How to prepare for the NDEB AFK

The Assessment of Fundamental Knowledge (AFK) is the first exam in the National Dental Examining Board of Canada's Equivalency Process, for dentists who trained at programs outside Canada and the US that aren't accredited. You need to pass it before you can move on to the other exams. Here's what it covers and a way to prepare that works with how the exam is built.

Always check the details against the NDEB's AFK page and the current AFK Protocol: they're the official word, and they change.

The exam at a glance

• 200 single-answer multiple-choice questions, in two parts of two hours each, on one day with a scheduled break.
• Taken on a computer at a Prometric test centre, or on paper at select exam sites.
• Every question is worth one point, and wrong answers cost nothing. Never leave a question blank.
• Scores are test-equated and re-scaled: 75 or higher is a pass. That is not the same as getting 75% of questions right, so don't aim for a raw number.
• You can take the AFK at most three times, so treat each attempt as precious.
• Teeth are numbered with the FDI two-digit system, and periodontal questions use the 2017 AAP classification.

What it covers

The protocol publishes a blueprint: the approximate share of questions in each area.

Area	Share of questions	Practise
Applied biomedical sciences (anatomy, biochemistry, biomaterials, cariology, growth and development, histology, immunology, microbiology, oral embryology, physiology)	20% ± 5	Practice set
Restorative, prosthodontics, implants	16% ± 5	Practice set
Oral medicine and pathology, oral radiology	15% ± 5	Practice set
Pharmacology and therapeutics, local anesthesia, medical emergencies	14% ± 5	Practice set
Orthodontics, pediatric and geriatric dentistry, special needs patients	8% ± 5	Practice set
Periodontics	8% ± 5	Practice set
Oral surgery, trauma, orofacial pain, dental emergencies	8% ± 5	Practice set
Endodontics	6% ± 5	Practice set
Evidence-based dentistry, prevention, infection control, ethics and jurisprudence	5% ± 5	Practice set

Use it to budget your time. Biomedical sciences, restorative and oral medicine together are around half the exam; endodontics is a small slice. That doesn't mean skipping small areas, only that an hour spent on a big area moves your score more.

A study plan that works with the exam

1. Start from the official material. The NDEB publishes a released question bank, the reference text list and other resources, and a free 100-question self-assessment. Take the self-assessment early to see where you stand, and again near the end. The NDEB asks that its released material be used for personal study only, so keep your own copies private.

2. Practise by recalling, not rereading. Answering questions, getting some wrong and checking why is what makes facts stick. On Quizzn, practise in Hardest first order: the questions you've missed most come up first, so your time goes where it's needed. Flashcards are good for quick definitions and drug facts.

3. Learn from each mistake. For every miss, read the explanation and ask why the right answer is right and why yours was wrong. If a question has no explanation, add one: writing it is study, and it helps everyone after you.

4. Rehearse the clock. Each part gives you two hours for 100 questions, or about 72 seconds per question. Do timed blocks of 100, and in the last weeks at least one full day: two blocks with a break in between. Stamina in the second part matters.

5. Study with others. Explaining an answer to someone else shows you what you really know. The NDEB fundamental knowledge study group has over a thousand members. Join, share your quizzes and compare notes.

6. Work through every area. We wrote a free practice set of 15 original questions for each blueprint area, each with an explanation and a reference, linked in the table above. Start with the areas worth the most, then fill in the rest. For more pharmacology, the most drilled area after biomedical sciences, also try Anesthetics, set 1 and Adrenergic drugs.

On exam day

• Read each question to the end: "most appropriate", "first" and "except" change the answer.
• Answer everything. With no penalty for wrong answers, a guess can only help.
• Flag hard questions and come back to them, but leave time to answer every one in that part, because unused time doesn't carry over.
• If you're at a Prometric centre, watch the NDEB's electronic exam orientation beforehand, and read Prometric's check-in rules.

Good luck. And if you passed the AFK and have advice for the next group, tell us: we'd love to share it.