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The Overseas Registration Exam (ORE) content and format of the ORE

The Overseas Registration Exam (ORE) is designed to test the knowledge, skills andprofessionalism relating to the practise of dentistry expected of graduate dentists on firstregistration with the General ental !ouncil (G!)" This means that #$ graduates andoverseas dentists are expected to have the same %asic level of knowledge and skills"

&ou are not expected to %e familiar with the 'ational ealth ervice (') or *ritish

culture other than in the way it might affect how you treat patients" &ou should %e familiarwith how people in the #$ might %ehave + you should not make assumptions a%out apatient %ased on their gender or ethnic origin, for example"

t is advisa%le to familiarise yourself with the G! guidance to registrants as you will %eexpected to conduct yourself in line with the advice they give"

-ain guidance .tandards for dental professionals/

upplementary guidance .0rinciples of consent/

0rinciples of confidentiality/0rinciples of dental team working/0rinciples of raising concerns/ and0rinciples of complaints handling"

The following pages descri%e1

The level of knowledge and skillsre2uired of a successful ORE candidate/

ORE 0art 3 format(including sample 2uestions) and content

ORE 0art 4 format and content

ORE %lueprint

http://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Standards+for+dental+professionals.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Patient+consent.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Patient+confidentiality.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Principles+of+dental+team+working.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Principles+of+raising+concerns.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Principles+of+complaints+handling.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Principles+of+complaints+handling.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Standards+for+dental+professionals.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Patient+consent.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Patient+confidentiality.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Principles+of+dental+team+working.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Principles+of+raising+concerns.htmhttp://www.gdc-uk.org/News+publications+and+events/Publications/Guidance+documents/Principles+of+complaints+handling.htm

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Knowledge and Skills

The overseas dentist should %e a%le to demonstrate that his or her clinical skills andknowledge are at the level re2uired for success in a final examination of a #$*5*!h programme"

&ou are expected to a%le to show competence, knowledge and familiarity in differentaspects of dentistry as outlined in The First Five Years A Framework forUndergraduate Dental Education (General Dental Council re!rinted "anuar# $%%&'

As stated in paragraph of TFFY! candidates sho"ld#

$e competent at# you should have a sound theoretical knowledge andunderstanding of the su%6ect together with an ade2uate clinical experience to %ea%le to resolve clinical pro%lems encountered, independently, or without assistance

%ave knowledge of# you should have a sound theoretical knowledge of thesu%6ect, %ut need have only a limited clinical5practical experience

$e familiar with# you should have a %asic understanding of the su%6ect, %ut neednot have direct clinical experience or %e expected to carry out proceduresindependently"

7 successful ORE candidate will1

$&O'E&A* S&E+ES A+ ORA* $&O*O,-

have knowledge of anatomy, physiology and %iochemistry relevant to dentistry/ have knowledge and understanding of %iomedical sciences and of oral physiology

and craniofacial, oral and dental anatomy in the management of their patients/

$E%A.&O/RA* S&E+ES

%e competent at communication with patients, other mem%ers of the dentalteam and other health professionals/

%e familiar with the social and psychological issues relevant to the care of patients/

%/'A+ &SEASE

have knowledge of the scientific principles of sterilisation, disinfection andantisepsis/

have knowledge of the pharmacological properties of those drugs used in generalpractice including their unwanted effects/

%e familiar with the pathological features and dental relevance of commondisorders of the ma6or organ systems/

%e familiar with the role of therapeutics in the management of patients re2uiringdental treatment/

%e familiar with the general aspects of medicine and surgery/ %e familiar with the main medical disorders that may impinge on dental treatment/ %e familiar with the work of healthcare workers/

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%e familiar with the place of dentistry in the provision of healthcare/'E&A* E'ER,E+&ES

%e competent at carrying out resuscitation techni2ues and immediate managementof cardiac arrest, anaphylactic reaction, upper respiratory o%struction, collapse,vasovagal attack, haemorrhage, inhalation or ingestion of foreign %odies, anddia%etic coma/

have knowledge of diagnosing medical emergencies and delivering suita%leemergency drugs using, where appropriate, intravenous techni2ues/

*A0! ET%&S A+ 1RO2ESS&O+A*&S'

%e competent at maintaining full, accurate clinical records/ have knowledge of responsi%ilities of consent, duty of care and confidentiality/ have knowledge of patients8 rights/ have knowledge of the regulatory functions of the General ental !ouncil/ %e familiar with the legal and ethical o%ligations of registered dental practitioners/ %e familiar with the o%ligation to practise in the %est interest of the patient at all

times/ %e familiar with the need for lifelong learning and professional development/

%EA*T% &+2OR'AT&S

%e competent at using information technology/ %e familiar with the law as it applies to records/

