Credentialing and Privileging of Doctors and Dentists
Information to help you apply for registration and practice licences as a doctor or dentist across many global jurisdictions
A PRO-ACTIVE APPROACH
Regulatory Authorities and Credential Requirements
Relocating to work abroad as a doctor or dentist offers exciting career advancement opportunities, but it also entails meticulous planning, particularly around professional registration.
Ensuring that you are correctly licensed to practise in your new country is a critical first step and often a prerequisite for securing a job offer or work visa.
This section is designed for doctors and dentists considering relocation abroad. It outlines how to determine which medical regulatory authority governs licensure in your destination country and what steps you must take to register.
1. Understand the Role of Regulatory Authorities
Practising doctors and dentists must be registered with a professional regulatory body. In most jurisdictions, regulatory authorities are national, permitting practice throughout the country, but in some they are federal or provincial, precluding the practice of medicine across the entire territory of the country and restricting it to a state or province.
This is an important consideration because licence eligibility can vary from one state or province to another and eligibility to practice in one state does not guarantee reciprocity by others. Doctors seeking jobs in the USA, Canada and UAE should therefore decide which state or province is their preferred location and seek clarification of eligibility for licence prior to making job applications.
Professional Regulatory Authorities are responsible for:
- Maintaining a register of doctors eligible to practice
- Issuing certificates of registration and licences to practice, often on an annual renewable basis
- Assessing qualifications and credentials of international medical graduates and specialists
- Ensuring adherence to local professional standards
- Maintaining public safety through regulation and discipline
Failure to register appropriately may result in delayed employment, visa issues, or disciplinary action for unauthorised practice.
2. Identify the Regulatory Authority by Jurisdiction: Country, State or Province
When planning to practise medicine or dentistry abroad, the first step is to determine which regulatory authority governs medical practice in the country, state or province where you plan to work. Below is a list of medical and dental regulatory authorities by country. For others not listed, please contact us for advice.
| Country | Medical Regulatory Authority | Dental Regulatory Authority |
|---|---|---|
| Australia | Medical Board of Australia via AHPRA | Dental Board of Australia via AHPRA |
| Bermuda | Bermuda Medical Council | Bermuda Dental Board |
| Canada | Provincial Medical Colleges (e.g. CPSO, CMPA) | Provincial Dental Regulatory Authorities |
| Ireland | Irish Medical Council | Irish Dental Council |
| Malta | Medical Council of Malta | Medical Council of Malta |
| New Zealand | Medical Council of New Zealand | Dental Council of New Zealand |
| Qatar | Ministry of Public Health (MOPH) | Ministry of Public Health (MOPH) |
| Saudi Arabia | Saudi Commission for Health Specialities (SCFHS) | Saudi Commission for Health Specialities (SCFHS) |
| Singapore | Singapore Medical Council (SMC) | Singapore Dental Council |
| South Africa | Health Professions Council of South Africa (HPCSA) | Health Professions Council of South Africa (HPCSA) |
| United Arab Emirates | DHA (Dubai), DoH (Abu Dhabi), MOHAP (other Emirates) | DHA (Dubai), DoH (Abu Dhabi), MOHAP (other Emirates) |
| United Kingdom | General Medical Council (GMC) | General Dental Council |
| United States | State Medical Boards (refer to FSMB for directory) | State Dental Boards |
3. Understand the Pathways to Registration
Medical and dental regulators have several categories of registration, which generally fall under the headings of of general, specialist and special purpose.
- General Registration: a non specialist registration used mostly by resident doctors which permits recent medical graduates to practice at the outset of their careers in internship and training or service (non training) positions.
- Specialist Registration: a registration category for qualified specialists and subspecialists who have completed postgraduate training and met the appropriate conditions for independent specialist practice.
- Special Purpose Registration: many regulators offer a registration category for doctors engaging in short term academic work, further postgraduate training, disaster relief or locum tenens work.
- Provisional registration or limited registration: conditional registration categories with a defined time period and conditions restricting practice. Most require the satisfactory fulfillment of a supervised practice term, after which full registration is granted. Provisional or limited licences often restrict the choice of jobs to those which are able to meet the requirements imposed by the regulatory authority.
4: Check Eligibility for Appropriate Registration Category
Medical and dental regulatory authorities determine their eligibility criteria for each category of licence. Credentials which are assessed include qualifications, current professional registration status, practice experience and language proficiency. Some regulators have their own licensing exams but may offer exemptions for some categories of registration.
