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NBDE-II test Format | NBDE-II Course Contents | NBDE-II Course Outline | NBDE-II test Syllabus | NBDE-II test Objectives

The NBDE Part II is a comprehensive examination consisting of 500 items. For each discipline, approximately 80% of the items are stand-alone, while approximately 20% are interdisciplinary and case-based. A case consists of a patient scenario, patient history, and a set of discipline-based items relevant to the scenario. NBDE items are developed by test construction teams composed of subject-matter experts in accordance with examination specifications approved by the JCNDE.
The Universal/National System for tooth notation that has been adopted by the American Dental Association is used on all National Board Examinations. This system is a sequential tooth numbering system, designating the permanent dentition (numbers 1-32), and the primary dentition (letters A-T).
In the June 2018 issue of the Journal of Periodontology the American Academy of Periodontology (AAP) published updates to its Classification of Periodontal and Peri-Implant Diseases and Conditions. Candidates completing examinations published through the Department of Testing Services—including those overseen by the Joint Commission on National Dental Examinations or by the American Dental Association—continue to be based on the prior (i.e., 1999) AAP disease classification. Candidates will be notified when examinations are updated to reflect the new terminology.
Discipline-Based Component (400 items)
The test items that comprise the discipline-based component are derived from the following disciplines:
1. Endodontics
2. Operative Dentistry
3. Oral and Maxillofacial Surgery/ Pain Control
4. Oral Diagnosis
5. Orthodontics/Pediatric Dentistry
6. Patient Management
7. Periodontics
8. Pharmacology
9. Prosthodontics
Case-Based Component (100 items)
The case-based component of the NBDE Part II presents items dealing with genuine patients. The patient cases are developed to include the following approximate distribution: adult patients – 70%; child patients – 30%. A minimum of 15% of case-based test questions will address the medical management of compromised adults and children. A compromised patient is defined as a person whose health status requires modification of standard treatment. Each case presentation in the examination consists of:
1. synopsis of a patients health and social histories,
2. patient dental charting,
3. diagnostic radiographs, and
4. clinical photographs of the patient (when necessary).
Each case contains from 10 to 15 questions about various aspects of the patients dental care. These questions-- totaling 100 across all cases-- might derive from any of the biomedical sciences and clinical disciplines, including Patient Management. The proportion stemming from any particular discipline depends upon the nature of the case itself. For example, the case of an elderly adult might be based upon Maxillofacial Surgery/Pain Control, Prosthodontics, and Operative Dentistry, whereas a childs case might derive from Orthodontics, Pediatric Dentistry, and Patient Management. In responding to case-based items, the candidate must:
1. interpret the findings and information provided.
2. identify problems and make diagnoses.
3. select materials, technique, and armamentarium.
4. apply treatment.
5. evaluate progress and complications.
6. establish procedures for prevention and maintenance.
Endodontics* (36 items)
• Case Clinical Diagnosis, Case Selection, Treatment Planning, and Patient Management
• Basic Endodontic Treatment Procedures
• Procedural Complications
• Traumatic Injuries
• Adjunctive Endodontic Therapy
• Post-Treatment Evaluation
Operative Dentistry (44 items)
• Dental Caries
• Examination, Diagnosis, & Treatment Planning
• General Operative Procedures
• Preparation of Cavities
• Restoration of Prepared Cavities
Oral And Maxillofacial Surgery/Pain Control (52 items)
• Surgery
• Anxiety and Pain Control
• Medical Assessment and Emergency Care
• Treatment Plan
• Diagnosis
Orthodontics/Pediatric Dentistry (44 items)
• Individual Tooth Pathology
• Supporting Tissue Pathology
• Dentofacial Variations
• Behavior
• Systemic Pathology
Patient Management (53 items)
• Communication and Interpersonal Skills
• Anxiety and Pain Control
• Health Behavior Change
• Disabled and Medically Compromised
• Epidemiology
• Prevention of Oral Diseases
• Evaluation of Dental Literature
• Infection Control
• Materials and Equipment Safety
• Professional Responsibility/Liability
• Practice Management
Periodontics (46)
• Diagnosis
• Etiology
• Pathogenesis
• Treatment Planning
• Prognosis
• Therapy
• Prevention and Maintenance
Pharmacology (35 items)
• General Principles
• Central Nervous System
• Autonomic
• Cardiovascular
• Local Anesthetics
• Chemotherapy
• Endocrines/Immunosuppressants
• Analgesics
• Antihistamines and Autocoids
Prosthodontics (48 items)
• General Considerations
• Complete and Removable Partial Denture Prosthodontics
• Fixed Partial Prosthodontics

