Background: This resolution urges CODA to adopt enforceable national standards requiring patient-based procedural training for graduation—clarifying that observation or conceptual instruction alone is insufficient for competency. It seeks to ensure CODA-accredited dental schools provide a minimum national standard of patient-based procedural training; and to strengthen CODA governance, transparency, and accountability, including collaboration with ADEA on educational capacity and student well-being. It calls for conflict of interest reform and accountability, and addresses the link between inadequate clinical education, overwhelming debt, and early professional burnout in students, with implications for patient safety, licensure portability, and the long-term health of the profession.
The Commission on Dental Accreditation (CODA) is responsible for establishing accreditation standards for U.S. dental education programs. Concerns have been raised by educators, students, and professional stakeholders regarding variability in clinical graduation requirements, particularly as institutions shift from structured, patient-based procedural requirements to more broadly interpreted competency-based assessments. This change has created inconsistencies in graduate preparedness and educational quality, with significant variation in clinical experiences among CODA-accredited programs. CODA standards state that “graduates must be competent in providing oral health care within the scope of general dentistry,” including procedures in restorative dentistry, fixed and removable prosthodontics, endodontics, periodontics, oral surgery, and operative care
(Commission on Dental Accreditation Predoctoral Standards, 2023, pp. 29–30;
A dentist’s competence cannot be fully assessed without direct patient-based procedural experience. Competency assessments cannot substitute for verifiable, hands-on clinical education. While some institutions cite limited patient availability as justification for reduced patient care requirements, this raises concern about consistency, accountability, and public safety—especially as tuition continues to rise and new programs are opened without sufficient clinical infrastructure.
Reports from dental graduates and educators confirm that some institutions now set extremely low procedural thresholds in core disciplines such as operative dentistry, restorative dentistry, endodontics, periodontics, oral surgery, and fixed and removable prosthodontics. In some cases, even those minimal requirements are waived in favor of passive observation rather than direct performance. This practice undermines the ethical obligation of dental schools and accrediting bodies to ensure that every graduate is competent to perform essential clinical procedures across the full scope of general dentistry.
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