technique examination. Conversely, a compensatory scoring model gives substantial allowances to United States dental school graduates and foreign dental school graduates taking the dental licensing examination.
At the legislative level, the ultimate policy issue that the Legislature must decide is whether to: (1) retain the state-constructed dental examination (the status quo), (2) abolish the state-constructed examination and allow candidates to pass any one of the four regional examinations, or (3) allow candidates to pass either the state-constructed examination or a regional examination. This legislative policy decision is separate and distinct from anyone's opinion on the technical merits or defects of the existing state-constructed dental licensing examination.
The question of whether to authorize the Board of Dental Examiners to accept the results of all four regional testing agencies' examinations does not depend on a determination that the existing state-constructed dental licensing examination is an undue exclusionary barrier to entry into the profession. Instead, this question depends on whether the Legislature's desire for local control of the dental licensing examination, if any, outweighs its concerns about state liability for alleged or proven injustices, convenience and affordability for candidates, and ongoing program costs to the State.
This federal class action, civil rights lawsuit was brought in 1976 against the Board of Dental Examiners, and contended that the Board had utilized the dental licensing examination to illegally discriminate against candidates for a dental license based on their racial (Caucasian) and nonresident status.
The Board denied Pekarsky's and Koch's allegations of wrongdoing but agreed to settle the lawsuit in 1980. The settlement agreement included the appointment of a court master in 1987-one Dr. A. Lewis Leo, Associate Dean of the University of Florida College of Dentistry and a national dental expert who had been involved in prior phases of the litigation-to modify the dental licensing examination, including the rules relating to its administration.
In 1991, the United States District Court modified the settlement agreement to eliminate the requirement that the court continue to supervise and monitor the dental licensing examination, and discharged Dr. Leo as the court's master. Paragraph 3 of the settlement agreement was modified to read as follows:
3. The requirements and procedures by which candidates for dental licensure are examined and licensed in the State of Hawaii ["licensure requirements"] [sic] shall at all times now and in the future conform to the requirements of the Constitution and laws of the United States and the State of Hawaii and shall (a) be based only upon the present state of dental practice and current trends in dental education; (b) utilize only valid and reliable test and measurement procedures; (c) employ only comprehensive objective criteria for measuring the competence of candidates; and, (d) assure that the Hawaii dental licensure examination is anonymous in all respects. . . . [emphasis added]
The United States District Court did not retain continuing jurisdiction to enforce or amend the settlement agreement after 1991.
This report reviews selected issues concerning the dental licensing examination. Even with the assistance of the Board of Dental Examiners and the Department of Commerce and Consumer Affairs, the Bureau does not possess adequate expertise in the fields of dentistry or psychometry, much less both, to conduct an expert level of review of this or any other professional licensing examination.
The Bureau cannot conclude that the dental licensing examination, as a technical matter, is either an appropriate test for professional competency or an undue exclusionary barrier to entry into the profession. Some of the Bureau's observations, as noted above, however, indicate that the examination process is less than perfect.
On the other hand, a court-appointed master and an impartial observer hired as a consultant have reviewed the dental licensing examination very favorably. The Bureau has no basis to doubt the findings of the impartial observer, and finds no compelling evidence to conclude that the examination is defective in any significant way.