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Medical II Test Prep

Falsely Accused MD: Arrested, Tried, Cleared -- but Now Works in Auto restoration | NBDE-II test Cram and test Braindumps

It turned into a cloudy October morning, and Joseph E. Oesterling, MD, was within the test room of his Saginaw, Michigan urology follow preparing for a technique. suddenly, the door burst open, and a federal agent charged into the test room unannounced, frightening Oesterling and the patient.   

Bewildered, Oesterling peered outside the room to look 10 greater officers armed with weapons storming during the constructing. As he watched in horror, Drug Enforcement Administration (DEA) brokers ransacked his observe and seized paperwork, computer systems, and statistics, Oesterling recounted to Medscape. An hour away, officers broke down the door of Oesterling's domestic in Ann Arbor when his wife did not immediately answer, shattering glass across the porch. one more raid was concurrently happening at Oesterling's observe about forty minutes away in the town of Caro.

"As all of this became going on, the brokers have been announcing to me, 'We're shutting you down. you are not ever going to observe again,' " Oesterling noted. "They said, 'we will throw you in penal complex, and you're never going to see the gentle of day.' "

What followed for Oesterling became every medical professional's worst nightmare: He was arrested, stripped of his license, bring to a halt from his property, and charged with seven crimes, together with running a criminal enterprise.

but the longtime urologist and renowned researcher fought lower back. After a grueling trial in 2017, Oesterling become acquitted on all seven prices. 

"The executive pursued him relentlessly," referred to Michigan lawyer Ronald W. Chapman II, who represented Oesterling in the case. "you've got got a person who led a pretty decent lifestyles who turned into attempting to do the right issue and who ended up getting caught up in straight executive greed. The prosecutor's office pursued him as a result of he had assets and he moved into their jurisdiction, and that they had sufficient on him to investigate and cost. Even once they gained the criminal case, they failed to take their grip off his lifestyles profits."

Tuscola County Prosecuting legal professional Mark Reene and Chief Assistant Prosecutor Eric Wanink didn't reply to messages seeking comment.

"This became the greatest upheaval of my lifestyles," pointed out Oesterling, now 64. "i might have on no account in my wildest dreams imagined leaving medicine this manner."

a success specialist Goes to penal complex

A busy urologist with two practices to supervise, Oesterling by no means intended to take over a family practice clinic in the small, impoverished metropolis of Caro, Michigan. however when the family general practitioner at Caro family Physicians P.C. died, her husband requested Oesterling if he would run the follow until a everlasting replacement may well be discovered.

"i used to be comfortable with doing the work, however the plan turned into this became to be a brief-term, temporary aspect to support out this follow," he observed.

Caro, a rural community about 35 miles north of Flint, is home to 4000 residents, 20% of whom fall under the poverty line, in line with census facts. lots of the health facility's patients had been farmers, blue-collar worker's, or jobless residents on public counsel. Oesterling mentioned when he took over the Caro medical institution in 2015, it immediately grew to be clear that the majority of sufferers he inherited were on ache remedy, similar to hydrocodone, methadone, and oxycodone.

"These people were on all these pain medications for one cause or a different," he pointed out. "in keeping with their clinical charts, you could argue it become justified, but in my own mind, they did not want all this remedy. When my nurse and that i received worried, they notion it became overdone and they all started them on a program to methodically lower their medicinal drugs over time."

