January 10, 2026
NDECC
ACJ Everything You Need To Know
The Assessment of Clinical Judgement exam, better known as the ACJ, is one of the most talked about steps in the pathway for international dentists in Canada. It is not a test of your hand skills. It is a test of how you think. Many candidates say the ACJ feels different from the AFK because the focus shifts from pure knowledge to clinical interpretation and decision making.
This exam checks whether you can interpret radiographs, make accurate diagnoses and select the correct treatment options the way a Canadian dentist would in real practice. The ability to reason clearly is the heart of this exam.
What the ACJ Exam Measures
The ACJ places you in realistic patient scenarios. You will see images, radiographs and case descriptions and then choose the most appropriate clinical response. The exam evaluates:
• Diagnostic accuracy
• Radiograph interpretation
• Ability to identify pathology
• Treatment planning
• Understanding of risk factors and ethical judgement
Each question expects you to think like someone responsible for a real patient’s health and safety.
Inside the Exam Format
The ACJ is a multiple choice and extended match exam. You may have to select one answer or pick several correct options depending on the question design. Radiographs often form the backbone of the exam so sharpening your interpretation skills is extremely important.
Timing is tight. Most candidates feel the pressure not because the content is impossible but because the decisions must be made quickly. With enough practice, your pattern recognition improves and everything feels less overwhelming.
Building a Strong Prep Strategy
Every ACJ success story shares one theme: consistent practice.
Here is what helps most people:
• Study radiographs every day
• Work through case based questions slowly at first
• Learn how to rule out wrong answers quickly
• Review clinical guidelines so your decisions match Canadian standards
• Join mock exams to test your speed and clarity
If you find radiographs difficult in the beginning, remember that it is a skill built over time. Set aside a small daily session dedicated only to imaging and you will see progress.
What Happens After the ACJ
Passing the ACJ is a major leap forward in your NDEB journey. After this, your path depends on your chosen route. Many candidates move towards the Canadian Dental Equivalency Process while others transition into university based advanced standing programs.
Whatever direction you take next, the ACJ gives you a strong foundation for clinical reasoning which you will rely on throughout your career in Canada.
Wrapping Up with Editor’s Note
The ACJ is challenging but fair. It rewards clarity, logic and practice. When you try enough questions and build confidence in your diagnostic thinking, the exam becomes far less intimidating. Each step in the equivalency process builds on the last and the ACJ is the stage where you start feeling like a clinician again rather than just a test taker.