&+TRO/T&O+ TO *&+&A* E+T&STR-

%e competent at o%taining a detailed history of the patient8s dental state/ %e competent at o%taining a relevant medical history/ %e competent at using la%oratory and imaging facilities appropriately and

efficiently/ %e competent at clinical examination and treatment planning/ %e competent at arranging appropriate referrals/ %e competent at maintaining an aseptic techni2ue throughout surgical procedures/ %e competent at o%taining informed consent/ have knowledge of managing patients from different social and ethnic

%ackgrounds/ have knowledge of dental pro%lems that may manifest themselves in older patients

and of the principles involved in the management of such pro%lems/ have knowledge of working as part of the dental team/ %e familiar with the complex interactions %etween oral health, nutrition, general

health, drugs and diseases that can have an impact on dental care and disease/

RESTORAT&.E E+T&STR-

%e competent at diagnosing and planning preventive, non.operative care for theindividual patient who presents with dental caries, periodontal diseases and toothwear/

%e competent at completing a periodontal examination and charting, diagnosis andtreatment plan/

%e competent at supragingival and su%gingival scaling and root de%ridement,

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using %oth powered and manual instrumentation, and in stain removal andprophylaxis/

%e competent at knowing when and how to prescri%e appropriate anti.micro%ialtherapy in the management of pla2ue.related diseases/

%e competent at completing a range of procedures in restorative dentistry including

amalgam and tooth.coloured restorations, endodontic treatments of single. andmulti.rooted teeth, anterior and posterior crowns, post crowns, simple %ridges, andpartial and complete dentures/

%e competent at deciding whether severely %roken down teeth are restora%le/ %e competent at designing effective indirect restorations and complete and partial

dentures/ have knowledge of when periodontal surgery might %e advised/ have knowledge of how missing teeth should %e replaced, choosing %etween the alternatives of no replacements, %ridges, dentures or implants/ have knowledge of the design and la%oratory procedures used in the production of

crowns, %ridges, partial and complete dentures and %e a%le to make appropriatechair.side ad6ustment to these restorations/

%e familiar with the diagnosis and management of temporomandi%ular 6ointdisorders/

%e familiar with dental implants as an option in replacing missing teeth/

E+TA* $&O'ATER&A*S S&E+E

have knowledge of the science that underpins the use of dental %iomaterials/ have knowledge of the limitations of dental materials/ %e familiar with those aspects of %iomaterial safety that relate to dentistry/

1AE&ATR& E+T&STR-

%e competent at diagnosing active caries and planning appropriate nonoperative

care/ %e competent at fissure sealing, preventive resin restorations, and pit and fissure

restorations/ %e competent in undertaking approximal and incisal tip restorations/ have knowledge of preformed stainless steel crown and pulp therapy in primary

molar teeth/ have knowledge of the role of sedation in the management of young patients/ have knowledge of the management of trauma in %oth dentitions/

ORT%OO+T&S

%e competent at carrying out an orthodontic assessment including an indication of

treatment need/ %e competent at managing appropriately all forms of orthodontic emergency

including referral when necessary/ %e competent at making appropriate referrals %ased on assessment/ have the knowledge to %e a%le to explain and discuss treatments with patients and

their parents/ have the knowledge to %e a%le to design, insert and ad6ust space maintainers/

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have the knowledge to design, insert and ad6ust active remova%le appliances tomove a single tooth or correct a cross%ite/

%e familiar with contemporary treatment techni2ues/ %e familiar with the limitations of orthodontic treatment/

1RE.E+T&.E E+T&STR- %e competent at oral hygiene instruction, dietary analysis, topical fluoride therapy

and fissure sealing/ %e familiar with an evidence.%ased approach to treatment/

E+TA* 1/$*& %EA*T%

%e familiar with the prevalence of certain dental conditions in the #$/ %e familiar with the importance of community.%ased preventive measures/ %e familiar with the social, cultural and environmental factors which contri%ute to

health or illness/ %e familiar with the principles of recording oral conditions and evaluating data/

O'1RE%E+S&.E ORA* ARE %e competent at working with other mem%ers of the dental team/ have knowledge of providing a comprehensive approach to oral care/

ORA* S/R,ER-

%e competent at undertaking the extraction of teeth and the removal of roots wherenecessary/

%e competent at undertaking minor soft tissue surgery/ have knowledge of the management of acute infection/ %e familiar with the principles of assessment and management of maxillofacial

trauma/ %e familiar with the diagnosis of oral cancer and the principles of tumour

management/ %e familiar with the principles of treatment of dento.facial anomalies including the

common orthodontic5maxillofacial procedures involved/ %e familiar with the %asic principles of oral surgery practice/

ORA* 'E&&+E

have knowledge of the drugs commonly used in oral medicine and of their sideeffects and drug interactions/

have knowledge of appropriate special investigations and the interpretation of theirresults/

