ADG: 10 steps to improve the overseas registration exam

The Overseas Registration Exam (ORE) is not fit for purpose. Demand among qualified international dentists to complete the ORE far outweighs the current number of available examination places. Given the UK’s growing dentist workforce shortage, urgent action is needed.

Here are 10 changes the GDC can make to improve the ORE immediately

1. Increase the number of places on the ORE Part 1

While the GDC has increased the number of places on Part 1 of the ORE, further increases can be introduced without significant additional costs, allowing more candidates to fill places on the Part 2 exam when further capacity is available following the procurement exercise to find a new ORE provider.

2. Deliver Part 1 online or in British Council offices overseas

Secure online examination rooms should be created to allow candidates to take the exam remotely. Alternatively, British Council offices overseas should be used as examination centres, as already happens for the Performance and Linguistic Assessment Board, the equivalent exam used for General Medical Council registration.

3. Increase the frequency of examinations

Currently, Part 1 of the exam takes place twice a year – in April and August – and Part 2 takes place four times a year. By scheduling both exams more frequently, with the same number of places each time, the GDC can reduce the backlog of applicants whilst running the procurement process to add additional providers to the list of those who can administer the exam. As the GDC subsidises the cost of each exam (~£400 per examination), minimal funding from the Department of Health could secure significant increases in examination places now.

4. Set a minimum of 2,400 Part 1 and 2,000 Part 2 places each year

From 9 March 2023, new rules were put be in place to allow the GDC to increase the fees for the ORE. By committing now to the number of examination places that will be made available, the GDC can help candidates to prepare accordingly. The ADG believes the minimum necessary spaces are 2,400 each year for Part 1 and 2,000 each year for Part 2, thereby allowing for a small failure rate for Part 1. This would allow 1,000 new dentists to be able to deliver NHS dentistry within 12 months.

5. Reduce the processing time for new applicants to take the ORE

Candidates are routinely waiting in excess of eight months for the GDC to process their application for permission to sit the exam – before they have started trying to secure a place in the exam. The GDC must act to stop the current trend of increased processing times for new applicants, which has risen 59% over the last two years.

6. Improve accessibility

Exam slots should be opened a minimum of six months before the exam date – rather than the current period of four-to-six weeks – to give candidates sufficient time to book and prepare for the exam, and
organise their flights and visas. The GDC’s website must also be improved so it can accommodate the high levels of traffic it experiences when the exam dates are released.

7. Prioritise candidates who will work in the NHS and who will most likely pass the examination

GDC should consider prioritising access to the exam to dentists who already have a job offer in a UK dental practice to deliver NHS care. Also, the GDC should consider prioritising applicants who can demonstrate that they have undertaken an approved preparatory course and are therefore more likely to be able to pass the exam. This will minimise the number of people who fail the course and ensure that candidates understand the requirements of the exam to prepare properly,

8. Review the pass rate and standardise ORE marking

A formal review should be conducted to understand why the pass rate for the Part 2 exam is so low – ranging from between 40% to 50% – including why some examiners have considerably lower pass rates. Attention should also be paid to whether the structure of the exam should be changed to allow any of the four sections of the ORE Part 2 to be passed independently.

9. Ensure procurement process is as ambitious as possible

The GDC should set a minimum number of examinations each year as part of the procurement exercise, with preferred providers being incentivised to provide additional capacity. The GDC should seek to award the contract to multiple providers, ensuring the greatest capacity and avoiding the risk of one provider collapsing or failing to deliver results. The contract should be awarded for a minimum of three years to allow the providers to invest in increasing provision and phantom head capacity.

10. Bring forward planned reforms to recognise overseas diplomas

The Section 60 Order allows the GDC to begin approving overseas diplomas as equivalent to the standards examined by the ORE, yet it does not expect to begin this process for another two years. By bringing forward these reforms, the GDC could allow several dental schools – including the 14 which, prior to 2001, were already permitted to offer this qualification – to begin offering diplomas this year, taking significant pressure off the ORE as the only means of having their qualifications recognised.


About the ADG
The Association of Dental Groups (ADG) is the trade association for large dental providers in the UK. Our members include 25 of the largest groups of dental practices in the country, representing approximately 10,000 clinicians delivering NHS and private dentistry to more than 10 million patients every year.
The ADG works for its members to improve the conditions for by investing in their patients and their people. We seek to improve quality and access to dentistry for patients by influencing the standards and shaping policy impacting Dental Groups. Our aim is to facilitate the provision of patient centred, high quality and consistent dental care by improving Dental Groups’ working environment.