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Canada · Licensing exam

NDEB ACJ: the Assessment of Clinical Judgement

The Assessment of Clinical Judgement (ACJ) is the second exam in the Equivalency Process of the National Dental Examining Board of Canada (NDEB), taken after the Assessment of Fundamental Knowledge (AFK). The NDEB ACJ tests whether you can reach a diagnosis, plan treatment, make clinical decisions and interpret radiographs. Questions can come with patient case histories, dental charts, photographs and radiographic images.

  • About 150Single and multi-answer questions
  • Five hoursExam time, with one scheduled break
  • A pass on the AFKWhat you need before you register
Read the 2026 ACJ Protocol

Updated October 2026 · Written from official sources, listed at the bottom of this page

How does the NDEB ACJ work?

The ACJ is on computer, at Prometric test centres and sometimes at sites NDEB runs itself. Every section mixes two kinds of question: case-based diagnosis, treatment planning and clinical decision-making questions, and radiographic interpretation questions.

The 2026 ACJ Protocol, effective January 19, 2026, says about 150 questions in five hours. NDEB’s ACJ web page gives 120 to 150 questions in 5.5 hours, but it also points you to the protocol for the format and scheduling details, so go by the protocol.

As with the AFK, NDEB says to watch its electronic exam orientation before you take the ACJ.

NDEB: Assessment of Clinical Judgement ↗

How ACJ multi-answer questions are scored

Some questions say “Select ONE correct answer.” Others say “Select ONE OR MORE correct answers,” and those can have one right answer or several.

Every question is worth between 0 and 1. On a multi-answer question you get the full mark only by picking every correct answer. Pick some of them and nothing wrong, and you get part of the mark. Pick any incorrect answer and the question scores 0, however many right answers you also chose.

Rarely, an option is neither clearly right nor wrong and is worth 0. Choosing it doesn’t change your score.

NDEB: Multi-Answer Multiple Choice Questions Example (PDF) ↗

ACJ blueprint

AreaQuestions
Oral medicine, pathology, oral surgery25 ± 5%
Pharmacotherapeutics, complex patients22 ± 5%
Cariology and restorative dentistry18 ± 5%
Periodontics15 ± 5%
Endodontics10 ± 5%
Orthodontics and pediatric dentistry10 ± 5%

The second row also covers medical emergencies, geriatrics and local anesthesia. Periodontal charts in the cases list probing depths and recession in millimetres, bleeding on probing, furcation class and Miller mobility.

Registering for the ACJ

  1. Pass the AFK.
  2. Log in to NDEBConnect while registration is open, register and pay.
  3. After the registration deadline, NDEB emails you instructions for booking your seat with Prometric.
  4. Book on Prometric’s NDEB page with “find my exam”. If you registered for a site NDEB hosts, you skip this step.

You can take the ACJ three times, and you need a test equated, rescaled score of 75 to pass. NDEB’s sample questions and answers for the ACJ are listed with the other official material under study options.

ACJ dates →NDECC →ACJ sample questions →
Sources: NDEB and 3 more. Checked October 2026.

Rules and fees can change, so check the official site before your test.

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