Dental Licensing Examinations Abroad

Dr. T.P Sethumadhavan

 With the emergence of more number of dental colleges in the private sector, dental graduates are facing unemployment problem in the country. Dental profession requires better skills to succeed. As economies become sophisticated and technologically complex, work demands a much higher and wider range of skills. Dentistry is a most wanted profession abroad which has more career and educational prospects. Dental licensing examination in developed countries involves lot of procedures. It may vary from country to country. This article highlights the different procedures for applying Dental licensing examination abroad.

1. NBDE for United States

National Board Dental Examinations NBDE consists of two parts and is administered by the ADA Joint Commission on National Dental Examinations (JCNDE). Part I of NBDE covers most aspects of the biomedical sciences while part II deals with clinical dentistry issues.

Effective from January 2010 the JCNDE started reporting performance in the NBDE exams as pass or fail only, and the new version of this exam combines both parts into one exam that is for the most part composed of clinical cases-specific questions. There are couple of issues that will arise because of this change, and those are mainly related to international dental graduates (foreign trained dentists). Until now the dental graduates from other countries are needed to take part I and use that score to apply to schools that used to look at the score and make their acceptance vs. rejection based on that score and many other criteria. When the new exam is rolled, this will be impossible, since you need to be enrolled in a dental school before being allowed to take the exam, as you can see, the new format can't be used as an admission requirements since you can't even take the exam before being already accepted into school, and because standard scores cannot be reported anymore.

What could make this even more complicated is the fact that with the new format schools may feel obliged to add more biomedical sciences courses to the curriculum of the international programs to make sure their students are adequately prepared to pass the NBDE in its new comprehensive format, this could very well mean longer programs (more than two years), and higher tuition.

The Joint Commission remains committed to the implementation of pass/fail scoring for Part I and Part II as well as for the Dental Hygiene examination from January 1, 2012 onwards.

The Dental Licensure Process

  1. Education
  2. Written examination
  3. Clinical requirement

Currently, all U.S. licensing jurisdictions accept passing the NBDE exams as fulfilling the written exam requirement.
The NBDE is given in two parts—the first to be taken at the end of two years of dental school, and the second to be taken during the last year of school. The first part spans basic biomedical sciences, including:

  • Anatomic Sciences
  • Biochemistry-Physiology
  • Microbiology-Pathology
  • Dental Anatomy and Occlusion

The second part is a comprehensive, 1½ day examination covering clinical dental sciences, and patient management. About 20% of the exam is based on patient cases. States may have different qualifying factors for the clinical requirement of licensure. Find out more from the jurisdiction that will license you.

The fee for the NBDE exam is $265. The following eligibility requirements for taking the NBDE exam apply to international dental graduates or foreign trained dentists.

You must submit an examination application and fee to:
The Joint Commission on National Dental Examinations
211 East Chicago Avenue, Suite 600
Chicago, Illinois 60611-2678

Applying process

  1. You must have your official dental school course transcripts verified by:

Educational Credential Evaluators, Inc.
P.O. Box 514070
Milwaukee, Wisconsin 53202-3470
414-289-3400 http://www.ece.org

You must contact Educational Credential Evaluators, Inc. (ECE) and request an ECE application form. The ECE form will describe what educational credentials are required and how to submit them to ECE. Fees for ECE services will also be listed ($85 at the time this page is published). You should indicate that a General Report should be sent directly to the Joint Commission on National Dental Examinations. It takes approximately four weeks for ECE to evaluate credentials.

  1. Educational Credential Evaluators, Inc. will send the ECE General Evaluation Report directly to a) you and b) the Joint Commission on National Dental Examinations.
  1. The Joint Commission will hold the NBDE examination application, but will not process it before the ECE Evaluation Report is received. The ECE report must be received in the Joint Commission office by the application deadline.
  2. Your name on the ECE report must match the name on the application. Any name changes must be accompanied by legal documentation.

Most schools require foreign trained dentists to take NBDE part I and they do assign a certain weight in their acceptance decision on your score on that exam, some may also require part II.

The NBDE exam is administered only at Prometric test centers in the US and Canada, once you register you will receive information directing you on how to register for a certain date.

According to the official candidate guide, the NBDE could take up to 7 hours, divided into 3.5 hours segments, 200 questions each; with an optional one hour break.

Part II
Again, your first step is to become familiar with everything listed in the NBDE Part II The examination fee for part II is $345. You do not need a newECE report if you have already taken care of this during Part I.

Part II is also computer-based, administered in Prometric, you can submit a paper application, or register online. Many other regulations and procedures are similar to Part I. The only difference is the scope of the exam; NBDE Part II tackles the different dental specialties, patient management, and pharmacology.

The exam is administered in two days, day one consists of two 3.5 hours segments and 200 questions each, of discipline-based questions. Day two consists of 100 case-based questions. You will be given several cases with 10-15 questions each.

