NDEB Equivalency Process — AFK → ACJ → NDECC

The NDEB Equivalency Process is the national route for graduates of dental programmes not accredited by the Commission on Dental Accreditation of Canada (CDAC). It consists of three examinations in sequence: the Assessment of Fundamental Knowledge (AFK), the Assessment of Clinical Judgement (ACJ), and the National Dental Examination of Clinical Competence (NDECC). Successful completion leads to NDEB certification, after which candidates apply to a provincial dental regulatory authority for a licence to practise. The final clinical examination is called NDECC, not ACS. ACS was retired in 2022.

Pathway Snapshot

The pathway begins with an NDEB application and credential verification, followed by AFK and ACJ (both available at Prometric centres in Canada, Australia, and New Zealand), and finally NDECC, which is held only at the NDEB Test Centre in Ottawa. After passing all stages, candidates receive an NDEB Certificate and then apply to the province where they intend to practise.

Complete Journey: Overseas Dental Qualification → NDEB Application & Credential Verification → AFK → ACJ → NDECC (Clinical Skills + Situational Judgement) → NDEB Certificate → Provincial Dental Licence → Practise in Canada.

On this page

Main Links

1 Application & Credential Verification 2 AFK — Assessment of Fundamental Knowledge 3 ACJ — Assessment of Clinical Judgement 4 NDECC — National Dental Examination of Clinical Competence 5 English Language Requirement 6 Provincial Licensing 7 Fees 8 Demand & Pass Rates 9 How to Apply 10 Retake Rules

Application & Credential Verification

The NDEB Equivalency Process is designed for graduates of dental programmes not accredited by CDAC. To begin, candidates create an NDEBConnect account, submit an application, and complete credential verification. NDEB does not require Canadian citizenship or permanent residence to apply or participate in the exams. There is no mandatory Canadian dental degree or bridging programme.

The NDEB application fee is CAD $900. The credential verification process is conducted by NDEB itself; no ECE/WES/DataFlow is required for this stage.

AFK — Assessment of Fundamental Knowledge

The AFK is the first examination in the Equivalency Process. It tests biomedical science knowledge and applied clinical science knowledge.

Feature	Details
Format	200 single-answer multiple-choice questions, delivered in 2 parts of 2 hours each
Total duration	4 hours
Question type	Single-answer MCQ
Delivery vendor	Prometric (electronic), with paper/booklet option at selected Canadian sites
Locations	Canada, Australia, and New Zealand (current official NDEB locations; verify before booking)
Pass mark	Equated/re-scaled score of 75 or greater. This is a standardised score, not a raw percentage of correct answers.
Attempts	Maximum 3 attempts
Fee	CAD $1,000
Official page	https://ndeb-bned.ca/equivalency-process/assessment-of-fundamental-knowledge/

What we offer

Full AFK question bank mapped to the NDEB knowledge domains, with clinical scenario questions, flashcards, self-assessments, trained AI companion, mentorship, a dental library, study groups, and more.

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ACJ — Assessment of Clinical Judgement

The ACJ is the second examination. It tests the candidate's ability to formulate diagnoses, make clinical decisions, interpret radiographs, and apply oral radiology knowledge.

Feature	Details
Format	Computer-based, 120–150 single-answer and multi-answer MCQs
Duration	5.5 hours, including one scheduled break
Question types	Case-based diagnosis, treatment planning, clinical decision-making, and radiographic interpretation questions
Locations	Canada, Australia, and New Zealand (current official NDEB locations; verify before booking)
Pass mark	Equated/re-scaled score of 75 or greater
Attempts	Maximum 3 attempts
Fee	CAD $1,350
Official page	https://ndeb-bned.ca/equivalency-process/assessment-of-clinical-judgement/

What we offer

Full ACJ question bank with clinical case scenarios, radiograph interpretation practice, treatment planning exercises, flashcards, and AI study companion.

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NDECC — National Dental Examination of Clinical Competence

The NDECC is the final examination in the Equivalency Process. It has two components: a Clinical Skills Component (CSC) and a Situational Judgement Component (SJC). NDECC is held only at the NDEB Test Centre in Ottawa, Ontario. There is no Prometric option for NDECC.

Feature	Details
Clinical Skills Component (CSC)	Full-day exam on simulated patients/manikins. Candidates complete 7 clinical requirements, which may include Class II amalgam preparation/restoration, Class II composite restoration, Class IV composite restoration, endodontic access cavity preparation, crown preparation, and provisional crown restoration. Duration approximately 8 hours.
Situational Judgement Component (SJC)	Half-day exam with 10 stations across 5 competency areas: Patient-Centred Care, Professionalism, Communication and Collaboration, Practice and Information Management, and Health Promotion. Candidates must pass at least 6 of 10 stations, and at least one station in each of the five areas.
Pass standard	CSC and SJC are assessed separately. No fixed numerical pass mark is published. SJC requires 6/10 stations passed, including at least one per category.
Location	NDEB Test Centre, Ottawa only
Fee	CAD $6,500 for both components; CAD $3,250 per component if retaking only one
Attempts	No fixed numerical attempt cap. Candidates have 5 years from the ACJ pass date to pass both components. Effective May 2027, candidates who have not demonstrated minimal competence in both components within 5 years cease to be candidates in the Equivalency Process, with narrow extension provisions.
Scheduling priority	NDEB uses a priority registration time: candidates with approved proof of Canadian citizenship or permanent residence can register at 9:00 a.m., other candidates at 10:00 a.m. This may affect session availability for candidates without Canadian status.
Official page	https://ndeb-bned.ca/equivalency-process/ndecc-2/

What we offer

NDECC preparation resources, including situational judgement scenarios, clinical skills guidance, and AI-based simulated patient encounters.