Little did Oesterling comprehend, native and federal authorities all started investigating the Caro observe no longer lengthy after he took it over. Officers install 24-hour surveillance backyard the property and sent undercover agents into the follow posing as patients. The investigation started following a police tip that fraudulent prescriptions have been being written on the observe, and information that a health care provider became providing narcotics to varied sufferers for money, in accordance with native news accounts on the time.

but Oesterling's legal professional Chapman says there changed into one more contributor. He believes it was the urologist's past criminal concern that drew the govt's skeptical eye to his apply in Caro.  

trained at the Johns Hopkins health facility in Baltimore and in a while group of workers at Mayo health center in Rochester, Minnesota, Oesterling became trendy within the early 1990s for assisting discover the link between the prostate certain antigen (PSA) and prostate melanoma. His suggestions on using the PSA verify in the analysis and administration of prostate melanoma has been used global, and he went on to develop into chief of urology on the university of Michigan.

youngsters, Oesterling resigned in 1997 after being accused through the school of double and triple billing for the cost of trips. at the time, his analysis also came beneath scrutiny for undisclosed conflicts of hobby with industry. He pleaded no contest to at least one legal count number of obtaining funds by using false pretenses and bought probation, based on courtroom statistics.

besides the fact that children virtually two a long time had handed on the grounds that the scandal and Oesterling had long past on to quietly practice urology in Michigan for more than 15 years, his past became not forgotten.   

"The government sees this new medical professional in town who has a listing it is questionable from U of M and that they anticipate he is just a fallen medical professional now attempting to pedal opioids to the group as a result of he has nowhere else to move," Chapman pointed out. "That was their narrative in charging him. That does healthy into the better photograph."

Oesterling had handled the Caro patients for a couple of 12 months and half when the DEA raids happened at his practices and home. Two months went by using as investigators reviewed the seized files and constructed their case in opposition t him. In December 2016, the Tuscola County Prosecutor's workplace charged  Oesterling with retaining a drug condo, five counts of delivery of a managed substance, and conducting a criminal commercial enterprise. The department of Justice declined to press federal prices. or not it's uncertain why. A DOJ spokeswoman stated the agency doesn't touch upon inside prosecutorial selections.

Three days after Christmas, cops arrived at Oesterling's urology apply and placed him in handcuffs. He changed into taken to the county detention center. 

"i used to be put in a phone with two other americans," he recollects. "It became simply horrible. there have been no covers, no pillows, just a cold bench all night with a tv enjoying."

Oesterling's spouse and grownup little ones attended his arraignment the subsequent morning the place the doctor appeared via video, dressed in blue scrubs and orange reformatory pants. His wife shielded her face as a native information picture snapped photograph after photo of the family unit. 

After posting $a hundred,000 bond, Oesterling was freed later that day. but he quickly realized the executive had frozen the family's bank debts and seized their very own property. A choose ultimately released satisfactory dollars that the medical professional may pay for his criminal protection.

Oesterling and his criminal team begun Preparing for trial. If convicted, the urologist turned into facing up to 30 years in penitentiary.

"The prosecutor wanted us to plead all the time," he said. "The final present became 4 years of detention center and $4 or $5 million in fines, and he idea that turned into a superb deal. I advised Ron we're certainly not pleading guilty. I did not care what the leisure of the area idea, I knew i was innocent."

One medical professional, Two pix Painted at Trial  

during his month-long trial that begun in September 2017, jurors heard two very different models of Oesterling and the way he operated the Caro follow. The prosecution painted the urologist as a slipshod health practitioner who dished out narcotics to sufferers without assessments or verification of their clinical complaints, according to court docket testimony and native information bills.

Witnesses for the prosecution, which included former personnel of Oesterling, testified that sufferers got prescriptions for pain treatment even after drug displays confirmed that they had illicit medication of their techniques. Former nurse practitioner Laura Hintz testified that the Caro health facility noticed between 50 and 70 patients each week for pain administration, and that the hospital's expenses rose from $60 to $one hundred ten after Oesterling took over the apply. Hintz pointed out she become authorized to make use of Oesterling's signature on prescriptions and to jot down out prescriptions on pre-signed varieties.