Key factors which may affect your ability to register include:
- Primary medical or dental degree: most regulators accept only degrees from medical and dental schools recognised by the World Health Authority (WHO)
- Specialist training and certification: the country where the training was undertaken and the structure and quality of the training. Some authorities maintain a list of recognised qualifications or fast-track pathways for doctors and dentists from comparable health systems.
- Current medical registration: status of registration in current jurisdiction of practice
- Clinical experience: duration of experience and recent scope of practice. Lengthy gaps in practice history may prevent registration.
- Language proficiency: English or French language fluency with evidence from formal testing eg IELTS/OET for English-speaking countries.
Doctors who have trained in the countries of the Anglosphere (UK, Ireland, Canada, USA, Australia, New Zealand and South Africa) and Western Europe or countries of the European Union often benefit from streamlined or reciprocal recognition pathways which grant preferential or expedited paths to registration.
Professional Registration Exams
PLAB
The PLAB (Professional and Linguistic Assessments Board) tests are a set of exams that assess the knowledge and skills of doctors who qualified outside the UK, ensuring they are fit to practice medicine in the UK.
There are two parts to the PLAB test: PLAB 1 and PLAB 2. PLAB 1 is an applied knowledge test that focuses on applying knowledge to patient care, while PLAB 2 is a practical exam that assesses clinical skills and ability to work in a UK hospital setting.
PLAB 1:
Format: An applied knowledge test (AKT).
Content: Tests the ability to apply knowledge in patient care, not just recall of facts.
Focus: Current best practice in the UK, and equipment routinely available in UK hospitals.
Compliance: Compliant with the Medical Licensing Assessment (MLA) requirements.
PLAB 2:
Format:
A practical exam assessing clinical skills and behaviors.
Content:
Covers what a doctor in a Foundation Year 2 role would be expected to know and do.
Focus:
Clinical knowledge, skills, and ability to apply this knowledge to patient care.
Testing:
Includes physical examinations, communication skills, and practical procedures, potentially using simulators.
Overall:
Purpose: To ensure doctors are ready to work safely in a UK NHS hospital setting.
Registration: Doctors need to register with the General Medical Council (GMC) to take the PLAB tests.
Visa: Candidates may need to apply for a visa to travel to the UK for PLAB 2.
Fees: There are fees associated with both PLAB 1 and PLAB 2.
MLA Compliance: The PLAB test is now compliant with the MLA requirements.
ORE
Foreign-trained dentists seeking to practice in the UK need to pass the General Dental Council (GDC) Overseas Registration Examination (ORE) or the Licence in Dental Surgery (LDS) from the Royal College of Surgeons. The ORE is specifically designed for dentists whose qualifications are not recognized in the UK. The ORE is a two-part exam that assesses both clinical knowledge and practical skills.
ORE Details:
Purpose: To assess the clinical skills and knowledge of overseas-qualified dentists, ensuring they meet the standards of a UK-trained graduate.
Structure: The ORE has two parts: Part 1 is a computer-based written exam, while Part 2 is a practical clinical examination, according to the General Dental Council.
Eligibility: Candidates need to demonstrate at least 1600 hours of clinical experience treating patients.
Application: Candidates need to apply to the GDC and pay an application processing fee.
Time Limit: Part 2 must be passed within five years of attempting Part 1.
LDS (Licence in Dental Surgery):
This is another option for overseas dentists to gain registration with the GDC.
It is administered by the Royal College of Surgeons.
Registration:
Passing either the ORE or LDS exam allows dentists to register with the GDC and legally practice dentistry in the UK.
Registration does not automatically grant access to the NHS Dental Performers List, which is needed to provide NHS treatment
MCCQE 1
The Medical Council of Canada Qualifying Examination (MCCQE) Part I is a summative examination that assesses the critical medical knowledge and clinical decision-making ability of a candidate at a level expected of a medical student who is completing their medical degree in Canada. Critical medical knowledge and clinical decision-making skills are assessed using multiple-choice questions.
Candidates graduating and completing the MCCQE Part I typically enter supervised practice. Aside from formal accreditation processes of the undergraduate and postgraduate education programs, the MCCQE Part I is the national standard for medical schools across Canada and, therefore, is administered at the end of medical school.
Passing the MCCQE Part I is a requirement for international medical graduates applying for entry into a Canadian residency program. The exam is also used by some Practice-Ready Assessment programs as an eligibility criteria to select internationally trained physicians into their programs.
