Appealing a clinical assessment or examination is challenging. Even in the internal appeal stage, where there are experts present, it is often impossible for the appeal body to review the actual work, which cannot effectively be preserved. As the Court said in Chauhan v The National Dental Examining Board of Canada, 2021 BCSC 1538 (CanLII), https://canlii.ca/t/jhfw2,
In this case, it is worth noting that the Appeal Panel’s review of the grading of the Dental Dam Requirement is necessarily limited by the factual constraint that the applied dental dam material, clamp and frame cannot be transported and therefore preserved in the event of an appeal. This practical constraint bears on this court’s assessment of the reasonableness of the Appeal Panel’s decision.
Even if preservation of the work is possible, internal appeals are generally a review of the process and procedures and not a completely fresh evaluation of the quality of the work.
Finally, on a judicial review, a court just does not have the capacity to evaluate the work on the merits. As said in Chauhan:
As this court noted in Verma, “[s]itting in a courtroom on judicial review, I have neither the qualifications nor an evidentiary basis that would justify me in characterizing the panel’s assessment as unreasonable.”
While there still is scope for review of processes and procedures, appeals of clinical assessments suffer from significant practical constraints.