Scenario-based Oral Clinical Examination Process


Approximately two months prior to the exam date, the ABO will notify the examinee as to the date and time of his/her clinical exam, including hotel and shuttle information.  A copy of the examinee’s orthodontic degree/certificate must be submitted to the ABO prior to the scheduled examination date.  When scheduling a return flight, allow at least 4.5 hours from the start of the oral examination time. For example, if the exam start time is 7:00am, a return flight should be no earlier than 11:30am.  Business Professional Attire is recommended on the day of the examination.


Examination Logistics

All clinical examinations are held in St. Louis, Missouri, at the ABO Examination Center.  At the designated time, examinees will ride the shuttle from the St. Louis Airport Marriott to the ABO Examination Center.  Examinees are asked to use restroom facilities before boarding the shuttle as the exam is on a timed schedule, and time will not stop if an examinee has to leave the room during the exam.


We ask that examinees do not bring any personal items to the exam other than a government issued ID.  Electronic devices, including phones, Google glasses, Apple watches, etc. are strictly forbidden in the exam rooms. Bottled water will be provided to examinees.


Examination Administration

The Scenario-based Oral Clinical Examination is presented as an Objective Structured Clinical Examination (OSCE), through which examinees testing at the same time begin in different rooms and progress from room to room until all of these examinees have completed the scenario-based questions at each station. The time allowed is the same for every room.


Each examinee will visit a total of six rooms during the examination.  Each room will have a different set of examiners.  The cases and scenario questions presented by these sets of examiners will change for each exam window offered.  When first presented with scenario case records, examinees will read the first question and then allow time for the examinees to familiarize themselves.  These questions will measure proficiency related to the tasks and skills required in each of the domains that the scenario is intended to test. Responses will all be oral, and the examiners will assess the responses as they are given.


Pencil and paper will be provided to take notes to formulate responses. Notes will be collected by the examiners for confidentiality purposes.  The exam cases have been selected to be representative of the skills and knowledge a qualified specialist with appropriate training should be able to personally manage. Whether examinees treat a particular type of patient in their practice or provide a particular procedure in their office is irrelevant.


Examinees should answer the questions as thoroughly as possible offering detailed responses that consist of pertinent facts/findings/observations.  If asked to describe something, do not skip to the obvious conclusion and ignore other important details. Examinees will be told how many questions will need to be answered in each exam room, and should therefore manage their time appropriately.  


Examiners may offer to repeat the question, or may ask the examinee to elaborate on an answer.  Examinees will have access to written questions as well as necessary images as they are formulating their answers. However, examiners will not clarify or interpret questions.  Once a scenario is completed, if there is still time left, examinees may ask to revisit previous questions.


The examiners remain impartial and have been trained not to give examinees any indication whether their responses are correct or incorrect. This behavior may appear unfriendly to some examinees, but it is essential to ensure that no examinees receive helpful positive reinforcement from examiners. 


Rating Scales and Examiner Training

During the examination, responses are independently scored by a total of 12 trained examiners who use an anchored rating scale to ensure consistency in scoring. The scales to be used in a case address the function of the case (e.g., diagnosis, implementation, critical analysis) and are standardized for all cases serving the specified function. Each unit of the scale is anchored with language that helps to ensure that the ABO’s standards are applied by all examiners.


The ABO’s examiner training program educates examiners in the intended application of the scales to candidate responses. The examiner training program provides practice opportunities as well as a required assessment of agreement with criterion ratings for a selection of responses. All examiners attend training and are recalibrated immediately prior to each testing and scoring cycle.


During the examination, each exam room is assigned an observer who takes records in real time focusing on the process of the examination. Direct feedback is given to the examiners after exam sessions in order to ensure consistency, objectivity, and fairness.



The rating scales for the clinical examination are weighted to achieve 25% allocations to each of the four domains covered in the examination. Points awarded to examinees are determined as a function of the ratings assigned and the weight of the question.  Psychometric analyses are performed after each testing cycle.


Exam results are presented in a pass/fail format which is based on minimum performance criteria.  If an examinee is unsuccessful on the examination, he or she will be provided with feedback outlining their level of success on the four main domains of the examination.  Examinees must re-take the entire examination in order to pass, and will not have the ability to be re-tested on individual sections.  Reliability, validity and objectivity are assessed by an independent psychometric examination consulting company.


Release of Clinical Examination Results

Clinical Examination results will be emailed to all examinees within a two month period.  Official results letters  will be mailed within a three month period. For first time Diplomates, this mailing will also include an ABO lapel pin, ABO Educational Toolkit information and an ABO certificate.


The Board Certified Orthodontist’s information will appear on the ABO website in the Orthodontist Locator directory within three weeks of receipt of email notification.


Click here for information about CE Credits issued by the ABO.