ITDs from all over the world make it over to Canada through the immigration process and then are faced with some challenges to become fully accredited and licensed dentists.
We wanted to go a little deeper into this side of the process for those internationally trained dentists that are not opting for specialized programs during immigration, but just want a closer look at how to become a dentist in Canada using the equivalency process.
The good news is that how to become a dentist in Canada does not require you to receive another dental degree if you already have a quality education.
It does require you to prove your dentistry capabilities by taking a series of tests or exams that can be challenging if you are out of practice or have been specializing for several years.
We understand the amount of frustration with the process of being a dentist in Canada. As long as you can keep your paperwork well organized and make it through the exams, you will come out the other side into a highly favorable job market with many lucrative job options in Canada.
This is a gorgeous country to live and work in with friendly people, cosmopolitan centers, rich natural resources, and culturally diverse.
We will be following the steps of a general dentist through an accredited and non-accredited/equivalency process. We have a lot to cover, so let’s dig in!
Where Do We Begin?
To be a licensed dentist in Canada, you must have some form of formal education like a BDS/DDS/DMD degree from a recognized school or university program and hold an NDEB certificate.
The most straightforward pathway for an ITD to become a dentist in Canada is to go through the equivalency process. This is designed for those ITDs with a degree program or formal training that is not recognized as accredited in Canada.
Let’s break this down a bit more and go over some steps. Everything starts by applying and receiving approval for the NDEB.
Step 1 - NDEB Application & Approval
The NDEB is the National Dental Examining Board of Canada that issues exams to certify which dentists can practice in Canada. They are responsible for keeping a record of who is appropriately trained, educated, and skilled enough to perform dentistry legally.
To qualify for the NDEB application, you must fulfill one of three requirements:
♦ Graduate from a Canadian dental program - your school will automatically send your confirmation of graduation directly to the NDEB on your behalf.
♦ Graduate from an Accredited Dental Program in the U.S., Australia, New Zealand, and Ireland - it is up to you to send your original official transcripts to the NDEB in a sealed envelope. This must confirm the date you received your degree.
♦ Successfully Complete the Equivalency Process – your university/school will have to submit proof of graduation and academic records as you will pass through the multiple exams.
General dentists must hold a degree from an institute, college, or university to be considered part of an accredited program. That means your school is recognized by the Commission on Dental Accreditation of Canada (CDAC). Otherwise, you will be considered a non-accredited applicant and must pass the equivalency exams.
To open an NDEB account, click here and pay the fee. Then, send over the documents required and wait for the NDEB to review and approve your application.
Step 2 - Pass the AFK
Any foreign dentist seeking certification in Canada must pass the AFK unless they are a graduate of an accredited school.
You cannot register for the AFK exam until you have received approval from the NDEB. That can take around 22 weeks from when you submit your application to when you receive final approval.
We highly suggest you take advantage of this time period by studying for the AFK so you can pass it on your first try and shorten the wait between steps.
The best way to manage how much money and time you will spend on the entire process of becoming a dentist in Canada has a lot to do with the pass rate of your exams.
We do not want to place added pressure on you as you move through this process, but the fewer times you have to take any of the exams, the faster you will become a qualified Canadian dentist.
The AFK is a 200 single answer multiple-choice questionnaire divided into two parts. This test is designed as the Assessment of Fundamental Knowledge in the field of Dentistry. You can find a decent self-assessment here to give you an idea of what the AFK will cover.
You can take this exam electronically or via a booklet, but it must be at a proctored location. If you do not pass the AFK, you will not continue towards being a dentist in Canada.
To pass, you will need a test equated, a re-scaled score of 75 or higher. Start by logging into your NDEB profile and register by paying for the examination. You will be notified by email with instructions to schedule your exam with Prometric (a proctor).
Step 3 - Option 1: Pass the ACJ & NDECC
If you are not going back to college in Canada or another accredited program recognized by the NDEB, then stick to this path. Most ITDs will follow these steps. Don’t worry. We will get back to the school route later in this guide.
Upon completion of the AFK, it will be time for the ACJ. The Assessment of Clinical Judgment reviews your ability to formulate a diagnosis and make clinical decisions. It also covers knowledge in radiology and if you can adequately interpret that information.
The ACJ is a 5.5-hour exam with only a 30-minute break, so be prepared to go through a lot of material. There are 120-150 single answer and multi answer multiple-choice questions. Every section contains case-based diagnosis and clinical decision-making questions. This is only administered electronically at a proctored test center.
Like the AFK, you need a passing score of 75 or more. You can schedule your test by logging into your NDEB profile and registering for the exam after paying the fee.
This used to be known as the ACS but was changed in December of 2021 to the NDECC. This is the third exam in the equivalency process of becoming a dentist in Canada without an accredited dental degree. The test is known as the National Dental Examination of Clinical Competence.
