There has been a lot of "buzz" about the Minnesota Board of Dentistry "having to" license dentists who graduated from non-accredited dental schools (that is, schools outside of the United States and Canada). In 2001, intending to help address the dental access problems in Minnesota, our state legislature mandated that the Board make it easier for dentists from other countries – graduates of non-accredited schools - to get licensed here. The law requires the Board to review applications to determine whether the candidates’ dental education was equivalent to or better than that obtained by dentists from ADA-accredited dental schools. Based on the Board’s determination, the candidate could then be eligible to take a regional clinical board examination and then become licensed if they pass the exam and complete other requirements of the Board.
Unfortunately, no one could have anticipated how burdensome and fraught with difficulties - and how controversial - that law and the review process would be. No dental board in the country is equipped to conduct such reviews—nor is that an appropriate responsibility for any state dental board – but our Board was mandated to take on this task.
Since 2001 the Board has reviewed over 450 applications from graduates of non-accredited dental schools from around the world. Of those, about 45% have ultimately succeeded in becoming licensed…but only about 84 of them practice here in Minnesota. And, they are experiencing a higher percentage of complaints being filed against them. Over the most recent six or seven months, 96 of 98 applications were denied by the Board. Increasingly, the Board is being challenged by candidates wishing to appeal the Board’s decision.
Clearly, the statute has not had the effect intended by the Legislature and something must be changed. Some have argued that these dentists do fill a gap for community clinics, but that, too, remains controversial. The Minnesota Dental Association has worked with the Board of Dentistry and the University of Minnesota over the past couple of years to get the law either acceptably revised or repealed altogether, and we are planning to aggressively pursue that effort during the 2008 legislative session.
The University of Minnesota School of Dentistry established a two-year program for dentists who graduated from non-accredited dental schools, called the "Program for Advanced Standing Students" (PASS). Dentists who graduated from schools outside of the U. S. and Canada enter as third-year dental students, graduating at the end of the fourth year. During its first three years, the program already has attracted over 1200 applications from highly-qualified dentists from around the world. The program has admitted six dentists in the first year, ten in the second, and in 2008 there will be a total of twelve dentists enrolled as third-year students.
The tuition for this hugely appealing program is high. The MDA, along with the School of Dentistry, is seeking to create a scholarship program for the PASS students who commit to serving in Minnesota’s Federally Qualified Health Centers or community clinics for a specified length of time after graduation and licensure.
One way to encourage newly-licensed dentists to practice in underserved areas, either rural or urban, is to offer loan forgiveness with a commitment for a specified length of service time. And, with today’s dental educational debt hovering typically over $150,000, that incentive should be appealing to new dentists, but it isn’t.
But Minnesota's current dental loan forgiveness program requires the dentist to ensure that 25% or more of their patients are public assistance recipients. This is actually a disincentive for new graduates to apply to the loan forgiveness program because of the state’s low funding for our public dental assistance programs! Funding for the loan forgiveness program has been woefully inadequate, too, around $19,000 per year for up to four years.
The MDA is also talking about expanding the loan forgiveness program to include “collaborative practice” dental hygienists who practice in underserved areas. In order to enter a collaborative agreement with a dentist, the dental hygienist must have been in clinical dental hygiene practice for at least 3,000, so this would be limited to those more experienced hygienists who may still have educational debts.
Primarily designed to help address dental access in rural communities, the MDA is interested in changing the dentist loan forgiveness program to eliminate that "25%" requirement for dentists; request more state funding for the program; expand the program to include dental hygienists who practice in underserved areas under a collaborative agreement, and keep the focus on the needs of designated underserved areas with a service commitment time of a minimum of three years/maximum of four years (as it is now).