Obtaining a pass result on the MCCQE Part I is one of the eligibility criteria you must meet to apply for the Licentiate of the Medical Council of Canada (LMCC). Canadian medical regulatory authorities may require you to have the LMCC to apply for a medical licence within their province or territory.
NDEB
Foreign-trained dentists seeking to practice in Canada need to complete the National Dental Examining Board of Canada (NDEB)'s equivalency process. This process involves passing a series of exams designed to assess their knowledge, skills, and clinical competence, ultimately leading to NDEB certification and the ability to apply for a license in a specific province or territory.
Here's a breakdown of the process:
1. Equivalency Process:
Foreign-trained dentists must apply to the NDEB and be accepted into the equivalency process.
This process is designed to bridge the gap between their dental education and the Canadian standard.
2. NDEB Exams:
Assessment of Fundamental Knowledge (AFK):
This exam assesses foundational knowledge in biomedical and dental sciences.
Accredited Clinical Judgment (ACJ):
This exam evaluates clinical decision-making and judgment in various dental scenarios.
National Dental Examination of Clinical Competence (NDECC):
This exam evaluates clinical competence and practical skills through simulated patient scenarios.
Virtual OSCE:
This is a national standard for dental competence, assessing knowledge, skills, and abilities expected of a beginning dental practitioner.
3. NDEB Certification:
Successful completion of the NDEB exams leads to certification.
This certificate allows foreign-trained dentists to apply for a license to practice in a specific Canadian province or territory.
4. Licensure:
Licensure is granted by the province or territory where the dentist intends to practice.
Each province/territory has its own licensing requirements, which may include additional exams or requirements.
Key Points:
The NDEB equivalency process is crucial for foreign-trained dentists seeking to practice in Canada.
The AFK, ACJ, and NDECC are the main exams within the equivalency process.
The Virtual OSCE is part of the broader NDEB certification process.
NDEB certification is a prerequisite for applying for a license in a specific Canadian province or territory.
USMLE
The USMLE assesses an examinee's ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills.
INBDE
Foreign-trained dentists seeking to practice in the USA need to pass the Integrated National Board Dental Examination (INBDE). This exam, administered by the American Dental Association (ADA), assesses their knowledge and ability to apply it in clinical scenarios. Additionally, most states require a clinical assessment, often conducted by third-party agencies, as part of the licensure process.
Here's a breakdown of the process:
1. INBDE:
The INBDE replaces the previous NBDE Part I and Part II and is a comprehensive exam covering basic sciences, dental sciences, and clinical knowledge.
2. Advanced Standing Program:
Many foreign-trained dentists opt to enroll in a 2-4 year Advanced Standing program at a US dental school after passing the INBDE. This program allows them to earn a DMD or DDS degree.
3. State Licensure:
After completing the program and passing the INBDE, they must apply for a dental license in the specific state where they intend to practice.
4. Clinical Assessment:
Most states require a clinical assessment, often involving a practical examination administered by a state or regional testing agency.
5. Credential Evaluation:
Foreign dental degrees must be evaluated by a recognized agency (e.g., Educational Credential Evaluators (ECE)) to verify their equivalency to US dental degrees.
Specific points to note:
Each state has its own specific requirements for licensure, so it's crucial to check the regulations of the state where you plan to practice.
Some states may have specific requirements regarding the type of clinical assessment they accept.
Some states may allow foreign-trained dentists to bypass the Advanced Standing program and apply for licensure directly after passing the INBDE and completing a clinical assessment.
AMC Exams
The AMC exam, or Australian Medical Council exam, is a two-part assessment for international medical graduates seeking general registration in Australia. It consists of the AMC MCQ (Multiple Choice Question) exam, a computer-based test of medical knowledge, and the AMC Clinical Examination, which assesses practical skills in a clinical setting.
AMC MCQ Examination:
This is a computer-administered, multiple-choice exam covering disease processes, clinical examination, diagnosis, investigation, therapy, and management.
It consists of 150 questions, with one correct answer from five options.
The exam is delivered by Pearson VUE at various locations in Australia and other countries.
AMC Clinical Examination:
This is a 16-station exam assessing clinical skills in various settings, including medicine, surgery, obstetrics, gynecology, pediatrics, and psychiatry.
It evaluates practical skills like performing medical procedures, communicating with patients, and applying clinical knowledge.
Key Points:
The AMC assessments are designed to ensure that international medical graduates meet the standards required to practice medicine in Australia.
