If you are an internationally trained dentist seeking to practise in Canada, the NDEB (National Dental Examining Board of Canada) pathway is your route to licensure. This page explains the process from start to finish.
The NDEB pathway
The NDEB pathway for internationally trained dentists consists of three steps, taken in sequence.
Step 1 — Assessment of Fundamental Knowledge (AFK). A written exam of 200 MCQ questions testing biomedical sciences, clinical dental sciences, and behavioural and community dental sciences. This is the first hurdle and the most commonly failed — pass rates range from 32 to 63 per cent. The AFK sits twice per year, typically March and September.
Step 2 — Assessment of Clinical Judgement (ACJ). A computer-based exam testing clinical decision-making and professional judgement. The ACJ uses a different format from the AFK — ranking and rating responses rather than standard MCQ. The ACJ is sat after passing the AFK.
Step 3 — Assessment of Clinical Skills (ACS). A hands-on clinical examination testing practical dental skills on manikins. This is the final step before licensure eligibility.
You must pass each step before progressing to the next. The total pathway from AFK to ACS typically takes 12 to 24 months depending on exam scheduling and your preparation timeline.
The AFK in detail
The AFK is where most candidates need the most preparation support. The exam tests knowledge at the level of a Canadian dental school graduate. The blueprint allocates approximately 20 per cent to biomedical sciences, 60 per cent to clinical dental sciences, and 20 per cent to behavioural and community dental sciences.
The exam is framed in Canadian context — drug names follow North American conventions (Epinephrine, Acetaminophen), ethical scenarios reference Canadian Dental Association standards, and public health questions may reference Canadian-specific policies.
How to prepare for the AFK
The high failure rate reflects three factors: underestimation of the biomedical sciences component, insufficient adaptation to Canadian context, and limited preparation resources. Four to five months of structured revision with a Canadian-context question bank is the recommended approach.
iatroX offers a dedicated NDEB AFK question bank with over 1,500 questions framed in Canadian dental context. The adaptive algorithm targets your weakest domains — typically biomedical sciences for candidates who have been in clinical practice. All included at £29 per month or £99 per year.
After the AFK
iatroX currently covers the AFK. The ACJ and ACS require different preparation approaches — clinical judgement scenarios and hands-on skills respectively — that are beyond the scope of a question bank. Dedicated ACJ and ACS preparation resources are available from Canadian dental education providers.