Resources for Preparation
Obviously, a strong and solid background is needed before you tackle any of these exams, being a foreign trained dentist gives you at least a theoretical advantage because chances are that you are familiar with at least some of the subject covered in the NBDE exams.

Released national board dental exams from previous years, can be a great resource, the more recent, the better, they can serve to familiarize you with the format of the exam, and you can use them to test yourself and your preparation,

You can purchase those directly from the American Student Dental Association.

First Aid for the NBDE Part I and First Aid for the NBDE Part II are useful guides published by McGraw-Hill.

  1. Another two books and useful guides published by Mosby are: Mosby's Review for the NBDE, Part I and Mosby's Review for the NBDE, Part II. Kaplan published a review guide for Part I: dentEssentials: High-Yield NBDE Part I Review (Kaplan Dentessentials)
  2. Crack the NBDE for the National Board Dental Examination Part 1 (2008 Deluxe Edition): It's a computer software that you download.
  3. The Student Doctor Network Forums provide a wealth of information

2.New Exam for Overseas Dentists, UK

The (General Dental Council) GDC is conducting Overseas Registration Examination (ORE)

The ORE will be in two parts:

Part One consist of a written paper covering clinical applied dental science and clinically applied human disease; and - a written paper in aspects of clinical dentistry, law and ethics, and health and safety.

Part Two will consist of an examination on a dental manikin; an objective structured clinical examination (OSCE) that tests candidates' clinical skills; an examination designed to test candidates' diagnostic and treatment planning skills; and a medical emergencies examination.

New candidates applying to sit the ORE must demonstrate that they have at least 1,600 hours clinical experience where they have personally treated patients in the dental chair.

The ORE will be run on a cost-neutral basis to the GDC and the fees, subject to Privy Council approval, will be:

- Part One - £600
- Part One(b) - £150 - this is for those candidates who have passed part A of the IQE and have transferred to the new exam
- Part Two - £2,250

Information for dentists

The General Dental Council (GDC) is the organization which regulates dental professionals in the United Kingdom. All dentists, dental nurses, dental technicians, dental hygienists, dental therapists, clinical dental technicians and orthodontic therapists must be registered with the GDC to work in the UK. When you register with the GDC you are licensed to work as a dentist in the UK.

Temporary registration allows dentists who are not eligible for full registration to practice dentistry in the UK in supervised posts for training, teaching, or research purposes only for a limited period.

An overseas qualified dentist can apply for temporary registration in specific approved posts if they hold a dental qualification from a university which is recognized by NARIC UK for the purposes of temporary registration and the overseas registration examination (ORE).

Temporary registration is granted for a minimum of 84 days and a maximum of 365 days at a time. Temporary registration may be renewed, by means of applying, for up to a maximum of 1826 days (5 years).

3. Dentists - Non-European Economic Area (EEA) nationals
Dentists from outside the EEA whose qualifications are not recognized for full registration with the GDC need to take the Overseas Registration Examination (ORE).The ORE tests the clinical skills and knowledge of dentists from outside the EEA whose qualifications are not recognised for full registration with the GDC. The examination is based on the UK dental curriculum and uses modern assessment methods to ensure a robust and consistent examination. Dentists who pass this examination become eligible to apply for full registration to practise in the UK. All applicants need to demonstrate that they have an appropriate level of English language competence before they can sit the ORE and are required to demonstrate their linguistic competence by sitting the International English Language Testing System (IELTS). The IELTS Test Report Form must be no more than two years old when you submit your application.

Vocational training
Dentists who complete the ORE examination may be required to do up to a year's Vocational Training (VT) in order to work for the NHS. Success in the exam is not a guarantee of employment or a VT place.

The right to work in the UK
Registration with an appropriate regulatory authority does not give you the right to work in the UK.

4. Canada

General Certification and Licensure
Dentists must be licensed to practice dentistry in Canada. Dental licensure is a provincial responsibility. Each province/territory has a dental regulatory authority/licensing body that establishes regulations and requirements for the licensure of general practitioners within their jurisdiction. There are fees for licensure and certification in each province that may change annually.

The National Dental Examining Board (NDEB) of Canada is the organization responsible for establishing and maintaining a national standard of competence for dentists in Canada.

5. Non-EU/EEA Nationals
The National Supervisory Authority for Welfare and Health (Valvira) may grant, upon application and subject to certain conditions, a right to practice as an authorised or licensed dentist in Finland to a non-EU/EEA national who has qualified as a dentist outside of the EU/EEA, who holds the required qualifications as prescribed by Decree and can demonstrate adequate language proficiency.

In order to be licensed or authorized, applicants must have completed any such service, any such additional studies and passed any such examination as may be prescribed by Valvira to ensure that their qualifications are of an equivalent standard to dentistry training offered in Finland. Applicants must also be able to demonstrate sufficient knowledge of Finnish or Swedish.Valvira grants, as a rule, non-EU/EEA nationals a license to practice as a dentist in Finland, provided that the above conditions are met in full.

