Wie wird man Zahnarzt in USA?
Dental Observer hat sich kundig gemacht!
After studying dentistry and passing exam – what now? Do need more qualification, e.g. to work at university or private practice?
After graduation from an accredited program, there are no restrictions on how and in what environment you can practice. There is no requirement for further education or training (as opposed to medicine, where a residency is mandatory). So, once you have a dental degree, you are allowed to open you own practice, work for someone else, get a job in a hospital, etc.
However, each state and/or region in the U.S. has its own rules and regulations about licensure. For clarification: the university gives you an academic degree, which allows you to call yourself a dentist; however, it is the states/regions which provide further testing to provide you a license which allows you actually to practice on patients without supervision.
These examinations generally go for two days, and they contain a written portion (clinical questions), a written jurisprudence portion, and a patient treatment portion.
So, in essence, there are a series of tests for “Staatsexamen,” and also separate, independent, state/region-administered testing for “Approbation.”
Failure rates for regional/state boards vary widely from region to region, and from year to year, but they often reach as high as 80%! They are rarely lower than 20%.
Here is some information which is taken from the handbook “Dental Boards and Licensure”:
“Although specific dental licensure requirements vary among jurisdictions, nearly all states require that applicants for initial dental licensure have graduated from an ADA-accredited dental school, have passed the National Board Exams 1 and 2, and have passed a clinical exam administered by the state or by a regional testing agency.
States vary on the eligibility of an internationally trained dentist. All states, except Minnesota (which has different options) require that graduates of non-accredited ADA dental programs obtain additional education to earn a D.D.S. or D.M.D. degree from an ADA Commission on Dental Accreditation (ADA-CDA) accredited program, Commission on Dental Accreditation of Canada (CDAC) accredited program, or a state dental board-approved education program. The additional education required can be anywhere from one to four years, depending upon the state.
CLINICAL TESTING AGENCIES
Until the late 1960s, clinical examinations were administered once per year by individual state dental licensing boards. By 1967, these boards began to realize that the clinical examinations could be improved by increasing and standardizing examiners and by making the examination available at a number of sites and on a number of dates throughout the year. The Northeast Regional Board of Dental Examiners was founded in 1969, and by 1976, four regional dental examination agencies had been established.
In July 2005, a new testing agency was formed – the Council of Interstate Testing Agencies (CITA), which currently has five member states (AL, LA, MS, NC, PR). Presently, all five regional dental Examination agencies provide clinical examinations for most states/jurisdictions. Discussions persist between the regional dental examination agencies and the states that continue to administer their own clinical examinations regarding the expansion of the regional concept and the possibility of a standardized examination.
The Dental Licensure Process
In the United States, each state sets its own requirements for professional licensure. In addition to health professionals such as dentists, physicians, nurses, and dental hygienists, etc., states also license realtors, attorneys and a myriad of other licensure categories. Although each state has a dental board, its level of autonomy varies. Even the independent boards, which exercise all licensing and disciplinary powers, are often functionally housed within other governmental departments. In rare cases board members may be elected but are most frequently appointed by the state’s governor. Generally, standards for licensure are set by statute and can be changed only by an action of the state legislature.
Preparing for the Exam—Location & Expense
Preparing for your state clinical licensing exam needs careful planning. Allowing enough time for the application process and patient selection is imperative. Plus, exam fees and liability insurance can be costly, and for those who need to travel to the exam, travel costs for both the candidate and the patients (who may also be paid!) need to be considered.
CURRENT FEES FOR CLINICAL LICENSURE EXAMINATIONS:
CITA $1,400
CRDTS $1,400
NERB $1,400
SRTA ?
WREB $1,475 – $1,725
California $606
Delaware $300 – $400
Florida $1195
Nevada $1200
Impact on the Recent Graduate
When it comes to licensure, the recent graduate faces a daunting task. Even dentists who plan to practice in the state in which they received their dental education find that their faculty may not be knowledgeable about the licensure examination. For the graduates who plan to practice in another state, there is even more uncertainty that being a good student will lead to successful completion of the exam. It is not uncommon for recent graduates to take the licensure examination for multiple states in order to enhance the likelihood for success.
This uncertainty also leads to a difficulty in entering professional relationships. For those entering associateships or employment arrangements, all negotiations are contingent upon the successful completion of the exam. New dentists who are acquiring practices or launching a new practice know that their financing and future career success hinges on licensure.
Plus, most new graduates are aware that up to one-third of new dentists relocate within their first ten years of practice–so there is a possibility that they will have to face this all again in the near future! For dual career couples, especially where both members are dentists, these difficulties are only compounded.“
Are there differences in the different states of US? (we have talked about, crazy system!
