Frequently Asked Questions

1. Why has the ABO decided that NOW is the time to change to a Scenario-based Oral Clinical Examination?

The decision to change the examination design did not come lightly and is based on years of rigorous evaluation and extensive research that stemmed from discussions and challenges faced within our specialty.


Since its inception in 1929, the ABO has always stayed abreast of different testing methodologies based on the trends of other dental and medical specialties.  As the practice of orthodontics continues to develop, we believe the time to change is now in order to do what is best for the future of our specialty. The changes being made are necessary in order to produce an objective examination that tests the knowledge, skills, and critical thinking abilities that are required of an orthodontist in a fair and valid manner ensuring that each certified orthodontist has developed exceptional expertise and the ability to provide the highest level of patient care.



2. Case submission has always been a core part of the Clinical Examination.  Why have case submission requirements been eliminated?

The ABO considered a more transitional approach, with fewer case requirements combined with scenario-based examinations.  However, based on our research and feedback from educators, we believe a full scenario-based format is the best approach to ensure we adhere to our mission to elevate the quality of orthodontics through certification, education, and professional collaboration.


We recognize the significance of this change and realize that case submission has always been part of the ABO process.  However, we feel that we now have the opportunity to improve this process.  This change eliminates unnecessary barriers for residents and orthodontists that are interested in participating in the certification process while allowing the ABO to accurately test all areas of the four domains established in the Practice Analysis Study as well as critical thinking skills.


We believe the scenario-based examination will allow us to more objectively test for proficiency and clinical excellence.  The tools previously created by the ABO to assess case outcomes will be utilized within the scenario-based examination process, including the discrepancy index (DI), cast radiograph evaluation (CRE), case management form (CMF) and cephalometric superimposition technique and interpretation.  We believe this examination will more effectively and reliably test critical thinking skills in all aspects of orthodontics. 



3. Will scenario-based testing make the Clinical Examination easier? 

No, scenario-based testing is not intended to be an easier examination design. The scenario-based examination will require hours of preparation and continued focus on outcomes.  The new examination design will require an orthodontist to be proficient in four key domain areas: data gathering and diagnosis, treatment objectives and planning, treatment implementation and management, and critical analysis and outcomes assessment.  This allows the examination to fully evaluate an orthodontist on all aspects of treatment in a standardized manner.


Orthodontists must demonstrate knowledge and skills as applied to specific cases selected for the scenario-based format. The examination will still be testing the same skills and outcomes required in individual case submission, but will be testing that knowledge in a more reliable, objective manner – as well as very specific critical thinking skills.



4. What are the biggest benefits of the new scenario-based examination design?

There are numerous benefits to the new examination design.  One of the most important is that all orthodontists now have the ability to go through the certification process regardless of their practice environment and where they are within their career. The challenge of finding the cases with specific criteria and submission requirements is no longer an issue.  Additionally, all orthodontists taking the examination will be objectively tested on their knowledge, skills, and critical thinking abilities.  Ultimately, this will benefit the general public to ensure the ABO has certified orthodontists who are capable of providing the highest level of patient care. 



5. How will these changes have an effect on orthodontic residency programs?

The ABO will continue to collaborate and work with educators to ensure residents are prepared for the certification examination.  We encourage program leaders to continue to focus on clinical self-evaluation and outcomes assessments as the scenario-based examination will test for knowledge and critical thinking skills that apply to these areas. 


The ABO will continue to use assessment instruments including discrepancy index (DI), cast radiograph evaluation (CRE), case management form (CMF) within the scenario-based examination. If a resident is not proficient in outcomes assessments utilizing these instruments, or is not able to interpret the results of superimpositions, they will likely not perform well on this portion of the examination.


The ABO plans to continue to meet with educators regularly to gain feedback on how we can best support the orthodontic programs so that the scenario-based Clinical Examination is complementing the curriculum the educators are teaching in their programs.  Many programs have expressed that they will continue to hold mock board exams and advocacy visits and will begin putting a larger focus on critical thinking skills.  The ABO will also provide detailed examination results to the educators to let them know where their resident’s strengths and weaknesses rank on the scenario-based Oral Clinical Examination. 



6. Does the scenario-based examination open up an increased opportunity for unethical behavior?

No, the ABO believes that the opportunity for unethical behavior will decrease as a result of the new examination design.  Case submission requirements involved a higher risk of unethical behavior with misrepresentation of cases and the possibility of technological alterations. The scenario-based examination will eliminate these issues, as we will ensure that the cases and problems remain secure and are rotated or replaced for all examinations. 



7. Who will be involved in the development of the scenarios? 

The scenarios will be created by the ABO Board of Directors, Examiners and CODA-accredited Program Directors/Program Chairs.  This process began at the November 2017 Educator’s Symposium where we worked closely with Castle Worldwide, a certification and licensure testing company with 30+ years of experience.  Castle will continue to assist the ABO with the testing design and development of the scenario-based examination utilizing their expertise and the knowledge they have gained as a result of the Practice Analysis Study they conducted on the ABO.



8. What are the travel and logistical requirements?

The Clinical Examinations will continue to be held in St. Louis, Missouri at The ABO Exam Center.  



9. Will there be online resources provided to assist with examination preparation?

A Scenario-based Oral Clinical Examination Study Guide will be available on the ABO website in late May 2018.  A sample case will be included with scenario-based questions provided for reference. 


The new examination design will require an orthodontist to be proficient in four key domain areas: data gathering and diagnosis, treatment objectives and planning, treatment implementation and management, and critical analysis and outcomes assessment.  Self-evaluation of clinical patient cases will play a large part in the preparation process.




10. What are the exam eligibility requirements? 

The ABO Written Examination will remain as it is with a format of multiple-choice questions on biomedical sciences, clinical sciences, and orthodontics. Examinees will remain eligible to take the written examination once they have completed at least 18 months of a CODA-accredited orthodontic program. Orthodontists will be eligible to take the Scenario-based Oral Clinical Examination immediately following completion of a CODA accredited program as long as they have also successfully passed the Written Examination.

11. Is Certification Renewal still required?

Yes, Certification Renewal is a critical component of the certification process because it requires a commitment to life-long learning, and it ensures continued clinical proficiency, improvement, and self-evaluation by the orthodontist. The current certification renewal format will remain and includes two pathway options to complete the necessary requirements.



12. What are the examination dates and when does registration open?

Registration for the February 2019 and November 2019 Clinical Examinations will open on May 22, 2018 and may be completed on the ABO website. A possible third examination will be added in 2019 if necessary.  Additional information may be reviewed on the Exam Timing.