THE STATE EDUCATION DEPARTMENT / THE UNIVERSITY OF THE STATE OF NEW YORK / ALBANY, NY 12234

 

TO:	Higher Education and Professional Practice Committee
FROM:	Johanna Duncan-Poitier
SUBJECT:	Proposed Amendment to the Regulations of the Commissioner of Education Relating to the Examination and Residency Program Requirements for Dental Licensure
DATE:	November 14, 2005
STRATEGIC GOAL:	Goal 3
AUTHORIZATION(S):

 

SUMMARY

 

Issue for Discussion

 

Should the Regents amend sections 61.2 and 61.18 of the Regulations of the Commissioner of Education, relating to the examination and residency program requirements for dental licensure?

 

Reason(s) for Consideration

          Required by State statute.

 

Proposed Handling

 

The proposed amendment was before the Committee for discussion in March 2005.  As a result of public comment, the regulation has been revised and is before the Committee again for discussion in December 2005.   The amendment will be submitted for action at the January 2006 Regents meeting.

 

Procedural History

 

A Notice of Proposed Rule Making concerning the proposed amendment was published in the State Register on March 2, 2005 and a Notice of Continuation was published on August 17, 2005.   A Notice of Revised Rule Making will be published in the State Register on November 16, 2005.

 

Background Information

 

This amendment implements the requirements of Education Law section 6604(3) and (4) by requiring applicants for dental licensure to complete an accredited dental residency program and eliminating the option of their completing a clinical examination in dentistry instead of the residency program, effective January 1, 2007, establishes a definition for an acceptable national accrediting body for dental residency programs, and adds two additional specialties to the list of specialty residency programs that may be used to fulfill the residency program requirement for dental licensure. 

 

An Assessment of Public Comment concerning the proposed amendment is attached.  As a result of public comment, the regulation has been revised to include the two additional specialties of oral and maxillofacial radiology and oral and maxillofacial pathology to the list of acceptable specialty dental residency programs that may be completed for dental licensure.  These specialties were added to provide additional clinical training opportunities to applicants for dental licensure. The Department, after consultation with the State Board for Dentistry, determined that the additional specialty dental residency programs provide appropriate clinical training for dental licensure.  The New York State Dental Association has written in support of adding these specialty residency programs to the list.  

 

Recommendation

 

N/A

 

Timetable for Implementation

 

The effective date of the proposed amendment is February 1, 2006.

 

 

AMENDMENT TO THE REGULATIONS OF THE COMMISSIONER OF EDUCATION

          Pursuant to sections 207, 6506, 6507, 6601, and 6604 of the Education Law, and Chapter 76 of the Laws of 2004.

1. Section 61.2 of the Regulations of the Commissioner of Education is amended, effective February 1, 2006, as follows:     

61.2 Licensing examination.

(a) Individuals, who on or before December 31, 2006 have completed all the education requirements for licensure and by that date have submitted an application for licensure and the required application fee, shall meet the examination requirements of this subdivision.  Individuals who do not meet these conditions shall meet the examination requirements of subdivision (b) of this section.

[(a)] (1) Content. The examination shall consist of three parts:

[(1)] (i)  . . .

[(2)] (ii) . . .

[(b)] (2) . . .

[(c)] (3) . . .

[(d)] (4) Special examination conditions.

[(1)] (i)  . . .

[(2)] (ii)  . . .

[(e)] (5) . . .

[(f)] (6) . . .

[(g)] (7) . . .

[(h)] (8) . . .

[(i)] (9) In accordance with section 6604(4) of the Education Law, [applicants who are issued by the department a license to practice dentistry between May 22, 2003 and December 31, 2005,] individuals, who on or before December 31, 2006 have completed all the education requirements for licensure and by that date have submitted an application for licensure and the required application fee, may substitute successful completion of a residency program that meets the requirements of section 61.18 of this Part in lieu of successful completion of Part III, the examination in clinical dentistry.

(b) Individuals who do not meet the conditions prescribed in the opening paragraph of subdivision (a) of this section shall meet the examination requirements of this subdivision.

 (1) Content. The examination shall consist of two parts designed to sample the knowledge from all areas related to dentistry.

(2) The department may accept grades acceptable to the State Board for Dentistry on an examination of the National Board Dental Examinations as meeting the requirements of Parts I and II of the licensing examination.

(3) Special examination conditions.

