‘Deeply unjust’: the impact of the overseas registration exam backlog

‘It’s deeply frustrating to feel capable and prepared yet powerless’: for one dentist, the overseas registration exam (ORE) booking system has taken a heavy toll. We hear why change could help thousands of fully-trained dentists enter the UK dental workforce.

Since qualifying in 2016, I have worked across both public health and private clinical settings for more than nine years, delivering comprehensive dental care to a wide range of patients.

My clinical focus has been on restorative dentistry, and I have completed more than one thousand full smile transformations. I was also active in patient education and public health, having led dental hygiene programs in underserved areas early in my career.

Alongside my clinical work, I’ve built a professional social media presence with more than 10,000 followers, using the platform to showcase my work and educate the public about dental treatments.

In 2021, I was honoured to be one of five dentists in my home country to win the national Tooth Restorative competition held by Tokuyama in Japan.

Throughout my career, I’ve treated many patients who travelled from abroad, and I found it incredibly rewarding to connect with people from diverse backgrounds. This inspired me to broaden my professional experience in a more global and inclusive healthcare system like the UK.

The UK’s vibrant dental community, high standards, and opportunities for continuous learning make it an ideal place to develop my skills further and contribute to a wider patient base.

The process has been long, unclear, and emotionally draining. It took eight months for my application as an overseas dentist to be approved, during which I repeatedly emailed and called to follow up – often without any clear response. That lack of communication made the process extremely stressful.

‘More like a lottery than a fair process’

Once I was finally approved, I began preparing for the exam four months in advance, knowing that the usual gap between booking and the exam date is only six to eight weeks – not enough time to fully study such a broad syllabus.

Unfortunately, I was unable to book a seat for the April exam, and again for the August sitting. Both times, although the booking button appeared active, the system processed for eight to 11 minutes before ultimately saying it was fully booked. Those few minutes feel agonising – like time slows down – especially after months of preparation and waiting.

The system lacks transparency, and the experience of repeatedly preparing without even getting a chance to sit the exam has been deeply frustrating.

There’s no waiting list, no queue system, and no priority given to those who have been unsuccessful in booking previously. The lack of transparency and structure makes it feel more like a lottery than a fair process for professional registration.

In one cycle, the booking link was activated two days earlier than announced, and while the GDC stated they would cancel those bookings, the candidates were still allowed to keep their seats. Another time, a candidate initially saw a ‘fully booked’ message, but after logging out and back in, they found a payment link and successfully booked. These inconsistencies make the process feel even more unfair.

Additionally, early booking access for refugees – while understandable – can feel deeply unjust when those of us who have relocated, paid substantial tuition fees and contributed economically from day one are left out entirely.

Heavy emotional strain

Being unable to access the ORE exam has affected nearly every part of my life – emotionally, professionally, and financially. I came to the UK with the hope of continuing my career and contributing meaningfully to the dental field here. But instead, I’ve found myself stuck in a system that won’t even allow me the chance to prove myself.

The emotional strain has been heavy. I’ve faced rejections not because of my skills or qualifications, but simply because I’m not yet GDC-registered – a process I can’t complete due to exam access barriers. It’s deeply frustrating to feel capable and prepared yet powerless.

My confidence and motivation have been tested many times, especially knowing how much I’ve already invested financially and emotionally to be here.

‘Locked out of opportunities’

To support myself while waiting, I initially worked weekends at a stationary shop, standing from nine to six, wiping shelves, and collecting rubbish – without even being allowed to sit down.

I remember thinking of my father’s words from childhood: ‘If you don’t study hard, you’ll end up collecting rubbish.’ And there I was – not because I hadn’t studied, but because I wasn’t being given a fair chance to move forward.

I worked there for almost a year, listening to dental podcasts through one earbud just to stay connected to my profession. It was physically and emotionally draining.

Later, I began working as a trainee dental nurse, which brought me a little closer to the clinical environment. But even that was emotionally difficult – I often found myself wiping chairs while dentists asked me questions about restorative procedures, which had been my daily work for years. It took everything in me not to break down.

In addition to clinical work, I also had teaching experience back home. I used to mentor and train colleagues in restorative techniques. To regain a sense of purpose, I reached out to several large dental companies in the UK, offering to teach or present courses based on my expertise.

Many were enthusiastic after reviewing my portfolio and course content, and we even had detailed discussions about structure and delivery. But as soon as they realised I wasn’t yet registered or working clinically in the UK, they also stepped back.

It was another painful reminder that, no matter how much experience I bring, I’m locked out of opportunities simply due to registration status.

There are thousands of overseas-qualified dentists with years of experience who are eager and ready to contribute, especially at a time when NHS dentistry is facing serious access issues.

How does the ORE system need to change?

1. Provisional registration

One immediate improvement would be to allow overseas dentists to work under provisional registration, where they could practice under the supervision of a GDC-registered dentist while preparing for their exams. This would help address the current patient backlog, ease workforce shortages, and allow us to integrate more effectively into the UK system.

2. Prioritisation for UK residents

Those of us who have relocated to the UK have made enormous sacrifices – we’ve left our families, careers, and comfort zones behind to start over. Unlike candidates who remain in their home countries with active practices and steady incomes, we are living in constant uncertainty, unable to progress despite being fully qualified.

That level of pressure is far greater, and it’s only fair that those living in the UK should be given priority access to exam bookings over short-term visitors.

When I returned home after two years away, I visited my former clinic and was overwhelmed to see that 50 of my previous patients were still waiting to see me. I could have stayed there working, earning and living comfortably, and simply travelled to the UK for the exam.

But I chose to fully relocate, to integrate, and to serve the community from within. That commitment should be acknowledged, not punished.

3. A structured waiting list

Finally, the system could be made much fairer by implementing a structured waiting list, based on the date each candidate’s application is approved. That way, bookings wouldn’t feel like a lottery.

We could plan our lives, study effectively, and contribute to society without constantly being held back by uncertainty.

‘Here to give back’

Overseas dentists are not here to take opportunities away – we’re here to give back. We bring years of training, hands-on experience, and a strong desire to contribute to the UK’s healthcare system.

All we ask for is a fair and transparent system that gives us the chance to move forward – to be assessed, to qualify, and to serve. We’re not looking for shortcuts, just the opportunity to prove ourselves and start doing the work we love again.

I hope that by sharing my experience, decision-makers will see how much potential is being lost – and how easily that could change with the right support.

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