Part III Clinical Examination - patient-based assessment of full-episode care
Part III is the clinical examination: you treat real patients in a teaching clinic while examiners observe and score you against the competencies expected of a registrable dentist in Hong Kong. It assesses the whole encounter - history, examination, diagnosis, treatment planning, consent, technical execution, cross-infection control and professionalism. It is the final part, and the one where textbook knowledge has to survive contact with an anxious patient.
How it runs
- You are allocated patient(s) and a defined task, commonly in periodontology, restorative dentistry, endodontics, prosthodontics or oral surgery.
- Scoring covers history and communication (including Cantonese where that is the patient's language, with interpretation available), examination and charting, radiograph interpretation, written diagnosis and plan, technical quality, asepsis, ergonomics and documentation.
- Examiners may question you during or after the procedure; you must be able to justify each decision aloud.
Core rules
- Consent first, in terms the patient understands, including the alternative of no treatment.
- Chart before you treat: Basic Periodontal Examination in six sextants (codes 0–4, with an asterisk for furcation involvement), mobility, vitality testing, plaque and bleeding scores, and radiographs as indicated.
- Codes 3, 4 or an asterisk in any sextant commit you to a full six-point periodontal chart of that dentition.
- Standard precautions throughout: hand hygiene, gloves, eye protection, safe sharps disposal and correct instrument reprocessing.
- Write the record as you go so the notes match what the examiner actually saw.
Worked example
A 55-year-old with BPE 3-3-4-3-3-3 and an asterisk in the lower right sextant. Reasoning: the code 4 plus asterisk oblige you to record a full periodontal chart and take a periapical of that sextant; the diagnosis is generalised periodontitis, moderate with a localised severe site. The plan is initial therapy - oral hygiene instruction, supra- and subgingival debridement by sextant, then reassessment at 6–8 weeks before any surgical or complex restorative commitment. In the examination you would present that plan, obtain consent, then carry out the allocated quadrant debridement with correct instrument adaptation, sharp instruments and ultrasonic support.
Traps that cost marks
- Skipping or mis-recording the BPE, leaving your plan indefensible.
- Starting irreversible treatment before records and consent are complete.
- Failing to adapt for gag reflex, trismus, or medical history such as anticoagulants and bisphosphonates.
- Breaking asepsis mid-procedure - gloves in the drawer, mask pulled down.
- Notes that do not match the procedure the examiner watched.