During this exam, you are assessed based on clinical competence, which walks you through a series of scenarios requiring a judgment. Your skills and clinical capabilities will be tested based on patient-centered care, professionalism, communication, practice management, and more in that field.
The first NDECC exam will be held in June of 2022, so we do not have more details about registering, but we anticipate it to be similar to the other exams. Keep a close watch on your NDEB account to learn more.
Step 3 - Option 2: Pass ADAT and Complete University
For those ITDs that want to go back to college, you must first pass the ADAT. This takes the place of the ACJ and assesses if you are ready for an advanced dental education program.
The test is known as the Advanced Dental Admission Test and is used by all colleges in Canada to determine eligibility to their program.
The test takes about 4.5 hours to complete and is available at Pearson VUE centers all over Canada and the U.S. Most ITDs that take this test have had at least a couple of years of training in dentistry and are seeking post-graduate training or specialty practice. You can learn more about the registration process for the ADAT here.
Once you have a passing score for the ADAT, you can apply to a number of qualified Canadian institutions like University of Toronto and Mc Gill University. These schools accepts ADAT results instead of AFK.
Other schools that offers Dentistry programs that require AFK results prior to enrolling in their International Dentist Advanced Programs:
- University of Alberta (School of Dentistry)
- University of British Columbia (Faculty of Dentistry)
- University of Manitoba (Faculty of Dentistry)
- Dalhousie University (Faculty of Dentistry)
- The University of Western Ontario (School of Dentistry)
- Université de Montréal (Faculté de médecine dentaire)
- Université Laval (Faculté de médecine dentaire)
- University of Saskatchewan (College of Dentistry)
Keep in mind that the cost of these institutions can be pretty expensive. Depending on the program and fees, you should expect to pay anywhere from $50,000 to $360,000 CAD.
Step 4 - Pass Board Exams
Every ITD will have to pass the OSCE to receive final certification as a licensed dentist in Canada.
This is the final test you will be given and stands for the Objective Structured Clinical Examination. As its name suggests, this is a comprehensive exam to determine you can operate within or own your own clinic.
The OSCE is a booklet test consisting of two sessions on the same day. The first is a 50 multiple choice questionnaire that will include everything from case history to dental charts. Every question will have up to 15 answer options with one or more correct answers.
The second session is a long-form answer to one structured question that does an in-depth look at your ability to practice.
Like all the rest, you must have a 75 or higher to pass this exam. You can schedule your OSCE by viewing your NDEB account and paying the fee.
We want to make a special note here about this exam. In 2023, this will become the NDEB Virtual OSCE. This will combine the written examination and OSCE into one exam delivered electronically in a single day instead of two separate sessions.
You can take the OSCE up to three times, but we highly recommend working with a local preparation center specializing in helping ITDs get through the entire examination process with the NDEB equivalency program. We have a great article about the top Dental Training Institutes/ Centers that help ITDs.
Once you have completed the OSCE, you have fulfilled all your obligations to be a dentist in Canada. All that is left is to send in your final application to the NDEB and them to issue you a license. That process can take a bit of time, but they are working hard to make it quick because dentists are so in demand right now.
You must communicate with the DRA (Dental Regulatory Authority) of the province where you want to practice. DRAs may require additional documentation or proof of specific skills.
There are some other nuances to this process, but we wanted to point out a few critical points. First, the cost of the equivalency is expensive. Every exam has its own fee:
♦ NDEB Profile & Paperwork - $900 CAD
♦ AFK - $800 CAD
♦ ACJ - $1,350 CAD
♦ NDECC - $9,000 CAD
♦ OSCE - $1,000 CAD
That is a total of $13,050 and does not include any preparatory help from dental study centers/institutes. If you wrap in those costs, you can expect to pay around $60,000 CAD for the entire process.
Of course, that is significantly less expensive than going back to college, but it is something you need to consider.
Second, you really should work with a dental clinic. There are significant differences in practicing dentistry in Canada compared to other countries, and you do not want to fail any of these exams as that can get expensive quickly.
Finally, speak to some ITDs who completed the equivalency program. We hear about so many questions on Facebook and Reddit that would fill a book to answer.
It really helps to join some of these groups to see if your question can be answered. Give us a follow on Facebook as we frequently post.
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Wrapping it Up
We hope this has been an informative resource for your research. It is a genuine pleasure to help ITDs come to Canada to open a dentistry practice. This is a wonderful country to set roots with many peer immigrants making the move because the job value and career outlook are so positive. Thank you for reading!
Karen Nunez was born in Valenzuela, Philippines. She received her Doctor of Dental Medicine degree from Centro Escolar University in Manila.
Karen currently is a practicing oral health care professional based in Alberta, Canada; and runs a Blog where she writes a slew of articles to empower internationally trained dentists to integrate into Canadian dentistry.
Read more of her blogs here.