DENTAL practice manager Fiona Speck was one of only four people to gain a merit in an examination.
Fiona, from Fulwell, Sunderland, who works at Whitburn Dental Practice, was among the highest performers out of 117 students who sat the dental sedation test.
She was one of six North-East Chamber of Commerce (NECC) trainees who took a five-month course that required study sessions at the chamber's training centre.
The exam combined a written paper and a practical session.
Fiona had to demonstrate resuscitation skills, set up and check intravenous equipment and a sedation machine and take her examiner's blood pressure and pulse.
All the NECC centre trainees surpassed the national pass rate of 85 per cent.
NECC assistant training manager Claire Kelly said: "It is not an easy qualification and it is a real feather in her cap to be within the top four in the whole country and singled out for excellence.
Fiona paid tribute to the people who had helped her achieve her success, including the staff at the Whitburn surgery.
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