The AMC MCQ exam is the first step in the process, and passing it is a prerequisite for the clinical examination.
Both exams are rigorous and require thorough preparation.
Detailed information on eligibility, application procedures, and exam content can be found on the Australian Medical Council (AMC) website.
ADC
The Australian Dental Council (ADC) assesses overseas-trained dentists to ensure they meet the standards for safe and effective practice in Australia. The process involves an initial assessment of qualifications, a written exam, and a practical exam. Successful completion of these stages allows for registration with the Dental Board of Australia.
Here's a more detailed breakdown:
1. Initial Assessment:
This stage involves submitting documents to verify your qualifications (degree, registration, etc.).
2. Written Examination:
This computer-based exam assesses your knowledge and clinical judgment in dentistry. It is held twice a year and covers four two-hour papers.
3. Practical Examination:
This is the final stage, evaluating your clinical skills and ability to provide dental care.
4. Visa Considerations:
The 482 temporary skilled shortage visa is a common pathway for dentists, but it's essential to confirm the specific requirements and visa conditions.
5. Registration:
Once you successfully complete the ADC assessments, you can apply for registration with the Dental Board of Australia.
Key Points:
The ADC exam is designed to determine if international dentists are capable of providing safe and effective dental care in Australia, according to Academically.
The ADC exam has two parts: a written exam and a practical exam, notes Academically.
The ADC website is the primary resource for up-to-date information on eligibility, requirements, and the assessment process.
Pearson VUE is the company that partners with the ADC to deliver the computer-based written examination.
The Dental Board of Australia has a specific page for international practitioners seeking registration
NZREX Clinical Exam
The NZREX Clinical examination is the practical assessment that international medical graduates (IMGs) need to pass to register and practice medicine in New Zealand. It's a clinical exam, specifically an Objective Structured Clinical Examination (OSCE), testing practical skills, communication, and professionalism. The NZREX is the only requirement for IMGs to start their medical careers in New Zealand.
Key aspects of the NZREX Clinical exam:
OSCE Format:
The exam utilizes the OSCE format, which involves a series of stations where candidates rotate through and are assessed on various clinical skills and knowledge.
Areas Assessed:
The NZREX assesses communication, professionalism, cultural safety, history taking, physical examination, investigations/clinical reasoning, and management.
Exam Structure:
The exam includes 12-16 OSCE stations, each with equal weighting, and the total exam duration is 3 hours.
Eligibility:
IMGs must have passed recognized medical licensing exams like AMC Part 1, USMLE Step 1 and 2, PLAB Part 1, or MCCQE Part 1 within the last five years.
Location and Frequency:
The NZREX Clinical exam is held only in Auckland, New Zealand, and is offered three times a year.
NZDREX
Foreign dentists seeking to practice in New Zealand need to pass the New Zealand Dentist Registration Examination (NZDREX), which is administered through the National Dental Examining Board of Canada (NDEB). The NDEB process includes assessments of fundamental knowledge, clinical judgment, and clinical skills. Additionally, applicants must fulfill specific entry requirements, including having an appropriate qualification and demonstrating English language proficiency
Prometric Exams Saudi Arabia
The Saudi Prometric exam, administered by Prometric under the supervision of the Saudi Commission for Health Specialties (SCFHS), is a mandatory computer-based test for healthcare professionals seeking to work in Saudi Arabia. It assesses a candidate's theoretical knowledge and practical skills in their respective medical field to ensure they meet the standards of the Saudi healthcare system.
Here's a breakdown of key aspects:
Purpose:
The exam is a licensing requirement for healthcare professionals to practice in Saudi Arabia, both in government and private sectors.
It aims to verify that professionals possess the necessary knowledge and skills to deliver safe and effective healthcare.
Who needs it?
All healthcare professionals, including doctors, nurses, dentists, pharmacists, and allied health professionals, need to pass the Saudi Prometric exam to obtain a license.
Key Features:
Computer-Based Test (CBT): The exam is conducted on computers at authorized testing centers.
Category-Specific: The exam content is tailored to each specific healthcare profession, ensuring relevance to the candidate's area of expertise.
Licensing Requirement: Passing the exam is a mandatory step for obtaining a professional license from the SCFHS.
Exam Details:
The exam is administered by Prometric, a global leader in assessment and testing services.
Passing the exam is a requirement for obtaining a work visa for medical professionals in Saudi Arabia.
