NDECC Clinical Skills Component 2026 – Complete CSC Procedure Guide

1. What Is the Clinical Skills Component? – Purpose and Structure

The Clinical Skills Component is the practical, hands-on portion of the National Dental Examination of Clinical Competence. It is designed to assess whether you can perform common dental procedures to the clinical standards expected of a dentist entering practice in Canada.

The CSC is administered at the NDECC Test Centre in Ottawa, Ontario – a purpose-built facility that includes a simulation clinic with fully equipped dental operatories and manikins. Unlike the AFK or ACJ, which are computer-based multiple-choice exams, the CSC requires you to physically perform dental procedures on typodont teeth.

The CSC is the final gate before the NDEB Certificate. Its low pass rate – 38.33% in 2025 – reflects the high standard of clinical competence required. The NDEB has confirmed through a formal consultation and review process that the passing standard is the absolute minimum required of a dentist entering practice in Canada.

2. The Seven Clinical Requirements – What You Must Perform

The CSC requires you to complete seven clinical requirements in an eight-hour period. The specific list of requirements is published in the NDECC Protocol, effective September 30, 2024.

Complete CSC Procedure List:

The NDECC includes one amalgam restoration (Class II) and two composite restorations (Class II and Class IV), reflecting the shift in Canadian dental practice where composite use now exceeds amalgam. However, amalgam remains in the blueprint because all accredited Canadian dental programmes continue to teach its use, and it remains clinically indicated for certain patient populations.

The Provisional Restoration requirement is performed on the crown preparation prepared by the examinee, mirroring real-world clinical workflow.

3. Time Allocation – Eight Hours Is More Than Enough

One of the most common concerns among CSC candidates is whether eight hours is sufficient to complete all seven procedures. The NDEB conducted a formal review of this question following the first series of NDECC results.

During the development of the NDECC, the NDEB consulted with four different groups of experts regarding the time required to complete the clinical skills requirements. These groups recommended that four to five hours would be adequate for well-prepared candidates to complete the seven clinical skills requirements. The decision was made to allot eight hours for the Clinical Skills component – double the amount of time recommended by the experts consulted.

Over the past years, the NDEB has received feedback from candidates indicating that they had sufficient time to complete the clinical skills requirements. The NDEB concluded that the eight-hour allotment is appropriate as it allows for more than sufficient time for a well-prepared candidate to complete the examination.

What this means for you:

Do not rush.
You have more time than you think.
Use the extra time to double-check margins, contours, and occlusal contacts.
If you are finishing procedures significantly faster than the suggested times, you are likely rushing and may be making errors.

4. Grading Criteria – How You Are Assessed

The NDECC Protocol publishes the grading criteria for each clinical requirement. The NDEB has confirmed that the passing standard is accurate and in accordance with accepted psychometric processes.

To receive a passing grade on a requirement, you do not have to produce an ideal result. You must demonstrate minimal competence with no major errors.

What “minimal competence with no major errors” means in practice:

Class II amalgam restoration: The restoration must have adequate proximal contour, a properly condensed marginal ridge, and no open margins. The amalgam must be properly condensed with no voids.

Class II composite restoration: The sectional matrix must be properly placed. The bonding protocol must be followed correctly. The restoration must have an adequate proximal contact and proper occlusal anatomy.

Class IV composite restoration: The shade must match adjacent teeth. The incisal edge contour must be correct. The surface must be properly finished and polished.

Crown preparation: The axial reduction must be adequate (typically 1.5–2.0 mm for all-ceramic crowns). The margin must be smooth and continuous. The taper must be appropriate.

Provisional restoration: The provisional crown must have a good marginal seal, proper contour, and adequate occlusal fit.

The passing standard for the Clinical Skills component is the absolute minimum required of a dentist entering practice in Canada. It was also determined that a dentist entering practice should be able to perform the seven basic clinical procedures at a minimally competent level on the same day.

5. 2025 Pass Rate Data – What the Numbers Tell You

The NDEB publishes annual results for all Equivalency Process examinations. The 2025 data for the Clinical Skills Component is sobering.

Key insights from the 2025 data:

The CSC is the lowest-passing exam in the Equivalency Process.
The ACJ pass rate was 62.44%, the AFK was 52.29%, and the Situational Judgement Component was 57.46%.
Repeat test takers perform slightly worse than first-time takers.
Over half of CSC candidates (897 of 1,667) are repeat test takers.