Conditions of licensing
Licensing is subject to the following conditions, as prescribed by Valvira:

1. Non-EU/ EEA graduates
Training is defined as the completion of a basic dental qualification fulfilling certain prescribed criteria, proof of which the applicant is required to present in the form of a degree certificate or diploma along with a transcript of subjects studied. The degree certificate and its appendix must be provided in Finnish or Swedish translation.

In addition we ask you to send original legalized degree certificate or diploma and degree transcript (Apostille or so-called Grand Legalisation).

2. Knowledge of the Finnish or Swedish language
Applicants are required to provide a Civil Service Language Proficiency Certificate (grade “satisfactory”) or a National Certificate of Language (intermediate level, skills levels 3–4) as evidence of language proficiency. Certificates of Finnish or Swedish studies, such as language courses, are not in themselves adequate proof of language proficiency.

3. Examination
Examinations to ascertain the applicants’ competence in dentistry are organised by the University of Helsinki Institute of Dentistry.
University of Helsinki Institute of Dentistry
Mannerheimintie 172
For further information, please contact:
kimmo.suomalainen@helsinki.fi and erja.riikonen@helsinki.fi

5. ADC Examinations
The Australian Dental Council (ADC) is responsible for assessing overseas trained dentists to enable them to obtain registration in Australia. The ADC also accredits Australian Dental Schools courses leading to registrable qualifications. The dental boards, the dental schools, the Royal Australasian College of Dental Surgeons, the Australian Dental Association, the Australian Dental & Oral Health Therapists Association and the Dental Hygienists Association of Australia are represented on the ADC.

Eligibility criteria
overseas trained dentists are eligible to undertake the ADC examination procedure if they have completed and passed a dental degree which included at least four years' full-time academic study at a university recognised by the ADC and are registered as a dentist in their country of training or practice.

Examination Procedures
The ADC examination procedures have been developed specifically to assess the qualifications of overseas trained dentists whose qualifications are not accepted as a basis for registration by Australian Dental Boards.

The examination procedure consists of three parts an Occupational English Test (OET); a Preliminary Examination (Multiple Choice Questions and Short Answer questions); and a Final Examination (Clinical). These must be taken sequentially.

Occupational English Test (OET)
A comprehensive knowledge of English is essential to the practice of dentistry in Australia. All overseas trained dentists (regardless of country of training) are required to pass the Occupational English Test (OET) prior to acceptance into the Australian Dental Council examinations.

The purpose of the OET is to assess a candidate’s understanding and use of English in the professional workplace. The OET assesses both written and spoken English in four categories: reading, writing, listening and speaking. All four categories must be passed at an ‘A’ or ‘B’ level to achieve an overall satisfactory pass in the test.

Web-site: http://www.occupationalenglishtest.org

Candidate must pass this test before you proceed to the Preliminary Examination. "A pass is valid for 2 years. Other English tests are not accepted."

Preliminary Examination
The Preliminary Examination is a written examination in multiple choice and short written answer format. It is designed to test your knowledge of the practice of dentistry and of clinical and technical procedures as they are practiced in Australia. Previous examination papers are not available, but sample multiple choice questions are made available to enrolled candidates.

Unlimited attempts are permitted for this examination. A pass is valid for three years. In order to be eligible to attempt the Preliminary Examination, at the closing date for the exam you must have a satisfactory pass in the OET (valid for two years).

Final Examination - Clinical
In order to be eligible to sit for the Final Examination, at the closing date for the exam you must have passed the Preliminary Examination (pass valid for 3 years) and have a satisfactory pass in the OET (valid for two years).

The Clinical examination is held over three to six days and includes the following three blocks:

  • Conservative Dentistry - Operative Dentistry and Paediatric Dentistry;
  • Treatment Planning -including consideration of Periodontics and Removable Prosthodontics;
  • Oral Surgery, Oral Diagnosis and Radiology.

Clinical disciplines include Orthodontics, Oral Medicine, Oral Pathology and Pharmacology will be included where appropriate (practical and/or theoretical and/or viva voce).

For more details contact Australian Dental Council (ADC) Ground Floor, 120 Jolimont Road East Melbourne Vic 3002, Australia
For further enquiries please email: Info@adc.org.au

6. KDLE (Kuwait Dental Licensing Exam)

The KDLE is a one day written examination in English, composed of 200 multiple-choice questions (MCQs) and is divided into two parts.

Part I: Biomedical Sciences (21/2 hours, morning session)

This part will contain 100 MCQs related to: Anatomical Sciences, Biochemistry, Physiology, Microbiology, Pharmacology, Dental Anatomy, Occlusion, and General Pathology

Part II: Dental and Clinical Sciences (21/2 hours, afternoon session)

This part will contain 100 MCQs related to: Endodontics, Oral Pathology, Oral Medicine, Oral Radiology, Oral Diagnosis, Operative Dentistry, Oral and Maxillofacial Surgery, Pain Control, Management of Emergencies, Orthodontics, Periodontics, Preventive Dentistry, Public Health Dentistry, Prosthodontics, and Pediatric Dentistry.


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