%e familiar with the pathogenesis of common oral medical disorders and theirtreatment/

ORA* 1AT%O*O,- A+ ORA* '&RO$&O*O,-

have knowledge of the role of la%oratory investigations in diagnosis/ have knowledge of the pathogenesis and classification of oral diseases/ have knowledge of the aetiology and processes of oral diseases/ have knowledge of matters relating to infection control/

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have knowledge of the causes and effects of oral diseases needed for theirprevention, diagnosis and management/

E+TA* RA&O*O,- A+ &'A,&+,

%e competent at taking and processing the various film views used in generaldental practice/

%e competent at radiographic interpretation and %e a%le to write an accurateradiographic report/

have knowledge of the ha9ards of ionising radiation and regulations relating tothem, including radiation protection and dose reduction/

%e familiar with the principles which underlie dental radiographic techni2ues/

1A&+ A+ A+3&ET- O+TRO*

%e competent at infiltration and regional %lock analgesia in the oral cavity/ %e competent at when, how and where to refer a patient for general anaesthesia/ %e competent at managing fear and anxiety with %ehavioural techni2ues and

empathise with patients in stressful situations/ have knowledge of inhalational and intravenous conscious sedation techni2ues/ have knowledge of conscious sedation techni2ues in clinical practice"

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ORE 1art 2ormat

0art 3 of the test comprises two, three.hour written papers, undertaken on a computerand is made up of Extended -atching :uestions (E-:s) and -ultiple !hoice :uestions(-!:s) in the form of ingle *est 7nswer 2uestions (*7s)"

Extended matching 4"estions (E'5s)Extended matching 2uestions are grouped into themes" Each theme has a heading thattells you what the 2uestions are a%out"

;ithin each theme there are several num%ered items" These are the 2uestions and the

pro%lems you have to solve" There are examples in the next section"

;e recommend that you %egin %y reading carefully the instruction that precedes thenum%ered items"

;e recommend that you consider each of the num%ered items and decide what youthink the answer is" &ou should then look for that answer in the list of options a%ove theitems (each of which is identified %y a letter of the alpha%et)" f you cannot find theanswer you have thought of, you should look for the option which, in your opinion, is the%est answer to the pro%lem posed"

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Example E'5s

Example 3 + a!!earances of oral tissueThe options provided %elow are diagnoses for conditions with characteristicappearances that may %e recognised when examining patients= mouths" ingual tonsilsG" -andi%ular tori" 0alatal tori

!linical scenarios

3" e%aceous glands visi%le as white or cream coloured spopts up to ?"@mm

diameter usually present in the la%ial and %uccal mucosa"

4" *ilateral raised red lumps, which enlarge during viral infections, at the lateral%orders of the %ase of the tongue" 2

A" 7 row of B.34 pink5red lumps on the dorsum of the tongue at the 6unction of theanterior two thirds and posterior third of the tongue" A

C" 7 milky white translucent whitening of the oral mucosa, commoner in %lackraces which disappears on stretching the mucosa"

@" *ilateral %ony hard swellings on the lingual aspect of the mandi%le in the

premolar regions6 ,

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Example 4 + Theme1 use of anti)iotics

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Single $est Answer 4"estions (S$As)ingle *est 7nswer 2uestions are characterised %y a 2uestion, which may %e %ased ona clinical scenario, followed %y a set of usually five possi%le answers" &ou are asked tochoose what you think is the most accurate answer"

Example S$AsExample 3 . ;hilst undertaking root canal preparation of a lower molar toothanaesthetised with interior alveolar nerve %lock, the patient experiences pain"

;hich root canal is most likely to contain sensitive tissue1

isto%uccal root canal istolingual root canal -esio%uccal root canal 'esioling"al root canal

istal root canal

Example 4 . &ou are considering your choice of local analgesia for a surgical procedurewhich you anticipate will %e difficult="

;hich one of the following agents provides the most prolonged analgesiaH

7rticaine $"pivicaine

>idocaine (lignocaine) -epivicaine 0rilocaine

Example A . 7 @3 year old man with chronic periodontal disease complains of polyuria,thirst and lethargy at his treatment review";hich of the following medical conditions is most likely to %e associated with hispresenting conditionH

7ngina !ushing=s syndrome ia8etes mellit"s >ymphoma Tu%erculosis

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Example C . 7 two year old experienced trauma to her upper deciduous incisors" ;hat isthe most likely permanent conse2uence for the developing incisorsH

ilacerated tooth

Enamel hypoplasia Geminated tooth utchinson=s incisor Turner=s tooth

ORE 1art ontent

The purpose of 0art 3 is to test the candidates= application of knowledge to clinicalpractice"

The ORE 0art 3 consists two papers testing candidates= knowledge of1

0aper 3linicall9 applied dental science/

!lick here for examples of the topics that may %e covered

linicall9 applied h"man disease/!lick here for examples of the topics that may %e covered

0aper 4All aspects of clinical dentistr9! incl"ding law and ethics and health and safet9"!lick here for examples of the topics that may %e covered

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Examples of knowledge areas tested in ORE 1art papers and :6 1lease note that this list is not exha"stive and provides 9o"with areas that MAY be tested. You may also be tested on areas that are not covered below.

