It has been said that “one should beware when the camel's nose is beneath the tent.” The camel's nose is a metaphor, of course, for a situation where the permitting of a small, seemingly innocuous act will open the door for larger, clearly undesirable actions.

Recently (January 2018), the American Dental Association (ADA) took action to support its policy calling for the elimination of patients from the dental licensure examination process. The ADA requested that the Council on Dental Education and Licensure direct the development of a Dental Licensure Objective Structured Clinical Examination (DLOSCE).

The ADA DLOSCE would be a written exam (much like the OSCE-administered exam in Canada) that excludes the assessment of clinical skills completed on a live patient. Written tests are an effective way to find out what level of knowledge has been acquired. No part of the OSCE assesses the applicant's...

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