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Assessment of Clinical Case Presentations for the Membership in Orthodontics, Royal College of Surgeons of England 1995, 1996

The Membership in Orthodontics of the Royal College of Surgeons of England is taken after a minimum of 2 years 9 months of recognized specialty training in orthodontics and is awarded to the successful candidates after completing 3 years training. An essential element of the examination is the presentation of the case records of three completed cases. It is necessary that these cases have been treated entirely by the candidates and these cases should represent the best efforts of the candidates during the training programme. It is expected that the cases will have been supervised closely during the training of the specialist, and therefore a high standard of treatment and case records is required. It was considered appropriate therefore to evaluate the nature and variation of cases being treated, and the quality of the results of these presentations on two consecutive years, 1995 and 1996. The objective was to establish an insight on the standards of the cases to enable comparison in future years or in other examinations. There are three cases presented by each of the candidates at the examination. These cases were assessed by two independent assessors not involved in the examination, and the nature of the treatment recorded. It was decided to use indices to record, first, the nature of the malocclusion being treated by the candidates, and secondly, the quality of the result and degree of improvement achieved. The Index of Orthodontic Treatment Need (Dental Health Component) described by Brook and Shaw (1989) is an accepted means of identifying those patients who would most benefit from orthodontic treatment. There are five grades for the Dental Health Component (DHC) with Grade 5 indicating a great need for treatment and Grade 1 indicating no need for treatment. Generally, cases with Grades 4 and 5 are objectively regarded as being in the greatest need of treatment. The Peer Assessment Rating (PAR) is a mechanism devised to assess the degree of improvement achieved from orthodontic treatment (Richmond et al., 1992a,b). The concept is to assign a score to various occlusal traits which make up a malocclusion.