Biomedical Sciences and Oral Biology 0aper 0aper 4$nowledge of anatomy, physiology and %iochemistry relevant to dentistry I$nowledge and understanding of %iomedical sciences and of oral physiology and craniofacial, oral and dentalanatomy in the management of patients

I I

Human Disease$nowledge of the scientific principles of sterilisation, disinfection and antisepsis I I$nowledge of the pharmacological properties of drugs used in general dental practice and their unwanted effects I I$nowledge of disease processes such as infection, inflammation, disorders of the immune system, degeneration,neoplasia, meta%olic distur%ances and genetic disorders

I

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%ntroduction to &linical Dentistry

!ompetence in o%taining a detailed history of a patient=s dental state + pain history, pain scenarios I!ompetence in o%taining a relevant medical history I!ompetence in using la%oratory and imaging facilities appropriately and efficiently I!ompetence in clinical examination and treatment planning I!ompetence in arranging appropriate referrals I!ompetence in maintaining an aseptic techni2ue during surgical procedures I!ompetence in o%taining informed consent + competence, when written consent re2uired I$nowledge in managing patients from different social and ethnic %ackgrounds I$nowledge of dental pro%lems that may manifest themselves in older patients and of the principles involved in themanagement of such pro%lems

I

$nowledge of working as part of a dental team I

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Dental Biomaterials Science

$nowledge of the science that underpins the use of dental %iomaterials I I$nowledge of the (strengths and) limitations of dental materials I I

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ORE 1art : 2ormat and ontent

The ORE part 4 consists of four practical assessments"

3" 7n operative test on a dental manikin" &ou will %e re2uired to perform threeprocedures over a period of three hours" These procedures will primarily involve

the preparation and restoration of teeth, %ut may also include other procedureswhere appropriate simulation can allow assessment of operative skills

!ommonly used instruments and materials will %e made availa%le to candidates"

4" 7n O%served tructured !linical Examination (O!E) will test candidates= clinicalskills and may include history and assessment, communication skills (such asexplanation of pro%lems and treatment plans) 6udgement and decision making,ethics and attitudes of candidates, clinical examination"

The series of stations may cover aspects of the following/ %ehavioural sciences,human disease, law, ethics and professionalism, clinical dentistry, restorative

dentistry, orthodontics, preventative dentistry, dental pu%lic health,comprehensive oral care, oral surgery, oral medicine, oral pathology and oralmicro%iology, dental radiology and imaging"

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0hat an OSE involves

The term O!E is short for O%6ective tructured !linical Examination, which consists ofa series of up to 4? stations designed to test a range of clinical skills"ifferent stations present clinical scenarios and tasks designed to test different skills orcom%inations of skills such as history taking and assessment of a patient, simplepractical procedures, communication and patient education, clinical 6udgement anddecision making, and ethics and professional attitude"

Examples of tasks set may include taking a history from an actor patient who has %een%riefed on the symptoms of a particular condition, discussing treatment options ando%taining informed consent, giving oral health education advice, demonstrating on amanikin how you would take an intra.oral radiograph, or interpreting radiographicevidence and prioritising treatment" 7ll the JpatientsK you meet will %e actors who have%een %riefed with the relevant information necessary for you to complete the set task"

Each candidate starts at a different station and moves on to the next station in the circuitevery six minutes, so that after 4 hours every candidate has visited each station"On arrival at each station you will have 3 minute to read instructions for the task you areasked to complete at that station" &ou then have @ minutes to complete that task" &oucannot leave the station if you complete the task in less than @ minutes and there is noextension of time if you have not completed what you have %een asked to do" &ou mustmove immediately to the next station at the end of the @ minutes"There will %e a small num%er of rest stations within the se2uence"

7 different examiner will o%serve you at each station" The examiner will assess yourperformance against a checklist of all the steps that are necessary to complete the taskcompetently" n essence the examiners have, in advance of the examination, consideredthe components of each task that must %e covered in order to demonstrate clinicalcompetence" uring the examination they o%serve how well you cover these" n order to

o%tain the maximum marks at any station you must demonstrate that you haveundertaken the task in a logical step.%y.step process as would %e the case clinically,covering all relevant aspects and reaching a conclusion within the time allowed"