The Kentucky Board of Dentistry has made it harder to practice in the state, and the change in policy has led the governor to investigate the board's president for a possible conflict of interest.
The board voted in May 2007 to change the criteria for the exam scores needed to obtain a Kentucky license. The change went into effect in October, but many students say they were unaware of it when they took the exam in the spring of 2008. At least 27 who would have qualified under the previous criteria were denied licenses, causing a potentially costly delay in their careers.
"Kentucky right now has a critical shortage of dentists," said Cathy Lindsey, spokesperson for Gov. Steve Beshear. "It's really difficult to turn away dental professionals."
The new policy primarily affects the Western Regional Examining Board (WREB) test. The board now requires applicants to score 75 or higher on all exam sections. Previously, it accepted the WREB's own standard: students have to achieve an average 75 or more, but can score as low as 55 on any individual section.
Last month, Gov. Beshear directed the state's Executive Branch Ethics Commission to investigate whether Board of Dentistry President David Narramore, D.M.D., had a conflict of interest because he also serves as president of the Southern Regional Testing Agency (SRTA), which administers a rival test. Passing the SRTA already requires at least a 75 on each individual section.
The ethics investigation is unwarranted, according to Dr. Narramore. "How can there be a conflict of interest because SRTA is a not-for-profit corporation and I get paid the same amount as any other SRTA examiner regardless of how many students I examined?" he wrote in an e-mail response to questions from DrBicuspid.com.
He also argued that students should have been aware of policy change. "The schools were notified in writing on December 26, 2007," he wrote. "This was after the administrative regulation had been taken through the appropriate steps to become law with proper and due notice."
If the letters went out, they didn't get to the right people, responded Fonda Robinson, D.M.D., a University of Kentucky assistant dean. "I found out about it May 19," she said.
By that time, many students had already taken the WREB test and received notice of their scores. Had they known the scores were not adequate, they could quickly have signed up to retake any sections of the exam at a cost of about $300 per section. By mid-May, fewer exam sessions were available, forcing some students to take a new exam at a cost of $1,600, some of them traveling long distances.
"I have one student who had to fly to Texas and stay overnight," Dr. Robinson said. "They're desperate. They have loans to pay and no income."
Beth Cole, executive director of the WREB, argued that the "compensatory" approach to scoring the exam is a more reasonable approach. "There are circumstances that can come up that can lead someone to have a low score on one section," she said. For example, "a patient might leave in the middle." Twenty-six states use the test, and all but Kentucky accept this standard for passing, she said.
Asked why the Kentucky board has broken ranks, Dr. Narramore stated that 21 states apply similar standards to the tests they use. "It is a state right's issue as to what we deem is appropriate to protect the citizens of the Commonwealth of Kentucky," he wrote.