Yes, the differences in requirements for a dental license vary tremendously from state to state. In the old days, each state had its own requirements and licensing examination. In recent years, however, more and more states have gotten together to form “regional” examinations. Currently, there are 5 separate regional testing boards which offer licensure. Several states belong to more than one region. Four states have their own independent test for licensure.
In theory, this means that if you pass a regional licensure examination, you should be able to apply for a dental license to practice in any and all of the states which are a part of that region.
Licensure examinations are not the same as the German “Staatsexamen,” which is administered by the university itself and is a requirement for graduation. In Germany, without a Staatsexamen, you don’t graduate, and you are not a dentist. In the U.S., the licensure exams are needed after graduation from an approved university program, and they are administered by the states themselves. So, the university bestows a DDS or DMD degree, and you are now a dentist, but the region/state provides the testing for the license to work in their state and treat patients.
Can you move to another state or are there problems? (see above, nobody can understand this policies…)
It can be very difficult to move from one state or region to another. While academic degrees from accredited universities are accepted and honored in all states, licensure examinations are all different and often do not transfer from one state to another. Often, a dentist must take an additional licensure exam in order to move to another state. This is especially true if you are moving to a state which has a different “regional” examination, or if you took your licensure examination more than five years ago.
Moving from one state to another state within the same regional examination has gotten easier, but it can still be complicated in some instances.
Then, as stated earlier, there are some states which don’t accept any licensure from any other states, no matter how long you have been practicing. So, even if it isn’t impossible to move from state to state, it is often very expensive and impractical.
How are the names? “Dentist”, “DMD” etc.
“Dentist” is a generic term, like “physician” or “chiropractor.” It simply means that you have an academic degree in dentistry.
All dental students who graduate from an accredited university get the title of “doctor.” There is no optional thesis requirement, like in Germany. If you would like to pursue additional academic training, you can get an “M.S. = Masters in Science” and/or a “Ph.D. = Doctor of Philosophy.” Dentists who get MS degrees are almost always specialists, such as endodontists, orthodontists, oral surgeons, pedodontists, periodontists, and so on.
Most post-doctoral university programs for dental specialists offer the option of original research with an accompanying thesis and oral defense (similar to Germany). A Ph.D., just like in the rest of the world, can be earned in any of the associated sciences, like Biomaterials, Biophysics, Biochemistry, and so on. As far as I know, Ph.D.’s are not available for purely clinical dental studies.
There is absolutely no difference between “DDS = Doctor of Dental Surgery” and “DMD = Doctor of Medical Dentistry.” I’ve been trying to research the historical difference for years, but I can’t find a good explanation. I once heard that DMD programs began at universities which had an associated medical school and also trained physicians, while DMD degrees were offered by universities which had their dental schools completely separated and independent from any medical school (if there even was one), but I have no verification of this explanation, and I don’t know if it’s true. I’ve also heard that it’s regional, and some areas simply prefer one name over the other for their graduates, but that doesn’t seem to be true either. In either case, legally, they are absolutely equivalent.
Are there regulations for post graduate studies (of course, there are, but how are these regulations specifically)?
Just like dental school itself, all post-doctoral programs must be accredited. With rare exceptions, only the top graduates from dental schools will be accepted into specialty programs. While each program is structured differently (according to the ideas of the university and the program director(s)), they must all meet standard criteria, such as number of class hours in each subject, number of specific types of cases completed, etc.
Residency programs generally run for two years, have an academic and a clinical component, and also require state or regional testing for licensure. As far as I know, they all require tuition (Schulgeld). Because of the significant time and money commitment, it can be very difficult for an established general dentist to go back to the university for additional training. Nonetheless, dozens of dentists give up their practices every year, leave their families and friends behind, and attend a university which offers the specialty training they want. Many post-graduate residents, however, come right out of dental school, which is logistically much easier.
There are also one-year residency programs available for dentists who would like further training (almost always in general dentistry) but who do not wish to specialize or attain an additional academic degree. These programs are usually hospital-based, with less emphasis on academics, and a focus on the development of diagnostic, treatment planning, and clinical skills. They are designed primarily for students who have just graduated but feel unsure about what type of practice environment they would like to settle into, are not confident enough in their clinical abilities, or are considering specializing in the future. Because these residents spend most of their time treating patients in a clinic (hospital, government facility, etc.), they generally receive a salary (they do not pay tuition).
Most post-doctoral programs offer an additional academic degree (i.e., an MS degree), but it is optional. If students chose not to pursue the research and thesis for an actual academic title, then a “certificate” of completion will be given upon finishing the program.
Lately, many oral surgery programs can be combined with an M.D. degree, so there are more and more MD/DDS practitioners then ever before.