The Equivalency Process & The Standard of Care


In 2011, the Canadian National Dental Examination Board (NDEB) launched the equivalency process for foreign or internationally trained dentists (FTDs). A foreign-trained dentist is a dentist who graduated from an un-accredited dental program. As of 2012, dental schools in Canada, the US, Australia, New Zealand and Ireland are considered accredited.

The equivalency process consists of four steps and three exams:

Part A: Application and document verification. According to the requirements, any dentist with a bona fide dental degree from any country in the planet and any GPA can apply be approved to proceed to part B. Although, there are a lot of great schools in Europe, there are a lot of private schools in developing countries where the admission and passing requirements are so low that it’s almost like buying a dental degree. Not to mention that work ethics is not as high.

Part B: Assessment of Clinical Skills. This is a multiple choice question exam on the theory of Dentistry.

Part C: Assessment of Clinical Judgement. This is also a multiple choice questions exam on possible clinical scenarios.

Part D: Assessment of Clinical Skills. This exam consists of a few excersises on plastic teeth and a manikin (simulation). This exam does NOT involve a real patient and doesn’t cover a lot of clinical procedures required of a dentist.

The Assessment of Clinical Skills excersises are:

Class II amalgam preparation.
Class III composite resin preparation.
Full metal crown preparation.
Metal-ceramic (porcelain fused to metal) crown preparation.
Endodontic access preparation on a molar tooth.
Direct Class II composite resin restoration on a pre-prepared* tooth
Direct Class IV composite resin restoration on a pre-prepared* tooth
Class II amalgam restoration on a pre-prepared* tooth.
Provisional crown restoration for a pre-prepared* metal-ceramic (porcelain fused to metal) crown preparation on Day 2 of the Assessment. The original unprepared tooth will be in the typodont used on Day 1 of the Assessment.
Rubber dam application
Those excersises are done by a Canadian or US dental student in the second year of the four year dental program!

The Clinical Skills Assessment does NOT test many necessary disciplines such as:

Endodontics (Root canal treatment)
Dentures (complete and removable)
Periodontics (gum treatment and cleanings)
Oral surgery such as extractions
Orthodontics (braces)
The equivalency process will lead to a drop in the standard of health care as more and more dentists with inferior training and work ethics are allowed to treat Canadian patients. Unfortunately the public are unaware of the equivalency price and its possible negative consequences.

According to the National Dental Examination Board (NDEB), about 250 foreign trained dentists have been licensed every year in the last 3 years. Those are dentists who were not trained in any of the 4 countries that hold bilateral accreditation arrangement with Canada. Moreover, the number of annual licensed dentists by accreditation has spiked by about 30% due to dentists coming from those 4 countries. To put things in perspective, only half the new dentists getting their licenses every year are trained in Canada.


2 thoughts on “The Equivalency Process & The Standard of Care

  1. DP

    I wonder if prior clinical experience from these FTD’s from non accredited programs is taken into consideration, We know of some, FTDs who graduated 5-6yrs ago and immigrated and never practiced in their own countries and it shows in their sloppy ways of practice. Its a great risk placing patient care in such hands. Patients get a superfluous belief from their graduation dates about their work experience as a dentist.

    Liked by 1 person

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