The exam assesses a wide range of topics relevant to the candidate's profession, including clinical knowledge, ethical and legal concepts, and evidence-based practice.
How to Prepare:
Candidates should thoroughly review the exam syllabus and content outline for their specific profession.
Utilizing study materials and resources recommended by the SCFHS or Prometric can be beneficial.
Practice tests and sample questions can help familiarize candidates with the exam format and question types.
Important Notes:
An eligibility number, issued by SCFHS, is required to schedule the exam.
The eligibility to take the exam generally lasts for three months from the date of issue.
Candidates should familiarize themselves with the ProProctor User Guide for remote exams.
Cancellation and rescheduling policies should be reviewed on the Prometric website.
Prometric Exams UAE
Prometric medical exams in the UAE are crucial for healthcare professionals seeking licensure. The Dubai Health Authority (DHA) exam, for instance, is a computer-based test required for practicing in Dubai. Similarly, the Ministry of Health (MOH) exam is necessary for practicing in other emirates of the UAE. Passing these exams, along with exams like the Health Authority Abu Dhabi (HAAD) (for Abu Dhabi), is a prerequisite for obtaining a medical license.
Key aspects of Prometric medical exams in the UAE:
Purpose:
These exams assess the knowledge, clinical proficiency, and understanding of local healthcare regulations for various healthcare professionals, including doctors, nurses, and pharmacists.
Format:
The exams typically consist of multiple-choice questions (MCQs) and, in some cases, an oral assessment to evaluate practical skills and communication abilities.
Regulatory Bodies:
DHA (Dubai Health Authority): For practicing in Dubai.
MOH (Ministry of Health): For practicing in other emirates of the UAE.
HAAD (Health Authority Abu Dhabi): For practicing in Abu Dhabi.
Passing Requirements:
Candidates must achieve a minimum passing score, often around 60%, and in some cases, need to pass both written and oral assessments.
Eligibility:
Passing the relevant Prometric exam is a key step in the process of obtaining an eligibility letter, which is often valid for a limited time (e.g., one year for DHA).
Preparation:
Thorough preparation is crucial, including understanding the exam format, syllabus, and practicing with sample questions.
Exam Centers:
Exams are conducted at authorized testing centers in the UAE and may also be available remotely with secure online proctoring, according to Prometric
IELTS
IELTS is the world’s most popular English language test for higher education and global migration.
OET
The Occupational English Test (OET) is an English language test designed specifically for healthcare professionals. It assesses English language proficiency in four areas: Listening, Reading, Writing, and Speaking, with a focus on communication within healthcare settings. OET is widely recognized by healthcare regulators, educational institutions, and visa/immigration services globally
5. Prepare Supporting Documentation
Early preparation of application forms and relevant documents is advised. Where appropriate obtain official translations and notarisation of documents in advance. Sound organisation can save weeks of application processing time and relieve the considerable stress encountered with delays in the process.
Documents Required:
- Medical degree and transcripts (certified copies)
- Specialist certificates or postgraduate qualifications
- Proof of registration from previous authorities
- Good standing certificates from regulatory authorities
- Professional references
- Language proficiency test results or proof of language fluency
- Passport and identity documentation
- Report of Primary Source Verification (PSV) of qualifications and professional registration by EPIC or DataFlow.
- Specialist registration usually involves additional documentation, including logbooks, training curricula, and letters of competence.
- Continuing Medical Education (CME) evidence
7. Plan for Timelines and Costs
Registration processing times can range from a few weeks to several months.
Associated costs may include application fees, translation services, notarization fees, exam charges, and third-party verification costs.
Budgeting for both time and money is essential when planning your relocation.
Information and insights
Credentialing and Privileging
Whilst credentialing is performed by the medical and dental regulatory authorities, privileging is the process performed by the healthcare organisations to establish rights of responsibility and procedural performance for doctors and dentists.
Here is a sample of what you will find in the articles below:
- Navigate appropriate registration scopes and pathways with medical and dental regulatory authorities in various jurisdictions
- Understand the credentials required for each scope of practice and pathway
- Learn how to verify medical and dental credentials at primary source
- Demonstrate language proficiency
- Estimate the time scale of applications for registration with medical and dental regulatory authorities
- Pass licentiate examinations
- Demystify the process of specialist training and scope of practice assessments
- Delve into the art of successful interviews with medical and dental regulators
- Prepare for provisional orientation and supervision periods
- Manage appraisals and revalidation
An Overview of Credentialing and Privileging for Doctors and Dentists
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