WREB

I would be remiss if I didn't document some portion of my state licensing exam on this diary/blog of my dental school experience. 

First, a little background:  Becoming a dentist is no easy feat.  (If you read my blog at all, you've already heard me complain many times of this fact.)  To get into school, you must likely have a 3.5 or better GPA, and a good score on the Dental Admissions Test (DAT), a four hour exam covering perceptual ability, mathematical skills through pre-calculus, reading comprehension, and all the basic sciences.  Each dental school in Texas interviews about 800 candidates out of over 6000 applicants.  From those 800, approximately 100 are chosen per year to come to dental school.

While in dental school at San Antonio, you will endure a barrage of didactic courses in your 1st and 2nd years.  Some of them are difficult, some of them are easy, but the real division between the courses is that some of them are non-remediating courses, meaning that if you fail one of them, you will repeat the entire year rather than just repeat that particular course.

Provided you make it through the first two years, you will need to take the National Board Exam Part I.  This is an 8 hour exam covering all the dental and basic science knowledge you should have learned during your first two years of dental school.  A passing score is required to continue your training.

In your 3rd year of dental school you begin to treat patients at the school.  You still have some didactic courses, but not as many.  Instead your grade is determined by the number of clinical procedures you do averaged with the quality of dental procedures you do.  This means that if your patients continually no show for appointments, or if you don't have patients that need fillings but you are short on your filling requirements, you will fail the year (and repeat it).

Following your 3rd year, you will take the National Board Exam Part II.  This is an 8 hour exam covering clinical dental knowledge you should have learned in your 3rd year.  A passing score is required to continue.

Your 4th year is much like your 3rd--you continue to treat patients but now your requirements double or triple from last year.  Again, if you do not reach these required procedure totals, you are doomed to repeat the entire year.

So, if all of the above is completed satisfactorily, you get your diploma from dental school.  You are a Doctor of Dental Surgery (DDS).  But you're not done.  You can't practice.

WHAT?!?

You still need a license from the STATE board where you're going to practice.  This is where the State Board Exam comes in.  The state board for this area is called WREB (Western Regional Examining Board).  The WREB exam consists of 5 parts that must be taken and passed in order for you to receive a license to practice in the state.  The first two parts are computer-based exams (Treatment planning and periodontics/prosthodontics) that are completed at an approved testing center.  The other three parts are Operative, Periodontics, and Endodontics.

For the operative and periodontic sections, you (the dental student) must provide patients that qualify under WREB criteria for a certain type of filling (for operative) or a deep cleaning (perio).  For the endodontic portion of the exam, you must provide two extracted teeth that meet WREB criteria on which you will do root canals.

These clinical exams are extremely high-stress evaluations, with lots of rules and lots of areas in which you can receive deductions.  (For example, during the Mock WREB exams at my school, I got a deduction for forgetting to send a pencil to the grading area.  Find your own pencils, you graders!)  Of course, none of us are nervous about completing the dental work for the exam.  In fact, on a typical day, if the same procedures walked into our offices, we'd say, "Oh, I have an easy day, two 2-surface fillings and a deep cleaning.  I'll be done by noon."  Instead, we are so nervous that we can barely form complete sentences on those days.  And, of course, since stress is high, strange things happen.

For example:

• One girl did her whole filling, and right before she sent it up for grading, she noticed that the entire thing wasn't connected to the tooth.  This had never happened to her before.  She had to re-do the entire thing in about 15 minutes.
• One girl was going to Philadelphia to complete a different regional board exam (she's going to practice in the North).  She had to book her patients' flights months in advance to get them to Philly with her.  The day before her exam, one of her patients called and cancelled.
• One girl's extracted tooth fractured into 6 pieces when she tried to do her root canal.
• Many people's patients were rejected for treatment due to the cavity being too big or too small for WREB's criteria.
• Several people's drills stopped working during the root canal exam.
• My personal favorite (because it happened to me):  My patient was getting a filling on a tooth in front.  The patient was approved for treatment, but before I started I noticed that the filling NEXT to where I was supposed to work was loose.  The floor examiners were contacted and exclaimed, "That's never happened before in WREB!"  (This is not something you want to hear during your licensing exam.)  I fixed the problem with their guidance, but it cost me quite a bit of time and angst.

Following the exam, we spend an excruciating 4 days waiting for the results to come in, but lo and behold, the results came and I PASSED.

(But I'm still not done--I still have to be fingerprinted, turn in notarized copies of my diploma, test results, CPR certification, etc, etc..before I'll get my license.)

But basically, I'M A DENTIST.

There.  That was easy.