Mohammed Ghafoor explains why the overseas registration exam (ORE) currently tests luck, not competence – and why this needs to change.
For overseas-qualified dentists, the ORE is not just another professional test. It is the gateway to practising dentistry in the United Kingdom, the decisive moment that determines whether years of training and investment can be translated into a career serving patients in the UK.
The ORE was introduced with a clear and necessary purpose: to ensure that dentists who qualified outside of the UK demonstrate the same knowledge, clinical ability, and professional conduct as their UK-trained counterparts. This is an important safeguard for patient safety and for maintaining the reputation of UK dentistry as a global standard-bearer.
But while no one disputes the need for robust assessment, the way this examination is organised and booked has descended into chaos. What was designed to be a fair test of competence has been reduced to a cruel lottery – a broken system that puts careers on hold, drains finances, and places unbearable strain on candidates and their families.
Understanding the ORE: two parts, high stakes
The ORE consists of two parts, each vital to proving a dentist’s ability to practise safely in the UK:
- Part 1: A computer-based written examination assessing applied dental sciences, clinical knowledge, and professional conduct
- Part 2: A hands-on practical exam testing clinical skills, patient management, treatment planning, and operative dentistry across multiple stations.
Passing Part 1 allows candidates to progress, but without passing Part 2 they cannot register with the General Dental Council (GDC) and cannot work as dentists in the UK.
The process is costly, time-consuming, and nerve-wracking. But the true problem lies not in the rigour of the exam, but in the flawed, almost arbitrary system for booking it.
A lottery, not a system
Booking an ORE exam slot has become an ordeal in itself. When places are released, candidates flock to the booking website in a desperate scramble. Hundreds of hopeful dentists sit at their computers, refreshing the page, waiting for the booking window to open. Then, with a single click, their fate is sealed.
For many, that one-second difference between pressing the button before or after someone else decides the course of their entire professional life. Those with faster internet connections, quicker reflexes, or sheer good fortune secure a slot. Others, equally deserving and equally prepared, are locked out yet again.
This is not meritocracy. This is not fairness. This is chance masquerading as order. The ORE booking process has become a lottery.
Eye-watering costs
The ORE is already financially punishing. Part 1 costs hundreds of pounds; Part 2 can run into several thousands. On top of that, candidates face additional expenses for revision courses, travel, accommodation, and visa renewals. Many are living in the UK unable to practise as dentists, forced into temporary work or living off savings while waiting for an exam place that may or may not come.
For those overseas, the cost multiplies. International flights, accommodation in the UK, and time off work in their home countries add another layer of financial pressure. It is no exaggeration to say that some candidates invest tens of thousands of pounds before even knowing if they will ever secure a booking.
But the heaviest cost is not financial. It is human.
Lives on hold
The current booking system freezes lives. Dentists who trained for years, who dedicated themselves to learning their craft, are left in limbo. They cannot plan their careers, support their families properly, or contribute their skills to the NHS or private sector.
For some, years have slipped away while waiting for the opportunity to progress. Couples delay starting families, professionals take on menial jobs to survive, and others simply lose hope. The stress, anxiety, and sense of wasted potential is immense.
This is not just about inconvenience – it is about wasted talent at a time when the UK is facing a well-documented shortage of dental professionals.
The cruel paradox of Part 2
Perhaps the starkest evidence of how broken the system has become is visible in the booking process for Part 2. Dentists who passed Part 1 only weeks ago are able to secure a Part 2 place, while others who cleared Part 1 two or more years ago are still waiting.
This inversion of fairness punishes patience and rewards luck. It undermines the very credibility of the system. How can it be right that someone who has been waiting years is overtaken in the queue by someone newly qualified for Part 2? Such illogical organisation leaves candidates bewildered, angry, and disillusioned. It is indefensible.
A systemic failure
The General Dental Council (GDC), which oversees the ORE, has a responsibility not only to uphold standards but also to administer examinations in a manner that is transparent, equitable, and efficient. Right now, that responsibility is not being met.
What exists instead is a bottleneck, a backlog, and a booking system that has become infamous for its unpredictability and unfairness. Candidates who should be preparing for a professional exam spend more time strategising about how to outclick the system than revising their clinical knowledge.
This is not a minor administrative issue. It is a systemic failure that affects lives, careers, and patient care.
The wider impact: patients and the profession
The irony is that this failure affects not just overseas dentists, but also patients in the UK. At a time when NHS dentistry is under severe pressure and access is increasingly difficult for patients, thousands of trained dentists are being prevented from joining the workforce.
Every blocked booking, every year of waiting, represents lost skills, lost capacity, and lost opportunities to provide care. The system is hurting not just dentists, but the very public it is supposed to protect.
A call for urgent reform
The ORE must remain rigorous. Patient safety must always come first. But fairness and transparency are not optional extras. They are essential to the integrity of the process. The GDC must urgently overhaul the booking system.
A fair queueing mechanism, prioritisation based on waiting time, or even a ballot system with clear rules would be better than the current chaos. Above all, communication must improve. Candidates deserve clarity, not uncertainty.
The ORE should test competence, not luck.