The NDEB‘s consultation and review process confirmed that the passing standard is accurate and that the low pass rate reflects the actual standard required for entry into Canadian dental practice, not a flaw in the examination.

6. Common Failure Points – What Typically Goes Wrong

Understanding why candidates fail the CSC is essential to structuring an effective preparation strategy.

The most common reason for CSC failure is under-reduction on crown preparations. Many internationally trained dentists were taught conservative preparation techniques that do not meet the Canadian standard. The NDECC requires specific axial reduction measurements – typically 1.5–2.0 mm for all-ceramic crowns. If your preparation is under-reduced, you will fail regardless of other qualities.

7. The Debate Over Amalgam – Why It Is Still Tested

Candidates taking the NDECC have questioned the relevance of the Class II Amalgam Restoration requirement and raised concerns about the materials provided to complete the amalgam restoration.

The NDEB responded through its consultation and review process. The inclusion of amalgam restorations in the Clinical Skills component was reaffirmed for several reasons:

All accredited Canadian dental programmes continue to teach the use of amalgam.
Amalgam remains the first choice for certain patient populations, including high-caries-risk patients and situations where moisture control is challenging.
Removing amalgam from the exam would create a gap between the licensing examination and the curriculum taught in Canadian dental schools.

The NDEB has confirmed that the Class II amalgam restoration requirement will remain in the CSC blueprint. Candidates should prepare for this procedure as thoroughly as any other.

8. CSC Preparation Strategy – How to Pass on Your First Attempt

The low first-time pass rate (40.65%) indicates that many candidates are under-prepared for the CSC. Here is a proven preparation strategy.

Step 1 – Read the NDECC Protocol (Week 1)

Download the NDECC Protocol effective September 30, 2024 from the NDEB exam resources page. Read the grading criteria for every clinical requirement. Understand what “minimal competence” looks like for each procedure.

Step 2 – Practise each procedure individually (Weeks 2–8)

Practise each of the seven clinical requirements repeatedly on typodont teeth. Use the same typodont teeth and handpieces (Kavo) used at the NDECC Test Centre. Focus on the most common failure points: crown preparation reduction, proximal contacts, and marginal adaptation.

Step 3 – Get objective feedback

Work with an NDECC preparation course instructor who can evaluate your typodont work against NDEB standards. Join a study group with other candidates who have passed the CSC. If possible, have a Canadian-trained dentist or recent NDECC passer evaluate your preparations.

Step 4 – Complete mock exams under timed conditions (Weeks 9–12)

Before your CSC attempt, complete a full eight-hour mock exam on typodont teeth. Use the same time allocations as the real exam. Have an instructor or experienced peer grade your work using the NDECC Protocol criteria.

Step 5 – Register strategically

Do not register for the CSC until you are consistently passing mock exams. However, do not wait too long – your five-year clock is running. Monitor the NDECC calendar for upcoming sessions and register at your tier-appropriate time.

9. What the NDEB Provides – Instruments, Materials, and Supplies

The NDECC Test Centre is a fully equipped facility. You do not need to bring your own instruments, handpieces, burs, or materials. The NDEB provides everything required for the Clinical Skills Component.

The NDECC Practical Guide contains detailed information about the facilities, instruments and materials provided. Download it from the exam resources page before your exam.

10. CSC vs SJC – Understanding the Two Components

The NDECC has two components: the Clinical Skills Component (this article) and the Situational Judgement Component. They are fundamentally different in format and grading.

Most candidates take both components during the same visit to Ottawa to minimise travel costs. However, you can take them separately if needed.

Related NDECC articles

References

• National Dental Examining Board of Canada | 2025 NDECC pass rates: Clinical Skills 38.33% (1,667 candidates, 40.65% first-time, 36.34% repeat); ACJ 62.44%; AFK 52.29%; SJC 57.46%
• National Dental Examining Board of Canada | Eight-hour CSC time allocation (expert recommendation 4–5 hours, NDEB doubled to 8); passing standard “minimal competence with no major errors”; amalgam relevance reaffirmed; if any requirement fails must retake entire CSC
• National Dental Examining Board of Canada | CSC blueprint: one amalgam restoration (Class II), two composite restorations (Class II and Class IV), crown preparation, provisional restoration performed on the crown preparation
• National Dental Examining Board of Canada | NDECC format, Protocol effective September 30, 2024, Practical Guide, withdrawal fee 50%, five-year rule
• PrepDoctors | Seven clinical requirements over two days (CSC day one, SJC day two)