It turned into "evident with the variety of scripts…that he wrote and that once I noticed the genuine numbers within the record, i was overwhelmed. I couldn't believe it was that many," Hintz testified. "…at first there turned into a time when he began to order checks on patients, but then it stopped…It become the staff's responsibility to order the checks, which within the majority of circumstances because these sufferers are Medicaid, it requires a previous authorization, and it's paperwork and lots of hoops to start through, and individually, I believe the ball received dropped a lot in Caro."

Dr Joseph Oesterling, middle, stands in entrance of the courthouse along with his attorneys Ronald W. Chapman II, appropriate, and Robert J. Andretz following the jury's verdict.

Chapman portrayed Oesterling as a hardworking general practitioner who took on too a whole lot when he permitted the Caro follow, but who cared deeply about his patients, worked diligently to examine medical complaints, and handiest prescribed ache treatment for clinical applications.

through discharge records and letters, Chapman confirmed that Oesterling had discharged greater than 70 patients from the follow for failing to conform to guidelines, mendacity, or having urine displays that got here returned bad for the medications prescribed, in line with court testimony. Charts that compared Oesterling's prescription dosages over time with those from the deceased health practitioner who formerly owned the observe illustrated clear decreases after Oesterling took over, in response to Chapman and court testimony. in addition, tax returns entered into facts printed that Oesterling took a financial loss in 2015 after taking on the Caro observe and seeing less urology sufferers.

"Does this look like intentional behavior for economic profit? No," Chapman mentioned all the way through the trial. "You do not discharge patients from the apply for monetary gain. You don't switch them from cash-paying sufferers to reduce-assurance patients for monetary benefit. You don't bring together below your urology seek advice from at $60 to $110 an hour. Urology become about $a hundred and fifty. You don't do that for fiscal profit. The prosecution hasn't met their burden on fiscal benefit as a result of they have not traced a single greenback from this alleged racketeering criminal business to Dr Oesterling as profit."

Oesterling watched from the defendant's desk as lots of his former patients took the stand, some for the prosecution and a few who spoke on his behalf.

Upon go examination, Oesterling's former nurse admitted that her courtroom testimony conflicted with what she told DEA brokers when first interviewed, and she or he recounted that she changed into granted immunity for testifying against her former enterprise. Jurors discovered also that most of the patients who testified against Oesterling got rate reductions in crook penalties or leeway for unrelated crimes.

at last, it become Oesterling's flip to talk.

On the stand, Oesterling recounted that he pre-signed prescriptions for his nurse practitioner, testifying he did so because they have been in diverse places of work on some days and emphasizing that they spoke by using phone concerning the situations before she used the pre-signed scripts. He admitted to battling digital health information and not holding the most reliable affected person information right through his time on the Caro follow.

but Oesterling turned into adamant that each and every prescription resolution he made took into account the interesting cases of every case and that he at the start relied on his patients until they gave him a purpose to suspect abuse or diversion. When questioned via Wanink about his discharge policy, Oesterling noted he took the act of discharging patients from the apply very seriously. 

"lots of these sufferers have been Medicaid patients and their existence and actions were restrained a few alternative ways," Oesterling spoke of throughout testimony. "a few of them failed to even have automobiles. They came to the workplace on a bicycle or they came by way of foot. number two, in the Caro group right here, i am not aware of too…many docs, other providers, accepting patients who were on Medicaid with chronic pain taking medicine. And yet these sufferers had been on their medicine, and some of them, in case you stopped their medication suddenly, it can be a grave clinical circumstance for the patient… One has to take into consideration all these various factors when making a choice."

In his closing commentary, Chapman reminded jurors of facts finding handiest 7% of Oesterling's complete office visits have been paid in cash. And of the seven undercover "affected person visits" by DEA agents, most effective two visits led to prescriptions for managed components. while the DEA presented video of the situations during which Oesterling prescribed to the undercover officers, brokers spoke of operator error and equipment boundaries led to lacking movie of several situations wherein Oesterling refused to prescribe.