(i) An applicant who has completed not less than two academic years in a program of dental education registered by the department, or accredited by an accrediting organization acceptable to the department may be admitted to Part I of the examination. Such applicant shall meet all requirements for admission to the licensing examination, except for the completion of professional education.

(ii) An applicant attending a program of dental education registered by the department, or accredited by an accrediting organization acceptable to the department, may be admitted to Part II during the last year of study.

(4) Passing score.  The passing score in each subject of each part shall be 75.0, as determined by the State Board for Dentistry.

2. Section 61.18 of the Regulations of the Commissioner of Education is amended, effective February 1, 2006, as follows:     

61.18 Residency [option pathway] program requirement for dental licensure.

(a) Definitions. As used in this section:

[(1) . . .]

(1) Acceptable national accrediting body means until December 31, 2006 the Commission on Dental Accreditation of the American Dental Association, and thereafter it means an organization accepted by the department as a reliable authority for the purpose of accreditation of dental residency programs, applying its criteria for granting accreditation in a fair, consistent, and nondiscriminatory manner, such as the Commission on Dental Accreditation of the American Dental Association, its successors, or an equivalent organization as determined by the department.

(2) . . .

(3) . . .

(b) Residency program. [In accordance with section 6604(4) of the Education Law, applicants who are issued by the department a license to practice dentistry between May 22, 2003 and December 31, 2005 may substitute successful completion of a residency program that meets the requirements of this section in lieu of successful completion of the examination in clinical dentistry (Part III of the dental licensing examination), prescribed in section 61.2 of this Part. In addition to meeting other requirements of this section, such residency program shall meet the following requirements:] To be acceptable to the department for purposes of licensure under section 6604 of the Education Law, a residency program shall meet the requirements of this section.

(1) The residency program shall be a postdoctoral clinical dental residency program in either general dentistry, or a specialty of dentistry as defined in paragraph (2) of this subdivision, of at least one year's duration in a hospital or dental facility accredited for teaching purposes by [the CDA] an acceptable national accrediting body, which is completed successfully by the applicant prior to the submission to the department of the application for licensure.

(2) The accredited residency program in a specialty of dentistry shall be in the specialty of endodontics, oral and maxillofacial surgery, orthodontics and dentofacial orthopedics, pediatric dentistry, periodontics, prosthodontics, oral and maxillofacial pathology, oral and maxillofacial radiology, or another specialty of dentistry, as determined by the department, for which at least 50 percent of the [CDA] accredited residency program consists of clinical training in one or more of the following areas: general dentistry, endodontics, oral and maxillofacial surgery, orthodontics and dentofacial orthopedics, pediatric dentistry, periodontics, [and] prosthodontics, oral and maxillofacial pathology, and oral and maxillofacial radiology.

(3) The accredited residency program shall include a formal written outcome assessment which is acceptable to the department.

(i) For [a CDA] an accredited residency program in general dentistry, the formal written outcome assessment used by the residency program shall be acceptable to the department if it includes:

(a) an acceptable notarized written statement by the residency program director attesting that the applicant has completed successfully the [CDA] accredited residency program and is in the director's judgment competent to practice dentistry; and

(b) acceptable notarized written statement(s) by the residency program director who supervised the dental procedures performed by the applicant, and/or the attending dentist(s) who supervised the dental procedures performed by the applicant if different from the residency program director, attesting that the applicant completed independently, and to generally accepted professional standards for dentistry, two full crowns, two endodontically treated teeth, four restorations (two anterior, two posterior) and one periodontal case during the accredited residency program.

(ii) For [a CDA] an accredited residency program in a specialty of dentistry, as defined on paragraph (2) of this subdivision, the formal written outcome assessment used by the residency program shall be acceptable to the department if it includes an acceptable notarized written statement by the residency program director attesting that the applicant has successfully completed the [CDA] accredited residency program in a specialty of dentistry, as defined in paragraph (2) of this subdivision, and is in the director's judgment competent to practice dentistry.

(c) . . .

PROPOSED AMENDMENT TO SECTIONS 61.2 AND 61.18 OF THE REGULATIONS OF THE COMMISSIONER OF EDUCATION PURSUANT TO SECTIONS 207, 6506, 6507, 6601, AND 6604 OF THE EDUCATION LAW AND CHAPTER 76 OF THE LAWS OF 2004 RELATING TO THE EXAMINATION AND RESIDENCY PROGRAM REQUIREMENTS FOR DENTAL LICENSURE

ASSESSMENT OF PUBLIC COMMENT

          A Notice of Proposed Rule Making concerning the proposed amendment was published in the State Register on March 2, 2005 and a Notice of Continuation was published on August 17, 2005.    Below is a summary of written comments received by the State Education Department concerning the proposed rule making and the State Education Department's assessment of the issues raised by the comments.