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English Language Requirement

NDEB itself does not require IELTS, TOEFL, or any specific language exam to enter or progress through the Equivalency Process. The examinations are administered in English or French, and candidates choose their preferred language.

Language proficiency is a provincial licensing requirement, not an NDEB requirement. For example, the Royal College of Dental Surgeons of Ontario (RCDSO) requires reasonable fluency in English or French, and accepts IELTS Academic (overall 7.5, with 7.0 in each component) or equivalent tests. Requirements vary by province; candidates should check the specific provincial regulator where they plan to practise.

No single Canadian “NDEB English score” exists. Do not publish “IELTS required to enter NDEB Equivalency Process.”

Provincial Licensing

Passing AFK, ACJ, and NDECC earns the NDEB Certificate, which demonstrates that the candidate meets the national standard of competence. The NDEB Certificate is not itself a licence to practise.

Candidates must apply separately to the provincial dental regulatory authority in the province where they intend to work. Examples include Ontario (RCDSO), Alberta (CDSA), and British Columbia (BC College of Oral Health Professionals).

Provincial requirements typically include the NDEB Certificate, language proficiency, a jurisprudence/ethics course or exam, certificates of standing, and immigration/work authorization. Ontario's jurisprudence and ethics course, for example, is a separate requirement. Employer sponsorship is not required for NDEB certification or provincial licensing, but immigration/work authorization is separate.

Fees

All fees in Canadian dollars. Official NDEB fees are published on the NDEB website. The base cost of $9,750 CAD covers NDEB fees only. It does not include provincial licensing fees, English language testing, travel to Ottawa for NDECC, accommodation, credential translation, or commercial preparation courses.

All figures are approximate and based on 2026 public information. Always confirm exact fees on the official portals before payment.

Item	Approx. Fee	Notes
NDEB application/credential verification	$900 CAD	Non-refundable
AFK	$1,000 CAD	Per attempt
ACJ	$1,350 CAD	Per attempt
NDECC — Clinical Skills Component	$3,250 CAD	If retaking only this component
NDECC — Situational Judgement Component	$3,250 CAD	If retaking only this component
NDECC — both components	$6,500 CAD	Full fee
Re-application fee (if candidate status lapses)	$400 CAD	Non-refundable
Score verification	$200 CAD	Per exam
Total base cost (all stages, first attempt)	$9,750 CAD	Application + AFK + ACJ + NDECC full fee

Demand & Pass Rates

The NDEB Equivalency Process has grown significantly in recent years. Official NDEB certification data shows Equivalency Process completions of 131 in 2023, 447 in 2024, and 745 in 2025. Total NDEB certificates issued in 2024: 1,303 (including all pathways). For FY2023–24, NDEB reviewed 2,244 Equivalency Process applications, approved 1,360, and 445 dentists successfully completed the process.

The AFK pass rate fell from 49.83% in 2023 to 33.10% in 2024. This makes high-quality preparation particularly important. 2025 pass rates are circulating on commercial sites but have not been independently verified against NDEB's current statistical publication. Use only official NDEB data if available.

Examination	Candidates	Pass Rate
AFK	1,843	33.10%
ACJ	1,007	57.0%
NDECC Clinical Skills	1,247	45.79%
NDECC Situational Judgement	1,046	62.72%

How to Apply

Step 1: Create an NDEBConnect account and submit an application. Pay the $900 application fee. Step 2: Complete credential verification through NDEB. Step 3: Register for and pass the AFK (CAD $1,000). Step 4: Register for and pass the ACJ (CAD $1,350). Step 5: Register for NDECC. Priority registration time applies (Canadian citizens/PRs at 9:00 a.m., others at 10:00 a.m.). NDECC is held in Ottawa. Step 6: After passing both NDECC components, receive your NDEB Certificate. Step 7: Apply to the provincial dental regulatory authority in your intended province of practice.

Important: From 1 September 2026, NDEB is introducing a second registration period for AFK and ACJ, opening approximately 6–8 weeks before the exam for seats freed by withdrawals. Check the NDEB website for current registration windows.

Retake Rules

AFK: maximum 3 attempts. A candidate who fails all three attempts cannot continue to ACJ. ACJ: maximum 3 attempts. NDECC: no fixed numerical attempt cap, but candidates have 5 years from the ACJ pass date to pass both components. Effective May 2027, candidates who have not demonstrated minimal competence in both components within 5 years cease to be candidates in the Equivalency Process, with limited extension provisions. No separate score validity period is published for AFK or ACJ results.