"it's very suspicious that two video clips that definitely show Dr Oesterling's frame of mind in deciding that he wouldn't treat these sufferers for what they were claiming they'd, in some way come up lacking," Chapman advised jurors.

finally, the trial ended and jurors all started to deliberate. Oesterling grew to become emotional and cried softly as he and his wife waited for a verdict. About 15 of his urology patients who attended the trial in support waited local. After virtually 5 hours of deliberation over two days, jurors introduced that they had reached a verdict.

"We went back to the courtroom, and that they noted, 'no longer guilty' on all 7 expenses," Oesterling recalled to Medscape, bursting into tears with the memory. "It was some of the surest days of my lifestyles. no one should must go through that."

From Urologist to Auto Mechanic

Oesterling had every intention of going lower back to drugs after being acquitted, however his return would not show handy. in an effort to get his license again, the board of drugs became requiring the doctor to pay a $one hundred,000 first-class, he noted. and since of his felony heritage, his malpractice service quoted him an outrageous price.

His courtroom fight wasn't over both. Oesterling and his attorneys needed to battle a lingering civil forfeiture case to reclaim the medical professional's automobiles, money, and apartment. The Michigan courtroom of Appeals finally affirmed a decrease courtroom's ruling permitting the return of greater than $6 million in belongings to Oesterling and his spouse.

however Oesterling nevertheless wasn't off the hook. In late 2017, the prosecutor's office issued new costs towards him, alleging that Oesterling had put false advice into sufferers' charts, amongst different claims. the new costs stemmed from the prosecutor's original investigation into Oesterling and have been involving his use of car-populated medical records.

throughout trial, Oesterling stated using auto-populated statistics that might elevate over a word from a previous discuss with into a brand new chart. He admitted he would every now and then neglect to delete a observe that become not important or not correct. while auto-inhabitants in medical charts can also be quite typical, it may well also be fodder for legal legal responsibility for putting "false tips into a clinical list," Chapman explained.

"he's an older guy and he struggled with use of the laptop," he stated of Oesterling. "We saw that all over the trial. He wasn't very respectable at taking notes and documentation, and the government went after that weak spot."

Oesterling changed into uninterested in fighting. The prosecutor provided a plea settlement that blanketed probation and a high-quality and he accepted. He pleaded no contest to 5 counts of putting false tips into clinical facts. (A no contest plea isn't considered an admission of guilt.) A choose dismissed the probation after the excellent changed into paid.

"We had been through pure hell," Oesterling spoke of. "We wanted to get on with life. My daughter turned into starting veterinarian faculty. It become between the cost of paying for four years of vet school or paying $200,000 or more on more prison expenses to keep combating. The cash was a lot greater spent on my daughter."

these days, Oesterling is a mechanic and proprietor of an auto restoration enterprise. He refused to pay the $a hundred,000 satisfactory to get his scientific license, he talked about. His license remains suspended. as an alternative, he pursued training in auto repair, bought a piece van, and began a new profession. Oesterling's enterprise, Dr. Vinyl of Michigan, focuses on interior repair and fabric restore services at dealerships within the Ann Arbor area. As part of the enterprise, Oesterling recruits and trains young personnel and collects a small commission from their work.   

"I miss medication, however i'm extremely convinced with my new job," he spoke of. When the board of medicine desired $one hundred,000, i thought, 'right here i am in my early 60's.' I chose a career that might support younger individuals and would also be a source of salary as I obtained older with no need to bodily exit and work hard conventional. When God closes a door, he opens a window."

looking lower back, he regrets ever getting thinking with the Caro follow, he pointed out, but he does not waste an awful lot time pondering about the past or his nightmarish felony event. he's concentrated on making the best of each day and looking towards the future. He encourages physicians accused in identical instances now not to lower back down when they are blameless. 

"i would say never deliver up," he observed. "establish a very good lawyer and work intently with them. not ever compromise. combat to the bitter end, since you can win."

Alicia Gallegos is a reporter for Medscape company of medicine based mostly within the Midwest. She has prior to now written for the American clinical news, the ACP Internist, and the AAMC Reporter. Contact Alicia at agallegos@mdedge.com or by means of Twitter at @Legal_med

For more news, observe Medscape on facebook, Twitter, Instagram, and YouTube.

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