          COMMENT: The replacement of the clinical licensing examination with the requirement to complete a clinically-based postdoctoral general practice or specialty dentistry residency program will not only reduce the burden on new dentists, but improve access to care for many New Yorkers.  It also acknowledges the rigorous and well-documented educational process now in place nationally in dental education. 

RESPONSE: No response is necessary to this comment.

COMMENT: Without question, successful completion of a dental residency is an extremely effective method of evaluating an applicant’s abilities and performance.  Not only does it provide a far better assessment, but it is also more “fair” to the applicant than the NERB examination.  It has the added benefit of enhancing professional development.  There are two considerations I ask you to consider.  Continue the one-year minimum and require that the entire year be at a single program.

          RESPONSE:  The existing regulation (Section 61.18[b][1]) requires the applicant to successfully complete a residency program of at least one year's duration.  This means that the applicant must complete the entire residency program, not portions of such a program.  No change in the regulation is necessary to respond to this comment.   

COMMENT:  I question why the regulation changes the definition of accrediting body from the American Dental Association Commission on Dental Accreditation to a definition that includes an equivalent organization as determined by the State Education Department. 

RESPONSE:  The regulation implements the requirements of section 6604(3) of the Education Law, as amended by Chapter 726 of the Laws of 2004.  This statutory change requires the residency program to be in a hospital or dental facility accredited for teaching purposes by a national accrediting body approved by the State Education Department.  The regulation establishes a reasonable standard for approving such accrediting bodies.

COMMENT:  At the present time there are not nearly as many advanced dental residency and specialty programs as dental graduates and therefore the number of new dentists will be reduced for New York.

RESPONSE:  At the present time, nationwide, there are approximately 2,700 residency positions while an average of 625 dentists were licensed in New York State per year in the previous five years.   There are adequate numbers of residency positions to accommodate applicants for New York State dental licensure.  

          COMMENT:  I have concerns regarding the competence of graduates of dental schools and the amount of responsibility placed on residency program directors.   It should not be the responsibility of the residency program director to certify the clinical and didactic aptitude of the student in the residency program.

          RESPONSE:  This comments does not pertain to the changes proposed by this rule making but to existing regulatory requirements.  In any event, Education Law section 6604(3) requires the dental residency program to include a formal outcome assessment evaluation of the resident's competence to practice dentistry acceptable to the State Education Department.  The regulation establishes standards for this outcome assessment that reasonably require the residency director to attest that the applicant has successfully completed the residency program and is in the director's judgment competent to practice dentistry, among other requirements.   

COMMENT: I congratulate the Board and the State Education Department on their progressiveness in this matter, New York is showing the lead to the rest of the states.  I do have one criticism.  The regulation's exclusion of certain specialty residency programs is in conflict with the scope of accepted dental specialties, all of which are Council on Dental Accreditation accredited.  The dental specialties of dental public health, oral and maxillofactial radiology, oral and maxillofacial pathology should be acceptable.

COMMENT: Residency programs in the specialties of oral and maxillofacial radiology and oral and maxillofacial pathology should be in the list of acceptable types of specialty dental residency programs that may be completed for New York licensure in dentistry.

RESPONSE:   Education Law section 6604(3) requires the applicant for licensure in dentistry to have experience satisfactory to the State Board for Dentistry and the State Education Department, including successfully completing an experience in a clinically-based postdoctoral general practice or specialty dental residency program, which includes an outcome assessment evaluation of the resident's competency to practice dentistry acceptable to the State Education Department.  The State Education Department, after consultation with the State Board for Dentistry, determined that the two specialties of oral and maxillofacial radiology and oral and maxillofacial pathology have appropriate clinical training for dental licensure.  Accordingly, the regulation has been revised to include residency programs in these two additional specialties.  The Department does not agree that specialty residency programs in dental public health should be included because these programs are not clinically oriented.  The regulation provides that such a program would be acceptable only if the Department determined that at least 50 percent of the residency program consisted of clinical training in one or more specified clinical program areas.