A welcome change in the journal! The first “Ethics in Orthodontics” column (Greco P. Academic impropriety. Am J Orthod Dentofacial Orthop 2011;139:5-6) was significant for its contemporary relevance. The author voiced valid questions and concerns relating to academic impropriety. Maybe in the future we can look forward to aspects of ethical values concerning the practicing clinician.

I do not find anything wrong in students previewing old questions. That is, in fact, 1 way of preparing for the examination and, after adequate preparation, doing a self-assessment of one’s theoretical knowledge. Usually, a study of 5 to 10 years of previous questions from reputed universities will expose students to the pattern of questioning and also help them to evaluate their depth and extent of knowledge.

Some universities are contemplating a “question bank” system. A student preparing for examination could go through the questions in the bank and patch the deficiencies in his or her preparation. However, there should not be a guarantee that in the real examination only those questions will come. Subject and syllabus can be prescribed, but questions cannot be limited. The manner, wording, and target of the questions on the same topic might vary. Similarly, answers and evaluation criteria of the same question will vary depending on the students’ levels (undergraduate, postgraduate, senior, postdoctoral).

In a specialty examination, evaluating theory (script) is only the tip of the iceberg. It will determine the examinee’s knowledge (depth and width) of an aspect of theory only. A large part of the evaluation will come from case discussions, clinical and practical procedures, oral presentations, and the record of work done during the course period. A team of honest and seasoned examiners will be able to evaluate the candidate’s theoretical and practical orthodontic ability, irrespective of the previewed questions.

As health care has become largely patient centered (patient autonomy dominated), dental (higher) education is also becoming student centered. Most students bear the financial brunt of their orthodontic education. Few can obtain free or subsidized orthodontic educations, even in wealthy countries. The student is an important stakeholder in orthodontic education, and his or her priorities cannot be easily ignored.

As an added measure of training and preparing for examinations, many institutions conduct a mock examination before the real examination. It is held in the same pattern of the university, with theory, practical and clinical, and oral components. Teachers from neighboring institutions are brought in as external examiners. This process gives the student a sort of rehearsal and practice for the real examination. At the undergraduate level, most universities prescribe internal assessment, to be conducted on the same lines as the university examinations. This will account for about 25% of the scoring. What is more important is that the student is exposed to the process of examination and is evaluated for his or her knowledge and skills in the subject. Why not include “preparing for excelling in examination” as part of teaching?